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January 13th, 2017

1/13/2017

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The ethics and morality surrounding transplant since the 1970s has been------waiting lists taking every patient in need that considered how sick, how old, how likely to recover----we did not bring youth as donors---we considered how long a person would live to benefit from these transplants---we encouraged but never thought of requiring citizens to donate.  The left social Democrat educates to enlighten----the far-right wing authoritarian demands and requires with no consideration of injustice.  The ethos before CLINTON was bringing more and more citizens from lower-class into this transplant process as the costs of transplant gradually dropped.  This was indeed happening as Medicaid funding was broadening patient accessibility.

I SHARED A MEDICAL ETHICS ARTICLE WRITTEN EARLIER THAT SAID JUST THIS=====WE ARE HEADING TOWARDS ABUSE AND INJUSTICE IF WE DO NOT KEEP TRANSPLANT TECHNOLOGY OPEN TO ALL-----KEEP IT CHEAP----KEEP OVERSIGHT AND ACCOUNTABILITY.

The Affordable Care Act eliminated all those ethics----creating a tissue and organ transplant MARKET---with global Wall Street BETTING ON BODY PARTS and driving transplant industry to highest price.  These Clinton/Obama global 1% Wall Street players KNEW to where ACA was going.

Of course as global 1% and their 2% now become the market for transplants we are MOVING FORWARD to an infrastructure that moves them and/or the organs globally with each state health system expanding globally and competing for those rich.  Know what an aging 1% would do to stay alive ----we are looking at what will become a complete body UPGRADE OF ORGANS ====think vintage cars having completely new mechanical parts.  This will of course raise the number of organs needed while bringing down the number of patients actually receiving them----the

OPPOSITE OF WHAT LEFT SOCIAL DEMOCRATIC ETHICS AND MORALS HAD AS A GOAL.

We already know here in Baltimore that a global JOHNS HOPKINS will take the lead on just this if not already tied to these transplant goals in China we see below.


National media and global corporate health campus data will show soaring numbers of organs and transplants but the numbers of people receiving these procedures with close to only those global 1% and their 2%........the 99% will participate in transplants------AS THE DONORS.



Doctor’s Plan for Full-Body Transplants Raises Doubts Even in Daring China

By DIDI KIRSTEN TATLOWJUNE 11, 2016

Dr. Ren Xiaoping, left, an orthopedic surgeon in Harbin, China, plans to carry out full-body transplants, raising concerns among medical experts and ethicists around the world. Credit Gilles Sabrie for The New York Times
HARBIN, China — Six years ago, Wang Huanming was paralyzed from the neck down after being injured wrestling with a friend. Today, he hopes he has found the answer to walking again: a new body for his head.
Mr. Wang, a 62-year-old retired gas company worker, is one of several people in China who have volunteered for a body transplant at a hospital in the northern Chinese city of Harbin.
The idea for a body transplant is the kind of thinking that has experts around the world alarmed at how far China is pushing the ethical and practical limits of science. Such a transplant is impossible, at least for now, according to leading doctors and experts, including some in China, who point to the difficulty of connecting nerves in the spinal cord. Failure would mean the death of the patient.
The orthopedic surgeon proposing the operation, Dr. Ren Xiaoping of Harbin Medical University, who assisted in the first hand transplant in the United States in 1999, said he would not be deterred. In an interview, Dr. Ren said that he was building a team, that research was underway and that the operation would take place “when we are ready.”

His plan: Remove two heads from two bodies, connect the blood vessels of the body of the deceased donor and the recipient head, insert a metal plate to stabilize the new neck, bathe the spinal cord nerve endings in a gluelike substance to aid regrowth and finally sew up the skin.
Whether or not he performs the operation, leading medical experts have condemned the plan.
“For most people, it’s at best premature and at worst reckless,” said Dr. James L. Bernat, a professor of neurology and medicine at the Geisel School of Medicine of Dartmouth College.
Dr. Huang Jiefu, a former deputy minister of health in China, said in an interview in November that when the spine is cut, the neurons “cannot be reconnected, so it’s scientifically impossible.”
“Ethically it’s impossible,” Dr. Huang added. “How can you put one person’s head on another’s body?”
Critics attribute such medical experimentation in China to national ambition, generous state funding, a utilitarian worldview that prioritizes results, and a lack of transparency and accountability to the outside world.
“The Chinese system is not transparent in any way,” said Arthur L. Caplan, a medical ethicist at New York University. “I do not trust Chinese bioethical deliberation or policy. Add healthy doses of politics, national pride and entrepreneurship, and it is tough to know what is going on.”

Photographs on the walls of Dr. Ren’s lab at Harbin Medical University showed his experiments on body transplants in mice. The mice lived only for a day after the procedure. Credit Gilles Sabrie for The New York Times



Some Chinese researchers are also concerned that the experimentation is going too far, too fast.
“I don’t want to see China’s scholars, transplant doctors and scientists deepening the impression that people have of us internationally, that when Chinese people do things they have no bottom line — that anything goes,” said Cong Yali, a medical ethicist at Peking University, referring to Dr. Ren’s plans.


The Chinese government invested 1.42 trillion renminbi ($216 billion) in scientific research and development last year, compared with 245 billion renminbi in 2005, according to the National Bureau of Statistics.
Last year, researchers at Sun Yat-sen University, in the southern city of Guangzhou, altered a gene in the human embryo that causes thalassemia, a rare blood disease, using a technique developed in the United States. The experiment crossed an ethical line, some scientists in China and abroad said, because the changes would be inheritable if conducted on viable embryos. (The experiment used unviable embryos.) That could pave the way for permanent gene modification for qualities such as looks or intelligence.
Despite the concerns, in April another team in Guangzhou altered embryos to make them H.I.V. resistant. Internationally, some scientists criticized the experiment, citing a lack of consensus on the ethics of such work.
The team, from Guangzhou Medical University, said that “significant technical issues remain to be addressed.” It added that on ethical grounds it would not advocate genome editing on viable lines “until after a rigorous and thorough evaluation and discussion are undertaken by the global research and ethics communities.”
Ethical issues have long dogged Chinese researchers in the field of organ transplants, where China was an international pariah for using the organs of executed prisoners. While China says it no longer uses those, Chinese transplant doctors still sometimes submit research from prisoner organs to international conferences, which is not permitted under global ethical norms.
This year, the International Society for Heart and Lung Transplantation said it had rejected research by a Chinese team at its annual meeting, in Washington, on those grounds.
Some Chinese scientists and ethicists say the concerns of medical experts, especially those overseas, are overblown. They attribute them to envy at China’s remarkable scientific and economic progress in recent decades.


“We see the reactions among Western commentators as a misunderstanding of the current situation,” Zhai Xiaomei, the dean of the School of Humanities and Social Sciences at Peking Union Medical College, wrote in the journal Developing World Bioethics in January.
Critics were unwilling to acknowledge China “as an equal partner in the international debate about proper limits to the development of new biotechnologies,” she wrote. Ms. Zhai declined to be interviewed.
Dr. Ren is not the only one exploring the science of body transplants. Dr. Sergio Canavero of the Turin Advanced Neuromodulation Group in Italy, is a prominent advocate, and scientists at the Institute of Theoretical and Experimental Biophysics at the Russian Academy of Sciences are also researching aspects of the procedure. Neither Dr. Canavero nor the Russian institute has plans to carry it out, though, they say.
PhotoDr. Ren studied an X-ray after an operation to replace part of a patient’s humerus. He admits that any attempt to successfully attach a person’s head to a new body would be extremely difficult. Credit Gilles Sabrie for The New York Times


Dr. Ren, a native of Harbin, spent 16 years in the United States before returning home in 2012. He was part of a team from the University of Louisville that assisted in the hand transplant. He later moved to the University of Cincinnati, according to the website of the university’s Academic Health Center.
Dr. Ren has experimented with head transplants on mice, but they have lived only for a day. He said he had also begun practicing on human cadavers, but declined to give details.
The doctor and his supporters say the operation could help people with potentially fatal diseases affecting body function, such as spinal muscular atrophy, as well as those with paralysis like Mr. Wang.
Some aspects of the plan are technically possible, said Dr. Abraham Shaked, a professor of surgery and the director of the Penn Transplant Institute at the University of Pennsylvania. He said it could be possible to preserve the recipient’s brain and the donor’s body before transplant, attach many of the blood vessels and muscles, and control adverse immune reactions.
But it is still not possible to connect the nerves of the spinal cord, Dr. Shaked said.
“At this stage, I would call the attempt stupid rather than crazy,” he said in an email. “Crazy means it may be done. Stupid should not be done.”
As for using the gluelike substance, polyethylene glycol, to facilitate the growth of nerve endings, Dr. Shaked said, “Put it this way: It is like if the trans-Atlantic phone cable is cut by half, and someone wants to put it together using Krazy Glue.”
Dr. Ren agrees that it would be stupendously difficult.
“I’ve been practicing medicine in China and overseas for more than 30 years,” he said in an interview. “I’ve done the most complicated operations. But compared to this one, there’s no comparison.”
“Whether it’s ethical or not, this is a person’s life,” he added. “There is nothing higher than a life, and that’s the core of ethics.”
Asked to comment, China’s Health Commission said surgeons were required to abide by ethical responsibilities outlined in the nation’s human organ transplant regulations.
Amid the medical and ethical uncertainties, Mr. Wang and his family cling to hope.
For three years, his daughter, Wang Zhi, 34, and her mother hand-pumped oxygen into his lungs. Today, they have an automatic pump paid for by donations. But medical bills have used up their savings, Ms. Wang said.
“He cannot live, and he cannot die,” she said.
The family knows that if the operation fails, Mr. Wang will die. But it gives them hope amid their desperation.
“A medical procedure that sounds impossible may save us,” Ms. Wang said.

__________________________________


Whenever global Wall Street wants to sound left social Democratic it ties words like SCHOOL CHOICE----OPT OUT------well, that is the Congressional global Wall Street policy that hit during Obama and Clinton neo-liberal several years. Of course Republicans have always fought any of these transplant policies when they were tied to public health, public universities, funded and open to all citizens----but now that organs are a hot global Wall Street commodity---the right wing leads in ways to reach that 100% body donor----
Currently we have LIVING WILLS and our DRIVER'S LICENSE as modes to identify DONOR STATUS. Citizens wanting to donate organs say YES in these venues-----citizens not wanting to don't need to do a thing. OPT-IN addresses this ------reversing what all know is human nature to PROCRASTINATE in these decisions. In nations around the world with FOREIGN ECONOMIC ZONES and global profit-driven health care if a citizen does not have that LIVING WILL or notation on DRIVER'S LICENSE----they will be assumed a donor.
TODAY in many cities those lines are already BLURRING----as sudden death means fast response medical teams are becoming more and more aggressive in procurement. Not to be crass------but this will easily MOVE FORWARD to pay-day-loan format where we have private money-lenders allowed to hawk cash for organ donation.
IT WILL LOOK LIKE THAT.

We can bet that global tissue and organ transplant health corporations will be hiring staff according to how well they PROCURE----CLOSING THAT SALE.



Transplants / Organ Donations
Medical Practice Management Public Health

Organ donation: is an opt-in or opt-out system better?
Written by James McIntosh
Published: Wednesday 24 September 2014

Around the world, organ donation policies vary greatly. Is it best to have a donation system where people have to opt in or opt out? To investigate, a team of researchers from the UK have analyzed the organ donation protocols of 48 countries to see which approach is working best.


In the US, a new patient is added to the waiting list for an organ transplant every 10 minutes.
With an opt-in system, people have to actively sign up to a register to donate their organs after death. In opt-out systems, organ donation will occur automatically unless a specific request is made before death for organs not to be taken.


Prof. Eamonn Ferguson, lead author from the University of Nottingham, UK, acknowledges that because the two systems are reliant on an active decision from individuals, it can lead to drawbacks:
"People may not act for numerous reasons, including loss aversion, effort, and believing that the policy makers have made the 'right' decision and one that they believe in."
However, inaction in an opt-in system can lead to individuals who would want to be a donor not donating (a false negative). In contrast, inaction in an opt-out system can potentially lead to an individual that does not want to donate becoming a donor (a false positive).

The US currently uses an opt-in system. According to the US Department of Health & Human Services, 28,000 transplants were made possible last year due to organ donors. Around 79 people receive organ transplants every day. Unfortunately, around 18 people die every day, unable to have surgery due to a shortage of donated organs.


In or out?

Researchers from the University of Nottingham, University of Stirling and Northumbria University in the UK analyzed the organ donation systems of 48 countries for a period of 13 years - 23 using an opt-in system and 25 using an opt-out system.


The study authors measured overall donor numbers, numbers of transplant per organ and the total number of kidneys and livers transplanted from both deceased and living donors.
They found that countries using opt-out systems of organ donation had higher total numbers of kidneys donated - the organ that the majority of people on organ transplant lists are waiting for. Opt-out systems also had the greater overall number of organ transplants.

Opt-in systems did, however, have a higher rate of kidney donations from living donors. The apparent influence that policy had on living donation rates "has not been reported before," says Prof. Ferguson, "and is a subtlety that needs to be highlighted and considered."
The authors acknowledge that their study was limited by not distinguishing between different degrees of opt-out legislation, with some countries requiring permission from next-of-kin for organs to be donated. The observational nature of the study means that other factors that may influence organ donation remained unassessed.


Moving forward


The researchers state that their results, published in BMC Medicine, show that "opt-out consent may lead to an increase in deceased donation but a reduction in living donation rates. Opt-out consent is also associated with an increase in the total number of livers and kidneys transplanted."

They suggest that although the results could be used in the future to inform decisions on policy, they could be strengthened further through the routine collection of international organ donation information - consent type, procurement procedures and hospital bed availability, for example - which should then be made publicly available.


Prof. Ferguson suggests that future studies could also analyze the opinions of those who have to make the decision to opt in or opt out:

"Further research outside of this country-level epidemiological approach would be to examine issues from the perspective of the individual in term of beliefs, wishes and attitudes, using a mixture of survey and experimental methods."
"By combining these different research methods researchers can develop a greater understanding of the influence of consent legislation on organ donation and transplantation rates," he says.



The authors note that countries using opt-out consent still experience organ donor shortages. Completely changing the system of consent is, therefore, unlikely to solve such a problem. They suggest that consent legislation or adopting aspects of the "Spanish Model" could be ways to improve donor rates.
Spain currently has the highest organ donation rate in the world. The Spanish utilize opt-out consent, but their success is credited by experts to measures such as a transplant co-ordination network that works both locally and nationally, and improving the quality of public information available about organ donation.

Recently, Medical News Today ran a spotlight feature on whether animal organs should be farmed for human transplants. Could this be a solution to the organ shortage, or this a problem to be addressed through changes to organ donation policy?

_______________________________________

Obama gutted Medicare and Medicaid of funding by almost $1 trillion under the guise of AUSTERITY national budget cutting to pay for the tens of trillions of dollars in Wall Street and health industry frauds these few decades.  Medicare has been JUNK BONDED-----even its infrastructure has been outsourced to global corporations during Obama's terms with CLINTON/BUSH/OBAMA POLS PUSHING ALL THIS AS HARD AS THEY COULD.  Any talk of saving MEDICARE in Congress today is SOCIAL PROGRESSIVE POSING by global 5% to the 1% Wall Street pols.

Obama appointed Wall Street executives throughout the Federal Department of Health and Human Services who sent all the funding that used to come to PUBLIC HEALTH AND OVERSIGHT-----to building global health corporation infrastructure including what is a very complex system of GLOBAL ORGAN TRANSPLANT.  Here in Maryland leading in these Wall Street profit-driven  global health systems we have fleets of Medi-Vac helicopters specifically tied to growing this transplant industry GLOBALLY.

We also have policies bringing high percentages of citizens in Baltimore more impoverished, more housing and food challenged-----we have a growing global labor pool having no sovereign rights----exactly the conditions overseas bringing more and more organ donation.


Obama's Health and Human Services broadened an ORGAN PROCUREMENT AND TRANSPORTATION DEPARTMENT while eliminating health access to 99% of citizens.  They did this because this is the most profitable global health industry----that's it.

Anyone thinking raging global Wall Street pols are building expensive access to all US citizens with these policies----and not building structures for PROFITEERING in transplant I have SWAMPLAND in Florida for sale.

Again, transplant technology and donation has been a good thing----we want a left social Democratic approach NOW-----

Organ Procurement and Transplantation Network




At a Glance

119,078people need a lifesaving organ transplant (total waiting list candidates). Of those, 76,356 people are active waiting list candidates. Totals as of today 9:06am

33,594organ transplants performed so far in 2016
Total Transplants January - December 2016
as of 01/12/2017

15,945donors
Total Donors January - December 2016
as of 01/12/2017
Organ donation and transplantation can save lives

Every ten minutes, someone is added to the national transplant waiting list.
On average, 22 people die each day while waiting for a transplant.
One organ donor can save eight lives. Sign up to be a donor in your state.
The need continues to grow

Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen.
While national rates of donation and transplant have increased in recent years, more progress is needed to ensure that all candidates have a chance to receive a transplant. [Graph description of Need continues to grow ]


___________________________________________


'He said the institution has slashed expenses by cutting experienced staff and increasing revenue through raising charges for organs 78 percent since 2010'.


Now, I am not sure how CLARIAN became tied to the corporate name CLARIAN METHODIST HOSPITAL AND TRANSPLANT-------but we are seeing too many FAKE RELIGIOUS ties to this industry we know is becoming corrupted and abusive--------WAKE UP and tell your religious leaders to END MOVING FORWARD-


'Hospitals with transplant programs received HealthGrades Transplant ... General Hospital; MCG Health Medical Center; Clarian Methodist Hospital ... profiles and cost information on the nation's hospitals, physicians, nursing' ...


When staff and citizens start using the term BANANA REPUBLIC to describe their health care facilities------we are MOVING FORWARD to third world status and in this Indiana health care facilities case---where all medical staff is leaving because of decline in standards---you can bet there are GLOBAL LABOR POOL MEDICAL WORKERS ON THE WAY.





Kelly
• 9 months ago From someone that has first hand information on how the system works, hospitals are losing great doctors everyday, because administration has become so much more focused on bloating hospital revenues than patient care. It's scary to think that administration, most of which are not doctor's, completely control the physician's ability to provide the best care for patients. It's become all about the hospitals bottom line revenue. It's frightening.
  • cfields • 9 months ago If you worked at IUH as I did you would understand why he is leaving. He is right on when he says they no longer try to be "pre-eminent". They don't value their employees and thus don't value their patients. I get my health care from other providers that care about quality.
    • Bannana Republic cfields • 8 months ago I have been there at IU for 14yrs. but the last 2-3yrs have been horrible. Nurses are leaving in droves because they expect more work with less resources. They have cut staff in all areas which all affects nursing because instead of paying attention to medications ect. We are emptying trash and taking trays out of rooms. Yes they hire techs, some are good but others sit around and wait to be asked to do something. It takes just as long for me to just take the tray out as it would for me to track them down and ask them to do it. I go in rooms trash linen overflowing because the administration cut house keeping staff. now I don't see a housekeeper unless we have them come clean a room for discharge or transfer. They give us more patients to care for and get mad because we don't do care plans. When you complain about the issues you get "I understand your frustration" Then you get suggestions for dealing with things which take more nursing time then just doing it yourself. I am totally burned out and I too am leaving, I hate too but I am just not being the nurse I want to be. I am like this doctor I became a nurse to take care of people not just a robot who performs a task and has to move on to the next task instead of connecting with the patients in a meaningful way.
  • Gina cfields • 9 months ago Agreed.

  • trey1 • 9 months ago
    Note to hospital systems: Great doctors and nurses make for a great hospital system. Hospital administrators provide ZERO health care. Let me repeat: ZERO. So often, hospital administrators think marketing campaigns, billboards, and silly surveys determine where patients want to go when a family is critically ill. Nope. It's great individuals providing great care that make a difference.
  • J Michelle • 9 months ago Need confirmation on this matter, please simply check an IU bill. Not the statements they give you, actually must request the bills. Methodist (IU) double bills to the tune of class action.
    The care received by our family as botched by hosptial decisions (not physicians). How can you be a level one trauma for brain patients and make them wait 3-5 days AVERAGE on an MRI?
    Our bill was more than the value of our home, two hospital infections, one urgent surgery due to delays in addressing issues because the the ICU were too short staffed, then dual charges for every test. Rehab Hospital of Indianapolis an IU organization suggested my husband drive while on narcotics after a recent massive head injury. Outpatient follow-up requires a rechecking in to be inpatient for ONE hour to get $275 doctor charge and $400 room rental fee.

    Double billings outstanding for months with no answer. IF they mis-post a check that you did pay it takes 9-months to locate it, in their words. I truly believe the doctor is this story. Professionals can sense genuineness in one another. IU has lost the war.
    • Christina Woodruff J Michelle • 4 months ago That's always been a problem with them as early as the mid 90s (that my mom has the paperwork for)




  • This isn't the only high-quality physician leaving the IU Health system. Many more top doctors with outstanding reputations are leaving or have been leaving for the last few years. The IBJ should dig a little deeper and they'll see an obvious trend. Several who have left worked for Riley and are pediatrics specialists. Hospital administrators are short-sighted at best, and criminal at worst. Putting profit ahead of patients will work for a while until the patients get wise and leave in droves for other systems that value experience and talent, or until an inexperienced doc kills a pediatric or adult patient and the bad PR/lawsuits suck millions from the bottom line. Then they'll wonder why they have to double their marketing budgets to bring back those customers and the revenue they've lost. Top doctors want freedom to research and care for their patients. It also doesn't take an MBA to know doctor, nurse and staff satisfaction = excellent care, which equals good word of mouth and return customers. Too bad the recent leadership at IU health can't get a common sense transplant. I guess they thought it wasn't cost-effective.
    • Yes, please look further into this exodus from IUHealth. I am a cancer patient at IU Health and an employee. In the last year -- three of my oncologists and two of my radiation oncologists have left to pursue patient care AND research at other high profile institutions. These are personally devastating losses for me -- I feel like they have helped keep my alive. I have lost confidence in the Simon Cancer Center but have no realistic out of network options since I am bound by insurance to pursue my care through this system. It is a very, literally, depressing and sad state of affairs.
  • thomaskn1 Renee • 9 months ago I can tell you IU does not care about lawsuits....they don't even go to court. IN has a limit of $500,000 for malpractice....they just pay it.

  • Becky Bechtel • 9 months ago My breast cancer surgeon left IU Health and she was one of the best in the country. The same thing happened with my reconstructive plastic surgeon. They left because doctors were not respected as they should have been. IU Health had no clear focus. So sad. Patients are looking at other places such as Community now.



  • Donny Football • 9 months ago You have to remember this point --- IU Health makes money from real estate, not providing health services. They provide health services to get good tax rebates. They get millions off in taxes by providing health services. They make money from their land holdings. Most don't know this fact.

  • John G Moore • 9 months ago Yeah, IU Health changed big time. In the early 2000's it (Clarian) was a great place to work. Once they started building the "Taj Mahal" hospitals, things started to changed. Clarian then started snapping up regional hospital and just getting to big. That was not a good plan at all. Get "good" not "big." When IU Health decided to be a "mini" UMPC, things just turned horrible. That was because of the fear that the world would end due to the ACA. Places like IU Health lose LOTS of money (millions) via departmental self dealing. There was RAMPANT self dealing going on there when I worked there, lots of money (millions) lost. Anyone who spoke up was dealt with very harshly. Sounds like this guy just got tired of the way things were going and just "tapped out." There are a LOT of great people who work at IU Health. There are even MORE horrible managers (especially the middle managers) at IU Health. Bad management is the problem at IU Health. Hopefully things will get better, Indianapolis deserves better.
  • Concerned • 9 months ago Why in the world would IU Health be shutting down important transplant research? Stinks of Gov. Pence. IU Health has no business aligning itself politically at the cost of patients and medical progress. When Tector does successfully transplant pig livers in humans (probably earn a Nobel) it will be Alabama that gets all the credit. Yet another Pence fail in the name of the Lord.
    And IU Health, you have taken everything that was great about IU, Methodist and Riley (Clarian) and ruined it. People used to be proud to work there. Shame on you.
    • I forgot everything was pences fault....thanks for reminding me....bet ur the same liberal that gripes when people blame Obama for things he had nothing to do with





  • Christina Woodruff Concerned • 4 months ago
    Clarion admin was never much better. Constantly billing our insurance backwards to try and get more money from at least '98 forward. And that's just when my mom started talking to me about it.
  • Joan • 9 months ago The decline of this once great institution is sad to watch. They have cut staff to unsafe levels use registry nurses in a transplant unit that are not trained for that acuity of patient. Cut housecleaning staff so short that Dr Tector once mopped and cleaned his patients room because it had not been cleaned. The truth is they cut staff so much to save money and make their bottom line look like their revenue is so high and that will lower the bond for the new academic center they are planning to build. What is ironic is that nurses no longer want to work there and the physicians are leaving rapidly so who do they plan to run the new center?


____________________________________________
DEPARTMENT
OF
HEALTH
&
HUMAN
SERVICES
Off~ce
of
Inspector
General
Washington,
D
C
20201
JUL
-
5
2005
TO:
Herb
Kuhn
Director,
Center for Medicare Management
M
y
T Services
FROM:
seph
E.
Vengrin
-
G/DeP;tY
Inspector General
for
Audit Services
SUBJECT:
Audit
of
Clarian Health Partners' Organ Acquisition
Costs
Claimed
for
the Period
January
1,2000,
Through
December
1,2000
(A-05-04-00049)
Attached
is an advance copy of our
final report
on
organ acquisition costs that
Clarian Health
Partners,
Inc.
(Clarian), claimed for calendar year (CY) 2000.
We
will
issue this
report to
AdminaStar
Federal,
Inc.,
the Medicare intermediary,
and
to Clarian
within 5
business days.
The
objective
of
this
self-initiated audit was to determine whether
the organ
acquisition
costs that
Clarian claimed
on the
CY
2000
Medicare cost report for
its
kidney, heart, liver, lung, and
pancreas
transplant programs
were
allowable. Specifically, did Clarian:
comply
with
Medicare
law,
regulations, and guidelines for claiming organ acquisition
costs?
receive excess
Medicare reimbursement for
organ
acquisition activities?
Clarian did
not always
comply with Medicare
law, regulations, and guidelines
for
claiming
organ
acquisition
costs
in
the preparation
of its
Medicare Part
A
cost report and received excess
Medicare
reimbursement
for
organ acquisition activities. Specifically, Clarian
did
not properly
adjust
some
costs
and did
not have
systems to accumulate certain costs
of
organ
acquisition
separately from the
costs
of
posttransplant and other hospital activities.
We
limited our
review
of
organ acquisition costs to
$4
million
of the $12.5 million that
Clarian
claimed on
its
CY
2000
Medicare cost report. Clarian claimed $414,385
in
unallowable costs
and
$2,524,864
in
unsupported costs.
The
unallowable costs of
$414,385 represented duplicate salary costs and
missing or
incorrect
adjustments for
unallowable
costs.
Based
on
these unallowable costs, Medicare
overpaid
Clarian
an
estimated $270,665.
The
unsupported
costs of
$2,524,864 did not comply
with
Medicare's documentation
requirements for
reimbursement.
We
recognize
that some
portion
of
the
$2,524,864
may have
related to
organ
acquisition activities
and
would have been allowable
if properly documented.
However,
based
on
Federal regulations and
the
Provider Reimbursement
Manual, the
unsupported costs were
considered unallowable
for
Medicare
reimbursement.
Although Clarian
was
unable to provide necessary documentation to support the $2,524,864
in costs
claimed for
Page 2 – Herb Kuhn
CY 2000, the Centers for Medicare & Medicaid Serv
ices (CMS) and the Medicare intermediary
may elect to use an alternative methodology to estim
ate the portion of these costs that relate to
organ acquisition. If Clarian
cannot provide alternative suppo
rt for the $2,524,864, a Medicare
overpayment of $1,818,679 will exist.


_____________________________________
Again, we are happy when citizens needing transplants get them----we are shouting against what is very quickly becoming predatory and selective profiteering within this tissue and organ transplant industry GLOBALLY. Now, Hopkins receives billions of dollars in Federal NIH, NSI research funding----it has tied itself to all at-risk health programs funneling all that low-income and at-risk Federal funding to itself. At the same time----Johns Hopkins leads in Trans Pacific Trade Pact-----Foreign Economic Zone development----and it leads in killing all public health---in writing health policy that will kill access to high-cost PHARMA and hospital procedures around the world---including HIV and HEP C PHARMA-----we will see here in the US what medical justice organizations have been shouting these several years-----what was readily available HIV/AIDS treatments---what are readily available HEP C treatments become too costly for 99% of citizens. Hopkins has gone to great lengths to identify HIV citizens.
Now, imagine as global citizens dealing with what are two of the largest disease vector today---HIV and HEP C -----now not able to afford or access treatment---what do they do? They DONATE ORGANS FOR TREATMENT. This is the glaring ETHICAL AND MORAL issues around denying health care in broad areas while funding what will be profiteering in global organ transplants. Our HIV and HEP C patients will see this coming soon----as will all population groups once able to access the best public health system in world history.



Trans-Pacific trade pact triggers fears over drug prices
Chris McCall
Published: 20 June 2015


A new trade agreement being negotiated between 12 countries has come under fire from health campaigners who say it will push up drug prices and weaken health services. Chris McCall reports.

Marh Mansor is HIV positive and lives in the outskirts of Malaysia's capital, Kuala Lumpur. For him, a new Pacific trade deal is a personal threat. He fears that, if it goes ahead, it might mean his life-saving antiretroviral treatment will be just too expensive to get.

49-year-old Mansor is a former intravenous drug user who learned he was infected with HIV in 2004. At one stage, he started to develop AIDS, and needed treatment for tuberculosis. But for the past 5 years, he has been stable on generic antiretroviral drugs paid for by the Malaysian Government. He also has hepatitis C but cannot afford treatment for that. It is too expensive.

If his first-line therapy eventually starts to fail, he will need second-line drugs, which the Malaysian Government does not currently pay for. The cost would be around 1000 ringgit per month, roughly US$265. If the new Trans-Pacific Partnership (TPP) goes ahead, he fears drug prices will increase and treatment could become unaffordable, for either him or his government. Around 86 000 people are living with HIV in Malaysia, according to official statistics. “We survive because of the generics”, Mansor told The Lancet.




Local

Johns Hopkins offers unique organ donor-pairing program


John Davis, 28, right, underwent a kidney transplant at Johns Hopkins Hospital. He got the organ through an innovative donor paring program. In the background is his girl friend, Rebecca Kocsis, left, and her mother, Deborah Kocsis, who donated her kidney to Davis. (Kenneth K. Lam/Baltimore Sun)


By Kevin Rector and Meredith Cohn December 31, 2013
When John Davis’s kidneys began failing in January, his girlfriend’s mother decided to donate one of her kidneys to help save his life. That the two weren’t actually a “match” — meaning Davis’s body would never accept her kidney — didn’t matter.
In a groundbreaking program at Johns Hopkins Hospital that is as much about nationwide networking as it is medical innovation, kidney transplants are being arranged not through isolated pairings of patient and donor, but through longer and longer chains of individuals who don’t even know one another.
Gone are the days when a donor might be discounted for not being a match with the specific patient, doctors say. Another patient in Hopkins’s network might be a match, and perhaps that patient also brought a willing donor to the mix, facilitating a successive chain of matches until everyone in the chain is paired up.


Many donor-patient matches are found in pools that reach well beyond individual circles of family and friends. They are identified by complicated computer algorithms scanning the characteristics of patients and donors across the country.
“John’s kidney came from Salt Lake City, from an ‘altruistic’ donor. They never met,” said Robert Montgomery, director of Hopkins’s Comprehensive Transplant Center and Davis’s surgeon. “And then John’s intended donor is going to give to someone else and continue the chain.”
“She graciously stepped up,” Davis, 28, said of his donor, Deborah Kocsis, 58, on a recent morning as they sat with family members around his hospital bed, days after the two underwent surgery to facilitate the swap.
Nearly 100,000 people are on a national waiting list for kidneys, out of just over 121,000 waiting for all organs, according to the United Network for Organ Sharing (UNOS), a private nonprofit group that manages the nation’s organ transplant system under a contract with the federal government.


In 2013, through Sept. 30, there were 12,584 kidney transplants in the country and 370 in Maryland, 177 of which were at Hopkins and 193 at the University of Maryland Medical Center, according to UNOS data.
Without a willing, living donor, people can wait for a kidney from a deceased donor for years, facing dialysis, other painful side effects of chronic disease and organ failure and, eventually, death.
But UNOS is facilitating a national Kidney Paired Donation Pilot Program to allow all willing donors to give, even if they aren’t a match with their own loved ones. The program works with dozens of hospitals across the country to find participants, including several that coordinate their own pairings, like Hopkins.
“There are so many incompatible donors, but their organs are perfectly suitable for someone. It seemed logical to try and address the needs of recipients who have their own donor,” said Christie Thomas, chair of UNOS’s living donor committee and a professor of medicine at the University of Iowa. “Every kidney donated is someone coming off the waiting list.”



Hopkins — which now finds pairings often, including with the University of Maryland Medical Center — was a pioneer in the concept of a chain, Thomas said.
Rhode Island Hospital performed the nation’s first paired transplants, involving two donors and two recipients, in 2000. But the “domino” idea was sparked, Montgomery said, with the arrival at Hopkins in 2003 of an “altruistic” donor, a woman from the Midwest who wanted to donate a kidney but didn’t have a specific recipient in mind. The hospital performed its first triple swap that year.
The idea grew from there.
Some modern chains of patients and donors can surpass 20 people, and one involving 60 people began in late 2011 — lines of compassion and selflessness that Davis’s father, also named John Davis, calls “tremendous.”
“Your heart starts to pound, and every once in a while you get tears in your eyes. It’s just an amazing thing,” the elder Davis said. “You just can’t believe it happens, but it does.”
Davis and his family, from the Pocono Mountains in Pennsylvania, have experience with the process. The younger Davis’s recent transplant was his second. His first was when he was in eighth grade.
His oldest sister, Diana Davis, 33, has had three kidney transplants, the most recent on New Year’s 2012, also at Hopkins. His older sister Lauren Lehman, 31, had her first kidney transplant at Hopkins in August 2010.
All three siblings have nephronophthisis, a recessive genetic disorder of the kidneys that leads to renal failure.
Diana Davis’s first two donated kidneys were both from deceased donors, as was John Davis’s first. Kidneys from deceased donors don’t last as long as those from live donors. Even kidneys from live donors typically fail after a couple of decades, and subsequent surgeries become more complicated.

For their most recent transplants, each came to Hopkins with a living donor willing to give. None was a match with the donor they arrived with, but they all were able to take advantage of the paired donor program.
In John Davis’s hospital room at Hopkins recently, he cracked jokes with visitors, including his parents, John and Ann Davis; his sisters Diana and Lauren; Lauren’s husband, Darrell Lehman; his girlfriend, Rebecca Kocsis; and her mother — his donor, Deborah Kocsis.

Deborah Kocsis said she felt “relieved.” Before the surgery, many friends had a hard time understanding what she was doing. She told them she was giving a kidney so that her daughter’s boyfriend would receive one, but that he wouldn’t be getting her kidney. People didn’t seem to grasp the concept, she said. But she did.
“I was asked by my creator to do this; I said, ‘Yes,’ ” she said. “It’s as simple as that, or as difficult as that.”
— Baltimore Sun

________________________________


APOLLO GLOBAL MANAGEMENT-----this is the Clinton Wall Street neo-liberal in office in Indiana these few decades killing the 99% of Indiana citizens and their HEALTH CARE because----he works for a global hedge fund -------GET RID OF THESE GLOBAL WALL STREET PLAYERS-----THIS GUY IS SAME AS A MARYLAND LARRY HOGAN OR O'MALLEY.
'New revelations about Bayh’s time in office cast more doubt on a Democratic campaign dogged by scandal. When Democrat Evan Bayh jumped into the Indiana Senate race last July, it was widely believed that the race would be a slam-dunk for his party. Bayh had served three terms as a U.S. senator in Indiana before stepping down in 2011, and, prior to that, was the state’s governor for eight years.

Of course Trump's VP Pence is from Indiana as well tied to all kinds of global health corporations.



Indiana Senate Race Tied as Bayh Slips Even Further fullscreen Evan Bay campaign ad (via YouTube) Share article on Facebook


  Alexandra DeSanctis November 2, 2016 12:05 PM @xan_desanctis

New revelations about Bayh’s time in office cast more doubt on a Democratic campaign dogged by scandal. When Democrat Evan Bayh jumped into the Indiana Senate race last July, it was widely believed that the race would be a slam-dunk for his party. Bayh had served three terms as a U.S. senator in Indiana before stepping down in 2011, and, prior to that, was the state’s governor for eight years. He had a cash advantage of $9 million dollars over his Republican opponent, Todd Young, and a last name that made him Indiana political royalty. Internal Democratic polls had him up by over 20 points. What a difference a year makes. Monday’s Monmouth University poll shows that Young has completely erased Bayh’s lead, with the two candidates now tied at 45 percent among likely voters. The same poll records Bayh’s unfavorable numbers creeping up considerably, from just 19 percent in August to 27 percent in mid October to 32 percent today.
That’s no accident: Bayh has been damaged by a slew of revelations about his post-Senate career in Washington, which have allowed the Young campaign to paint him as a political insider in this year of outsider candidates. Just last night, the Huffington Post reported that Bayh’s private schedules from his time in office indicate possible congressional-ethics violations related to his hunting for a Wall Street job while still serving in the Senate: The job titles of four of the people Bayh met with were at the time “chief talent officer”; “global head of human resources”; “senior vice president, talent acquisition leader for campus recruiting, executive recruiting and commercial banking”; and “global head of talent acquisition.” Those are not the sort of executives a senator meets with to talk about legislation. In other words, under the guise of Senate business, Bayh appears to have met with headhunters in an effort to score himself a private-sector job. He even met with executives from his future employer, the private-equity firm Apollo Global Management, which he joined shortly after he left office in January of 2011. He had also broken with most Democrats to oppose a proposed tax increase that would’ve hurt financial companies such as Apollo. When the Indianapolis Star asked Bayh’s campaign about the nature of several taxpayer-funded trips that he had taken to New York City in late 2010, the campaign said Bayh hadn’t met with anyone from Apollo during those trips. This was false. In fact, he stayed overnight three times at an Apollo executive’s residence and met with the company’s CEO twice. The schedules also show that Bayh held numerous private meetings with fundraisers, lobbyists, and donors as early as 2009, sometimes with his own campaign fundraiser present. RELATED: Republicans Increasingly Optimistic about Indiana Senate Race Josh Holmes, president of the policy-management firm Cavalry, tells National Review that these latest revelations are rightly damaging to Bayh’s candidacy. “When a senator uses public office as a headhunting firm to line up a multi-million dollar payday while their constituents are suffering amidst a recession, bad things tend to happen,” Holmes says. “Nobody but Evan Bayh is responsible for the fact that it’s an issue in his Senate race.” Bayh’s potential misuse of his office isn’t the only scandal to have dogged his campaign. Bayh’s potential misuse of his office isn’t the only scandal to have dogged his campaign. In August, news broke that Bayh had not been living in Indiana as he had repeatedly claimed. When an interviewer asked the candidate if he would move back to the state after beginning to run for Senate again, Bayh responded, “I’ve never left.” But in reality, he had listed his two, multi-million-dollar homes in Washington, D.C., as his primary residences rather than his $53,000 Indianapolis condominium. After leaving the Senate, he officially changed his address to reflect D.C. residence. And when he returned to Indiana last summer for a Democratic event, he stayed at a hotel a mere twelve miles away from his condo. The portrayal of Bayh as a Washington insider distant from the people of Indiana has been aided by the former senator’s support for President Obama’s policies, which are very unpopular in the reliably red state. When Bayh first entered the Senate race, he enjoyed a surge of positive press due to the fact that he had jumped in at the last minute to replace Democratic candidate Baron Hill. He had been encouraged to run by Senate minority leader Harry Reid and minority whip Chuck Schumer, who hoped that he would obtain a substantial lead and force Republicans to pull their resources out of the Indiana race entirely. More Congress GOP Should Entice Dems to Help Replace Obamacare A Health-Care Plan the GOP Could Get Behind Wastebook Exposes More than $5 Billion in Questionable Federal Spending Since then, however, Bayh’s public image has taken endless fire, to the point where the Democratic Senatorial Campaign Committee has had to spend millions in the state to salvage his candidacy. “Somebody on their campaign, maybe Bayh himself, made an incredible miscalculation on how this race was going to play out,” says Greg Blair, a spokesman for the National Republican Senatorial Committee. “Other than the week that he announced his candidacy, you really can’t look back at this campaign and identify a single week that Bayh won.” Though the race will likely be tight down to the wire, the momentum seems to be on Young’s side, and if negative revelations about Bayh continue to surface, the last week of the Indiana campaign might not bring the Democrats much relief.

______________________________________


Again, we are happy when citizens needing transplants get them----we are shouting against what is very quickly becoming predatory and selective profiteering within this tissue and organ transplant industry GLOBALLY. Now, Hopkins receives billions of dollars in Federal NIH, NSI research funding----it has tied itself to all at-risk health programs funneling all that low-income and at-risk Federal funding to itself. At the same time----Johns Hopkins leads in Trans Pacific Trade Pact-----Foreign Economic Zone development----and it leads in killing all public health---in writing health policy that will kill access to high-cost PHARMA and hospital procedures around the world---including HIV and HEP C PHARMA-----we will see here in the US what medical justice organizations have been shouting these several years-----what was readily available HIV/AIDS treatments---what are readily available HEP C treatments become too costly for 99% of citizens. Hopkins has gone to great lengths to identify HIV citizens.
Now, imagine as global citizens dealing with what are two of the largest disease vector today---HIV and HEP C -----now not able to afford or access treatment---what do they do? They DONATE ORGANS FOR TREATMENT. This is the glaring ETHICAL AND MORAL issues around denying health care in broad areas while funding what will be profiteering in global organ transplants. Our HIV and HEP C patients will see this coming soon----as will all population groups once able to access the best public health system in world history.

Trans-Pacific trade pact triggers fears over drug prices
Chris McCall
Published: 20 June 2015


A new trade agreement being negotiated between 12 countries has come under fire from health campaigners who say it will push up drug prices and weaken health services. Chris McCall reports.

Marh Mansor is HIV positive and lives in the outskirts of Malaysia's capital, Kuala Lumpur. For him, a new Pacific trade deal is a personal threat. He fears that, if it goes ahead, it might mean his life-saving antiretroviral treatment will be just too expensive to get.

49-year-old Mansor is a former intravenous drug user who learned he was infected with HIV in 2004. At one stage, he started to develop AIDS, and needed treatment for tuberculosis. But for the past 5 years, he has been stable on generic antiretroviral drugs paid for by the Malaysian Government. He also has hepatitis C but cannot afford treatment for that. It is too expensive.

If his first-line therapy eventually starts to fail, he will need second-line drugs, which the Malaysian Government does not currently pay for. The cost would be around 1000 ringgit per month, roughly US$265. If the new Trans-Pacific Partnership (TPP) goes ahead, he fears drug prices will increase and treatment could become unaffordable, for either him or his government. Around 86 000 people are living with HIV in Malaysia, according to official statistics. “We survive because of the generics”, Mansor told The Lancet.



'More than
80% of the AIDS drugs that MSF
uses worldwide are generics from India.

MSF routinely also relies on generic drugs to
treat TB, malaria, and a wide range of
infectious diseases.
MSF is concerned about the public health implications of the U.S.’s IP demands
on the countries
currently negotiating the TPP.
Furthermore
, as the final text of the TPP is likely to become a precedent
for future trade agreements and IP negotiations, MSF is concerned that these restrictive IP policies,
known as “TRIPS
-
plus” provisio
ns, will be imposed on additional developing countries, including where

MSF works, affecting access to medicines for millions of patients'.



Can you imagine the millions of global HIV and HEP C citizens that could----and will likely be held captive to organ donation in exchange for affordable PHARMA-------


500 new cases of HIV/AIDS every year in Baltimore

Katrina Bush
6:58 PM, Feb 5, 2015
Baby kidnapped from Jacksonville hospital found alive 18 years later
WMAR
It is no longer a fatal diagnosis, but HIV/AIDS is still a major problem in 2015. 
 
"We in Baltimore City like other urban cities across the U.S., have HIV as a significant problem that is an epidemic," Dr. Leana Wen, Health Commissioner in Baltimore City, said. 

 
It is an epidemic that impacts 13,000 people in the city. African Americans constitute about 62 percent of the population in Baltimore, but account for about 82 percent of people who are HIV positive in the city, Dr. Wen said. 
 
"African Americans are disproportionately affected by HIV/AIDS in Baltimore City and around the country, especially when it comes to diagnosis but also when it comes to death from HIV. African Americans are five times more likely to die from HIV/AIDS than their white counterparts, which is a huge disparity," Dr. Wen said. 
 
She said there needs to be a focus on testing and education. The same goes for Mayo McClinton who has been living with HIV since 2005. He said his work as an outreach specialist at LIGHT Health and Wellness Comprehensive Services, Inc. has become his passion. 
 
"A lot of schools don't have that health piece like they did back in the day. So, a lot of young black African Americans right now don't know or aren't really aware of HIV and what it really can do and what it really is. So, they get their education built off the stigma and what they hear from word of mouth," McClinton said. 
 
"I feel like if another young person like myself gets involved with what's going on with HIV and passes it along to the community, I can help," Charmaine Stern, also an outreach specialist at LIGHT Health and Wellness, said. 
 
Stern said in talking to some of the 100-150 clients at LIGHT Health and Wellness, she can see that protection from HIV/AIDS is often not a priority for people with other problems they see as more pressing. 

 
"If you're dealing with homelessness or being a parent or trying to figure out how you are going to get your next meal, really you don't have time to think about HIV. Because if you're homeless, you're thinking about taking medication, what are you going to do to keep up with your medications, where are you going to put them? You might be couch surfing or outside on the street somewhere so again, HIV wouldn't be a number one priority," Stern said. 
 
The theme for this year's National Black HIV/AIDS Awareness Day is "I am my brother's and sister's keeper. Fight HIV/aids!"
 
"That says to me that we're all at risk. We all have to get tested. We all have to get educated and we all have to protect each other," Dr. Wen said. 
 
Dr. Wen will be speaking at the National Black HIV/AIDS Awareness Day event in Baltimore on Saturday, February 7, 2015. It is being held at Mondawmin Mall from 12:00 p.m. to 4:00 p.m. 
 
The free event includes free health screenings. 

___________________________________________


We are glad for the opportunity for citizens with HIV to participate in organ transplant process-----with compromised immuno-system we will need to watch what is a very difficult procedure to manage. Please consider these issues as we watch Congress deregulate health care----dismantled oversight----and dealing with quality of service and product----for decades the expansion of tissue and organ transplant overseas is filled with tainted tissue used in the pursuit of profit.

When we open the door to deregulating the tissues and organs that can be collected in a growing global transplant industry-----we will be bringing with it tiered levels of professionalism----tiered transplant corporations saying they are qualified when they are not. When one is desperate and unable to afford they will turn to operations that will fill that niche as US citizens are pushed from health care access.

We will have so many fly-by night corporations tied to tissue and organ collection here in the US --we already do have those corporations sending tissue and organs overseas. We now no longer have the safeguards on quality for transplant operations by global corporations coming to US cities deemed Foreign Economic Zones.


Records sought in tainted organ transplant

November 16, 2007
    •  
A woman who says she contracted HIV and hepatitis C through a kidney transplant in January filed a legal petition Thursday to obtain medical records related to her case.
The woman, identified only as Jane Doe, filed the petition against the University of Chicago Hospitals and the Gift of Hope Organ & Tissue Donor Network.



She is asking a judge to order them to turn over the records of the transplant to her attorneys, "so that they may properly investigate all pertinent matters," according to the petition filed in Cook County Circuit Court
The hospital and donor agency both knew that the donor -- identified only as John Doe -- "had engaged in high-risk behavior," Jane Doe's attorney, Thomas Demetrio of Chicago, wrote in the petition. But he said Jane Doe was not informed.
A hospital spokesman declined to comment, and the donor network could not be reached Thursday.
Earlier this week, health officials said four patients contracted HIV and hepatitis C from an infected donor in January and did not know of the potential risk to their partners and close contacts until they tested positive for the diseases in the last two weeks.
The infected donor had not tested positive for the diseases, likely because the infections were too recent to register on screening tests, officials believe.
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    Cindy Walsh is a lifelong political activist and academic living in Baltimore, Maryland.

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