POWER HATES TRUTH!!!!!
PLEASE FIGHT FOR A RETURN TO STRONG FREE PRESS AND PUBLIC MEDIA. WE CANNOT RETURN TO A FIRST WORLD DEMOCRACY WITHOUT THEM!
ALL OF MARYLAND'S CANDIDATES FOR GOVERNOR SO FAR ARE NEO-LIBERALS THAT WILL NOT ALLOW UNIVERSAL CARE!
Regarding the Maryland health co-ops and reform:
We are thankful most people in Maryland are understanding that this health reform is very, very, very bad for everyone but particularly people of color and working class as people will die from lack of access to basic health care. Join a Universal Care group---National Physicians are doing a good job.
This is what the American people are now forced to listen to. We have a Health Care.Gov that doesn't work because it was outsourced to hundreds of private contractors. The Federal requirements just don't work for global corporate rule. If you look at the Medicare site-----done completely with public workers all working for the public good----you see one of the most complex systems in the world. It is the outsourcing that creates the pay-to-play bid awards and the need to give to connected people because there is so much fraud and corruption. That is what has crippled every government activity these days and it is because since the 2008 crash this outsourcing has gone on steroids. The people who lie, cheat, and steal are in leadership positions and they are not the best and the brightest. Universal Care would have simply required everyone on the Medicare system, expanding coverage to 100% from 80%, and building oversight and regulatory structures to stop the bleeding from massive health industry fraud. GOVERNMENT IS NOT BAD-----IT IS THE OUTSOURCING TO CONTRACTORS WHO SUBCONTRACT TO SUBCONTRACTORS!
Today I wanted to explain the next debacle to health reform. This is the health co-op. In Maryland we have Evergreen, again run by Hopkins (remember Maryland Health Care for All was a Hopkins capture of Universal Care that worked for the republican health plan ACA----we all knew that would not protect people!). The 1% are trying to move everything that is public to private hands and they are doing it as neo-liberals so people are confused as to why democrats would do so much harm to their democratic base. Co-op has a socializing sound so that is why neo-liberals use it for what is naked capitalist policy. What Beilenson/Evergreen is doing on Hopkins' behalf is creating what is a consolidated health system they say will make health costs cheaper. They pretend we do not know that the health cost is highest in the US because of massive health industry fraud and profiteering and not from lack of efficiency.
Raise your hand if you see how consumers will be soaked and have no choice or control if these health systems promoted by Evergreen get off the ground..EVERYBODY. Imagine, a automobile manufacturer, mechanics, auto insurance, and auto sales all fell under the same corporate umbrella. How do you think consumers would fare as regards quality/access and service? The manufacturer sells you a car reasonably priced because once you have it they will soak you with the insurance rate, repair bills, and re-sale. THAT IS THE TECHNOLOGY MODEL OF SELLING A CELL PHONE FOR NEXT TO NOTHING AND THEN SOAKING PEOPLE FOR CONNECTION, APPS, AND DOWNLOADS.
For those not reading the Wall Street news that is the goal of these 'co-op' systems that will handle largely the middle-class because they are the one's with enough wealth to soak. So, think Hopkins hospital with its own insurance, medical device/procedure R and D, teaching school, and control of public health and you have the concept of EVERGREEN. If you join them you have to buy and use everything else in the system. This is naked capitalism and you see they are labelling it as socialism with the co-op theme.
This is why everyone from conservative republicans who like free market to all of labor and justice are shouting that these crony systems do not allow for competition, they capture people into limited and controlled health care, and they are designed to send all wealth to a few at the top----SOUND FAMILIAR? WALL STREET ALL THE WAY. So, as they send working/class and poor into third world public health checkups with no access to quality care, they are trying to get the middle-class stuck in these crony systems that will soak them for all they are worth!
DO NOT LET NEO-LIBERALS FOOL YOU WITH WORDS LIKE CO-OP AND SUSTAINABILITY---IT SIMPLY MEANS 'SINCE YOU ARE POOR AND WE ARE NOT PAYING TAXES YOU NEED TO LIVE THIRD WORLD LIVES'. Actually, with tens of trillions of dollars in corporate fraud coming back to the public-----the public will be just fine. WE JUST NEED TO SHAKE THE NEO-LIBERAL BUGS FROM THE RUG!
MD citizens have already decided they are going with Universal Care. We know health care is a right and that trillions lost to health fraud need to fund equal care for all. Health care is not for-profit--it is life and death!
Evergreen faces challenges in delivering health insurance Small businesses may be the future of health insurance co-op in Maryland
By Meredith Cohn, The Baltimore Sun 12:04 p.m. EDT, October 29, 2013
Evergreen faces challenges in delivering health insuranceSmall businesses may be the future of health insurance co-op in MarylandOctober 29, 2013|By Meredith Cohn, The Baltimore SunFour weeks since it began selling health insurance on the state's new marketplace for the uninsured, Evergreen Health Cooperative Inc. has signed up only five people.
That's a long way from the nonprofit health insurance provider's first-year goal of 15,000 people, so Evergreen is already shifting focus.
Technical problems making it difficult for people to register for the state exchange culminated last week for Evergreen when its plans disappeared from the exchange offerings. The plans were restored after a short time.
Statewide, more than 3,100 people have signed up for health coverage on the exchange, according to the latest numbers released by the Maryland Health Connection. There are about 800,000 uninsured Marylanders.
Evergreen isn't waiting for the exchange to start working properly. For now, the co-op has switched focus from individuals buying its insurance on the exchange to small businesses buying plans directly from Evergreen, said Dr. Peter Beilenson, the former city health commissioner who started it. (The state's small-business exchange has been delayed until Jan. 1.)
"We obviously were predicating most of our business on the exchange market, which is not bearing fruit right now," Beilenson said. "That was a problem for us in two ways: financially in terms of generating enough members and for our mission. We did this for the middle class who would qualify for subsidies."
But the co-op was new and nimble enough to switch "almost overnight to small businesses," he said. "We think it will provide us with enough members to get through until the exchange is running smoothly."
Evergreen's small group rates were approved Oct. 25, so no group has enrolled yet, but the prices are below average and attracting attention from businesses and brokers, Beilenson said. The co-op will depend on enrollment to survive — members' premiums will pay to run the co-op and cover startup costs. Any profits would be returned to the plans.
The co-op's small-group rates are at the lower end of the spectrum, with an average premium of about $368 per insured, according to data from the Maryland Insurance Administration.
The lower rates may reflect Evergreen's model. The co-op employs its own doctors, who work in one of four centers for a salary rather than fee-for-service. The idea is to focus on prevention while managing multiple chronic conditions and staving off costly emergency visits and hospital stays.
Evergreen also offers a traditional plan using a network of doctors.
It's cost that matters most to small businesses, and a competitive premium will serve Evergreen well, said Karen Davis, a professor in the Johns Hopkins University's department of health policy and management. There is a "fair amount of evidence" that shows Evergreen's patient-centered model cuts costs, she said.
But insurance tends to be dominated by large insurance companies, so it remains unclear whether Evergreen and co-ops in other states can slice off enough business.
"The major challenge is size and scale," Davis said. "But the advantage Evergreen has is that its model of care is more effective. … I think they're in a better position than most of the co-ops."
Nationwide, 24 co-ops received federal funding as part of the Affordable Care Act. Evergreen got $65 million in federal loans, but all but about $13 million will go to a required reserve fund
Others wanted to start co-ops in Maryland, seeing the potential to compete with traditional insurance companies and bring down prices. One was MedChi, the state medical society, which planned to start a co-op largely on the Eastern Shore but was stymied when Congress cut startup funding.
"We're very supportive of the idea of co-ops and think they can work really well," said Gene Ransom, MedChi's CEO. "I don't think they have an easy task ahead. We are rooting for Evergreen because more competition is good for the marketplace."
Beilenson said Evergreen has made other adjustments to survive. It has hired some staff from the insurance industry to serve as a balance with those employees who know more about public health. It has raised $5 million in startup money from private foundations and another $1 million from other private sources for marketing, including a new TV ad (federal law prohibits explicit marketing with government money).
"I think we're well-positioned," Beilenson said. "We think we know what we're doing. And we think we have a really good product."
An earlier version misquoted Dr. Peter Beilenson concerning subsidies for the middle class. The Sun regrets the error.
Do you know that Johns Hopkins is partnered with MedStar Washington DC? Do you know that Maryland deliberately has policy that keeps Medicare from auditing in the state? Do you know that entitlements are fleeced of 1/2 of total spending in fraud?
Billions are lost to Medicare and Medicaid in Maryland every year because there is absolutely no oversight!
OIG: MedStar Washington Hospital Center Overbilled Medicare $1.06M
Written by Bob Herman (Twitter | Google+) | October 29, 2013
MedStar Washington Hospital Center in Washington, D.C., will have to repay more than $1.06 million in Medicare reimbursements to the government after an audit from the HHS Office of Inspector General found incorrectly billed inpatient and outpatient claims.
The OIG looked at 313 claims the hospital billed during 2010 and 2011. The 926-bed MedStar Washington Hospital Center, a teaching hospital, was found to have complied with Medicare billing requirements on only 44 percent of the claims.
Errors cited in report included billing Medicare for inpatient services when they should have been billed as outpatient or observation — one of the most common errors in OIG audits — as well as incorrect diagnosis-related group codes, excessive billed units of outpatient services and noncovered dental services, among other errors.
Officials at MedStar Washington Hospital Center agreed with most of the OIG's findings and recommendations, but they disagreed with some of the agency's review of the hospital's outpatient billing. The OIG stood by its report and maintained that all "findings and recommendations are valid."
When the democratic base came out for Obama it was because he ran as a progressive. Then he became a raging Wall Street neo-liberal as are the democratic leadership in Congress. This is why we had a supermajority of democrats and could not get a public health program for all. The result was a republican health plan called ACA and this corrupted notion of co-ops that we all know does not address affordability and access. You see below how this was used in Texas to move all chronically ill/costly patients and then it was allowed to implode......this is what Wall Street does to all that is allowed to go public private!
'While health care cooperatives are useful for helping small businesses offer more choice to employees and easing the burden of administration, there is no evidence that cooperatives help to provide more affordable health care to purchasers'.
Health care co-ops The release of the Senate Finance Committee’s health reform bill includes the establishment of health care co-ops as an alternative to the public option touted in the Senate HELP committee and House health reform bills. A prior analysis from the General Accounting Office discusses the pros and cons of such cooperatives.
Nearly two-thirds of all Americans under the age of 65 obtain their health insurance coverage from their employer. However, the likelihood of getting health insurance from work differs dramatically for individuals who work for big firms (more likely) versus small firms (less likely). In response to Congressional request (made in 2000), the Government Accounting Office produced a report that detailed the usefulness of health care cooperatives in the provisions of health care in the United States. This topic is worth revisiting again today because the Senate Finance Committee’s health reform plan consists of a proposition to encourage the use of health care cooperatives to provide affordable health insurance to employees of smaller firms (less than 50 workers).
While health care cooperatives are useful for helping small businesses offer more choice to employees and easing the burden of administration, there is no evidence that cooperatives help to provide more affordable health care to purchasers.
The goals of health insurance cooperatives, some of which in the past have been either sponsored by states or by private small business associations, is to offer small employers the advantages larger employers have – increased bargaining power, administrative simplicity, and a choice of more insurance options.
On two fronts health care cooperatives can deliver on these proposed benefits. Some administrative streamlining is possible through a health care cooperative for small businesses. Likewise, choice of insurance plans is improved from the typical solo option up to 90 percent of small employers provide. However, these plan choices are limited in rural areas and are highly dependent on the voluntary participation of private health insurers.
A major failure of health care cooperatives is the lack of bargaining power for employers obtaining health coverage within the cooperative. In fact, in some cases, the price of the health insurance premium obtained through the cooperative was more expensive ($231 for a 55-year old) than a similar product obtain outside the cooperative ($216). Part of the reason for this failure is the extremely small market share for health care cooperatives (approximately 5 percent or less of the small group market). An additional reason cited for the failure of cooperatives to reduce health insurance premiums for members is the effect of adverse selection. Adverse selection is the process by which persons who are more likely to be sick (and therefore drive of health costs) are more likely to enroll in plans through the health care cooperative. Such adverse selection has lead to a “death spiral” where health insurance costs within the cooperative continues to rise until the risk pool shrinks to include only the sickest, most expensive patients. At that point, the cooperative implodes as happened in Texas in 1999.
With the release of the Senate Finance committee’s vision for health reform in the United States, the full debate between the policy options of private market delivery of health care, versus non-profit health co-ops, and a full public option can begin in earnest.
Evidence from the non-partisan GAO and other researchers indicates that co-ops are not an effective tool for keeping health costs low for consumers. With co-ops performing about the same and sometimes worse than the private insurance market, perhaps the public plan deserves a try.
Public opinion is still divided on the public option. The debate should shift from ingenuous assertions about a government take-over of health care to whether or not government can provide health care more “efficiently” than the private market, Medicare, a well-respected public plan, certainly is more efficient than the market; so why not let a public option for all Americans have a chance to join in the competition.
General Accounting Office. March 2000. PRIVATE HEALTH INSURANCE: Cooperatives Offer Small Employers Plan Choice and Market Prices. Publication GAO/HEHS-00-49.
RAISE YOUR HAND IF YOU KNOW THAT PRIVATE NON-PROFITS ARE NOW EXTENSIONS OF CORPORATIONS?
'But hey, wait, Blue Cross and Blue Shield do in fact have long histories as co-ops.
So what went wrong? If you read the Mark Pauly quotation on p.2 of the first link, it seemed that health care customers did not in fact end up controlling the co-op (or mutual). The managers ran the show in their own interest. Maybe so, but then will health insurance customers do so much better controlling or influencing a government-run plan'?
What are health care co-ops?
by Tyler Cowen on August 19, 2009 at 1:44 am in Medicine | Permalink
Here is one quasi-answer:
But so far, cooperatives have been defined in the health-care debate primarily in terms of what they are not: They would not be run by the government.
That may make the cooperatives more politically palatable to conservatives, as well as to some Democrats such as Conrad, who fear that the public option may be a bridge too far. But it also presents new challenges: Cooperatives would face potentially greater difficulty getting off the ground and obtaining discounted rates from doctors and hospitals, observers say.
Whether this would end up as a public plan under a different name, I cannot say and indeed it seems that maybe no one knows. Ezra Klein tries to clear up some issues.
I am in any case puzzled by the topic. If, say, rescission is a major problem, why do not health insurance customers seek out health insurance mutuals or co-ops, both of which offer the possibility of greater consumer control and thus less opportunism from the supplier.
Note that mutual banks were quite common before the rise of deposit insurance and mutual life insurance companies played major roles in the history of the industry. So mutual and co-op forms can arise when the market agency problem is severe. Why don't health insurance mutuals or co-ops take over the sector today for that matter? But hey, wait, Blue Cross and Blue Shield do in fact have long histories as co-ops.
So what went wrong? If you read the Mark Pauly quotation on p.2 of the first link, it seemed that health care customers did not in fact end up controlling the co-op (or mutual). The managers ran the show in their own interest. Maybe so, but then will health insurance customers do so much better controlling or influencing a government-run plan?
There is thus an unusual implicit claim on the table. It runs something like this: decisive customers, with exit rights, cannot control a health insurance co-op. Those same individuals, in their roles as voters, being non-decisive, and with fewer exit rights, can control a government-run health insurance system, co-op or not.
I can think of some models in which that claim is true, but I would not want to go to the mat for them.
BELOW YOU SEE THE PROPAGANDA GAME PLAYED WITH TWO BLACK LEADERS BOTH FIGHTING TO END WAR ON POVERTY AND ENTITLEMENTS.
Dr Carson is a Hopkins doctor who has led the fight against public health care throughout the reform writing. He does this because Hopkins has completely dismantled the public health sector in Baltimore/Maryland and created private non-profits that run all public health and end all public participation in policy and ability for oversight. So, Maryland has billions of dollars lost to health industry fraud each year----we are ranked at the bottom nationally for fraud and corruption. Why is Carson shouting socialism to what is the most naked capitalist approach to health care---private state health systems? Remember, neo-liberals work for wealth and profit and most democratic states like Maryland are run by neo-liberals.
HE IS SHOUTING AGAINST THIS REPUBLICAN CORPORATE HEALTH PLAN TO MAKE OBAMA LOOK LIKE HE IS ACTING LIKE A DEMOCRAT----IT IS ALL A DOG AND PONY SHOW!
Since it is people of color who will overwhelmingly lose out by the ending of entitlements-----which is what health reform is about----they are giving us two black leaders. THIS GOES FAR BEYOND PEOPLE OF COLOR, IT WILL KEEP MOST FROM ACCESSING NEEDED LEVEL OF CARE!
Is it the worst thing since slavery? Well, people of color will tell you they have been used for research as the only way of accessing health care and it is life and death. Mandating the purchase of insurance with prohibitive co-pays and deductibles makes this process simply a tax that supports health care for the affluent. THAT IS VERY BAD!!
Dr. Ben Carson "Jumps Jim Crow" Wednesday, 30 October 2013 10:29 By Dr Wilmer J Leon III
Gage Skidmore / Flickr)" height="266" width="400">Dr. Ben Carson speaking at the 2013 Conservative Political Action Conference (CPAC) in National Harbor, Maryland. (Image: Gage Skidmore / Flickr)
"You know Obamacare is really, I think, the worst thing that has happened in this nation since slavery. ... It is slavery in a way, because it is making all of us subservient to the government, and it was never about health care. It was about control."
- Dr. Ben Carson, October 11, 2013
Dr. Ben Carson is a world-renowned American neurosurgeon. He is a brilliant physician with an incredibly compelling and motivational story. Born into poverty in Detroit in 1951 and raised by a single mother with a third-grade education, Carson became the first surgeon to separate conjoined twins joined at the head and the youngest to lead a surgical department. His focus, work ethic and commitment to excellence should be emulated by as many as possible.
In the past year, Dr. Carson has emerged on the political scene as a spokesperson for conservative interests. Most recently he addressed the 2013 Values Voter Summit in Washington, DC, making the remarks referenced above.
"Obamacare" - or more accurately the Affordable Care Act (ACA) - is the worst thing in this nation since slavery? Really? I understand political diatribes and hyperbole, but the worst thing in America since slavery? How can reducing the number of uninsured Americans through an expansion of Medicaid and the creation of new health insurance exchange marketplaces be worse than slavery?
The 13th Amendment abolished slavery in America except as punishment for a crime in 1865. Since then, African-Americans have been lynched, had their farms confiscated, dealt with mass-incarceration, been denied the right to vote and had limited or no access to public and private facilities. For an African-American of Dr. Carson's intellect and stature to publically make such assertions is historically inaccurate, irresponsible and promotes many of the racist stereotypes that are being used to garner support to overturn the law.
Does Dr. Carson really believe that the ACA is worse than the Tuskegee syphilis experiment of 1932? This infamous clinical study was conducted by the US Public Health Service on 399 African-American men from 1932 to 1972 to trace the natural progression of untreated syphilis. These human "laboratory animals" thought they were receiving free health care from the US government. By the end of the "experiment," 28 of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected and 19 of their children had been born with congenital syphilis.
Would Dr. Carson have us believe that the ACA is worse than the government-sanctioned, racially motivated attack on the Greenwood district of Tulsa, Oklahoma, in 1921? The Greenwood district of Tulsa, also known as Black Wall Street, was the wealthiest African-American community in America. During a 16-hour period from May 31 to June 1, 1921, whites rioted, attacked the community and burned it to the ground based upon the rumor that an African-American shoeshiner named Dick Roland touched a white female elevator operator named Sarah Page. An estimated 10,000 African-American residents were left homeless and 35 city blocks composed of 1,256 residences were destroyed by fire. The official death count by the Oklahoma Department of Vital Statistics was 39, but other estimates of African-American fatalities have been up to about 300.
From 1920 to 1970, North Carolina forcibly sterilized more than 7,600 women. Most of these women were poor and African-American. This eugenics program began as a means to control the birth rates of poor white woman and quickly expanded as an attack on African-American woman. Women were being sterilized like cats and dogs are spayed and neutered.
Dr. Carson wants us to believe that the ACA is worse than this?
As Carson is being promoted in conservative political circles as an informed spokesman on the talk circuit, he quickly has become a political minstrel show. He's jumping Jim Crow. "Jump Jim Crow" is a song and dance that was performed in blackface by a white comedian named Thomas Dartmouth around 1830, the early minstrel era of American entertainment. It made a mockery of African-Americans, lampooning them as dim-witted, lazy and buffoonish. The expression to Jump Jim Crow came to mean "to act like a stereotyped stage caricature of a black person," usually by a white person.
Dr. Carson has once again put his black face on political ideology that is contrary to the interests of the African-American community and validates denigrating stereotypes perpetuated by its enemies. Earlier in 2013, Carson told a CPAC audience that "Nobody is starving on the streets (of America). We have always taken care of them. We have churches which actually are much better mechanisms for taking care of the poor because they are right there with them. This is one of the reasons we give tax breaks to churches. ... "
He is lending his voice and using his personal narrative to validate the conservative "blame the poor" political agenda and undermine the social safety net in America.
That social safety net is needed as much today as it was in 1963, when Dr. Martin Luther King Jr. stated at the March on Washington, "One hundred years later (after the Emancipation Proclamation), the colored American lives on a lonely island of poverty in the midst of a vast ocean of material prosperity."
Today according to the Bureau of Labor Statistics, the national unemployment rate stands at 7.3 percent and 15 percent in the African-American community. Today, "in the midst of a vast ocean of material prosperity," according to Bread For the World, "14.5 percent of U.S. households - nearly 49 million Americans, including 16.2 million children - struggle to put food on the table" and "more than one in five children is at risk of hunger. Among African-Americans and Latinos, nearly one in three children is at risk of hunger."
In the midst of rampant poverty in America, Republicans in the House recently pushed through a bill that cuts billions of dollars from the food stamp program. On a vote of 217-210, they agreed to slash more than $40 billion from the program in the next 10 years and require program participants between 18 and 50 without minor children to find a job or to enroll in a work-training program to receive benefits.
Part of the problem with the Republican agenda, as indicated by the unemployment statistics referenced above, is that the economy is not growing fast enough to provide gainful employment for the individuals they are targeting. Conservatives also are cutting the work-training programs that they want these individuals to enroll in.
Conservatives are using the political process, as Dr. Ronald Walter called it, to "enact a new regime of social control" over African-Americans and other poor people in this country. They are using the Ben Carsons of the world to carry their water and validate their arguments.
The argument is that the Carsons of the world have overachieved in spite of the odds; therefore, the inability of the poor (stereotypically, the "black poor") in America to rise into the middle class or beyond is because of personal failure, lack of drive, initiative and dependence upon the government. Again, "blame the poor." Carson made it; why can't they? If an African-American such as Carson touts this rhetoric, it must be valid.
Carson reminds me of Clarence Thomas. During Thomas' confirmation hearing for the Supreme Court, too many people ignored his dismal record as the assistant secretary for civil rights at the Department of Education and his destructive impact as chairman of the Equal Employment Opportunity Commission. Left unchecked, as an associate justice on the U.S. Supreme Court, Thomas has assisted ultra-conservative interests who have used the court to overturn a lot of the progress that was made in the areas of court-protected civil rights and civil liberties.
It's not that the Ben Carsons of the world will have an immediate impact on the national policy debate. He is becoming a galvanizing force within the conservative echo chamber. As such, if left unchecked, he, like Associate Justice Thomas, can become another tool used by those who are interested in using the political system and policy reform to impose their will and implement greater social control.
The ACA is far from perfect. The flaws in the legislation will be flushed out and addressed over time, or it will die a natural death. How the Obama administration allowed the government web site to go live without beta testing, without anticipating the problems and without immediate fixes for them is at least irresponsible.
These issues should not invalidate the reality that providing access to health care coverage for more Americans is a good thing.
Dr. Carson's stature in the medical community makes his comments even more reckless. As a physician, he should know better. If he has problems with the ACA, he should present his issues using accurate data and facts, not baseless political ideology and foolish hyperbole.
He is allowing the reputation that he has earned based upon his stellar professional accomplishments, focus, work ethic and commitment to excellence as a surgeon to be used as a front by white ultra-conservatives. He is attempting to undermine greater access to health care and other social programs, the social safety net that is needed now more than ever before.
He's a pitiful one-man minstrel show. He's Jumpin' Jim Crow.