Healthcare for All Issues

Please check out this organization as it is working hard to stop the loss of money that should be going to patient care and quality service......

UMMSCodeRed.org is part of an effort by 1199SEIU United Healthcare Workers East to hold the University of Maryland Medical System accountable to the public

UMMS is seeking $155 million for the Upper Chesapeake Health System even as the system’s debts mount from the purchase of St. Joseph Hospital and even though UMMS has failed to build a promised hospital on the Eastern Shore. All the while, UMMS is laying off frontline caregivers.

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We need all unions on board with Expanded and Improved Medicare for All as you will be losing your health coverage soon. Do not say only single-payer because the Affordable CAre Act is making most people Medicaid for All.

In Maryland the AFL-CIO, AFSCME, and SEIU are backing Anthony Brown------who is the #1 pol behind what is the most private and profit-driven state health plan in the nation. WHY WOULD A UNION BACK A POL THAT HAS AS A GOAL ENDING PUBLIC HEALTH PROGRAMS MEDICARE AND MEDICAID EVEN AS UNION HEALTH BENEFITS ARE GOING TO BE SENT TO THESE EXCHANGES????

BLET-Kentucky State Legislative Board Endorses HR.676
Kay Tillow, All Unions Committee for Single Payer Health Care,
May 8, 2014

Bryan Aldridge, Chairman, reports that the Brotherhood of Locomotive Engineers-Kentucky State Legislative Board has endorsed HR.676, national single payer health care legislation introduced by Congressman John Conyers, Jr. The legislation is also known as “Expanded and Improved Medicare for All.” The BLET-Kentucky State Legislative Board represents approximately 900 members and 12 divisions in the State of Kentucky. The resolution affirms that BLET-KSLB “will work with other unions and community groups to build a groundswell of popular support and action for … HR.676 until we make what is morally right for our nation into what is also politically possible.” In other news, Congresswoman Janice Hahn of California’s 44th District and Tim Ryan of Ohio’s 13th District have signed on to HR.676 bringing the total to 57 in addition to chief sponsor Conyers.

HR.676 would institute a single payer health care system by expanding a greatly improved Medicare to everyone residing in the US. Patients will choose their own physicians and hospitals. HR.676 would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental (including oral surgery, periodontics, endodontics), mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care and correction, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, podiatric care, and long term care. HR 676 ends deductibles and co-payments. HR.676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs. In the current Congress, HR.676 has 57 co-sponsors in addition to Congressman Conyers.

HR.676 has been endorsed by 613 union organizations including 147 Central Labor Councils/Area Labor Federations and 44 state AFL-CIOs (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NJ, NY, NV, MA, RI, NH, ID & NM).

For further information, a list of union endorsers, or a sample endorsement resolution, contact:

Kay Tillow, All Unions Committee for Single Payer Health Care - HR.676
c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
502-636-1551

Email: nursenpo@aol.com
http://unionsforsinglepayer.org/

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Below we see a corporation wants its land for free because it will hire people to do its business. Why don't we give a local citizen that much money to build a small, local biomedical manufacturing plant to provide enough generic PHARMA to local citizens, hiring just as many people? Because Emergent, located next to Hopkins will be used to develop and market the biotech patents of Hopkins.....ie, it will be a profit-maker for Hopkins. But wouldn't it be more valuable to give away public land to a business working to supply local people with common drugs that are used every day right here in Maryland rather than yet another PHARMA manufacturer of drugs that will be sold all over the world? Did you know PHARMA manufacturing is becoming highly automated and will not bring many new jobs beyond the 100? With generic drug markets ready to explode why would we invest in yet another PHARMA manufacturer set to sell Hopkins' patents?

A generic PHARMA manufacturer would benefit tens of thousands of citizens right around Baltimore and think of the savings to have it manufactured locally? The state could even subsidize the process making generics even cheaper for the public! So, why again are we giving public land free to a business that will send most of its product away? Because it will work to profit Hopkins!

What is the Generic Pharmaceutical Manufacturing Industry?

Generic pharmaceutical and medicine manufacturers develop prescription and over-the-counter drug products that are used to prevent or treat illnesses in humans or animals. Generic drugs are produced and distributed without patent protection, and industry operators are not significantly engaged in the research and development of new drugs. The industry does not include manufacturers of nutritional supplements or cosmetic beauty products.

'Emergent wants to buy the land at a discount. The option provided for sale of the land at a price of $715,691, but the city would provide a credit of up to $245,000 for environmental analysis and remediation. The company has asked for an additional credit worth up to $250,000 if it creates 100 new jobs by the end of 2020'.

Emergent BioSolutions seeks to buy land from city for expansion Officials to vote Wednesday on sale of 8 acres in East Baltimore

By Scott Dance, The Baltimore Sun 7:21 p.m. EST, December 16, 2013

Emergent BioSolutions wants to exercise an option to buy 8 acres next to its East Baltimore manufacturing facility for an expansion that eventually could add up to 100 jobs, a company official said.

The Rockville-based biotechnology company bought its facility on East Lombard Street for $7.85 million in 2009, and has invested $50 million there since, Chief Financial Officer Bob Kramer said.

The City Council is slated to vote Wednesday on the sale of the city-owned parcel next to the facility near Johns Hopkins Bayview Medical Center.

Emergent expects to spend between $40 million and $120 million over the next decade on the campus, Kramer said. Driving the future growth is a $220 million federal contract Emergent struck last year to make flu vaccines in the case of a pandemic.

Kramer said there were no immediate plans for construction.

"We think it's important to have more space to be able to expand our presence and footprint in Baltimore long term," he said.

The company is already set to grow that footprint in Baltimore through the $222 million deal it struck last week to buy Canadian biotech company Cangene Corp., which operates a manufacturing facility in West Baltimore.

Emergent bought the facility at 5901 E. Lombard St. from the MdBio Foundation, a private charitable group that advocates for the state biotechnology industry. As part of that deal, Emergent also paid the city $415,000 to buy the 5.3 acres on which the facility sits and an option to buy the neighboring parcel at 6001 E. Lombard St.

Emergent wants to buy the land at a discount. The option provided for sale of the land at a price of $715,691, but the city would provide a credit of up to $245,000 for environmental analysis and remediation. The company has asked for an additional credit worth up to $250,000 if it creates 100 new jobs by the end of 2020.

The parcel is worth $807,000, according to state property records.

About 60 people work at the East Lombard Street facility, where Emergent makes components of a cancer drug called otlertuzumab.

The company is still in the process of evaluating what improvements it might need to comply with the flu vaccine contract, Kramer said. The contract requires that Emergent be able to produce 50 million doses within a matter of months.

The company should have a better understanding of its possible needs for new construction, as well as possible opportunities through the Cangene deal, in the coming months, Kramer said.

The Cangene facility, in the Carroll-Camden industrial area, performs contract manufacturing. It adds the capability for final filling and preparation of biopharmaceutical products — something Emergent now lacks, he said.

That capability could save Emergent money in producing one of its key products: BioThrax, a vaccine for anthrax disease. The company makes the vaccine in large batches in a Michigan facility, but has to hire a third-party manufacturer to fill vials for sale to customers, Kramer said.

Emergent made $13.5 million in profit on $89.1 million in revenue in the quarter that ended Sept. 30. Its stock price has surged since it announced the Cangene deal, from $21.31 on Dec. 11, the day before the deal was announced, to $22.92 at the close Monday.

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We thank Dr Naumberg for shouting for Expanded and Improved Medicare for All.

Market Place Money stated clearly today the goal of Affordable Care Act. They said that Clinton and Obama have made a single-payer system.....Medicaid for All. Indeed that is what state health systems are, a way to move Federal entitlements to states along with state and city public sector health plans where they will be basically Medicaid level of care. Most people now are close enough to poverty to meet that level of care. This is a corporate wealth and profit reform and is all about maximizing health institutions wealth by limiting people's access to care. Did you know funding for Medicaid was gutted by Congress and again by MD Assembly and funding is so low as to make it a public health checkup?

You will hear pols calling the ACA single-payer because everyone is falling into a Medicaid level of care. What citizens of MD want is Expanded and Improved Medicare for All----don't let pols fool you, this is a matter of life and death!

On health care, President Obama put his faith in a house of cards [Letter]

12:00 p.m. EST, November 27, 2013 Baltimore Sun

President Obama is reaping what he sowed by relying on the health insurance industry when he promoted the Affordable Care Act ("As president grovels, politics of Obamacare get worse," Nov. 19).

The health insurers literally wrote the law, in the person of Liz Fowler, a former vice president at WellPoint, and they clearly know Obamacare better than the president, whose ill-fated promise about keeping your health insurance if you are happy with it blew up in his face.

But the reality is that the American public never wanted their favorite health insurance plan. What they want is affordable, accessible health care. In fact, a majority of Americans want a government-funded health-care system similar to traditional Medicare.

The complexity of the Affordable Care Act undoubtedly contributed to its difficult launch. But the real weakness of the law is that once you have health insurance you still are not protected from bankruptcy due to illness, nor are you guaranteed access to the doctor and hospital of your choice.

We need a humane health-care system, not a profit-driven one. In a rich country like America, health care should be a right, not a privilege.

If we expanded traditional Medicare to cover everyone, there would be no need to figure out if you can afford a bronze, silver, gold or platinum plan; instead there'd be one standard of care for everyone.

Dr. Eric Naumburg

The writer is co-chair of the Maryland Chapter of Physicians for a National Health Plan.

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Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes

By Anna Gorman and Julie Appleby Kaiser Health News

KHN Staff Writers

Oct 21, 2013

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

The main reason insurers offer is that the policies fall short of what the Affordable Care Act requires starting Jan. 1. Most are ending policies sold after the law passed in March 2010. At least a few are cancelling plans sold to people with pre-existing medical conditions.

By all accounts, the new policies will offer consumers better coverage, in some cases, for comparable cost -- especially after the inclusion of federal subsidies for those who qualify. The law requires policies sold in the individual market to cover 10 “essential” benefits, such as prescription drugs, mental health treatment and maternity care. In addition, insurers cannot reject people with medical problems or charge them higher prices. The policies must also cap consumers’ annual expenses at levels lower than many plans sold before the new rules.

But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them.

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

An estimated 14 million people purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices.

Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.

Some Policies Targeted

Both Independence and Highmark are cancelling so-called “guaranteed issue” policies, which had been sold to customers who had pre-existing medical conditions when they signed up. Policyholders with regular policies because they did not have health problems will be given an option to extend their coverage through next year.

Consumer advocates say such cancellations raise concerns that companies may be targeting their most costly enrollees.

They may be “doing this as an opportunity to push their populations into the exchange and purge their systems” of policyholders they no longer want, said Jerry Flanagan, an attorney with the advocacy group Consumer Watchdog in California.

Insurers deny that, saying they are encouraging existing customers to re-enroll in their new plans.

“We continue to cover people with all types of health conditions,” said Highmark spokeswoman Kristin Ash.

She said some policyholders who may have faced limited coverage for their medical conditions will get new plans with “richer benefits” and the policies “in most cases, will be at a lower rate.”

Paula Sunshine, vice president of marketing with Independence, said the insurer hopes the cancelled policyholders will “choose Blue when they decide on a new plan.”

Higher Costs?

Some receiving cancellations say it looks like their costs will go up, despite studies projecting that about half of all enrollees will get income-based subsidies.

Kris Malean, 56, lives outside Seattle, and has a health policy that costs $390 a month with a $2,500 deductible and a $10,000 in potential out-of-pocket costs for such things as doctor visits, drug costs or hospital care.

As a replacement, Regence BlueShield is offering her a plan for $79 more a month with a deductible twice as large as what she pays now, but which limits her potential out-of-pocket costs to $6,250 a year, including the deductible.

“My impression was …there would be a lot more choice, driving some of the rates down,” said Malean, who does not believe she is eligible for a subsidy.

Regence spokeswoman Rachelle Cunningham said the new plans offer consumers broader benefits, which “in many cases translate into higher costs.”

“The arithmetic is inescapable,” said Patrick Johnston, chief executive officer of the California Association of Health Plans. Costs must be spread, so while some consumers will see their premiums drop, others will pay more -- “no matter what people in Washington say.”

Health insurance experts say new prices will vary and much depends on where a person lives, their age and the type of policy they decide to buy. Some, including young people and those with skimpy or high-deductible plans, may see an increase. Others, including those with health problems or who buy coverage with higher deductibles than they have now, may see lower premiums.

Blue Shield of California sent roughly 119,000 cancellation notices out in mid-September, about 60 percent of its individual business. About two-thirds of those policyholders will see rate increases in their new policies, said spokesman Steve Shivinsky.

Like other insurers, the Blue Shield letters let customers know they have to make a decision by Dec. 31 or they will automatically be enrolled in a recommended plan.

“There is going to be a certain amount of churn in the marketplace as people have to make their decisions,” Shivinsky said.

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THAT'S FOR SURE.....but remember, the ACA is only about consolidating health institutions into global corporations like they did with the banks.....it is all about maximizing profits at the people's expense!

Single Payer Advocate Quentin Young: Passing Obamacare Worse than Doing Nothing Passing Obamacare was worse than doing nothing and the legislation should have been defeated.

That’s the conclusion of single payer advocate Dr. Quentin Young, national coordinator for Physicians for a National Health Program (PNHP), in his just released autobiography – Everybody In, Nobody Out: Memoirs of a Rebel Without a Pause.
This policy memo explores the economic implications of enacting the Maryland Health Security Act (MHSA) and establishing the Maryland Health System Trust (MHST) a single-payer system to finance health care in Maryland. The proposed trust would finance virtually all necessary medical care including hospital care, doctor visits, dental care, mental health, prescribed occupational and physical therapy, prescription drugs, medical devices as well as medically necessary nursing home care and home health care. Medical care would be financed through the MHST without co-payments or deductibles.

The MHST will finance medical care with substantial savings compared with the existing multi-payer system of public and private insurers. Some of these savings would be used to extend coverage to the 15 percent of nonelderly adults in Maryland without insurance and to improve coverage for the growing number with inadequate coverage. In addition to improving access to health care, the MHST would reduce economic inequality by replacing the current regressive system of health insurance finance with progressive and proportional taxes. By reducing administrative and other waste, the MHST would increase real disposable income for most Maryland residents while reducing the burden of health care on Maryland businesses.

Financing the Maryland Health Security Act (31 pages):
http://www.md.pnhp.org/docs/Maryland-single-payer-study.pdf

House Bill 1035 - Maryland Health Security Act of 2011:
http://mlis.state.md.us/2011rs/billfile/hb1035.htm

Comment: By Don McCanne, MD

Many proposals have been advanced and bills introduced for single payer programs. Perhaps the most frequent question asked is, "How would you pay for it?" The general answer is easy. You simply use progressive tax policies to fund a universal risk pool that pays for all appropriate care for everyone. Most people want specifics. In this report, Professor Gerald Friedman describes a financing proposal for the Maryland Health Security Act of 2011, a single payer model of reform.

As with all other single payer proposals, he reaches the conclusion that the substantial savings of the single payer model could be used to extend coverage to the uninsured and to improve coverage for the growing number with inadequate coverage. This would increase disposable income for most residents and reduce the burden of health care costs on Maryland businesses.

Friedman also provides a graph projecting three scenarios for Maryland health expenditures for the next decade: 1) the existing health care finance system, which we all know is terribly inflationary, 2) growth under the Affordable Care Act, which is much worse (since this is the most expensive model of reform), and 3) growth under single payer, which is dramatically reduced - bringing cost escalation down to tolerable levels - truly "bending the curve."

One important footnote in his report should be mentioned: "We assume that all necessary federal waivers are granted and legislation is enacted to allow the incorporation of existing federal programs into the MHST (Maryland Health System Trust), including Medicare, Medicaid, and the Veteran’s Administration." We might add to that legislation addressing the preemption clause for self-insured, employer-sponsored plans under the federal Employee Retirement and Income Security Act of 1974 (mentioned in the fiscal and policy note for HB 1035).

Activists should continue to support state efforts for single payer reform while simultaneously supporting enabling federal legislation, for the reasons mentioned. The former is not possible without the latter. A far better option would be to enact a national single payer program, but until we can bring sanity to our political process, state single payer reform should be pursued.

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IT MATTERS WHO IS ELECTED GOVERNOR AND MAYOR AS THEY APPOINT ALL THE HEADS OF DEPARTMENTS AND AGENCIES. MARYLAND IS A CORPORATE STATE BECAUSE OF THIS. STOP LETTING THESE NEO-LIBERAL POLITICAL MACHINES CHOOSE WHO YOUR CANDIDATE WILL BE! All governor candidates and MD AG candidates are neo-liberal incumbents!

RUN AND VOTE FOR LABOR AND JUSTICE IN ALL PRIMARY ELECTIONS! CORPORATIONS ARE WRITING YOUR HEALTH CARE LAWS!

As the Affordable Care Act goes into affect we need to look at what is happening with public justice in health care issues. I spoke of the lowering level of access to care, the lowering level of training health employees are getting, the staffing shortfalls placing stress and impossible task assignments on these health workers. Now, we have corporate universities working to patent medical research for profit and universities are of course the ones that in the past would provide the oversight to corporate R and D to see it worked in the public interest. Now, universities are the corporate R and D. With Federal agencies like the FDA and OSHA operating like the SEC in that they are now a skeleton crew that tends to do the bidding of the corporations they are supposed to monitor......NO ONE IS LOOKING OUT FOR THE PUBLIC PERIOD.....BUT ESPECIALLY IN HEALTH CARE. In Maryland, those responsible for creating the health care structures for this reform are dismantling even the state and local public health agencies that would have given oversight for the public. This at a time when they are handing all of health care over to private non-profits and national health chains all rife with patient abuse, malpractice, fraud, and lack of transparency. SOUND LIKE A GOOD REFORM FOR THE PEOPLE? OF COURSE NOT----IT IS HORRIBLE!

Below you see who is responsible state and locally for these appointments to agencies making these changes. Whether it is the state court ruling in corporation's favor over individuals or the legislators writing the law, MD is a great, big, fat corporate state and its incumbents make it that way. My district is filled with Johns Hopkins pols that make health care a profit industry at our expense. Baltimore has the worst in health fraud, health access, and lack of oversight and its pols all work to see this stays as the status quo. WE WANT THE ASSEMBLY TO WRITE A WELL-DEFINED CORPORATE FRAUD LAW!!!!!! I said to Mary Washington right after the crash. 'Oh', she said......' I don't think THEY would like that'. I said------MARY, YOU DO NOT WORK FOR HOPKINS, YOU WORK FOR THE PEOPLE WHO ELECT YOU! She ran off at just the thought!

LOOK AT PETER FROSH WHO IS RUNNING FOR STATE ATTORNEY GENERAL----APPOINTING THE JUDGES THAT ARE OVERWHELMINGLY VOTING FOR CORPORATE INTEREST!

WE CAN REVERSE ALL OF THIS CORPORATE CAPTURE IN MARYLAND IF WE SHAKE THE BUGS FROM THE RUG AND RUN AND VOTE FOR LABOR AND JUSTICE IN ALL PRIMARIES!

Below you see the Baltimore City pols that approve the governor's appointments to all kinds of government positions. Placing an energy executive on the MD Public Service Commission? Fill the MD Depart of Education with education privatizers? Appoint the heads of Depart of Health that are privatizing all public health and creating private health systems? THESE ARE THE PEOPLE. YOU CAN SEE THAT MOST OF THE POLS IN THE CHARLES VILLAGE DISTRICT OF JOHNS HOPKINS ARE THE ONES DOING ALL OF THESE NEO-LIBERAL APPOINTMENTS THAT GIVE PROFIT OVER PEOPLE! Look as well at FROSH-----looking to be State Attorney General!

This is why Maryland is so corporate and all of its laws and the higher court almost always protects profit over people! STOP ELECTING THESE NEO-LIBERALS! RUN AND VOTE FOR LABOR AND JUSTICE CANDIDATES IN ALL PRIMARIES!

Executive Nominations Committee (NOM)

Examines all nominations for appointments made by the Governor that require Senate

confirmation. The committee reports its recommendations to the Senate, which

subsequently votes to confirm or reject the nominees.

2 East, Miller Senate Building, Annapolis, MD 21401

(410-946-5200 Annapolis/Baltimore or 301-970-5200 Washington, D.C.)

Chair: Delores G. Kelley Vice Chair: James E. DeGrange, Sr. David R. Brinkley Edward J. Kasemeyer
Richard F. Colburn Allan H. Kittleman Joan Carter Conway Katherine Klausmeier George C. Edwards Nathaniel J. McFadden Jennie M. Forehand Thomas M. Middleton Brian E. Frosh Thomas V. Mike Miller, Jr. Rob Garagiola E. J. Pipkin Norman R. Stone, Jr.

Rules and Executive Nominations Committee (HRU)

Room 145, House Office Building, Annapolis, MD 21401

(410-841-3927 Annapolis/Baltimore or 301-858-3927 Washington, D.C.)

Chair: Hattie N. Harrison Vice Chair: Rudolph C. Cane Elizabeth Bobo Wade Kach
Talmadge Branch James E. Malone, Jr. Norman H. Conway Maggie McIntosh Dereck E. Davis
LeRoy E. Myers, Jr. Kathleen M. Dumais Anthony J. O’Donnell Brian J. Feldman Shane E. Pendergrass Jeannie Haddaway-Riccio James E. Proctor, Jr. Peter A. Hammen Samuel I. Rosenberg Sheila E. Hixson David D. Rudolph Carolyn J. B. Howard Nancy R. Stocksdale Adrienne A. Jones Joseph F. Vallario, Jr.

As we watch neo-liberals lowering the level and quality of care most people receive we are seeing laws that protect public justice over health malpractice being dismantled. So, health malfeasance will soar with the health reform and protections of people disappear. Neo-liberal Maryland is ground zero for this! The Maryland Assembly works hard to make sure the public does not take away an corporate profit....health care included.

Below you see the start of medical clinical trials being replaced by the 'THROW IT OUT THERE AND SO WHAT IT DOES' approach to new medical developments. So, instead of studying a new procedure with controlled and supervised clinical trials, the FDA simply approves a drug/procedure using the companies research results to justify safety concerns. This started in the Clinton Administration and is part of the COST BENEFIT ANALYSIS that says policy should not cut into corporate profits embraced by neo-liberals like Clinton and now Obama.

What this says is that because the FDA OK'ed the use of this drug in 1999, but then found in 2011----twelve years later (the normal length of a clinical trial)....that it looked to increase bladder cancer, people dying from exposure to this drug have no recourse. Mind you that the FDA is still doing this---Obama and neo-liberals have not changed the FDA's oversight and using corporate research to approve usage.

For those in Maryland it gets even worse because Maryland works hard to protect profit over people it has a law called CONTRIBUTORY NEGLIGENCE barring recovery of money in a tort lawsuit. So, the family whose loved one died from bladder cancer in Maryland taking this drug will have the corporate lawyers saying that because this man smoked ( the contributory negligence) the bladder cancer could have come from that even though ACTOS has been identified as causing this cancer. Just think how many things can be used for Contributory Negligence-----smoking, drinking, bad eating habits, air pollution.
JUST ABOUT ANYTHING.

Contributory Negligence in Maryland
December 28, 2011 By mdlawyer

Maryland is one of only four states that recognize contributory negligence in personal injury claims. Contributory negligence means that you have contributed, in some way, to your injury. If you have contributed to your personal injury you are not permitted to recover any damages for the injury. This means that if you are only one percent liable, while the other party is 99 percent responsible, you cannot recover any money for medical bills, lost wages, pain and suffering, or anything else. Most other states recognize comparative negligence, which is where the fault of both parties is looked to in order to determine what amount of damages is fair for the injured party to receive. A Maryland accident attorney can help you to determine if you will be able to recover for a personal injury.
'For now, however, any plaintiff whose own negligence contributes to his or her injury is completely barred from recovery. The Court of Appeals has spoken, and contributory negligence remains the law in Maryland'.
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We were told several weeks ago that the Obama Administration had cut the USDA inspection of poultry so severely that one inspector would be responsible for inspecting a processing line of chicken carcasses passing by at the speed of light. Basically, inspections are not happening at all with US meat processors. That is happening because in order for global meat sellers to COMPETE with other global third world meat sellers the US must end all first world public protections.

THIS IS DONE AS PART OF THE TPP----PUBLIC HEALTH IS A DRAG ON CORPORATE PROFIT AND MUST GO SAY NEO-LIBERALS.

HOW WILL YOU PAY FOR MULTIPLE TRIPS TO THE DOCTOR FROM CONSTANT FOOD POISONING? YOU WILL NOT!

USDA to Let Industry Self-Inspect Chicken Email 38 Smaller Font Text Larger Text | Print By Jim Avila
@JimAvilaABC
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Apr 18, 2012 3:11pm Image Credit: Scott Sinklier/AgStock Images/Corbis

Chicken is the top-selling meat in the United States. The average American eats 84 pounds a year - more chicken than beef or pork. Sorry red meat, chicken is what’s for dinner.

Now, the USDA is proposing a fundamental change in the way that poultry makes it to the American dinner table.

As early as next week, the government will end debate on a cost-cutting, modernization proposal it hopes to fully implement by the end of the year – a plan that is setting off alarm bells among food science watchdogs because it turns over most of the chicken inspection duties to the companies that produce the birds for sale.

The USDA hopes to save $85 million over three years by laying off 1,000 government inspectors and turning over their duties to company monitors who will staff the poultry processing lines in plants across the country.

The poultry companies expect to save more than $250 million a year because they, in turn, will be allowed to speed up the processing lines to a dizzying 175 birds per minute with one USDA inspector at the end of the line.

Currently, traditional poultry lines move at a maximum of 90 birds per minute, with up to three USDA inspectors on line.

Whistleblower inspectors opposed to the new USDA rule say the companies cannot be trusted to watch over themselves. They contend that companies routinely pressure their employees not to stop the line or slow it down, making thorough inspection for contaminants, tumors and evidence of disease nearly impossible.

“At that speed, it’s all a blur,” one current inspector tells ABC News.

“I think that there needs to be a critical evaluation of this program,” said Amanda Hitt, director of the Food Integrity Campaign, an organization that empowers industry whistleblowers and citizen activists. “People need to have an opportunity to question some of these results and different things that the agency is coming up with in regard to the safety of this program.

“We’re listening to the people that are actually doing [the inspections] and they’re saying unequivocally the traditional inspection produces higher quality and safer poultry,” Hitt said.

According to OMB Watch, a government accountability organization, cutbacks at the USDA have coincided with a significant rise in salmonella outbreaks. The group says 2010 was a record year for salmonella infection and 2011 saw 103 poultry, egg and meat recalls because of disease-causing bacteria, the most in nearly 10 years.

The USDA, which has been running a pilot program of the changes in 20 U.S. poultry plants, says the new system is not about cost-cutting, but about bringing food safety up to date.

“You can’t see pathogens. You can’t see campylobacter,” Alfred Almanza, administrator of the U.S. Department of Agriculture’s Food Safety Inspection Service, told ABC News.

The USDA admitted the new system does not employ more lab tests that can see salmonella and other bacteria.

Critics said some companies are not to be trusted when it comes to testing because they cheat the system by rigging the test.

“We do not have evidence of that,” Almanza said. “But when we’re told of anything of that nature we take those allegations seriously.”

Watchdog groups insist a combination of increased testing and government inspection is needed to lower salmonella and other disease outbreaks from chicken.

“The proposed inspection system will better protect the public from foodborne illnesses by reducing reliance on old-fashioned visual and sensory inspection and moving to prevention-oriented inspection systems based on actual risk to consumers,” Ashley Peterson, vice president of science and technology at the National Chicken Council, said in a statement. “It is the goal and primary focus of the chicken industry and USDA alike to provide consumers with safe, high-quality and wholesome chicken. This proposed rule does not change that goal.”

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Below you see how Maryland is among 4 states in the country that keeps this law that makes it almost impossible to sue a business for damages. Remember, it is also the only state that opts out of Medicare requirements that keep Medicare oversight away.

WHEN IT COMES TO OVERSIGHT ----MARYLAND HAS EVERY BASE COVERED----LITERALLY!

Commentary: Contributory Negligence Remains the Law in Maryland

By James P. Steele and Andrew M. Williamson | August 6, 2013

On July 9, 2013, Maryland’s highest appellate court, the Court of Appeals, declined to abandon the longstanding common law doctrine of contributory negligence, which is a complete bar to recovery for any plaintiff whose negligence contributes to his or her injuries.

In Coleman v. Soccer Association of Columbia, a case that had been highly anticipated by Maryland’s legal community, the Court affirmed that it had the power to adopt comparative negligence as the law in Maryland but elected not to do so.

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Click Here to Learn More.In comparative negligence jurisdictions, a plaintiff recovers only for those damages for which he or she is not responsible. The 15 page opinion was accompanied by a 51 page dissent and a 4 page concurrence.

The case arose as a result of injuries sustained by James Kyle Coleman, “an accomplished soccer player who had volunteered to assist in coaching a team of young soccer players in a program of the Soccer Association of Columbia (Association), in Howard County, Maryland.”

When evaluating the insured’s liability, insurers can continue to consider whether a plaintiff’s own negligence contributed to the alleged injuries, creating a complete bar to recovery. During a team practice, Coleman jumped up and grabbed the crossbar of a goal. The crossbar was not anchored to the ground, and Coleman fell backwards, “drawing the full weight of the crossbar onto his face.”

Coleman’s injuries included facial fractures that required three titanium plates in his face. Coleman sued the Association, which asserted contributory negligence as a defense.

At trial, the parties offered differing testimony about what, if any, duty the Association owed Coleman and whether Coleman’s injuries were caused solely by his own negligence. The Association’s evidence showed that it neither owned nor provided the goal in questions, and that the goal was not in an area that the Association controlled.

The Association also offered evidence that the goal’s condition was open and obvious and that Coleman was responsible for his own injuries. Coleman disputed this, arguing further that it is common for players to hang from crossbars, and the Association should have anticipated this and anchored it properly.

At the close of evidence, Coleman submitted a jury instruction on comparative negligence, which the judge declined to give to the jury.

The jury found that the Association’s negligence was a cause of Coleman’s injuries, but that Coleman’s own negligence also contributed to his injuries. Under Maryland’s doctrine of contributory negligence, Coleman was completely barred from recovery. The trial court denied Coleman’s motion for judgment notwithstanding the verdict and entered judgment in the Association’s favor.

The Court of Appeals agreed to hear the case before it was briefed and argued at Maryland’s intermediate appellate court, the Court of Special Appeals.

Coleman’s sole issue on appeal was whether the Court of Appeals “should retain the standard of contributory negligence as the common law standard governing negligence cases,” in Maryland.

The Court of Appeals answered this question by noting that it “has the authority to change the common law rule of contributory negligence,” but it declined to abrogate this “long-established common law principle….”

Judge John C. Eldridge (Retired, Specially Assigned), who wrote the opinion, revisited the last time the issue of whether to replace contributory negligence with comparative negligence was before the Court.

In Harrison v. Montgomery County Bd. Of Educ., 295 Md. 442, 464, 456 A.2d 894 (1983), the Court ruled that contributory negligence remained the law in Maryland and that “any change in that established doctrine [was for] the Legislature.”

In Harrison, the Court reviewed the historical origins of contributory negligence, including early English cases. The Harrison Court noted that early American courts adopted contributory negligence because of concerns that high jury awards would stifle emerging industries.

Early courts also were wary of rewarding people who suffer injuries as a result of their own wrongdoing. Relying on these concepts, Maryland first adopted contributory negligence in an 1847 case, Irwin v. Sprigg, 6 Gill. 200, 205. (Maryland later modified the doctrine to note exceptions for injured persons under 5 years old and if the defendant could have exercised sufficient care to avoid the consequences of plaintiff’s carelessness.)

The Harrison court noted that in the early 20th century, Maryland’s legislature adopted comparative negligence for “certain perilous occupations,” but later repealed those provisions. In 1983, 31 of the 39 states that had adopted comparative negligence did so by statute.

While acknowledging that the trend favored adopting comparative negligence, the Harrison court noted that there are different versions and it is best to have the legislature decide which version, if any, to adopt.

The court also invoked the legal doctrine of stare decisis as weighing in favor of leaving contributory negligence as the law in Maryland absent legislative action.

Judge Eldridge noted that since Harrison, Maryland’s “General Assembly has continually considered and failed to pass bills that would abolish of modify the contributory negligence standard.”

This failure to act legislatively is “a clear indication of” and “very strong evidence that” the legislative policy in Maryland is to retain contributory negligence. Courts should not change common law contrary to Maryland’s public policy as set forth by the General Assembly.

In the concurring opinion, Judge Clayton Greene noted additional problems that would arise were the Court to throw out contributory negligence and adopt comparative negligence. How would it apply in cases of multiple tortfeasors? How would it impact the concept of joint and several liability? Would it destroy the viability of the Uniform Contribution Among Joint Tort-Feasors Act? Would it abolish the doctrines of last clear chance and assumption of the risk?

These questions, and the question of which version of comparative negligence to adopt, are best suited for the General Assembly to decide, in Judge Greene’s view.

Judge Glenn T. Harrell, Jr., in dissent, compared contributory negligence to a dinosaur that, in his view, the Court should have rendered extinct.

Judge Harrell invoked long standing criticism of the “all-or-nothing consequences” of contributory negligence. Citing many legal commentators, Judge Harrell called for a comparative negligence system that “apportions damages between a negligence plaintiff and negligent defendant according to each party’s relative degree of fault.” Ultimately, Judge Harrell would prefer adoption of pure comparative negligence.

Judge Harrell noted that even at the time Harrison was decided, the Court of Appeals recognized that jurisdictions that had transitioned from contributory negligence to comparative negligence did so with little difficulty.

Further, none of the judges on the Court of Appeals disputed that the Court had the power to make the change. Judge Harrell was unconvinced that stare decisis was sufficient reason to refrain from making the change and believed that the court need not defer to legislative inaction.

Judge Harrell wrote the dissent hoping that a future majority of the Court of Appeals would rely on it to abolish contributory negligence and adopt comparative negligence.

Coleman has implications for insurers and insureds alike. Insurers will not face the increased litigation that may have accompanied a switch to comparative negligence as Maryland sorted out implementing this new law.

When evaluating the insured’s liability, insurers can continue to consider whether a Plaintiff’s own negligence contributed to the alleged injuries, creating a complete bar to recovery. Further, the specter of a defense verdict based on the Plaintiff’s negligence can be useful to insurers during settlement negotiations.

Insureds remain able to avoid adverse liability findings for their negligence, but they also continue to risk looking like they are “blaming the victim” when they rely on contributory negligence as a defense.

It remains to be seen how, if at all, this opinion spurs any legislative action in the General Assembly to change Maryland to a comparative negligence jurisdiction.

For now, however, any plaintiff whose own negligence contributes to his or her injury is completely barred from recovery. The Court of Appeals has spoken, and contributory negligence remains the law in Maryland.
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THESE ARE THE MARYLAND COURT OF APPEALS APPOINTMENTS MADE DURING O'MALLEY'S TERM AS GOVERNOR-----they all voted for corporate interests. It was Glendening's appointments that called this law a dinosaur!

Shirley M. Watts, 6th Appellate Judicial Circuit. Appointed July 3, 2013. Sworn in July 31, 2013, to replace Robert M. Bell, who retired July 6, 2013.
Mary Ellen Barbera, 7th Appellate Judicial Circuit. Appointed Chief Judge July 3, 2013. Sworn in July 8, 2013, to replace Robert M. Bell, who retired July 6, 2013.
Robert N. McDonald, 2nd Appellate Judicial Circuit. Appointed Dec. 22, 2011. Sworn in Jan. 24, 2012, to replace Joseph F. Murphy, Jr., who retired Sept. 30, 2011.
Mary Ellen Barbera, 7th Appellate Judicial Circuit. Appointed Aug. 7, 2008. Sworn in Sept. 2, 2008, to replace Irma S. Raker, who retired April 24, 2008.
Sally D. Adkins, 1st Appellate Judicial Circuit. Appointed May 27, 2008. Sworn in June 25, 2008, to replace Dale R. Cathell, who retired July 30, 2007.
Joseph F. Murphy, Jr., 2nd Appellate Judicial Circuit. Appointed Dec. 4, 2007. Sworn in Dec. 17, 2007,

Harrell noted that only Maryland, Virginia, Alabama, North Carolina and the District of Columbia still have the law.
Judge Glenn Harrell, writing in dissent along with recently retired Judge Robert Bell, compared the law to “a dinosaur.”
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The federal Food and Drug Administration approved the drug in 1999 to treat type 2 diabetes, and it became the diabetes drug of choice in 2007 after GlaxoSmithKline’s Avandia was linked to a higher risk of heart attack. However, the FDA released a safety advisory on June 15, 2011, stating that using Actos for more than one year “may be associated with an increased risk of bladder cancer.”

Tuesday, September 3, 2013 Volume 124 | Number 229 Online at TheDailyRecord.com

Actos trial set for Md.

In first case to go to jury, Calif. judge set aside April verdict of $6.5 million
BYSTEVELASHSteve.Lash@TheDailyRecord.com

Jury selection is scheduled to begin Tuesday in a Baltimore family’s $10 million wrongful death lawsuit against the maker of the prescription diabetes medication Actos. Diep An’s widow and three children allege An died because Takeda Pharmaceuticals U.S.A. Inc. and its affiliates did not meet its legal duty to warn doctors and patients that longterm use of the drug could cause bladder cancer. Diep An, who began taking Actos in 2007 for type 2 diabetes, died on Jan. 14, 2012. Takeda denies the family’s allegations and said it plans to mount a strong defense of Actos during what attorneys expect will be a four-week jury trial before Judge M. Brooke Murdock in Baltimore City Circuit Court. Last April, in the first Actos trial to go to verdict, a California state jury awarded the plaintiffs $6.5 million. However, the judge in the case threw out the verdict in May, ruling there was insufficient evidence to link plaintiff Jack Cooper’s bladder cancer to his use of Takeda’s drug. The Deerfield, Ill.-based company is also fighting similar claims elsewhere, including more than a thousand in actions that were filed in federal courts nationwide and consolidated in the U.S. District Court in western Louisiana. “Takeda is confident in the therapeutic benefits of Actos and its importance as a treatment for type 2 diabetes,” Kenneth D. Greisman, Takeda Pharmaceuticals U.S.A. Inc.’s general counsel, said in a statement. “We have empathy for the plaintiff, but Takeda believes that we acted responsibly with regard to Actos,” Greisman added. “Patient safety is a critical priority for Takeda and we intend to vigorously defend Takeda against these lawsuits.” Failure to warn claim Actos has had a checkered history. The federal Food and Drug Administration approved the drug in 1999 to treat type 2 diabetes, and it became the diabetes drug of choice in 2007 after GlaxoSmithKline’s Avandia was linked to a higher risk of heart attack. However, the FDA released a safety advisory on June 15, 2011, stating that using Actos for more than one year “may be associated with an increased risk of bladder cancer.” That same month, Germany and France suspended distribution of the drug due to its suspected link to bladder cancer. In its lawsuit, the An family claims that Takeda knew of the drug’s risks before it was prescribed to Diep but did not warn him or his doctors. The Takeda companies “concealed and continued to conceal their knowledge of Actos’ unreasonably dangerous risks from Diep An, his physicians, other consumers and the medical community,” the complaint states. “Specifically, defendants failed to adequately inform consumers and the prescribing community about the risk of bladder cancer associated with the use of Actos,” the lawsuit adds. “Diep and his physicians would not have used Actos had defendants properly disclosed the risks associated with its long-term use.” The family’s failure to warn claim is one of several related allegations it makes against Takeda. The lawsuit also alleges design and manufacturing defects in the drug, as well as breaches of express and implied warranties of safety by the company. Stuart Simms, an attorney for the family, declined to comment on the coming trial beyond citing the papers filed with the court since the initial filing on June 8, 2012. “From all parties and all sides it would be inappropriate to comment prior to commencement” of the trial, said Simms, of Brown Goldstein Levy LLP. The Baltimore law firm is serving as co-counsel in the case, which was filed by attorney Michael J. Miller of The Miller Firm LLC in Orange, Va. The firm was also on Cooper’s legal team in the California litigation. The An family’s claim is one of at least three similar lawsuits that have been filed against Takeda in state and federal courts in Maryland. On March 2, 2012, the estate and family of John Dunlavey Sr. filed suit

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Why is a state so blue so desperate to avoid public hospitals? MD is not blue....it is corporate and having private and non-profit hospitals rather than public keeps the public from oversight and enforcement as well as accessing data. We watch as public money goes to private Johns Hopkins for dispersal for instance. What you get are health institutions built by Hopkins that are basically extensions of this private institution. Hopkins has built itself into a global presence with taxpayer money and controls Baltimore because of its ability to control the money coming in for services. Hopkins made itself the public sector.

This is why MD went with private health systems and not public/Universal Care. As people are beginning to see, the Affordable Care Act will greatly reduce people's access to ordinary hospital care and it is all done to maximize health industry profits. What we want is Universal Care or expanded and enhanced Medicare for All so that everyone will have the same health care access. Health costs are driven by health fraud and profiteering, not patient's use of health care. In MD we lose billions of dollars each year to health fraud and these private non-profits are ground zero for this. Now, we have national health chains coming for the poor and elderly already rife with fraud.

We do not want releases from Medicare rules..we want Medicare to rule!

State releases new plan on Medicare waiver

By Andrea K. Walker, The Baltimore Sun 12:12 p.m. EDT, September 27, 2013

The way hospitals do business would get a complete overhaul under a plan proposed by state health officials that they hope to test for five years.

The plan released by the Maryland Department of Health and Mental Hygiene Friday would tie hospital spending to the state economy and virtually eliminate a payment model based mostly on how many patients the medical facilities treat.

The proposal is part of an application that must be approved by the federal Centers for Medicare and Medicaid Services to update the state's Medicare waiver, an agreement with the federal government unique to Maryland that allows the state to set hospital rates.

The proposal is updated from one that state officials first presented in February that brought criticism from hospitals and insurance companies that complained it lacked details.

The state then formed a committee that included hospitals and insurers to provide their input. The trade association that represents the hospitals supports the revised proposal.

"The goals will be very challenging for hospitals as the ideas included have never been tried nor tested before on this scale," said Carmela Coyle, President and CEO of the Maryland Hospital Association. "Hospitals will have to find ways to provide care at a lower cost than today." PROFITS NOT PEOPLE FOR SURE!

The new proposal includes more specifics, including the exact amount of spending increases hospitals would be allowed.

The 36-year-old waiver creates a system in which insurers pay the same cost to all hospitals for procedures, and funds uncompensated care so there is no need for public hospitals. But the state has had a hard time meeting waiver test that requires it to show Medicare costs grow more slowly than the rest of the country.

State health officials said its plan would result in the state's Medicare costs growing $330 million less than that of the rest of the country in five years.

But they acknowledge the plan is innovative and they want to put a date limit on it to see if it works. If the plan does not seem to be working, the state will move to the same Medicare model as the rest of the country, according to the proposal.

Rather than basing rates on Medicare cost per admission, the new plan is population-based. It would cap hospital spending to 3.58 percent in the first three years — the year-over-year growth rate over the last decade.

The plan calls for reducing costs by working on reducing admissions and implementing programs that focus more on preventive care, such as the use of accountable care organizations, where groups of doctors, hospitals, and other health care providers coordinate the care of patients.

The state says the waiver test is based on an old health care model that focuses on inpatient hospital stays. Health care is moving toward a model of keeping patients out of the hospital by providing sufficient preventive and outpatient care.

The plan still must be approved by the Centers for Medicare and Medicaid Services. The state is also taking public comments on the proposal through Oct. 7.

________________________________________________________________________
Wouldn't it be better if O'Malley simply reinstate Rule of Law and follow the public money that is supposed to give health care to the poor and mentally ill, to the old and young and end the massive fraud that takes 1/2 of all taxpayer money sent for health care in these groups?

Maryland has a history of underfunding all social programs and then allowing what little it sends to be lost to fraud and corruption. Whether the poor dying 20-30 years earlier than others from lack of access to care or whether Veterans who have to deal with a VA hospital worst in the nation, you can bet theat mental health facilities are grossly underfunded and unable to operate.

Do you hear a repeated pattern in all administrative issues regarding the government in MD? Remember, MD is one of the richest states in the nation so it is not the lack of funding....it is the lack of funding making it to the operation before it goes into someone's pocket....ergo, the wealth inequity in the state.

We need MD citizens to shake these corporate pols out of the rug..they are only working for wealth and profit. A democrat does not allow these conditions to be systemic at huge expense to the people. Whether repub or dem....incumbents need to go! Rule of Law needs to be reinstated in MD so fraud and corruption in the state stops the short-changing of social programs and undermines quality of life for everyone!

Salisbury hospital laying off 58; offering buyouts Peninsula Regional Medical Center says it is treating fewer patients By Andrea K. Walker, The Baltimore Sun 2:17 p.m. EDT, September 18, 2013

Peninsula Regional Medical Center announced Wednesday that it will lay off 58 employees and offer buyouts to 130 as the number of patients it treats declines.

The employees who lose their jobs will be offered severance packages and the opportunity to apply for other jobs at the Salisbury hospital, the company said in a statement.

Peninsula Regional on average has 66 fewer patients in the hospital a day than last year. The medical center is licensed for 288 beds and expects that number to decrease to 250 within the next two years. The hospital was licensed for 363 beds four years ago.

Maryland has recently eliminated 703 licensed beds, including 406 in the past two years, the hospital said.

Peninsula Regional also said that it lost $4 million in lost revenue from Medicaid cuts as a result of federal sequestration. It also said that hospital rate increases approved by the state's Health Cost Services Review Commission have not kept up with inflation, also putting pressure on revenue.

Patient declines are occurring as more people are getting outpatient care rather than at a hospital where they stay overnight, hospitals officials said in the statement. Hospitals will soon be designed for the critically ill, complex surgeries and emergency care, Peninsula Regional officials said.

Peninsula Regional is among other hospitals, including

Johns Hopkins Bayview

and the

University of Maryland Medical Center

, that has cut staff in recent months.

THIS MOVEMENT IS NOT CO-OPTED BY NEO-LIBERALS. WE NEED EXPANDED MEDICARE AS IT HAS BEEN GUTTED THESE FEW YEARS. MAKE SURE IT IS COMPREHENSIVE AND EQUAL FOR ALL!

Delegates to the Convention overwhelmingly re-affirmed their support for a single-payer, Medicare-for-All healthcare system. One resolution called for Protecting and Expanding Medicare Benefits. It declared the Federation’s “ironclad opposition to any and all proposals to cut Medicare benefits or shift costs to beneficiaries.” “Instead of looking for ways to destroy Medicare,” the resolution concluded, “…we must build on its experience as a single-payer program, demonstrating that single payer is the most cost-effective and equitable way to provide quality health care.”

At the AFL-CIO Convention: Finish the Job! September 16, 2013 By Labor for Single-Payer

Calling on the labor movement to “Finish the job! Make healthcare a human right!,” activists from the Labor Campaign for Single Payer, Labor United for Universal Healthcare and the Campaign for Healthy California were all over last week’s AFL-CIO Convention. They distributed copies of the Open Letter to the AFL-CIO, signed by over 600 union leaders and activists and attended workshops and spoke from the convention floor.

Leslie Lashinsky (AFM), Tom Newman (IATSE) and Betty Madden (IATSE) at the AFL-CIO Convention

Delegates to the Convention overwhelmingly re-affirmed their support for a single-payer, Medicare-for-All healthcare system. One resolution called for Protecting and Expanding Medicare Benefits. It declared the Federation’s “ironclad opposition to any and all proposals to cut Medicare benefits or shift costs to beneficiaries.” “Instead of looking for ways to destroy Medicare,” the resolution concluded, “…we must build on its experience as a single-payer program, demonstrating that single payer is the most cost-effective and equitable way to provide quality health care.”

A second resolution, on the Affordable Care Act presented a bill of particulars regarding union problems and concerns with Obamacare. The resolution went into detail on how the ACA will undermine “…the ability of workers to keep health care coverage through collectively bargained, non-profit Taft-Hartley multiemployer plans.” It declared that, unless changes are made, “…the ACA will effectively use taxpayer dollars to subsidize employers that refuse to take responsibility for providing their employees health care.”

In addition, the resolution cited concerns that the ACA could create “a new underclass of less-than-30-hour workers” and condemned the Act’s “cruel” and “short-sighted” denial of eligibility to immigrants. It reaffirmed the AFL-CIO’s “commitment to pursue health care for all ultimately through a single-payer system.”

Some Convention delegates were reluctant to support this resolution. They argued that it was inappropriate to antagonize the Administration while discussions were still ongoing about the possibility of regulatory changes that could relieve some of the pressures on multiemployer plans. On September 13 (two days after the Convention adjourned), they got their answer. The Treasury Department effectively shut the door to all union fund requests for waivers. As the anti-labor Forbes Magazine declared, “Well played, Mr. President.”

The Labor Campaign for Single Payer will work to transform the “resolutionary politics” of the AFL-CIO Convention into real commitment of resources and organizing capacity at the grassroots of the labor movement. On September 27, union leaders and healthcare justice activists will meet at the California Nurses Association headquarters in Oakland. Together with former State Senator Sheila Kuehl and California Labor Federation President Connie Leyva, they will lay out the agenda and strategy of the Campaign for a Healthy California. This is the type of substantial organizing effort for healthcare justice that labor must lead.

We cannot go backwards. The only effective way to overcome the problems inherent in the ACA is to keep moving forward to healthcare for all.

Do you hear in this article that 1/2 of entitlement spending these few decades, Medicare and Medicaid, has been stolen by health industry fraud and needs to come back to these Trusts? Do you know that when these people describe the increase in primary care access they do not tell you that those patients are now being denied further access to higher levels of care? THIS IS NOT A GOOD THING, IT IS COSTING LIVES. You could fully fund all public hospitals for decades by just recovering and stopping future health fraud.

THAT IS WHAT THIS IS ABOUT AND IT IS AFFECTING MOST FAMILIES AS THE ABILITY TO AFFORD HEALTH INSURANCE DISAPPEARS BECAUSE THE CAUSE OF HIGH HEALTH COSTS....FRAUD AND PROFITEERING IS THE PROBLEM....UNIVERSAL CARE IS THE SOLUTION.

Why NYC needs hospitals to close By Stephen Berger

September 9, 2013 | 2:55am New York Post

Bill de Blasio holds a press conference Aug. 30 to discuss steps to keep Long Island College Hospital open. Photo: Bill de Blasio for Mayor

It’s painful to see a hospital close its doors for good. Painful for patients, painful for workers and painful for the community it has long proudly served. But that pain, and the public outcry that always accompanies a hospital closure, doesn’t change the fact that sometimes hospitals simply reach a point where their survival is no longer financially tenable and their services are no longer essential.

That’s why the highly publicized efforts to save two Brooklyn hospitals that have struggled for years and are drowning in red ink — Long Island College Hospital, or LICH, and Interfaith Medical Center — are so misguided.

In addition to ignoring economic reality, the multiple court decisions and public demonstrations to keep these facilities open do nothing to improve care and everything to prevent true health-care reform.

Health-care delivery in America is evolving into a system marked by fewer hospitalizations and more community-based primary care, as well as myriad public-health innovations. As the decline of LICH and Interfaith so starkly demonstrate, the time has come for New Yorkers, especially those in vulnerable, low-income neighborhoods, to overcome their reliance on hospitals and embrace the rapidly shifting health-care landscape.

The change has been a long time coming.

In 2005, Gov. George Pataki created the Commission on Health Care Facilities in the 21st Century — better known as the Berger Commission, after me, its chairman. As chair, I was tasked with making recommendations to stabilize, improve and restructure New York’s health-care delivery system. Our ultimate goal was to begin a series of difficult steps and decisions to ensure that all New Yorkers have access to high-quality care.

The commission’s work confirmed what many health-care stakeholders long knew: New York had more hospital beds and physical plants than it needed. As our final report noted, “Health-care services are migrating rapidly out of large institutional settings into ambulatory, home and community-based settings.”

Our hospital “right-sizing” recommendations included “48 reconfiguration, affiliation and conversion schemes, and 9 facility closures.” We called for the hospital community to downsize by more than 4,000 beds.

In 2011, as part of Gov. Cuomo’s Medicaid Redesign Team, or MRT, initiatives, I headed the Brooklyn Health Systems Redesign Workgroup to assess the strengths and weaknesses of the borough’s hospitals and their future viability. In a summary letter to the state health commissioner, I wrote that six Brooklyn hospitals (including LICH and Interfaith) “are not currently positioned to seize the opportunities and manage the risks associated with the changes under way at the state and federal levels.”

All the while, hospitals in New York — especially “safety net” facilities that serve a disproportionate number of Medicaid and uninsured patients — have been losing money year after year. Too many New Yorkers were (and still are) using hospital emergency departments for routine primary care. Medicaid costs were skyrocketing. The system was rupturing.

We’ve come a long way. Since the Berger Commission formed, 18 hospitals across the state have closed, including 12 in New York City — yet health-care access hasn’t worsened.

The Affordable Care Act (a k a ObamaCare) and MRT reforms are helping New York pursue the “triple aim” of improving population health, enhancing the patient experience and reducing health-care costs.

As part of this transformation, New York state has requested a 5-year, $10 billion federal Medicaid waiver to enable hospitals and other providers to expand primary care and invest in public-health innovations. Ironically, this will give hospitals the resources to keep more patients out of their facilities.

Yet we’ve still got a long way to go, as the decline of LICH and Interfaith make clear. That’s why the developments in Brooklyn are so counterproductive.

Why are judges and politicians keeping these hospitals open when there’s no money to operate them? Whatever their motives, they’re ultimately harming the very communities that LICH and Interfaith can no longer effectively serve — communities that desperately need more primary care, not more inpatient beds.

They are also willfully ignoring the fact that Brooklyn and the rest of New York will always have enough high-quality hospitals to care for the patients who need them.

Their actions will also have a chilling ripple effect. Other hospitals on the financial brink will put off necessary downsizing or outright closure simply to avoid the chaos unfolding in Brooklyn, and healthier hospitals nearby will be reluctant to step in and help.

It is the human condition to be wary of change, and the loss of a longtime hospital is certainly an unsettling experience. But New York’s recent history has shown that allowing hospitals that have outlived their usefulness to close is a necessary step in the transformation of our health-care system.

For the good of all New Yorkers, let’s hope that certain judges and politicians recognize that soon.

Stephen Berger, the chairman of Odyssey Investment Partners, has advised the city and state on fiscal issues in a series of positions since 1976.

I think the key words here are 'skilled nursing' facility. As all patients in Maryland and Baltimore know the level of skill in health care training has fallen profoundly since health care training has gone to career college-job training format. Hopkins leads the push to create these cheapened versions of skilled labor. We are not looking for Hopkins or any other hospital to do anything other than provide a high level of care throughout a patient's involvement with care and in Baltimore, that has failed precipitously since health care reform became about making health care a market and health institutions about profit-making.

So, this is why Hopkins is closing what was a remnent of quality care. Perhaps these skilled nursing employees will go instead to Hopkins Boutique health care at East Baltimore hospital where the rich go for health care we all have enjoyed and expect to in the future!

Lastly, we encourage labor and justice to highlight how the expense of health care comes from massive health fraud and profiteering by doctors and health institutions and simply recovery of tens of billions of dollars in health fraud in Maryland alone will fund all hospitals to the amount needed for quality health care for all.

60 people lose jobs at Hopkins Bayview Hospital closes skilled nursing facility

By Andrea K. Walker, The Baltimore Sun 7:56 p.m. EDT, September 9, 2013

Sixty workers at Johns Hopkins Bayview Medical Center lost their jobs last week after the hospital closed its skilled nursing facility division where patients go for rehabilitation after a hospital stay.

The hospital said its skilled nursing unit has faced financial challenges for several years and has shrunk from 200 beds in the mid-1980s to fewer than 50 last year.

"We had to look carefully at this program and decided to close the 38-remaining facility beds," Hopkins said Monday in a statement.

The hospital said it is working with the affected employees to provide "support during the transition." Hopkins Bayview employs 3,500 people.

The layoffs come as hospitals have said they are facing increased financial pressure. Many have complained the state Health Services Cost Review Commission, which sets the state's hospital rates, hasn't approved rates that keep up with rising costs.

Other hospitals have laid off workers. University of Maryland Medical System closed the obstetrics unit at its Maryland General hospital in Baltimore. About 50 employees, including 10 to 15 doctors and midwives, were expected to lose their jobs at the time. The system also laid off people at the University of Maryland Medical Center this summer.

Hopkins said it has not laid off employees at other hospitals. Low rate increases and revenue reductions expected from health reform are causing it to watch labor costs, the health system said.

"Our goal is to preserve jobs and avoid layoffs if possible," the health system said in a statement. "We do not have any immediate plans to reduce our workforce. … Like other health care systems, we know that we need to minimize our total labor costs. If at all possible, we will try to reduce these costs through normal attrition."

Below you see why Maryland is pursuing a private health system that is market-based and not public......even our so called public institutions have been made private and profit-driven.

Health care labor has been unable to organize and demand protection by labor laws because UMMS has been made a quasi-organization and as you see in this article....it wheels and deals with Wall Street without regard to commitments to serve the public.

Under Maryland's new health insurance laws UMMS now turns away certain patients that now cannot access levels of care always given by public hospitals. That is because in Maryland it is all about profit in the health industry!

1199 Reveals Risky Finance Scheme, $180,000,000 Debt at U. of MD Medical System

Aug 13, 2013 SEIU MARYLAND

The University of Maryland Medical System, which receives 58 percent of its revenues from public funding, has a more than $180 million debt due to a complex financial scheme that Robert Chrencik executed when he was CFO, and which continued after he became CEO of the statewide system in 2008, according to a new corporation information campaign by the state’s largest healthcare workers union, 1199SEIU United HealthCare Workers East.

The debt, which has at times ballooned to more than $200 million, is a result of UMMS issuing variable rate debt and interest rate swaps. The value of this debt and swaps is tied to interest rates, which, like the spinning wheels of a slot machine, change frequently. In entering into these agreements, UMMS bet that interest rates will rise but it was a poor bet because interest rates are difficult to predict. This gamble has caused UMMS to pay more in interest than it would have paid absent the interest rate swaps. In addition, to cover the bets, UMMS is forced to post collateral. Thus, financial resources that could be used for patient care are instead being used to service this debt.

“Executives at the University of Maryland Medical System are gambling with patient care dollars, resulting in debt—and now they are laying off workers while still paying themselves millions each year,” said John Reid, executive vice president for the Maryland/DC region of the Union. “The people of Maryland deserve better use of our patient care resources. UMMS receives the majority of its funding from our tax dollars.”

In addition to releasing the results of research to the media, a corporate information campaign with billboard, radio, newspaper and online advertisements was launched on August 11 in the Baltimore area. The website for the campaign is www.UMMSCodeRed.org and the Facebook page is www.Facebook.com/UMMSCodeRed.org.

The fact that the University of Maryland Medical System, with 12 hospitals throughout the State, receives a majority of its funding from the public raises other important issues about whether UMMS should be engaging in risky financial transactions:

—The Potential Misuse of Charitable Assets.
UMMS is both an instrumentality of the State and a registered 501c3. In addition to receiving a majority of its revenues from public funding, it solicits and collects donations. We believe that their unique position warrants a more conservative financial stewardship.

--Proper Exercise of Fiduciary Duty by UMMS Executives
Executives who run charities have a heightened responsibility to ensure that monies entrusted to them are used in a conservative and appropriate manner. Compared to the other large hospital systems in Maryland, we believe UMMS took more ill-advised risks that have turned out poorly.

—The Use and Exposure of Taxpayer Funds in Risky Interest Rate Swaps
Unlike the other large hospital systems in Maryland, UMMS receives more state funding and is governed by the State. Also, due to its aggressive growth plans that are state-financed, Marylanders have an additional incentive to make sure that the healthcare system is being prudent with funds, especially as the Affordable Care Act is implemented. Both the State and its taxpayers are potentially on the hook for any losses resulting from the System’s variable rate debt and interest rate swaps.

While other large hospital systems in Maryland participated in these risky financial gambles during the economic collapse of 2008 and 2009, UMMS—which was in poorer financial health and, at times, has had a larger share of these bets—was impacted to a higher degree than its competitors by their use.

Visit:

» www.UMMSCodeRed.org
Like and share on Facebook:

» www.Facebook.com/UMMSCodeRed.org

Aug 15, 2013, 12:10pm EDT Updated: Aug 16, 2013, 11:02am

EDT Health care union blasts UMMS over finances

Sarah GantzReporter- Baltimore Business Journal

A health care workers union has launched a full-blown advertising campaign against the University of Maryland Medical System’s financial practices, complete with full-page newspaper ads, highway billboards, radio spots and an advertisement-plastered vehicle circling the system’s flagship Baltimore hospital.

The campaign by 1199SEIU United Healthcare Workers East takes issue with the medical system’s $180 million in debt and accuses medical system CEO Robert Chrencik of sinking the system into debt with risky financial investments in the early 2000s. The union says that because 58 percent of the medical system’s revenue comes from public funds, administrators should be held more accountable. The medical system has disputed the union’s claims.

“Problems at UMMS have been adding up, including, now, the laying off of workers and a recent fraud settlement,” John Reid, executive vice president for the Maryland/D.C . division of 1199SEIU United Healthcare Workers East, said in a statement. “At the same time, they are pursuing aggressive expansion throughout the state. We felt it important for these financial management issues to be raised for the public, which supplies so much funding to the system.”

University of Maryland Medical Center laid off 65 workers in June, citing budget concerns. Other hospitals in the system have also cut staff.

The union has its numbers right when it comes to funding — about 58 percent of the medical system’s revenue comes from government sources. Specifically, that money comes from Medicare and Medicaid, the federal and state-backed insurance programs for seniors, the disabled and the poor.

Medical system spokeswoman Mary Lynn Carver said that about 31 percent of the medical system’s patient revenue comes from Medicare and about 27 percent of patient revenue comes from Medicaid payments. The medical system reported $1.4 billion in revenue in fiscal 2012, $1.3 billion of which was program service revenue, according to tax records.

“To suggest that the medical system receives any more taxpayer support than other hospitals in America or in Maryland is inaccurate,” Carver said.

Carver said the medical system does not receive any money from the state or federal general funds and is not a division of the state. The governor does appoint its board members from a list of recommendations from the medical system.

Regarding the medical system’s debt, Carver said the medical system’s practices are similar to those at other hospitals.

“Much like individuals take out car or house loans to pay for large long-term purchases, hospitals do the same thing.” Carver said. “If the hospital system could not take on debt, we would not be able to take on large capital projects like investing in our IT infrastructure, purchasing new equipment, or renovating or expanding buildings.”

Moody’s Investors Service in February affirmed an A2 rating for $354.2 million in revenue bonds for the medical system. Moody’s revised its outlook for the medical center from stable to negative, citing the system’s acquisition of the former St. Joseph Medical Center, among other factors.

Vanessa Johnson, a vice president for the union, said SEIU wants the campaign to spur greater financial accountability and transparency within the medical system.

Sarah covers health care, higher education, biotech and technology.

JOIN THIS GROUP IN FIGHTING.....THESE HEALTH REFORMS ARE ALL ABOUT CUTTING PATIENT ACCESS!!

Demonstrators call for single-payer healthcare system in Baltimore

By Bill Hughes · March 22, 2013 ·
·
Demonstrators took to the streets Thursday at McKeldin Square in Baltimore to raise awareness about the rising medical debt in this country and the need to adopt a single-payer healthcare system. Nearly 60 percent of the bankruptcies in the nation are related to the inability to pay medical bills, according to a recent study.

To learn more about this growing economic and healthcare crisis and what can be done about it, click here. Speaking on camera about this matter is the social justice activist, Dr. Margaret Flowers of Baltimore City:

Thank you for your fight for Universal Care in Maryland.....

Healthcare is a Human Right - Maryland

Last night, our very first chapter celebrated their One Year Anniversary! Our Carroll County chapter got started last June after reading T.R. Reid's "The Healing of America" and realizing this healthcare crisis would only continue unless regular folks such as themselves got involved. So they reached out to Healthcare-Now of Maryland who were just starting to brainstorm how to work with United Workers, Physicians for a National Health Program -MD, and others on how to make a Healthcare is a Human Right campaign a reality in Maryland. Folks in Carroll helped show the way by demonstrating that there is already very real commitment on the ground, it's simply a matter of reaching out to one another.

Before we celebrated with a sweet birthday carrot cake courtesy of Sandy and Wilbur, we had a productive meeting where we heard from Dr. Aukerman of Access Carroll on the growing need amongst the uninsured and the essential services his organization provides to help meet some of the huge gaps in coverage. We also figured out logistics for an upcoming Ministerium Luncheon at noon on June 17th at 125 Water St in New Windsor where faith leaders from across the County will be meeting on how to help expand the campaign for our human right to healthcare, and we did some fun role playing on how to engage our neighbors on the concept of healthcare as a right, and the need for us to get involved in building a grassroots movement.

We had earned our carrot cake, is what we're trying to say Thanks Carroll for helping to get this statewide campaign off the ground!!

____________________________________________________________________________

In Maryland the Universal Care is blocked by Johns Hopkins and its private non-profit Maryland Health Care for All. This is an organization that captures this Universal Care issue by standing for the ACA as health care for all. WE ALL KNOW THAT THE ACA WILL KILL HEALTH CARE ACCESS FOR MOST. Please watch these faux groups meant only to capture an issue. In Maryland, we have United Workers/National Physicians with Health Care for All Maryland!

Please check this article out....I could not copy it.

Circular Political Logic Kills People and Single-Payer Reform, So Long as We Allow Itwww.commondreams.org

On an early morning conference call on Friday, I heard the circular logic being used in high level political circles to effectively block any progress

Here we have the wholesale fraud within our Entitlement system....we know there is no oversight in Maryland as well.

Whether Medicare or Medicaid ----these health services have been gutted with fraud AND WE NEED TO GET THAT MONEY BACK TO THESE TRUSTS!

Auditor Says California Not Watching Mental Health Funds Source: Sacramento Bee
| California | August 16, 2013

State agencies have not properly overseen how California counties are spending billions of dollars on mental health care programs generated by Proposition 63, according to a state audit.

The 2004 ballot initiative, written by Senate President Pro Tem Darrell Steinberg, created the Mental Health Services Act. It levies a 1 percent tax on people who make more than $1 million, to be spent by counties on mental health services. It also created an oversight commission to monitor the funds.

But that commission and associated state agencies have not adequately monitored the county programs that receive Proposition 63 funds, says the review by state auditor Elaine Howle.

"Because of the minimal oversight (the Department of) Mental Health and the Accountability Commission provided in the past, the State has little current assurance that the funds directed to counties - almost $7.4 billion from fiscal years 2006-07 through 2011-12 - have been used effectively and appropriately," Howle wrote in a letter accompanying her audit.

The programs have been dogged by complaints for years. Media reports have cited spending on yoga, gardening and public relations efforts, and critics have complained that the overall effort doesn't address the needs of many of the most seriously mentally ill. The state audit does not address those complaints, instead focusing on the dynamic between the state and county governments.

______________________________________________________
Did you know the Affordable Care Act is all about creating global health systems that maximize profits by cutting access and quality of care for Americans? It consolidates the health industry as banking consolidation gave us Wall Street global banks...and these health systems will be just as greedy, unaccountable, and profit-driven as banks. Not a good thing for public health would you say? Johns Hopkins is the leader in all of this and it is Maryland leading the way to private health insurance systems and ending access to health care for most people....preventative care only since hospitals lose money when health procedures are performed on people without private insurance or means.

Here are some questions:

1) Why would you allow a hedge fund owner of Manor Care run senior care facilities? Do you think hedge funds got rich being moral, ethical, and even following laws?

2) Why are you privatizing Public Health departments to private non-profits funded by the rich and corporations and having no public transparency? How will the public hold these health systems accountable?

3) When government watchdogs and oversight agencies all say that entitlements are rife with fraud that take almost 1/2 of Medicare/Medicaid funding to fraud....and you have MD health agency leaders saying there is no fraud....do we really think the public is getting the care it deserves?

State opens health reform call center

By Andrea K. Walker 6:35 p.m. EDT, August 13, 2013

Maryland has opened the first call center where people can take their questions about health reform.

The center that opened last week at 1 South Street in Baltimore has staff that can help Maryland residents and small businesses understand their insurance options and explain tax credits and other financial incentives in which they may be eligible under health reform.

The center, which has bi-lingual staff, will open on a limited basis from 8 a.m. to 6 p.m. through Sept. 30.

During open enrollment, the call center will open seven days and week and operate at full capacity with 125 staff.

Open enrollment on a state exchange, where people who don't have employer-sponsored insurance can buy plans, begins Oct. 1. Open enrollment ends March 31, 2014 and implementation of reform begins in January.

Following open enrollment, the call center will open during normal business hours which are Monday through Friday from 8 a.m. to 8 p.m., and Saturday from 8 a.m. to noon.

A translation help line will also provide translation services in 200 languages.

Marylanders can also call toll-free phone numbers: 855-642(MHC)-8572 or 1-855-642(MHC)-8573 for TTY service.

An estimated 14 percent of Maryland’s population of 5.8 million, or 800,000, are currently uninsured.

As a justice organization in Maryland I can attest that indeed this HEZ model will be applied just as Enterprise Zones across Maryland. We all know Enterprise Zones today look nothing like the Harlem model that these neo-liberals like O'Malley and Brown pretend. They are using the poor as a way to garner tax breaks and grants to build luxury and affluent developments and communities. So what Anthony Brown is providing is a how-to guide to use poverty to get free money to push people of poverty out of a community set to become affluent.....PERIOD. Check my website.....Citizens Oversight Maryland for the real truth in health care in Maryland. The underserved black communities have life expectancies 20 years shorter than affluent because they have no access to meaningful health care in Maryland. Government watchdogs tell us that billions of dollars in Entitlement fraud occur each year in each state....and this model is just an extension of using money slated for the poor and elderly on profit and affluent development!

Health Enterprise Zones: Maryland's Unique Approach

Posted By Dylan Scott | December 18, 2012

In the next month or so, Maryland will announce the location of its four Health Enterprise Zones (HEZs). It’s a unique pilot program -- which is being carried out by Lt. Gov. Anthony Brown and the state health department -- dedicated to reducing health disparities among the economically disadvantaged.

Numerous studies have shown that poorer Americans are more likely to be obese, and as a result, have the associated chronic health conditions like heart disease and diabetes. Down the road, these chronic conditions lead to higher costs for everyone. Health Enterprise Zones are being touted as a possible solution.

Brown compares them to economic development zones, except with a focus on health instead of business. In order to qualify for the pilot program, coalitions comprised of health-care providers, government agencies, nonprofits and local businesses must identify the population they want to help (which must be at least 5,000 people so data-tracking would be possible), the health disparities they want to reduce, their plan for expanding primary-care access and the community resources they have to do it. A total of 19 groups initially applied to the state health department for funding in September. The applicants have been whittled to 10, and four will eventually be chosen, according to Brown.

This article appears in our free, monthly Health e-newsletter. Click to subscribe. The state Legislature has allocated $16 million over four years ($4 million a year, for an average of $1 million per zone per year) for the pilot. Here’s where the zones get creative. The coalitions that receive funding can use that money for six purposes: state income tax credits, hiring tax credits, loan repayments (for medical school students, for example), capital improvement grants, priority in a state patient-centered medical home program and priority in a state program that provides finance assistance for electronic health records (EHR) adoption. The funding's flexibility helps groups tailor their program to their specific needs. If they need more primary-care doctors, hiring tax credits and loan repayments would be useful. If they need a better care infrastructure, capital improvement grants and EHR adoption might make more sense.

I caught up with Brown at our Healthy Living summit last week in Atlanta, where he spoke about Health Enterprise Zones to state and local policymakers of all parties and regions. Here's a transcript of our conversation, condensed and edited for clarity.

Collaboration seems to be a key component of the Health Enterprise Zones, as evidenced by the coalitions. Why is collaboration so crucial to reducing health disparities?

Lt. Gov. Anthony Brown: Collaboration is extremely important in addressing health disparities, so that’s why when we designed the Health Enterprise Zone program, we require applicants to demonstrate that they're collaborating across stakeholder groups -- that providers, local departments of health and patient and community advocates are involved. Then, of course, the state will continue to be involved, not only in providing financial resources but technical assistance and support to the zones and the applicants so that they’re successful.

Collaboration is important for a number of reasons. One is that, look, we’re in a tough budget environment and you’ve got to leverage resources -- not only financial ones, but experience, talent, knowledge and best practices. Also, for the Health Enterprise Zones to be effective, we have to be able to reach deep into the communities and connect to those people who are the intended beneficiaries -- many of whom are living in poverty or in economically disadvantaged communities. Government can’t do that alone. We need community-based organizations. We need organizations and individuals familiar with the communities that can help us connect the enhanced services that are going to be provided in the zones to the population that's in greatest need.

Applicants have to use data to pinpoint the health disparities that they want to address, and then track data to show their progress. Why have you placed such an emphasis on data for this program?

AB: Data drives so many decisions in our lives. Data drives decisions on the best educational policies to implement and how to implement them. Data drives decisions we make about deploying public safety resources in the communities that are in greatest need. And that’s no less true for addressing health disparities. What we're requiring for a successful Health Enterprise Zone is that we at the outset identify the metrics that are going to be used to measure the progress toward the stated goals. The goals are to reduce health disparities, to deliver more services in underserved areas and to reduce the cost of delivering health care.

So we will measure things like hospital admissions and readmissions, particularly for those conditions that are going to be addressed in the Health Enterprise Zones. So in other words, if the goal is to reduce asthma, then we’re going to measure the number of emergency room visits for asthma attacks. We’ll look and see if there's a downward trend as we’re bringing more services into the zone. But we’re also going to ask the applicants to identify the metrics that we should use to measure progress. What are the enhanced resources in the zone? Are we increasing the number of primary-care resources in the zone? So that’s some of the data that we’ll be looking at.

Public health advocates often talk about having to “make the case” to those outside public health circles. Obviously, you had to make the case for Health Enterprise Zones with the state Legislature to get funding, and you’ve talked about wanting to take the program statewide after the three-year pilot period. How did you make your case the first time, and how will you again?

AB: I think the most compelling case to address disparities and to invest in the resources that it takes to do that is the moral imperative that every Marylander regardless of race and ethnicity should experience the same quality of health. When you live in a state like Maryland or in a country like America where an African-American child is two and a half times more likely to die before their first birthday than a white child, that’s not good enough. We can do better. And by addressing disparities of hypertension and diabetes and other contributing factors to infant mortality, we will in fact save more babies. So there’s a real moral imperative.

But if you’re not convinced that there’s a moral imperative, there’s certainly a business case to be made. In Maryland alone, in 2010, we spent $800 million for excess hospital admissions of African-Americans, and when you look at the percentage of African-Americans in Maryland, and you compare it to the percentage of African-Americans who are admitted into hospitals, it’s a higher percentage that are being admitted. And the cost of that is $800 million a year. There’s certainly a cost to the quality of life, but there’s a real financial cost.

In Maryland, we’re in an all-payer system. So for those African-American patients who are admitted to the hospitals, some are on Medicaid and that’s certainly a cost to taxpayers. For those African-Americans who do not have health insurance (and African-Americans are disproportionately without health insurance) in our all-payer system, the cost of that uncompensated care is spread out among bill payers. So everyone is paying for the cost of treating and insuring and responding to health disparities, particularly in our hospitals. We know that three-quarters of the cost of delivering health care in this country is for treating chronic diseases and illnesses. African-Americans and Latinos have higher rates of chronic diseases. So that’s costing us all money.

So if you’re not convinced that there’s a moral imperative to ensure that all of us enjoy the same quality of life and quality of health, there certainly is this business case to be made that all of us have a financial interest to reduce and eventually eliminate health disparities in our communities.

To create the Health Enterprise Zones, you looked at existing models like economic development zones and the Harlem Children's Zone, and then turned them into a health initiative that hasn’t been seen elsewhere. Do you think this program could be a model for the rest of the country? Or more broadly, do you think it will have lessons for policymakers elsewhere who are confronting health disparities?

AB: The Health Enterprise Zones are modeled around two similar programs in different areas. The economic development enterprise zones were created several decades ago to help economically disadvantaged communities that have high rates of unemployment. The idea was to offer incentives to employers to create jobs in those communities. Over the past several decades, we’ve experienced success across the country with that model.

In the area of education, the Harlem Children's Zone has proven to be a very effective concept or tool to identify low-performing schools that have considerable disadvantages. The goal being to target those schools and those districts and bring in additional resources. The program is so successful in Harlem that the Obama administration developed the program at the national level, in a program called Promise Neighborhoods. The idea that you can target disadvantaged communities and neighborhoods, deliver additional resources and incentivize the private sector to participate has proved successful. That's what gave birth to the concept of the Health Enterprise Zones.

Maryland has always led the way in health care and health reform. We’re proud of the work that we’re doing on behalf of our residents. But we’re equally committed to sharing our best practices, the models that we develop with partners around the country. If we can eliminate disparities in Maryland, and our model gives policymakers on the West Coast or in the Midwest or in the southern states a tool that can be implemented in their states and their communities to address disparities, that’s a good thing. Then we will have done our part not only for Marylanders, but for Americans.

I always point out that government watchdogs and even doctors working to reform health care say that 1/2 of Entitlement spending is lost to fraud....Medicaid hit hardest. I identify Hopkins as the one who is given broad authority to receive most health funding from federal, state, and local government so they are to where the buck stops in massive health fraud for the poor and elderly. Today I want to point again to another player with the ABC.........This charity receives and disperses grants and gives grants and from all that I can see, they work with the establishment .....Baltimore Development and the mayor....against the interests of the citizens of Baltimore. I spoke to the CEO about this at a Federal Reserve/Wall Street event here in Baltimore as to why Black Charities does not shout out and fight all of these civil justice/civil liberties issues suspending the rights of people of color......WHO IS GETTING HALF OF ALL MEDICAID AND MEDICARE FUNDING?

Hopkins has the overall responsibility as to loses from these health Trusts since it takes the primary stance of dispersing the funds, but we know that justice organizations are not doing their jobs in working for public interest!

Below is a Baltimore City Board of Estimates award for low-income health care.

ASSOCIATED BLACK CHARITIES, $155,583.00

INC. (ABC)

Account: 4000-427711-3023-603051

On November 16, 2011, the Board approved the original

agreement with the ABC for the period July 1, 2011 through

February 29, 2012 in the amount of $10,528,363.00. The ABC

serves as the Administrative Fiscal Agent for the HIV

Emergency Relief Project Grants. This amendment will

increase the award to ABC by $155,583.00 for a total award

of $10,683,946.00.

Johns Hopkins is merely becoming a corporation just as MIT and Stanford for a few others. This is not a corporate partnership; it is not a plan to grow jobs and businesses. As we see from the history of these two other elite private universities that are now corporate factories, the intent is to patent research paid for by taxpayers through grants from the NIH or the NCA for example. As with MIT these corporate universities simply combine businesses and Rand D to where a university department head is paid like a corporate executive he is and the students who come through this university..remember these are elite schools with affluent families attached to the schools..very few of the 95% included. Also remember that Hopkins was built on trillions of dollars in taxpayer money and now they intend to partner with business and patent research paid for through large Federal grants all while staying in the category of 'non-profit meaning they pay no taxes.

University of Maryland is a smaller public version of this that uses students more as free labor and student tuition to fund marketing and research facilities for what will be startups that simply are handed over to global corporations. That is also what will happen at Hopkins as the taxpayer funded research that is successful will be patented and Hopkins will hand it over to connected corporate interests for patent profit.

Now, it is important to know that none of this has any value to the Baltimore community as all the students come from all over the world and almost none from the city. It also takes all of Baltimore's revenue to keep a corporation that is categorized as a non-profit operating and let's nt even talk about Baltimore as a Hopkins' company town.....corporate rule.

Hopkins is the driver of private health systems and fought the public option and universal care because it intends to be the global health corporation that is enriched by all of this. It is empire-building on the backs of the people and taking their access to health care away all for corporate profits. These are really dangerous dudes! When you patent medicine as they are trying to do with biogenetics you have left the arena of hippocratic oath and entered the arena of public 'superfund for toxic waste of public money'. We need to be heading in the opposite direction as Johns Hopkins has a huge debt to society that needs to be paid by making the hospital and services free.....HOPKINS IS A PUBLIC HOSPITAL UNTIL THE PEOPLE RECEIVE THE TRILLIONS OF DOLLARS FUNNELLED TO HOPKINS TO GO GLOBAL.

Hopkins accelerator aims to give startups a jump start FastForward facility is part of university's entrepreneurship push

1/13 By Jamie Smith Hopkins, The Baltimore Sun 6:23 p.m. EDT, June 24, 2013

In the bowels of a building where a long-gone manufacturer once made fine silver, the Johns Hopkins University cultivates fledgling firms.

The FastForward business accelerator is a first for Hopkins, which quietly launched the operation last year and will publicly unveil it Thursday. The move into business incubation is the latest example of the university's effort to remake itself into an entrepreneurial engine — something it has felt pressure to do over the years.

Three startup businesses are in the accelerator now, with about half a dozen more coming later this year and others in talks. The university expects all 16 slots will be full in a year or two.

Hopkins, which licenses its intellectual property to companies around the world, sees the startup assistance as an opportunity to help its research bear commercial fruit — including jobs — close to home.

"Companies tend to stay where they're created," said John N. Fini, director of intellectual property and technology commercialization at Hopkins' Whiting School of Engineering, which is paying for the new facility. "It's very rare for a company to move."

Maryland has about 30 business incubators, most of which receive some public funding, said Rob Rosenbaum, president and executive director at Maryland's Technology Development Corp., better known as TEDCO.

Hopkins is late to the university incubator party, but it was hardly the last institution in Maryland without one. Rosenbaum can think of five other universities in the state that run incubators. The oldest is the University of Maryland's Technology Advancement Program, created in 1984.

Hopkins conducts more research and development — $2.1 billion in 2011 — than any other U.S. academic institution. But it has lagged in commercialization, and officials have ramped up efforts in that area in recent years.

Kelvin Liu, founder and CEO of biotech firm Circulomics, one of the FastFoward companies, sees a difference since he came to Hopkins in 2004 to get a doctorate in biomedical engineering. Hardly anyone he met there in those days seemed interested in going the startup route — a sharp difference from his experience in California, where he worked for three startups.

"Now," Liu said, "there's more and more of that. I think it's great."

Richard Clinch, director of economic research at the University of Baltimore's Jacob France Institute, said Hopkins will probably make its accelerator a success. But he thinks it might have been better to locate the facility cheek by jowl with the biotech park just north of Johns Hopkins Hospital. When it comes to entrepreneurship, he said, you want lots of people working in close proximity so they can spark off one another.

"Location matters," he said.

Rosenbaum, for his part, sees great potential in the accelerator's rapid prototyping capabilities.

"One of the strengths that you have with Hopkins is the biomedical engineering, or more simply put, medical devices — the intersection of their medical school and their engineering school," he said.

Indeed, a medical-device company was the first on board at FastFoward. Clear Guide Medical moved in a year ago, when the space still needed major work and the idea was so new that organizers weren't even promoting it within the university.

The building, on Wyman Park Drive near the university's Homewood campus, was the Stieff Co. factory until it closed in 1999. Remnants of the fine-silver maker still remain as the university converts the basement into offices, labs and other work space.

It's not a window-filled, tech-startup backdrop. The site is zoned industrial. There's a machine shop behind one of the doors, a bio lab behind another and a forklift in the hallway. FastForward staff are in the midst of converting one large space into an area for building "major things," as Fini puts it — the sorts of products that require a crane to move. (The crane's already in place.)

The engineering school has budgeted $1 million a year to operate the facility. Participating companies can stay up to two years, rent-free, in exchange for debt that the university can convert to a stake in each firm down the road. The companies also receive services intended to help speed them toward profitability, such as assistance with business plans and introductions to potential investors.

Firms don't need an engineering-related product to move in, but they must have a Hopkins connection — intellectual property or people.

Clear Guide Medical has both ties. Two Hopkins labs developed the technology the company hopes to take to market next year — an ultrasound guidance device — and the small staff includes Hopkins faculty and graduates.

The company's product clips onto ultrasound imaging devices and guides doctors as they insert a needle into patients for biopsies. Guidance devices are on the market already, but company officials say their technology is much less expensive, takes less time to use and is more portable than the competition.

Clear Guide Medical is tucked into about 2,000 square feet of the accelerator, space that looks quite different now than it did last year.

"When we first saw this, there was this enormous spray booth — a silver spray booth," said Dorothee Heisenberg, the company's chief operating officer. "It is sort of a transformation."

jhopkins@baltsun.com

_________________________________________________________________

Marylander's have a harder task at hand because we are working with carpet corporate democrats and Johns Hopkins as the profit-driven global health system lobby.....they are the ones writing these HORRIBLE International Trade deals maximizing corporate profits in health!

WE MUST VOTE OUR INCUMBENTS OUT OF OFFICE AND RUN AND VOTE FOR LABOR AND JUSTICE CANDIDATES IN ALL ELECTIONS!

Single-Payer Forges Ahead in New York

June 7, 2013 By Labor for Single-Payer

While some in the labor movement counsel that the fight to establish a single-payer expanded and improved Medicare for All system must wait until the Affordable Care Act (ACA) is fully implemented or until a Democratic majority is restored to the U.S. Congress, activists in New York continue to move the healthcare justice struggle forward.

They are mobilizing support for Assemblyman Gottfried’s “New York Health Bill (A.5389)” that would create a single-payer, universal healthcare system for all New Yorkers funded through equitable public financing and with no co-pays, no deductibles and no premiums.

“The ACA has made some important improvements in how we organize and pay for healthcare in this country,” said Gottfried, who chairs the Assembly Health Committee. “But it still leaves us and our healthcare and our wallets in the hands of private insurance companies… We can do better.” A just released study finds that, even if New York State embraces Medicaid expansion under the ACA, over 1.2 million New Yorkers will remain uninsured in 2016. Millions more will be afflicted with inferior insurance plans that would do little to protect them from bankruptcy if they experience a major medical catastrophe.

Last month, hundreds of union members, doctors, community advocates and seniors assembled in Albany to deliver 10,000 signatures in support of the Bill. Major labor supporters include LCSP endorsing unions IATSE Local One, New York State Nurses Association (NYSNA), New York State Public Employees Federation (PEF) and United University Professionals/AFT. Other allies include Single Payer New York, Healthcare NOW NY, and the New York Metro Chapter of the Physicians for a National Health Program.

NYSNA RN Lisa Blodgett told supporters that nurses see patients every day who could benefit from the bill. “Not only is it the humane thing to do, it is the financially responsible thing to do,” she added, because the Bill would eliminate wasteful administrative costs and private insurance company profiteering while closing coverage loopholes for millions of working families.

Wayne Bayer, PEF Vice President, pointed out that, “With single-payer, New York manufacturing would be more competitive with the western European countries and Canada that have had universal healthcare for decades.” A 2009 report by the New York State Department of Health and Insurance Department found that a single-payer system would provide universal coverage at a lower total cost than plans relying on private insurance.

The New York Health Bill currently has 76 co-sponsors. This is a majority in the 150-member State Assembly. A companion bill in the State Senate, sponsored by Senator Perkins, has 18 co-sponsors among the 63 Senators. Assemblyman Gottfried is pushing to bring this Bill to a vote this session with the recommendation of the Assembly Health Committee.

Some activists, however, are urging New Yorkers to be wary of the “California Effect” in which legislative support for a single-payer bill appears to evaporate right at the moment when passage seems possible. They attribute this effect to the massive power that the for-profit healthcare industry can bring to bear on individual legislators and governors through a myriad of avenues.

The Labor Campaign for Single Payer was launched to support the building of a grassroots movement strong enough to overcome this massed corporate power. Labor is central to this fight because of its ability to marshal the resources and organizing capacity to build this movement. Victory in New York will ultimately depend on our ability to mobilize a statewide movement for healthcare justice. Now is the time for every union in the state to commit to this movement.

All Out on July 2!

On a national level, the “Grand Bargain” proposals released earlier this year to balance the federal budget through cuts to Social Security, Medicare and other core social insurance programs have proven to be spectacularly unpopular. Rep. Alan Grayson, among others, has declared the proposals, “Dead. Dead. Dead.”

But, just as in New York, it would be a mistake to ever underestimate the power of the corporate interests promoting these proposals. The Alliance for Retired Americans has called for a Human Chain Against the Chained CPI on July 2.

The Labor Campaign understands that our movement is an organic part of the fight to defend and expand the social insurance model. Human Chain actions are currently planned in 19 states. We urge you to help mobilize support in your area. More information is available here.

How do you assure a person with mental illness does not seek treatment......you do what Maryland is trying to do.....and they are doing it to protect health institution profits!!!

Health department to review psychiatric bed registry, brief legislators Review to be conducted at committee request after bill fails to pass

By Kevin Rector, The Baltimore Sun 2:45 p.m. EDT, April 10, 2013

A bill that would have required the state health department to report to legislators on the effectiveness of a new online registry of psychiatric hospital beds did not pass this legislative session — but the review will be conducted anyway.

On April 4, Del. Peter A. Hammen, a Baltimore Democrat and chair of the Health and Government Operations Committee, wrote a letter to health secretary Joshua Sharfstein — in lieu of moving the bill out of his committee — requesting the health department conduct the review and report back to his committee before the 2014 legislative session.

Brian Hepburn, director of the Mental Hygiene Administration, said his agency and Maryland Institute for Emergency Medical Services Systems will conduct the report as requested while continuing to "support the project and encourage voluntary participation."

The registry is aimed at streamlining services for mentally ill patients who show up at hospital emergency rooms, speeding their transfers to dedicated psychiatric units in the state, officials have said. Patients and hospital officials have reported psychiatric patients taking up needed space in emergency rooms, a setting that is not optimal for their care.

Participation in the registry, which allows hospitals to share information as to bed availability in different units, is currently voluntary.

Following coverage of the registry in The Baltimore Sun, Del. Samuel I. "Sandy" Rosenberg, a Baltimore Democrat, announced he would introduce legislation to require participation among Maryland hospitals.

The bill he eventually filed instead called for the MHA and MIEMSS, which are both already involved in the operation of the registry, to conduct a review.

Rosenberg said the agreement reached produces the same result as his bill, so he is pleased.

krector@baltsun.com

The Affordable Care Act is all about making health care more profitable by making it less accessible. It will has no goal of bringing prices down for US citizens. All savings that occur will go to corporate profit. This is why Johns Hopkins fought so hard against the public option/universal care..they want to maximize health industry profits and grow global health systems. It is also why it created the MD Health Care for All so that real advocacy for health care for all would be sidelined!!! We now have a new health care for all movement.

What they are doing with health care exchanges has more to do with building competitiveness for what is being made big business rather than a public human right..think the NYSE for Wall Street. We know that has nothing to do with public interest don't we! As people are mandated to have insurance and as the most in need of care are being priced out of it with higher co-pays and deductibles...health care becomes more profitable. Businesses will drop their employee private plans so very few...less than 20%...maybe 10% will be able to afford private insurance and quality care we all got for decades.

To make sure the public doesn't put a crimp in the profits Hopkins has again created the private non-profit model like Evergreen that supposedly catches all those people shaken from coverage. They will make sure coverage will be minimal.

Part 2:

Third Way corporate democrats as are all Maryland's pols tell you your children will stay on the plan until 27 and pre-existing conditions will be covered..but they don't tell you that only about 10% of people will be able to afford private insurance which is who gets these perks!

Meanwhile Medicaid has basically been axed as funding is gutted and the program becomes a Third World public health service.

preventive medicine with little hospitalization. Medicare is moving towards this as well. Imagine that 80% of people will more than likely fall into this Medicaid/State insurance system and you get towards what Third Way corpoate democrats are pushing. See how maximized profits can be when almost all the people needing health care the most are out of the system? This is the Affordable Care Act.

Remember, baby boomers et al paid income taxes and payroll taxes to get the care they paid researchers to develop. Medical care that are now turning profits was paid for by taxpayers and now they are saying NO to our access. On top of that 1/2 of entitlement payments have been lost to health fraud by doctors and the health industry pushing us out. Trillions of dollars lost from Medicare and Medicaid lost and the fraud is growing. That is why these corporate pols need to go. Stop reelecting corporate democrats and RUN AND VOTE FOR LABOR AND JUSTICE NEXT ELECTIONS!!!

Health reform's changes stir worries as they take shape in Md. State readies for launch of new insurance marketplace Oct. 1, with federal law taking effect in 2014

By Scott Dance, The Baltimore Sun March 31, 2013

State lawmakers put finishing touches last week on plans to apply federal health care reforms in Maryland come Jan. 1. But who becomes newly insured — and at what cost —still worries stakeholders as the state speeds toward becoming one of the first to adopt a revamped system.

Under legislation passed by the House of Delegates and Senate, more low-income Marylanders would qualify for government-funded health care through Medicaid, and an existing tax on health insurers would sustain a new insurance marketplace once federal support wanes.

State health and insurance officials face a long to-do list during the next nine months as they implement reforms needed before the Affordable Care Act takes effect. They will decide what health plans will be offered in the state, and at what prices; recruit uninsured residents for new coverage; and launch a complex computer system to parse who is eligible for new government assistance.

Given all the work yet to be done, there are still questions about how health care and insurance will look to consumers and how much it will cost. How many people take advantage of the new coverage— and how healthy they are — will help determine whether patients' bills will continue, slow or reverse their rise.

And a dramatic proposed change in the way state hospitals can charge for services could add to the upheaval. On Tuesday, state hospital regulators submitted an application to change the state's Medicare waiver, which allows them to set hospital rates. In other states, hospitals are reimbursed based on rates negotiated with insurers or dictated by Medicare. The proposal would create incentives for Maryland hospitals to reduce the cost of care, ending compensation based on inpatient admissions and thus removing an incentive to fill more hospital beds.

State leaders who embraced adoption of the Obama administration's 2010 reform law acknowledge the uncertainty. But Gov. Martin O'Malley's top health care deputy said the administration crafted the complex new system over three years hand-in-hand with key players in the state's health care industry.

"I think it's natural that when you have the type of reform we have seen in the Affordable Care Act, and whether it's in health care or any other policy area, there's always going to be some trepidation. It's pretty much around the uncertainty or the unknown of what's to come," Lt. Gov. Anthony G. Brown said. "I believe in Maryland, given the nature of our process, we have done a good deal to tamp down the anxiety."

That process began when O'Malley's issued an executive order the day President Barack Obama signed the health act into law, launching a program to oversee health reform changes in the state. Since then, the O'Malley administration and state lawmakers have passed laws including one in April 2012 creating the Maryland Health Benefit Exchange.

Now the state aims to open the exchange Oct. 1, so those in search of affordable insurance can enroll in plans by the start of 2014. To meet that timeline, "every day counts," said Rebecca Pearce, the exchange's executive director.

Insurers must submit proposed plans and rates Monday to the Maryland Insurance Administration, giving an idea of what choices the exchange might offer consumers. The state's regulatory review of those plans is expected to take months; state insurance officials have broad authority to ask for changes before approving plans for sale.

The exchange hired public relations firm Weber Shandwick to develop an advertising campaign likely to hit television and radio waves, websites and public transit by September. It is hiring six regional contractors to coordinate grass-roots education on coming health reform changes, as well as a vendor to train those responsible for outreach and another vendor to launch a statewide telephone helpline for people with questions about the exchange.

Health officials aim to reach Maryland's estimated 750,000 uninsured residents and explain their new coverage options so they can enroll by the end of the year. Their goal is to enroll 147,000 in insurance in the first year.

Another 108,000 will gain coverage through expanded Medicaid eligibility O'Malley is expected to sign into law this spring.

But some question whether the state's expectations will become reality. The federal health reform law includes a mandate that all be covered by health insurance or pay a penalty, a divisive aspect of the legislation that the Supreme Court upheld last year. That leaves open the possibility that some could choose to remain uninsured, and outside of the exchange's risk pool. Reform rests on the notion that spreading the risk over more individuals will reduce costs for all.

"There will not be a magical flipping of the switch where all of the sudden everyone is going to be covered," said Al Redmer Jr., a former state delegate and state insurance commissioner under Republican Gov. Robert L. Ehrlich. "There's a percentage of folks that will never get enrolled for a variety of reasons."

That could mean a problem for insurers, he said, and for health reform advocates' predictions that competition among carriers in the exchanges will drive down the cost of insurance premiums.

A Society of Actuaries report released Tuesday forecasted that medical costs could rise by nearly a third across the country under the federal health reform mandates. For Marylanders who buy insurance individually, rather than through their employers, costs could rise by more than two-thirds, the society said. The increase will be driven by more chronically ill people gaining access to coverage as healthy people opt to pay the penalty for lacking insurance, the report said.

"The ability to manage the risk is going to be challenging," said Frank Kelly, CEO of Hunt Valley insurance administrator Kelly & Associates Insurance Group. "I think there's going to be some fairly significant rate increases, but it remains to be seen."

State and federal health officials cast doubt on such forecasts. U.S. Health and Human Services Secretary Kathleen Sebelius called it "speculation," but acknowledged costs could rise for men and young people. For Maryland, the estimates don't take into account that the state won't immediately shift those covered in a high-risk insurance program into the exchange, for example, said Carolyn Quattrocki, executive director of the governor's Office of Health Care Reform.

Getting more Marylanders covered by health insurance also could help hold down or even reduce insurance costs, because the cost of care the state's uninsured receive —mostly in expensive emergency rooms — is spread across all insurance holders in the state, Quattrocki explained.

But she acknowledged that the federal reforms will make it more difficult to keep costs in check.

"There is some pressure for very positive reasons," said Quattrocki, citing a ban on denying coverage for pre-existing conditions and permission for adults 26 and younger to remain on their parents' insurance. "All those consumer protections are great news for Marylanders, but at the same time can create pressure on the rates."

Even if plenty of healthy uninsured Marylanders flock to the exchange, there could be other problems, critics said.

"We're setting up a system where we're going to expand health coverage, but the question is, where will we get the providers?" said Del. Adelaide Eckardt, an Eastern Shore Republican and a registered nurse. "If you overload the existing providers, then you're sacrificing the quality of care."

State health officials acknowledged that they will need to be ready to respond to glitches likely to arise along the way.

"We've done everything we can," Brown said. "We've done a lot to minimize the risk, and we need to maintain flexibility to respond to any unforeseen consequences of the risk that may still exist."

Reuters news service contributed to this article.

This is just one step towards the privatization of entitlements as we see private systems and private non-profits acting as public insurance players in states like Maryland......Third Way corporate democratic.

In Maryland entitlement people, starting with uninsured and Medicaid are being tracked into these private non-profit insurance pools. These pools are nothing but extensions of the corporate health industry, in Maryland's case.....Johns Hopkins. Just look at the director of Evergreen Health Insurance to see they are simply moving entitlements to private hands as with any public private partnership!!!!!

Some U.S. States Can Shift Medicaid Funds to Exchanges

By Alex Wayne - Mar 30, 2013 12:00 AM ET Bloomberg Financial

Low-income people may get Medicaid money to buy health insurance from private plans such as UnitedHealth Group Inc. (UNH) or Humana Inc. (HUM) in a “limited number” of states, U.S. officials said.

Arkansas and Ohio have asked President Barack Obama’s administration to allow them to adjust how Medicaid dollars are used. The U.S. Centers for Medicare and Medicaid Services said yesterday it would allow an unspecified number of states to do this as long as it doesn’t cost the government more than the traditional Medicaid program.

The plan is a departure from the 2010 Affordable Care Act, which calls for an expansion of government-run Medicaid, the health program for the poor. Under the health law, about 12 million people are expected to be added to Medicare’s rolls by 2020 as the program grows to cover people earning as much as about 138 percent of the federal poverty level, or about $32,500 for a family of four.

“We remain committed to working with states and providing them with the flexibility and resources they need to build new systems of health coverage,” Cindy Mann, the agency’s Medicaid director, said in a blog post yesterday. “Premium assistance is simply one option.”

Arkansas Governor Mike Beebe, a Democrat, received informal approval on Feb. 18 from Kathleen Sebelius, the U.S. Secretary of Health and Human Services, for a proposal to use money for the Medicaid expansion to instead buy private coverage for low- income people in the state’s new insurance exchange.

Awaiting Approval The state’s Medicaid director, Andy Allison, said in an interview yesterday that he hopes to receive approval for the plan from Mann’s agency soon.

Ohio Governor John Kasich is negotiating a similar plan for his state with Mann’s agency. Republican lawmakers in other states including Florida and Tennessee have expressed interest, and are waiting on the outcome of the Arkansas and Ohio negotiations, said Matt Salo, executive director of the National Association of Medicaid Directors in Washington.

“Everybody else is sort of saying, ’we’re going to watch this,”’ Salo said in a phone interview yesterday. “If Arkansas and Ohio can’t figure this out, they’ll reevaluate.”

Mann’s agency said in the question-and-answer document that states can include in their proposals savings they may gain by adding more people to exchanges.

We need to be clear with Johns Hopkins Medical located here in Baltimore MD. Johns Hopkins has been the recipient of literally trillions of dollars in taxpayer grants and public donations over some decades and what the people of Maryland and especially Balt has gotten is a corporate entity that uses what should be funding to better the lives of the people living close to this institution but rather the funds have been used to make this institution a global presence. This was on the taxpayer dime and you still have the Hopkins President telling us they will not pay taxes now that they are a corporation.

Meanwhile, while Hokins was soaking all of the Federal grant money for the underserved and baby boomer income tax money in the form of research grants, the underserved in Baltimore are found to die 30 years earlier than the affluent because of the lack of access to health care..and it is worse now that a Hopkins-driven health care reform that makes health systems private not public so are geared to corporate profit not level of care. Not surprising that Hopkins, which grew its own infrastructure instead of providing increasing level of care would lobby for corporate profits over care in this health reform.

So, the idea with global corporations is to grow markets and that is what this expansion into Peru is all about..maximizing corporate profits with expanding presence.

Hopkins enters into agreement with Peruvian hospitals

By Andrea K. Walker 1:28 p.m. EST, February 13, 2013 Baltimore Sun

John Hopkins Medicine International entered into a collaboration with a network of Peruvian hospitals in an effort to improve medical services in the area.

The deal with Pacífico S.A. Entidad Prestadora de Salud also includes making improvements at an oncology clinic, clinical and pathology laboratories and outpatient centers that have recently been acquired by Pacífico Salud.

One of the main goals of the partnership will be accreditation of the hospitals. The organizations will also work on strengthening patient safety, operation and the infrastructure for delivering care.

“This important endeavor is designed to raise the quality of health care services across a vast and committed corps of caregivers,” Steven J. Thompson, chief executive officer of Johns Hopkins Medicine International, said in a statement.

_____________________________________________________________________
This is the concern regarding Health Enterprise Zones. First, we are seeing this consolidated approach to care for the Medicaid and Medicare patients that nobody wants. We will never create a fair and quality approach to health care by marginalizing groups by socioeconomic factors, in fact this precipitates inequity. The idea that we must create warehouse-style care in order to make it affordable when we all know the problem lies with fee for service and massive health industry fraud is an insult to all citizens not just those who will fail into the category of these entitlement programs. You had better believe that most people will as those pushing these policies are motivated by private profits and not access and quality. So, as co-pays and deductibles are allowed to rise, even middle-class families will not be able to afford insurance and will fall into these warehoused facilities.

Second, we are already seeing these entitlement zones being handed to national medical chains and in Baltimore's case the hedge fund Carlyle Group gets all of our senior care facilities for goodness sake. Raise your hand if you think a hedge fund has your health interests at heart!!! Who is committing all of the entitlement fraud? National health chains and individual doctors now being forced into health systems who will be more predatory for profits.

Maryland is setting the stage for health fraud becoming worse even as it continues to ignore the current fraud and in fact has no state laws defining health fraud and has caps on awards just like the financial industry caps that protect against awards. Setting the stage for more health fraud with no laws and oversight in place!!! Hello!

The last concern is that we all know what Enterprise Zone means to these pols. It is not the Harlem Enterprise Zone that actually helps the underserved. Here, Enterprise Zone means sending taxpayer money in the guise of helping the poor to build affluent infrastructure. We will be watching as this pilot moves forward where these zones will be. We already know Druid Hill is slated for affluent development for example.

It doesn't seem to far-fetched to those who know the political players involved to say that this HEZ scheme will be yet another way to use taxpayer money for affluent development and it will be riddled with corporate fraud. Take a look nationally at the level of fraud attached to these national medical chains. Carlyle Group? Really?

State designates five 'health enterprise zones' New program will address disparities in health care

Michael Dresser

, The Baltimore Sun 6:39 p.m. EST, January 24, 2013

The O'Malley administration launched an effort Thursday to bring medical services to disadvantaged neighborhoods by designating the state's first five "health enterprise zones" created under a law passed last year.

One of the areas selected for such a zone, aimed at bringing health care to the poor, is in West Baltimore, where the Bon Secours Health System will take a lead role.

Lt. Gov.

Anthony G. Brown

, who led the administration's efforts to start the four-year, $16 million pilot project, announced that the other four zones will be in

Annapolis

, Capitol Heights (

Prince George's County

), Greater Lexington Park (St. Mary's County) and Dorchester-Caroline counties.

The program's goals include reducing health disparities among races and ethnic groups, improving access to care in communities that lack services, and reducing costs and hospital admissions.

The program will offer tax breaks and other incentives to physicians and community groups to bring medical care to underserved neighborhoods. The zones were chosen after community coalitions identified areas with a documented history of poverty and poor health. The five zones were selected from 19 proposals submitted by local health care coalitions.

Where a person lives is considered one of the best predictors of overall health. In Baltimore, for example, a recent study found that the life expectancy of white residents of

Roland Park

is about 30 years longer than that of African-Americans who live in Upton/Druid Heights.

Brown, who was credited by health care advocates as the driving force behind the initiative, said the program will bring more than 100 health care providers, including 37 primary-care physicians, to the selected communities. The bill creating the program was part of the administration's 2012 legislative agenda and was the first bill Gov.

Martin O'Malley

signed last year.

Sen. Verna Jones-Rodwell, a Democrat who represents many of the West Baltimore neighborhoods included in the zone, said the program will bring needed services to communities that have been neglected for decades.

"This has been in the making for three years," she said. "This is the first time this kind of collaboration has happened in the city of Baltimore."

Dr. Samuel Ross, chief executive of Bon Secours, said the program will emphasize connecting residents of low-income neighborhoods with primary care and preventive services.

"What we can do free, we will. Otherwise it will have to be low-cost to be available to this population that we serve," he said. The West Baltimore zone is defined as the areas with ZIP codes 21216, 21217, 21223 and 21229.

Among other things, Ross said, the zone coalition will hire community outreach workers from the local population to bring information to residents and encourage them to seek the help they need

Dr. Joshua M. Sharfstein, secretary of health and mental hygiene, said the state will seek grant money in the hope that it can expand the zone program to some of the 14 areas that were not selected.

"We do not want to have to wait for four years," he said.

It is important to know that Obama's handing a Federal program like Medicaid over to states was his way of killing the program as we all know that most states are now gutting the funding and making it a public health program not a health care program. This is how Maryland has handled it and as Johns Hopkins, the designer of Maryland's private health system likes to claim, Maryland's medical institutions have never been more profitable. The key is ending access for most poor and elderly and that is what is happening with health reform.

So, as people with Medicare and private health insurance increasingly become unable to meet co-pays and deductibles or are bankrupted by them, fewer people will actually get care. Remember, when Obama speaks of shoring up health care costs for people, he is talking about the 20% who will be able to afford to buy health insurance. The rest will fall to these public health programs and as Hopkins stated the medical businesses have never been more profitable.

The people need to remember that entitlements have been defrauded of trillions of dollars by these doctors and medical businesses so that is the key to shoring up these Trusts and getting back to real coverage....bringing back and ending entitlement fraud. A doctor told me 1/2 of expenditures on the poor and elderly are stolen....that's a lot of trillions!

Kaiser study finds Medicaid coverage gaps in states

David Morgan Reuters 12:57 p.m. EST, January 23, 2013

WASHINGTON

(Reuters) - Adults who qualify for

Medicaid

often must have incomes well below the federal poverty line, while adults who have no dependent children are allowed to receive benefits in only nine of the 50 states, according to a survey released on Wednesday.

The survey by the nonpartisan Kaiser Family Foundation provides a snapshot of widespread coverage gaps in the national healthcare program for the poor, less than a year before Medicaid is scheduled to undergo a dramatic expansion under President

Barack Obama

healthcare reform

law.

Kaiser, which tracks health issues, found that Medicaid coverage in 2012 was stable for children and

pregnant

women, who are among the program's targeted beneficiary groups.

But eligibility for parents was limited on average to those earning no more than 61 percent of the federal poverty line, which equals about $19,000 a year for a family of three. Thirty-three states required parents to earn less than the poverty rate, with 16 restricting eligibility to less than 50 percent.

Nine states extended full Medicaid coverage to adults without dependent children while three states, Hawaii, Illinois and Minnesota, reduced eligibility for adults where it was not required by federal rules.

Medicaid, which is run by states but has federal funding and oversight, represents a major budget expenditure for state governments. Many have sought to curtail benefits and eligibility in recent years because of fiscal constraints imposed by the recession and a slow economic recovery.

Benefits and eligibility can vary widely from state to state, with many limiting Medicaid coverage to defined groups, including children and their parents, pregnant women, the very old and people suffering from certain health conditions.

But the Obama administration's chief officer for Medicaid said the program has made years of progress in enrollment and will become more accessible next year under the reform law, even in states that do not participate in the coming expansion.

"As enrollment barriers are eliminated, participation rates of eligible people increases and the uninsured rate for individuals declines," Medicaid director Cindy Mann said at event marking the survey's release.

Obama's health care reform law, known as the

Patient Protection and Affordable Care Act

, offers states Medicaid funding to provide health coverage for most Americans earning up to 133 percent of the poverty rate from January 1, 2014. The cut-off equals about $24,000 for a family of three in 2012 dollars.

INDUSTRY AND PUBLIC PRESSURE

But the expansion has encountered political resistance, mainly from

Republicans

In a ruling last June, the

U.S. Supreme Court

gave states the option not to participate, and more than half of state governors have yet to support the expansion. Just over a dozen have rejected the plan as a costly and unnecessary government program and more are expected to decide whether to back the expansion in coming weeks, as they roll out budget proposals for the new year.

The administration has recently proposed rules allowing states greater flexibility for increasing Medicaid charges on beneficiaries as a way of easing budget worries.

Access to healthcare would remain elusive to adults earning less than the poverty rate in states that reject the Medicaid expansion. Those with annual incomes at or above the poverty level would be eligible to receive federal subsidies to purchase private insurance in new state online marketplaces known as health insurances exchanges, another creation of the law.

Officials in states that have not opted to join the expansion face intensive pressure from the healthcare industry, which stands to gain millions of new customers.

A poll released on Tuesday by the

American Cancer Society

, which favors expansion, also showed that large majorities of registered voters in seven states favor accepting the federal subsidies that would fund expansion. Five of the seven states - Florida, Kentucky, Iowa, Michigan and New Jersey - are undecided. The two others are Texas, which opposes expansion, and New Mexico, whose Republican governor supports it.

But even as state Medicaid programs fail to reach large numbers of the country's poor, Kaiser reported that nearly all states are pressing forward with federally funded technological improvements to streamline their Medicaid enrollment systems and provide online access under the healthcare law.

As of January 1, 37 states had an online application for Medicaid or the federal program for children, up four from a year earlier. Twenty-eight states now allow families to renew their benefits online, an increase of eight since the start of 2012.

"On balance, states made more positive improvements than adverse changes (in 2012), often capitalizing on technology to gain administrative efficiencies and reduce paperwork," the Kaiser survey said.

(Reporting by David Morgan; Editing by Andre Grenon and Leslie Gevirtz)

In Maryland, we have the national corporate lobby against the public option.......Johns Hopkins Medical Center. They fought for the private health systems and their School of Public Health designed the private system being implemented in Maryland. Johns Hopkins boasts that it has made Maryland health institutions more profitable than ever by limiting access to care. People in Maryland are already dying.

We need to know our adversaries in order to mount a campaign against them and we can win as we are very public about what is happening to the people Hopkins is working to keep out of the system. Baltimore has the worst record in the country as regards health access and the poor.....longevity for the poor in Baltimore is 30 years less than the affluent from lack of care.....ALL DRIVEN BY JOHNS HOPKINS!!!

Healthcare is a Human Right - Maryland

Healthy Lives. Healthy Community. Our Human Rights Dialogue this past Saturday was a complete success!

Over 100 Marylanders came together to reflect on Dr. King's legacy and we were also able to break out and strategize on the next phase of our healthcare campaign as we begin planning for Community Conversations in each of our counties. Check out this

slideshow

that highlights just some of our discussions and reflection. We are all excited to see that the campaign continues to gain steam since our launch last month. It has been deeply inspiring to see how folks from all across the state are working to build a human rights-based grassroots movement that will eventually succeed in universal healthcare for

all

Marylanders and is already working towards building a statewide network of leaders focused on empowering their communities and fighting to protect their rights!

We look forward to the coming months of continued growth!

Part of that growth is also going to depend on ensuring we support our fully grassroots fundraising effort to support each of our counties and continue our momentum. For those interested and able, below is a

link

to make either a one time donation or join our members as a monthly sustainer!

Help Sustain Our Movement for Healthcare for ALL Marylanders!

Thanks again for all your leadership and support, and let's continue to build this movement!

In solidarity,

Sergio España

Healthcare is a Human Right - Maryland

240-478-8193

You are receiving this email because you opted in either through our website, surveying, or are an active member of our campaign.

Our mailing address is:

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FOR THOSE PEOPLE STILL THINKING THAT THESE THIRD WAY CORPORATE DEMOCRATS ARE GOING TO DO ANYTHING FOR THE PUBLIC.....THIS STATE OF MASSACHUSETTS....HOME OF HARVARD...IS NOW TAKING THOSE UNFUNDED PENSIONS AND ENDING THEM ONCE AND FOR ALL, PLACING ALL CITIZENS ON WHAT WILL BE A PUBLIC SERVICE-STYLE HEALTH COVERAGE.....THE RICH DON'T WANT TO BE EXPOSED TO TB YOU KNOW!

Massachusetts governor seeks to revamp retiree health care By Hilary Russ, Reuters
Jan. 11, 2013 1:30PM PST

Massachusetts Governor Deval Patrick addresses the first session of the Democratic National Convention in Charlotte, North Carolina September 4, 2012. REUTERS/Eric Thayer Related Articles

(Reuters) - Massachusetts Governor Deval Patrick said on Friday that he will file legislation to overhaul benefits for public retirees, including a proposal to double the number of years an employee would have to serve to be eligible.

The bill would require most current employees of the state and its cities, towns and school districts to work for 20 years instead of 10 years to become eligible for health benefits when they retire.

Retirees would also have to pay a higher percentage of their health insurance premiums, leaving the employer responsible for a smaller share.

The changes, which would not apply to current retirees or to employees who are within five years of retiring, would also raise the minimum age of eligibility to 60 from the current 55.

States' public pension systems are facing large unfunded liabilities that have led to reforms in most states. But massive gaps in public funds to pay for post-employment benefits have received less attention - until now.

On average, states have set aside only about 5 percent of what is estimated to be their retiree health care and other non-pension benefits such as life insurance. At the end of 2010 that left a $627 billion gap, according to a report by the Pew Center on the States.

In response, a growing number of states and cities have begun eliminating or reducing health coverage for retirees.

The proposed Massachusetts legislation could save the state and its local governments up to $20 billion over the next 30 years, Patrick said in a statement.

The commonwealth is scheduled to sell $230.5 million next week and an additional $1.2 billion over the next few months, according to a statement from Massachusetts Treasurer Steven Grossman.

"We think this nation-leading reform work will be reflected in lower interest costs for Massachusetts taxpayers," Grossman said.

The $230.5 million sale of general obligation refunding SIFMA index bonds was postponed from December.

BWI to start charging for ambulance services this year Move dictated by General Assembly, matches statewide trend to offset EMS costs

By Candy Thomson, The Baltimore Sun 6:28 p.m. EST, January 1, 2013

Sometime this year, the

BWI Marshall Airport

fire and rescue department will begin billing people for ambulance rides to the hospital.

The move, dictated by the General Assembly last year, follows a statewide trend to try to recover some emergency medical costs from insurance companies.

Montgomery County

, the state's most populous jurisdiction, began charging Jan. 1.

"It's become pretty standard in the aviation industry and in EMS in general," said Paul Wiedefeld, the airport's executive director. "We will mirror as much as possible Anne Arundel County and adopt a similar fee structure."

BWI is expected to submit its proposal to state lawmakers on Jan. 16. If it is accepted, officials would hire a third-party agent to manage fee collection, with an anticipated summer roll-out of the program, Wiedefeld said.

Anne Arundel, which provides more than 40,000 rides a year at a cost of nearly $100 million, implemented a flat fee in 2009. The $500 charge has generated an average of $6 million in revenue annually, with a collection rate of 30 percent, according to fire Chief John Robert Ray.

Ray called the system "a success" when he testified last year before the Montgomery County Council as it prepared to vote on fees.

Anne Arundel residents do not pay any portion of the fee not covered by insurance. Medicaid, Medicare and most private insurance policies already allow for reimbursement for the service.

It costs about $10 million a year to run the airport fire and rescue service. The Maryland Aviation Administration capital budget for fiscal year 2013 includes nearly $4 million in equipment purchases, and its long-range plan includes expansion of the fire station off Route 170, construction of a fire training facility and construction of a second fire station closer to the BWI terminal, according to the Department of Legislative Services.

In a report last year, legislative budget analysts said that the BWI fire and rescue service responded to 3,793 calls in 2011, with 1,290 of them coming from surrounding jurisdictions with mutual aid agreements.

The report said a fee could raise $250,000 annually and recommended that airport officials establish a framework for management and collection.

Reagan National Airport and Dulles International Airport already charge fees for service, as do 18 of the 23 counties and

Annapolis

and Baltimore.

But that's not to say the fee has been welcomed across the state. Montgomery County voters in 2010 rejected a ballot initiative authorizing a fee, but the county council ignored the opposition and in May approved a fee that ranges from $300 to $800. It is projected to raise $18 million.

Volunteer firefighter companies opposed the fee, saying it would make residents hesitant to call for assistance.

In the weeks leading up to the new fee, Montgomery County launched an information campaign featuring a letter to residents from County Executive Isiah Leggett and announcements on cable TV with assurances that no one would be denied service.

candy.thomson@baltsun.com

THIS IS JUST A SAMPLE OF THE LAWS UNDER CONSIDERATION IN THIS HEALTH REFORM. IT IS GOOD TO LET ORGANIZATIONS LIKE MD JUSTICE KNOW YOUR THOUGHTS AS WELL AS THE STATE AND CITY HEALTH DEPARTMENTS. I DON'T HAVE MUCH FAITH IN THIS GOVERNOR'S APPOINTMENTS ACTUALLY LISTENING TO PEOPLE, BUT HAVING YOUR COMMENTS ON RECORD ALWAYS HELPS!

MARYLAND JUSTICE-----Health Law

PUBLIC BENEFITS TASK FORCE

Chair: Kate Lang
Senior Attorney Advocate: Victoria Robinson
Senior Paralegal Advocate: Barbara Coleman, Odella Oliver, Carol Ahlum

Public Benefit Forum Posts

Disaster Unemployment Assistance in Wake of Hurricane Sandy
Agenda for November 1 Public Benefits Task Force meeting
Medicaid Hearings
Public Benefits Task Force meeting on Thursday, November 1
Health care reform: Caring about costs, too
Maryland Chooses Essential Health Benefits Benchmark
Summary of Benefits and Coverage and Uniform Glossary
10th Annual Advocacy Conference
Agenda for September 6 Public Benefits Task Force meeting
Public Benefits Task Force meeting on Thursday, September 6

Public Benefit Legal Resources

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HERE WE GO FOLKS!!!!! HEALTH CARE FOR ALL MARYLAND KNEW THIS WAS COMING.....BUT THEN, THE DIRECTOR IS JOHNS HOPKINS!

It is important to see Health Care Reform as simply an effort to consolidate the health industry into Wall Street size health systems that intend to go global. It has nothing to do with people being able to access care. What these pols are trying to do is limit the number of people able to access health care and to make those that do access it less likely to cost much. Sok, when you hear 'people with existing conditions will be covered by their health care insurance' the key here is who will have health insurance. These pols are making it impossible for anyone short of $100,000 annually to be able to afford insurance and those not able will be either on catastrophic or Medicaid.....both being reduced to public health checkups.

We know that health care costs are driven by fraud and waste.....almost a trillion dollars annually and that is conservative. Then you have all of the profit that should not be apart of a life and death business. If your incumbent went for Health Care for ALL in Maryland and not the private system being built now, which none in Maryland did as Johns Hopkins would not allow that, we would not be facing 2/3 of the American public not having health care beyond a public health checkup. Let these pols know this is not what you want by voting your incumbent out of office.

Employers hit by rising health costs look to high-deductible plans With open enrollment here, workers may have a new option

By Eileen Ambrose, The Baltimore Sun November 4, 2012

There's a good chance during open enrollment this fall that you will be offered a high-deductible insurance plan with a savings account — if you haven't already been nudged into one.

Increasingly, employers are offering this as a way to rein in their health insurance costs. The high deductible means lower premiums, benefits experts say. And employees — confronted with the prospect of potentially paying thousands of dollars before insurance kicks in — are less likely to run to the emergency room for minor problems, which also keeps costs down.

The plan frequently is paired with a health savings account, in which workers may set aside pre-tax money to cover the deductible and other medical costs. Employers sometimes chip in, too, to encourage participation.

This year, 19 percent of workers with insurance from an employer were enrolled in a high-deductible plan, more than double the percentage from just three years ago, according to the Kaiser Family Foundation. And these plans now have edged out HMOs as the second-most-popular option offered by U.S. employers, benefits consultant Aon Hewitt reports.

Studies suggest that these plans reduce health care costs — at least initially.

"They are seeing a savings. The question is why and if it's sustainable," said Paul Fronstin, director of the health research and education program at the Employee Benefit Research Institute. "The jury is still out."

With employers seeing health care costs rise year after year, though, more are willing to try high-deductible plans. Some employers are beginning to make this their only choice.

M&T Bank, for example, is doing just that for next year, using its current insurance provider. The bank also will contribute to employees' health savings accounts on a sliding scale.

"Employees who make less get more of a contribution," spokesman Phil Hosmer said.

As with all plans now, preventive care is fully covered, so M&T workers don't have to pay any deductible for physicals or cancer screenings. In recent years, the bank also added wellness initiatives, such as cash incentives for workers and their families who take health assessments or undergo counseling sessions with a health coach.

"We feel by increasing the focus on employee health now, [we] can manage the cost of the growth of health care over time," Hosmer said.

High-deductible plans sprang up in the late 1990s, partly in response to the public revolt against health maintenance organizations, which were seen as limiting access to needed care, according to a report released last month by the Robert Wood Johnson Foundation.

Health savings accounts started to appear in 2004. Employees can contribute untaxed money into this account and use it later to pay deductibles and other medical expenses. About one-third of employers add money to workers' accounts, according to an Aon Hewitt survey.

For 2013, the most that can be contributed to a health savings account is $3,250 for an individual and $6,450 for those with family coverage.

Any money unused at the end of the year remains in the account, where it can earn interest or be invested. When employees leave the company, they can take the money with them.

(Health savings accounts are different from so-called flexible spending accounts, another popular option in which employees set aside money for health expenditures but the cash must be spent annually or it's forfeited.)

Under federal rules, plans paired with a health savings account must have a deductible next year of at least $1,250 for an individual and twice that for family coverage. Kaiser reported this year that the average deductible for a plan with a health savings account was $2,190 for an individual, and $4,068 for a family.

Some plans will pick up the full cost of coverage once the deductible is met, while others require workers to pay a certain percentage of their medical bills until they hit a cap. Next year, the maximum out-of-pocket expense will be $6,250 for an individual and twice that for families.

(Some employers offer a health reimbursement arrangement instead, which follows different rules. The employer contributes money annually on behalf of workers, and the company keeps any balance left over once employees leave. Baltimore-based T. Rowe Price started offering HRAs this year with plans that have modest deductibles. The company kicks in up to $400 in the HRA and adds $50 to $150 extra for each healthy action workers and family members take, such as getting a physical.)

High-deductible plans often are called consumer-directed health plans, a name that implies patients will question their doctors on whether a test is really necessary or insist on generics over brand-name drugs.

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For those of us trying to shout out what bad policy this health reform push to consolidate the health industry into mega-institutions, this is a poster child. As health systems are allowed to grow and consolidate they will become as unaccountable as the Wall Street banks. At the same time, the likelihood that they will care for the poor and elderly decrease because they are more and more profit-driven. For those who say Hopkins is a non-profit, remember, it is only one law that allows them to become private. Hopkins fits most descriptions for 'for-profit' now. When you have one operation running all aspects of health care with no oversight or accountability, this is what you get.

How a private entity can control Medicaid dispensement to subcontractors mirrors the practice for all Board of Estimates bidding and subcontracting. It is a bad way to do public policy. We know that entitlement fraud in Maryland reaches billions each year and we know that Hopkins oversees much health care for the poor in the state. We know that the public has no ability to demand access to records from these private non-profits and we know that government never does. There is an inherent lack of transparency they know exists.

The reasons for discontinuing the contract may have to do with Hopkins' expansion of their company Chase Brexton providing the same service...itself a conflict.

Priority Partners is one of seven Managed Care Organizations authorized by the State of Maryland to provide health care services for over 200,000 Medicaid, Maryland Children’s Health Program (MCHP), Medical Assistance for Families and Primary Adult Care (PAC) recipients.

Priority Partners is proud to provide outstanding health care services for our members. No-cost benefits that are offered include:

Doctor’s visits
Immunizations
Lab tests, screenings, and x-rays
Low cost prescription drugs and over-the-counter medications
Substance abuse services

Protesters accuse Hopkins of withholding Medicaid funds Turning Point substance abuse program says it is owed more than $100,000

By Andrea K. Walker, The Baltimore Sun 7:17 p.m. EDT, October 18, 2012

The owner of a Baltimore substance abuse center led a protest of more than 120 people Thursday morning at the doors of Johns Hopkins Hospital, saying the medical giant owes his organization more than $100,000 in Medicaid payments.

The Rev. Milton E. Williams, who operates the Turning Point Substance Abuse Clinic in East Baltimore, said his organization had provided hundreds of patients with free care because a Hopkins affiliate has not reimbursed it for treating Medicaid patients.

The Hopkins affiliate, Priority Partners, is one of several managed-care organizations that has a contract with the state to manage Medicaid claims. Much like an insurance company, Priority Partners pays clinics, doctors, hospitals and other organizations that treat Medicaid patients.

Williams said Priority Partners will not reimburse it for costs to assess and conduct drug evaluations on new patients.

"We are here to make our voices heard," Williams roared to the protesters, including many recovering addicts. "Friends, everyone needs to know the hypocrisy of the world's greatest health care institution."

The group said it has tried more than a year to get the unpaid funds, but Hopkins has resisted.

Hopkins officials would not answer questions on whether Priority Partners withheld payments from the clinic. The hospital said in a statement it had recently ended its partnership with the substance abuse treatment organization.

"We're disappointed that Rev. Williams chooses to voice his dissent in very public and unproductive ways." Hopkins said in a statement. "We strive to help our members pursue quality treatment in a professional environment, and we regret any inconvenience this may cause for them."

Williams said he also had tried to work with the state Department of Health and Mental Hygiene, which oversees the Medicaid program, with no luck. He accused the state of being afraid of Hopkins' influence and "political punch."

A spokeswoman for the Department of Health and Mental Hygiene said the department had never been contacted about problems receiving payment.

The protesters arrived in a caravan of white vans beeping their horns as they approached the front of the facility. They carried signs that read "Don't Stand in Our Way" and "Get Out of My Way of Recovery."

Many of the protesters are recovering addicts who credit Turning Point for their transformation. They worry the clinic will not be able to help so many people if it is not completely reimbursed for care.

Romaine Vance said she started using heroin in college during parties and quickly found herself addicted. The 40-year-old said she tried many times to quit. It was only Turning Point's holistic approach to treatment that worked, she said.

"It wasn't just the addiction and drugs," Vance said. "I was beaten up inside. That is why I am here today protesting. They helped me, so I am helping them."

Williams said his group will continue to protest Hopkins.

"Even though Medicaid will pay for their care, these folks can't receive treatment because you, 'Big John,' keep their money instead of paying Turning Point for their treatment," Williams said.

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It is important to know that Chase Brexton is Johns Hopkins and their expansion looks to be only in neighborhoods that are affluent or slated to become affluent soon. This is important for two reasons. One is that health care reform is about building global mega-health institutions that will be profit-driven and not interested in the poor and elderly. So, as we watch this one case of an institution that has served the poor now moving into the affluent market we see just that shift.

Secondly, we are seeing these expansions that we know will become affluent being funded by grants and tax breaks given for helping the underserved. These add up to hundreds of millions and as with the Enterprise Zones never really help the underserved. We are watching as the development downtown expands from corporate infrastructure on the waterfront to corporate infrastructure in health care.

We want monies designated for the poor to actually help the poor not just a selected, very small group of people. We are watching as community resources dry completely in existing underserved communties while all these funds are diverted into what we all know to be future affluent communities.

MY COMMENTS TO TO MARYLAND DAILY RECORD, ALSO CARRYING THIS ARTICLE:

Chase Brexton is a Johns Hopkins Medical institution that was built on taxpayer money to help the underserved that now seems to be expanding into areas all being or soon to be affluent. It is very much like the Hopkins movement into the boutique health care field and the global marketing to the world's wealthy 'health tourists'.

Now, one might say that trillions of taxpayer research money and entitlement money built Johns Hopkins Medical Campus so, when do we stop thinking of Hopkins as a non-profit and start getting all that public investment back?

Chase Brexton begins renovations on new headquarters

Lt. Governor Anthony Brown joins staff from Chase Brexton Health Services as they break ground on a new building (October 5, 2012)

By Andrea K. Walker 12:59 p.m. EDT, October 5, 2012 Baltimore Sun

Chase Brexton Health Services began renovations this week on a new location in Mt. Vernon that will allow it to see four times as many medical patients.

The community health center is moving next year a few blocks from its current building to the historic Monumental Life Building on Charles Street.

Lt. Governor Anthony Brown and Baltimore City Health Commissioner Dr. Oxiris Barbot joined Chase Brexton staff Thursday to celebrate the beginning of renovations.

The expansion into the 95,000-square-foot building will allow the 35-year-old organization to offer more services, including dental care to two times as many patients and behavioral health care to four times as many patients.

Chase Brexton was founded in Baltimore’s Mt. Vernon neighborhood in 1978 as a volunteer-run gay men’s health clinic. It now provides health care to more than 24,000 Marylanders.

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THIS WEBSITE CALLS FOR VOTING ALL THIRD WAY INCUMBENTS OUT OF OFFICE, BUT WE RECOGNIZE THE NEED TO VOTE FOR OBAMA IN NOVEMBER.....WE WERE DUPED AND DELIBERATELY LEFT WITH NO CHOICE. WE MUST UNDERSTAND THAT THE POLICY BEHIND HEALTH CARE REFORM IS NOT FOR THE PUBLIC INTEREST.......IT IS FOR CORPORATE GAINS AND A GLOBAL MARKET IN HEALTH. THE FARM TEAM AT STATE AND LOCAL LEVELS MUST GO!

VOTE YOUR INCUMBENT OUT OF OFFICE!!!!!

PHYSICIANS FOR A NATIONAL HEALTH PROGRAM IS PUSHING THE SINGLE-PAYER OPTION THAT GIVES ALL AMERICANS EQUAL CARE. WHAT WE HAVE NOW IS A PRIVATE SYSTEM THAT WILL GIVE MOST AMERICANS LITTLE OR NO CARE......BUT LOTS OF CORPORATE PROFITS.

Wednesday, March 11, 2009 Full Show Dr. Quentin Young, Longtime Obama Confidante and Physician to MLK, Criticizes Admin’s Rejection of Single-Payer Healthcare download:   Video Audio Get CD/DVD More Formats Printer-friendly Transcript | While the Obama administration claims "all options are on the table" for healthcare reform, it’s already rejected the solution favored by most Americans, including doctors: single-payer universal healthcare. We speak with Dr. Quentin Young, perhaps the most well-known single-payer advocate in America. He was the Rev. Martin Luther King’s doctor when he lived in Chicago and a longtime friend and ally of Barack Obama. But he was noticeably not invited to Obama’s White House healthcare summit last week. [includes rush transcript]

Filed under  Healthcare, Dr. Quentin Young

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WE KNOW THAT WITH HEALTH REFORM GOING IN THE DIRECTION TAKEN IN MARYLAND THAT THESE CONDITIONS WILL WORSEN CONSIDERABLY. THESE ARE NOT FIRST WORLD CONDITIONS AND THEY EXIST LARGELY BECAUSE OF THE CORPORATE POLICIES OF THE LAST FEW DECADES.

Who will provide for the providers? Many community health workers and volunteers in Baltimore are themselves in need

By Maiju Lehmijoki-Gardner 2:20 p.m. EDT, August 30, 2012 Baltimore Sun

Over the past year, I have had the privilege to follow the work and lives of many of Baltimore's committed community health advocates. These health promoters, organizers, practical nurses, pastors, interns and volunteers are often the trusted leaders of impoverished neighborhoods. The best ones stay even when grant monies run out and short-term projects are deemed complete; they work and volunteer at odd shifts to reverse the plight of underserved communities. They promote stability that benefits us all. Unfortunately, these local heroes often struggle with the same uncertainties that they selflessly work to ease. Some live in outright poverty. They serve others even when they themselves might be in need of assistance.

Are we as a society doing an adequate job to support those who support and empower our communities?

Many recent initiatives and publications, including the Affordable Care Act, National Prevention Strategy (2011) and Healthy Baltimore 2015, emphasize the preventive aspects of health care and the power of healthy communities. Community health promoters provide exactly the types of comprehensive services called for by the current focus on social determinants of health. Yet, very little discussion is dedicated to the challenging realities that shape the lives of those at the front lines of urban health promotion.

Many health care providers struggle to make ends meet. For instance, a full-time home health aide will have to get through a month with just a little over $1,000. Interns and other recent college graduates provide key services as community health promoters but sustain themselves on salaries that may leave them several thousands of dollars below the federal poverty level of individual annual earnings of $11,170. These young people are building their futures and American communities on food stamps.

Follow @BaltSunLetters for the latest reader letters to The Sun.
The group that is at the forefront of Baltimore's hands-on community health promotion seems also to be the one that bears the heaviest burden financially and socially: women of color. The people whose work and lives I follow are often African-American women who provide essential health services to underserved, struggling communities through their professional capacity or volunteering.

In many instances, the socio-economic volunteer profile in the city of Baltimore falls outside the stereotypical philanthropy where a volunteer or a donor shares the fruits of their plenty. The common impression of a volunteer or a donor is of a well-off person sharing the fruits of their plenty, but the socio-economic profile of many Baltimore volunteers and advocates does not fit this stereotype. Many of these women are vulnerable, yet many embrace their roles as health promoters because they are survivors of difficult circumstances. Many turn their experiences of struggle into communal currency, often with little or no financial benefit.

A broad range of studies demonstrates that women — and their children — bear a disproportionate share of poverty. The Great Recession of recent years left t African-American women especially vulnerable. A study by The National Women's Law Center revealed that the black women's unemployment crisis has included a particularly slow employment recovery, even after the recession officially ended in June 2009. We must ask: What can we do to empower those who serve their communities even as they often struggle with unemployment?

Though women shoulder much of Baltimore's health-related volunteering and supply significant labor to the health care industry — one of the largest employment sectors in the city — their own struggle with poverty correlates with a broad range of health challenges. When the Social Science Research Council surveyed female life-expectancy in "Measure of America" (2012), Baltimore landed in the second to last place of 25 metro areas studied. Again, what mechanisms should nonprofit, governmental and educational agencies have in place to ensure that the various positive ways in which women promote health reward them and support their own wellness?

Community health advocates deserve society's solidarity and recognition. Particular attention should be paid to empowering those who often are the most vulnerable, young people and women, so that their involvement in health advocacy serves their professional career advancement. It is hardly possible to imagine a healthy Baltimore if the grass-roots conditions of health promotion work force the workers and volunteers to provide to others that which they, themselves do not have.

Maiju Lehmijoki-Gardner, R.N., Ph.D., teaches theology at Loyola University. She blogs at http://www.healthfaithbaltimore.org.

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What we are seeing in Maryland that is equally as troublesome is the introduction of national medical/dental chains with little or no oversight and as such across the country these chains are found guilty of fraud and abuse. These chains are directed at medicaid populations.

As we move the poor out of emergency rooms to save money and cost, we must understand that corporate interest is profit and as such there needs to be as little of the chain medicine as possible and a lot of oversight.

Medicaid matters to children
Opinion --- Baltimore Sun

Three of every 10 children in the U.S. rely for their health needs on Medicaid, the single largest health insurer of children. Access to Medicaid not only ensures that 30 million children receive adequate medical care and preventive services, but also benefits society.

Because of Medicaid, low-income families are protected from burdensome medical expenses. Children with Medicaid are more likely to receive timely and appropriate medical care than uninsured children, saving the entire health care system money.

Although children represent half of all Medicaid enrollees, they account for only 25 percent of Medicaid spending. Without Medicaid, most if not all of these children would have no health insurance.

Over the past decade the rates of uninsured children has dropped substantially because of prior Medicaid expansion through the State Children's Health Insurance Program (SCHIP). Between 1997 and 2005, the number of uninsured children fell by more than one-third, from 23 percent to 14 percent, and currently 437,000 Maryland children are enrolled in Medicaid.

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However, despite these benefits to children and their families, and the relative low cost compared to adult expenditures, Medicaid is under attack. Many congressmen and state governors are calling to scale back the Medicaid expansion in the Affordable Care Act, and Paul Ryan's budget proposal would cut Medicaid funding by 34 percent by 2022.

The Urban Institute estimates that states could have to drop between 14 million and 27 million people from Medicaid by 2021. In addition to losing insurance, children will also lose access to their pediatrician if the cuts go through.

Current Medicaid payments are set to rise to equal Medicare compensation by year's end. Without this increase, many physicians will no longer accept Medicaid patients and access will be further reduced.

While reducing the federal deficit is important, it should not be at the expense of children not having access to the health care they need.

Scott Krugman, Baltimore

Copyright © 2012, The Baltimore Sun

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Where elected officials are pretending it is budget shortfalls that make them gut health care, it is actually health fraud of billions each year in Maryland that goes without recourse that drives the deficits. Think about the billions still to come from that first $25 billion mortgage fraud settlement. With $600-800 billion still left to collect, Maryland’s piece of that will be billions as well.

Several billion in financial and health fraud accounts for the shortfalls in budgets and accounts for our high insure rates as well. So, no need to cut services or benefits….just enforce the law!

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Cumberland hospital will cut jobs to reduce costs
Posted: 12:07 pm Thu, August 16, 2012
By Associated Press Maryland Daily Record

CUMBERLAND — The Western Maryland Health System in Cumberland says it plans to eliminate some jobs as it seeks to reduce costs by 10 to 15 percent over the next five years.

The Cumberland Times-News reported Thursday that the cuts will include two senior management jobs and the elimination of many positions that are now vacant.

Chief Executive Officer Barry Ronan says the health system ended its fiscal year in June with an operating loss of $8 million and a net loss of $1.9 million. The cuts are intended to save $6 million to $8 million this year.

Ronan says an expected reduction in public spending on Medicare and Medicaid programs makes it imperative that health system reduce its costs.

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THERE YOU GO ....THE HEALTH SYSTEM BOHEMOTH WITH HUGE PROFITS. PROFITS MADE BY REDUCING WHO USES THE EMERGENCY ROOM, HOW MUCH STAFF ARE PAID, AND HOW MANY STAFF ARE USED.
JOHNS HOPKINS IS PUSHING THIS IN MARYLAND AND YOUR INCUMBENT IS MAKING IT POSSIBLE. DO YOU HEAR MARYLAND'S HEALTH CARE FOR ALL? YOU WON'T........THAT'S NOT THEIR TASK!

VOTE YOUR INCUMBENT OUT!!!

Giant Hospital Chain Creates a Windfall for Private Equity
By JULIE CRESWELL and REED ABELSON Published: August 14, 2012

During the Great Recession, when many hospitals across the country were nearly brought to their knees by growing numbers of uninsured patients, one hospital system not only survived — it thrived.

Readers’ Comments "When a company is allowed to ask - Is it financially viable for us to treat this illness? - there is a huge conflict of interest. "Outraged in D-town, Denver

In fact, profits at the health care industry giant HCA, which controls 163 hospitals from New Hampshire to California, have soared, far outpacing those of most of its competitors.

The big winners have been three private equity firms — including Bain Capital, co-founded by Mitt Romney, the Republican presidential candidate — that bought HCA in late 2006.

HCA’s robust profit growth has raised the value of the firms’ holdings to nearly three and a half times their initial investment in the $33 billion deal. The financial performance has been so impressive that HCA has become a model for the industry. Its success inspired 35 buyouts of hospitals or chains of facilities in the last two and a half years by private equity firms eager to repeat that windfall.

HCA’s emergence as a powerful leader in the hospital industry is all the more remarkable because only a decade ago the company was badly shaken by a wide-ranging Medicare fraud investigation that it eventually settled for more than $1.7 billion.

Among the secrets to HCA’s success: It figured out how to get more revenue from private insurance companies, patients and Medicare by billing much more aggressively for its services than ever before; it found ways to reduce emergency room overcrowding and expenses; and it experimented with ways to reduce the cost of medical staff, a move that sometimes led to conflicts with doctors and nurses over concerns about patient care.

In late 2008, for instance, HCA changed the billing codes it assigned to sick and injured patients who came into the emergency rooms. Almost overnight, the numbers of patients who HCA said needed more care, which would be paid for at significantly higher levels by Medicare, surged.

HCA, which had lagged the industry for those high-paying categories, jumped ahead of its competitors and was reimbursed accordingly. The change, which HCA’s executives said better reflected the service being provided, increased operating earnings by nearly $100 million in the first quarter of 2009.

To some, HCA successfully pushed the envelope in its interpretation of existing Medicare rules. “If HCA can do it, why can’t we?” asked a hospital consulting firm, the Advisory Board Company, in a presentation to its clients.

In one instance, HCA executives said a private insurer, which it declined to name, questioned the new billing system, forcing it to return some of the money it had collected.

The hospital giant also adopted a policy meant to address an issue that bedevils hospitals nationwide — reducing costs and overcrowding in its emergency rooms. For years, the hospital emergency room has been used by the uninsured as a de facto doctor’s office — a place for even the most minor of ailments. But emergency care is expensive and has become increasingly burdensome to hospitals in the last decade because of the rising number of uninsured patients.

HCA decided not to treat patients who came in with nonurgent conditions, like a cold or the flu or even a sprained wrist, unless those patients paid in advance. In a recent statement, HCA said that of the six million patients treated in its emergency rooms last year, 80,000, or about 1.3 percent, “ chose to seek alternative care options.”

“Many E.R.’s in America, particularly in densely populated urban areas where most HCA-affiliated facilities are located, have adopted a variety of systems to determine whether a patient in fact needs emergency care,” the statement said. “About half our hospitals have done so. Typically, our affiliated hospitals have two caregivers — usually a triage nurse and a physician — make that determination. It should be noted that other non-HCA affiliated hospitals are using similar processes to address E.R. issues.”

As HCA’s profits and influence grew, strains arose with doctors and nurses over whether the chain’s pursuit of profit may have, at times, come at the expense of patient care.

HCA had put in place a flexible staffing system that allowed it to estimate the number of patients it would have each day in its hospitals and alter the number of nurses it needed accordingly.

Several nurses interviewed said they were concerned that the system sometimes had led to inadequate staffing in important areas like critical care. In one measure of adequate staffing — the prevalence of bedsores in patients bedridden for long periods of time — HCA clearly struggled. Some of its hospitals fended off lawsuits over the problem in recent years, and were admonished by regulators over staffing issues more than once.

Many doctors interviewed at various HCA facilities said they had felt increased pressure to focus on profits under the private equity ownership. “Their profits are going through the roof, but, unfortunately, it’s occurring at the expense of patients,” said Dr. Abraham Awwad, a kidney specialist in St. Petersburg, Fla., whose complaints over the safety of the dialysis programs at two HCA-owned hospitals prompted state investigations.

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WE WANT THE AFRO TO SPEAK UP FOR THE AFRICAN-AMERICAN COMMUNITY, NOT THE PEOPLE SET TO BRING THEM DOWN! ANTHONY BROWN AND BEN CARSON ARE AFRICAN-AMERICANS BUT THAT DOESN'T MAKE THEM ADVOCATES FOR THE UNDERSERVED AND THEIR BEST INTERESTS.......AND THEY ARE NOT!!!!!!

Health Care Reform in Maryland has been handed over to health corporations as a private health system decides on how health businesses will reflect the medicare/medicaid cuts onto the patients rather than their bottom line. We already know that Maryland's health care industry has a long history of neglect of the underserved communities as we see with the longevity figures for poor communities being 20 years lower than that of the more affluent neighborhoods. So, with very large cuts to medicaid last year and this year that will only get worse. This article featuring Anthony Brown, a corporate politician who works hard at privatizing all that is public, lowering public sector wages and benfits, and promotes development projects that move the underserved out of their neighborhoods and into charter schools that will track them for life into poverty vocational jobs is no friend of the underserved community.

As such, one can look to his comment on Enterprise Zones as a signal as to what these Health Enterprise Zones will be. We know that the true meaning of turning an impoverished area designated as an Enterprise Zone means moving the current citizens out to create luxury developments. This will be no different for Health Enterprise Zones. There is nothing good coming for the citizens of these communities, it will only build clinics and health facilities for the affluent the developers plan to occupy these underserved communities. The underserved will get compound type medicine with immigrant health workers giving basic, public health care.

Addressing Health Disparities: An Innovative Approach 1
by Anthony G. Brown Lt. Gov of Maryland   The Afro in Baltimore

As a child, I watched my father, an African American physician, work in some of the most underserved neighborhoods in our community. He treated medical conditions that had escalated to serious illness and disability because of lack of access to affordable, quality health care. Although he served these communities with hope, it pained him to see how unchecked disease and disability had diminished so much potential in underserved, minority communities. He worked patiently, tirelessly to right this inequity the only way he knew: one patient at a time.

Forty years later, health care access and quality are still woefully unequal and alarming racial disparities still exist. African American babies in Maryland are three times more likely to die before the age of one than white babies. African Americans are four times more likely to visit an emergency room for asthma. When adjusted for age, African Americans in this state are twice as likely to die from diabetes or kidney disease than whites, and are almost twice as likely to lack health insurance.

In a state with nationally ranked hospitals and medical schools, and the second highest number of primary care physicians per capita, such disparities are not acceptable. Health disparities are not only untenable at the societal level, but they also have tragic results for individuals and families in shortened lives and increased suffering.

At the request of Governor O’Malley, I have spent the past five years working with leading health care experts and providers and asking: Can’t we do better than this in Maryland? The answer is a resounding “Yes.” And we must. Addressing health disparities is a moral imperative.

That’s why the Governor and I worked with our partners in the General Assembly this year to pass the Maryland Health Improvement and Disparities Reduction Act, which created an innovative pilot program of Health Enterprise Zones (HEZs) in underserved communities. Primary care providers working with community-based organizations in these zones will be offered incentives – loan repayment assistance, tax credits, grants, health information technology – to provide services that directly reduce disparities and improve access to care. The HEZ Initiative provides $4 million in new funding to support a pilot program of two to four zones across the state.

It’s no coincidence that communities in Maryland without basic health care services, frequently communities with large minority populations, have the highest rates of chronic and often preventable illness, such as hypertension, asthma, diabetes and other controllable medical conditions. In underserved neighborhoods, routine symptoms that might be easily treated become serious, intractable health conditions. By saturating these communities with primary care providers and health care services, we can ensure healthier Marylanders who live a better quality of life.

Reducing health disparities also lowers costs for all taxpayers. A 2009 report by the Health Policy Institute at the Joint Center for Political and Economic Studies estimated that between 2003 and 2006, nearly $230 billion in direct medical care costs could have been saved nationwide if racial and ethnic health disparities did not exist. One report of Medicare claims found that African Americans were nearly twice as likely to be hospitalized for such treatable conditions as asthma, hypertension and heart failure, costing Maryland an additional $26 million in 2006. Attracting practitioners to deliver health care services in underserved communities through the Health Enterprise Zones program will help drive down costs while reducing serious illness and disease.

The enterprise zone model has worked successfully on another long-standing problem: economic underperformance in distressed communities. Maryland’s Enterprise Zone program allocated $38 million in property tax credits in 2010 to over 1,000 businesses across 29 qualified economically distressed zones. Those credits stimulated nearly $400 million in private investment, helping to revitalize communities and create over 2,100 new jobs.

The zone model also worked on academic underachievement in New York. The Harlem Children’s Zone initiative blanketed a single block with poverty-reduction programs that included mentoring, tutoring and year-round academic enrichment. The effort won a steep rise in academic success, including high school graduation and college attendance rates. Have you seen any positives out of the Enterprise Zones for anyone other than the affluent? This Harlem example was what the Enterprise Zone program was supposed to look like!

Our new HEZ program applies a similar, targeted zone concept to specifically improve health care and health outcomes in areas where health disparities have been demonstrated, which are all too often communities of color. As a leader in health care reform, the O’Malley-Brown Administration has been tackling health care challenges with vision and resourcefulness from day one, and adding Health Enterprise Zones to our strategy is the kind of creative thinking for which Maryland is nationally known. We have a responsibility to continue leading the way.

Over the next few weeks, we will be hosting public forums in Baltimore City, Prince George’s County, and Southern Maryland where citizens will have the opportunity to offer input and discuss how this new and exciting program can best make a positive impact on their communities. In addition to the public forums, the State has set up a website, http://dhmh.maryland.gov/healthenterprisezones, and is receiving comments via email at hez@dhmh.state.md.us.

Equal access to health care should be a right, not a privilege. It’s also fiscally responsible. We cannot afford the rising costs of treating preventable disease and chronic illness. More importantly, we cannot afford the loss of talent and dignity when even one of our neighbors’ potential goes unrealized for lack of health care.

I believe that every Marylander, of every race and ethnicity, in every part of our state, should have the same chance to live a healthy life and to maximize their contributions to society. By continuing to work together, we can make that ideal a reality.

As Chair of Maryland’s Health Quality and Cost Council, Lt. Governor Anthony G. Brown leads the O’Malley-Brown Administration’s efforts to reduce costs, expand access, and improve the quality of care for all Marylanders. Under the leadership of Governor O’Malley and Lt. Governor Brown, Maryland has implemented reforms that have expanded health coverage to over 330,000 Marylanders and put the State in position to maximize the Affordable Care Act (ACA).

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IT IS IMPORTANT TO SEE THAT THE PUBLIC FIGURES BEING PLACED BEFORE US ON THESE ISSUES ARE NOT WORKING IN OUR INTEREST. BEN CARSON WORKS FOR JOHNS HOPKINS AND THEY BOTH ARE CORPORATE SPONSORS. PROFIT OVER PEOPLE DRIVES THEIR ISSUES.

Dr Ben Carson and Healthcare Reform Dr Ben Carson says Obama Healthcare Reform “... is ... going in the wrong direction”

by J. C. Spencer

One of our favorite doctors, Ben Carson, MD, the keynote speaker at one of our Glycomic Conferences, sits down and discusses what is wrong with the proposed healthcare reform. “My biggest problem is I feel it’s going in the wrong direction.” In the interview, Dr. Carson said, “That’s one of the things that disappoints me about the lack of honesty … We can’t really debate when there’s all this subterfuge.” Pointing to doctors that he brought to the White House and gave white coats to put on, Obama declared, “Nobody has more credibility with the American people on this issue than you do.” Here is one of the most credible doctors in America. Here, you can read part of this discussion or watch the TV interview.

“Gifted Hands” Surgeon Rips Into Obamacare

by John Berlau

As the Senate Finance Committee completed its work on a bill that would greatly expand the government’s role in health care – requiring nearly everyone to buy insurance, and designing that insurance through subsidies and mandates – President Obama is trying to rally doctors to his side. At an event last week at the Rose Garden, phalanxed by doctors wearing their white coats (as well as some that White House staffers had handed out), Obama declared, “nobody has more credibility with the American people on this issue than you do.”

Dr. Benjamin Carson receiving the Presidential Medal of Freedom

Yet one of the nation’s top surgeons, with credibility and acclaim the world over for the pioneering surgeries he has and his personal story of overcoming hardship, recently ripped the dominant health care legislation before Congress in a critique similar to that of conservatives and libertarians. Benjamin Carson, director of pediatric neurosurgery at the Johns Hopkins Medical Institutions in Baltimore, Md., and recipient of numerous awards including the Presidential Medal of Freedom, criticized in a recent interview the approach of the current bills for their mandate, creation of a “public option,” and lack of malpractice liability reform.

“My biggest problem is I feel it’s going in the wrong direction,” Carson told reporters at TV station WLOS in Asheville, N.C. (Video here.)“It’s giving us more government and less autonomy. And I think we should be going in exactly the opposite direction. We should be having more autonomy and less government. And that is the kind of thing that brings the prices down.”

Considered one of the best neurosurgeons in the world, Carson gained acclaim in the ’80s and ‘90s for his pioneering operations separating conjoined twins joined at the head and other procedures that have saved children from epilepsy and brain cancer. But Carson is also celebrated for his personal story of overcoming poverty and prejudice. An African-American, Carson grew up in a single-parent home Detroit ghetto, but his mother pushed him and his brother to achieve excellence. He is the author of the popular autobiography “Gifted Hands: The Ben Carson Story,” which was made into a TV movie this year with Cuba Gooding Jr. portraying Carson. And he does much philanthropic work through charities such as his “Carson Scholars” fund.

Over the past few years, Carson has been writing and speaking more about public policy, including health care reform. He has railed against excessive litigation, pointing out how much malpractice insurance and other forms of “defensive medicine” to protect against lawsuits add to medical costs. In the interview with WLOS, Carson insisted that tort reform must go “hand in hand” as part of any true health care reform.

“We have to bring a rational approach to medical litigation,” he said. “We’re the only nation in the world that really has this problem. Why is it that everybody else has been able to solve this problem but us? Simple. Special interest groups like the trial lawyers’ association. They don’t want a solution.”

Carson also blasted proposals backed by Obama and most Democrats that would create a government-backed “public option,” saying it would inevitably lead to a “single payer” system like that of Canada, in which the government as the sole insurer would end up calling all the shots for patients. He pointed to how the Canadian government itself crowded out private insurance. “What happened to the private insurance companies in Canada? Just like that, they were gone, because they couldn’t compete with it (the government). Now, why would it be any different here? That’s one of the things that disappoints me about the lack of honesty … We can’t really debate when there’s all this subterfuge.”

Carson said that despite the problems with American health care, Canada and European countries were not models to emulate in their health insurance financing systems. “All we have to do is go to other places and see what’s going on. See how long people have to wait. Very, very long waiting periods. Why do you think so many people from Canada come here when they have a problem? I know a young man in England who has a problem with his knee. He needs an operation, and the waiting list is so long. … These are the kind of things that people in this country are not used to. But more importantly, it’s something that we don’t have to get used to. We can fix this without going to that kind of system that causes those kinds of long waits.”

As his main “fix”, Carson proposes a system of patient empowerment in which “individuals and families can own their own insurance; it doesn’t have to be through their employer.” Not all of Carson’s ideas expressed in the interview were free-market, though. He did propose that the government set insurance rates, and cover patients’ catastrophic costs above $250,000

Above all, Carson was adamant that there transparency and deliberation, rather than a rush to force through a health care bill that no one had read. In fact, he proposed bringing health care to a national vote of the American people “I would say we should have a national referendum on it. People should be able to vote. That would really work, because now, people would have to explain it. They would have to know what was in it. When we do these big sweeping national things and just sort of jam them through and nobody even knows what’s in it, that’s not democracy. At some point, someone has lost their ideal of what democracy is.”

Carson’s colleagues at Hopkins – ranked by U.S. News and World Report for 19 years as the nation’s best overall hospital and lauded for the millions it spends on charity care for the poor –have also voiced concerns about the direction that health care legislation is going. Citing the cuts to hospitals to pay for the goal of universal coverage – cuts of more than $150 billion in Medicare and Medicaid payments to hospitals, according to the Congressional Budget office “preliminary analysis” of the Max Baucus’ Senate Finance Committee bill – the Hopkins officials have been warning about severe stress on Hopkins and other hospitals that Hopkins and other hospitals would face. THE CHARITY FOR THE POOR THAT HOPKINS GIVES IS PAID FOR IN TAXPAYER MONEY, NOT THEIR ENDOWMENTS. IT IS ABSURD TO ALLOW THIS TO BE PRINTED......VAINGLORIOUS!!!!

At a Sept. 18 “town meeting” on the campus of the main hospital in Baltimore, Md., Johns Hopkins Institutions Director of Federal Relations Beth Felder was blunt about the cuts in reimbursements. “That is going to come out of hospitals and health systems,” she said. “I think that’s not a good thing for us.” Similarly, Johns Hopkins Medicine health system CEO Edward Miller told C-Span on Sept. 16 that cuts in the reimbursement rates for Medicare and Medicaid, “There are going to be less physicians that will care for these patients.”

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THIS IS WHERE YOUR HEALTH CARE GOES.....AS THEY CONSOLIDATE AND BECOME MEGA-INDUSTRIES THEY WILL BECOME LIKE THE FINANCIAL INDUSTRY WITH FRAUD AND CORRUPTION. YOUR MEDICARE/MEDICAID IN THEIR POCKETS. THIS IS THE NEW APPROACH TO HEALTHFRAUD....A GROWTH INDUSTRY!

Why would hospitals like HCA perform unnecessary surgery? Because it pays
. Posted by Sarah Kliff on August 7, 2012 at 9:56 am Washington Post

If you want to understand the problem of how we currently finance our health-care system, there’s a great case study to be had in HCA, the largest for-profit chain of hospitals in the country. A New York Times investigation out Tuesday morning found HCA cardiologists in Florida to be performing unnecessary procedures on patients who, in some cases, did not even have heart disease in the first place.

Why perform a an invasive procedure, which comes with risks to the patient, if it’s unnecessary? Reed Abelson and Julie Creswell combed through thousands of pages of confidential memos and e-mails, where they saw “hospital officials [asking] information on how the physicians’ activities affected the hospitals’ bottom line.”

In other words, the doctors may have performed unnecessary procedures because there was a financial incentive to do so (HCA, in the Times story, disputes this, saying that decisions about care were motivated by a “strong focus we have on quality patient care.”).

If you are a hospital that wants to boost its bottom line though, performing more cardiac procedures — even those that aren’t necessary — is pretty much the way to go. Right now, doctors get paid for each service they provide. The cardiologist that inserts more stents and performs more surgeries tends to net a higher salary.

There’s a lot of griping about this “fee-for-service” payment model exactly for this reason: It nudges doctors to deliver the most health care, even when less could be better for the patient — not to mention better for bringing down health-care costs.

Separate research suggests this phenomena of unnecessary cardiac surgeries isn’t necessarily isolated to HCA hospitals. Health policy researchers at the University of Michigan recently looked at cardiology procedures done across the state. They found that nearly half — 43 percent — should not have happened if surgeons had followed medical guidelines. The risks outweighed the possible benefits.

This happens so much that there’s actually a term for it in the medical literature.  “Oculostenotic reflex” was defined over a decade ago as the “irresistible temptation” on the part of interventional cardiologists to expand narrowed coronary arteries, despite evidence-based guidelines” suggesting the use of a different intervention, such as medication (which comes with fewer risks and at a lower cost).

The health-reform law does take some steps to address these unnecessary procedures, by creating new payment models where providers would essentially lose money by performing procedures they don’t need to. That’s the whole idea behind the health law’s Accountable Care Organizations, where doctors band together and take a lump-sum for covering a set number of patients. If they can deliver care for less — while hitting certain quality metrics — they pocket what’s leftover. Doctors that perform unnecessary care, and go over that set amount, will find themselves in the red.

Right now, however, that’s not how most of our health-care system works. As of 2008, a Bureau of Labor Statistics report found that 78 percent of health plans pay their doctors on a fee-for-service model. Most of Medicare works this way, too — creating an incentive for doctors to keep inserting more stents into patients — even if the medical literature suggests otherwise.

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CUOMO, THE THIRD WAY DEMOCRATIC GOVERNOR OF NEW YORK PRESSED FOR TORT REFORM LAST YEAR AND LOST, BUT WILL NO DOUBT TRY AGAIN. WITH HOSPITALS BECOMING INCREASINGLY ABOUT PROFITS WITH THIS HEALTH REFORM AND WITH MEDICAID AND MEDICARE BECOMING PUBLIC HEALTH CHECKUPS WITH LIMITED HOSPITAL CARE, DOCTORS WILL SEEK PROTECTION FROM MALPRACTICE AS MORE PEOPLE DIE FROM NEGLECT AND DENIED CARE.  WE ALREADY SEE AUTOPSIES DISAPPEARING AS HOSPITALS ARE NO LONGER INTERESTED IN FINDING DOCTOR'S ERRORS. REPUBLICAN STATES ARE ALREADY ELIMINATING PATIENT LAWSUITS THROUGH TORT REFORM. MARYLAND'S GOVERNOR O'MALLEY FOLLOWS NEW YORK IN EVERY WAY SO STATE TUNE FOR THE WORDS 'TORT REFORM' COMING TO MARYLAND AS PRIVATE HEALTH SYSTEMS REFUSE TO PAY FOR MALPRACTICE INSURANCE.

Troubled New York Hospitals Forgo Coverage for Malpractice

Christopher Gregory/The New York Times

Every hospital makes mistakes. But some New York City hospitals may not have enough money to pay for them.

Readers’ Comments Share your thoughts. Several of the city’s most troubled hospitals are partially or completely uninsured for malpractice, state records show, forgoing what is considered a standard safeguard across the country.

Some have saved money to cover their liabilities, but others have used up their malpractice reserves, meaning that any future awards or settlements could come at the expense of patients’ care, and one hospital has closed its obstetric practice, in part out of fear of lawsuits.

Executives of these hospitals, most of which are in poor neighborhoods, say their dire financial circumstances and high premiums make it impractical to pay millions of dollars a year for insurance.

But insurance experts say that though dropping coverage may make economic sense in the short term, it is hardly in the best interest of patients, and in the long term it may be costly to hospitals and their bondholders, including some bonds backed by the state, should large judgments force them into bankruptcy.

“From a kind of self-interest of the hospital, it seems if you’re a marginally capitalized hospital barely making it, it would be perfectly rational not to buy insurance,” said Tom Baker, a law professor at the University of Pennsylvania who has written about malpractice insurance.

“From a social perspective, it’s very irresponsible. They’re taking in these people knowing they’re not able to make good on the harm they caused. Even a really good hospital is going to have a certain amount of medical malpractice. It’s inevitable.”

Hospitals in New York do not need malpractice insurance to function, and they need not tell patients when going “naked” or “bare,” in industry parlance.

Many states do not require malpractice insurance, and New York is not the only city where hospitals go without coverage. Generally the uninsured hospitals are in areas where juries award big judgments, insurance executives say.

“In New York and in poor venues, difficult venues — Philadelphia is one, New York City, Chicago Cook County, Florida Dade County — it’s not effective for the hospitals to buy the coverage because they charge so much,” said Dominic A. Colaizzo, chairman of the national health care practice for Aon, an insurance brokerage.

The choice may be grim. “If I have to pay for nurses versus fund for malpractice, what are the hospitals going to do?” Mr. Colaizzo said.

There is no central record of which hospitals have insurance. But in 2009, the state Health Department took a survey of so-called self-insured hospitals. It found that three — Interfaith Medical Center, Kingsbrook Jewish Medical Center and Wyckoff Heights Medical Center, all in Brooklyn — were completely self-insured.

Twelve other hospitals across the city were partially self-insured, including St. Vincent’s Hospital in Manhattan, which went bankrupt and closed in 2010; Lenox Hill in Manhattan; Jamaica Hospital Medical Center in Queens; and New York Hospital Queens.

Some of the 12 had bought insurance to cover lower-dollar or “primary” claims, but not “excess” judgments. The others had excess coverage but not primary.

The Health Department has not done a follow-up survey, but hospitals that responded to questions about their coverage said it had not changed.

In interviews, some hospital executives said their physicians had separate insurance which is subsidized or reimbursed by the hospital. Interfaith, for one, gives its emergency-room physicians a letter promising to assume liability, said Luis A. Hernandez, the hospital’s chief executive.

Without insurance, many hospitals set aside money to pay for claims, but a review by The New York Times of state records and hospital financial records indicates that several of the hospitals have insufficient reserves to cover their malpractice liabilities.

Two of the hospitals without insurance have no money set aside, according to their financial documents and interviews with hospital officials. In the case of the third, Kingsbrook, it is unclear from financial statements if it has any money in reserve.

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IT IS IMPORTANT TO REMEMBER THAT THIS CRISIS IN HEALTHCARE IS CAUSED BY CORPORATE PROFITS PLACED BEFORE THE PUBLIC. IT IS ALSO ABOUT THE FAILURE OF DEMOCRATS IN CONGRESS TO ADDRESS CORPORATE TAX RATES......THEY NEED TO BE PAYING THEIR FAIR SHARE.  IT IS ALSO ABOUT WASTE AND FRAUD. INSTEAD, THIRD WAY DEMOCRATS ARE WORKING TO PUSH THE POOR AND OLD OUT OF THE HEALTHCARE SYSTEM. ENTITLEMENTS-----REALLY? NONE OF THIS NEEDS TO HAPPEN.

THE PURPOSE OF HEALTHCARE REFORM IS TO GET MOST PEOPLE OUT OF THE HEALTHCARE SYSTEM, SHORING UP ACCESS FOR THE AFFLUENT. MIDDLE-CLASS NEED NOT APPLY.......YOU WILL HAVE NO DISPOSIBLE INCOME TO PAY FOR HEALTHCARE!

Decisions like 'Kool Smiles' and private health systems explain this discrepency!  When access to private hospitals give cursory care and a discharge with few options for follow-up or routine checkups.....this is the result!

City health data illustrates chasm between rich and poor neighborhoods Life expectancy in Roland Park 20 years higher than in Upton

By Meredith Cohn and Adam Marton, The Baltimore Sun 12:16 p.m. EDT, July 12, 2012

Baltimore health officials have been staring at a daunting statistic for years: life expectancy in the richest neighborhoods is 20 years longer than in the poorest ones.

But a plan unveiled recently aims to battle the intractable health problems causing the gap, including high rates of HIV infection, heart disease and violence.  An interactive map created by The Baltimore Sun using city data illustrates many of the stark differences between city neighborhoods:

The median income for Roland Park is 90,000 while in Upton it is 13,000.
In the wealthiest parts of the city, people are dying from heart disease, cancer, stroke, respiratory disease and injury.
In the poorest parts of the city, people are dying from heart disease, cancer, stroke, HIV/AIDS and homicide.
Life expectancy also follows these trends. Life expectancy in Roland Park is 20 years higher than in Upton.

Called Healthy Baltimore 2015, the city's plan targets the city’s top 10 ailments. And it maps out for the first time specific and comprehensive goals such as cutting smoking rates by 20 percent and the number of obese adults by 15 percent.

There are no special funds dedicated to the cause but city agencies have all been directed to do their part, such as improving lighting in parks so residents feel safe going for a walk or luring fresh produce vendors so healthy food is more available.

In addition, officials have been engaging residents, as well as businesses, faith groups, hospitals and others, in the process. Each community has been given their specific data and residents have been instructed to choose problems on which to focus.

Dr. Oxiris Barbot, city health commissioner, said the progress will be documented every few years. The goal is to improve the statistics by 10 percent to 25 percent by 2015.

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Medicare recipients to get more coordinated care Federal health law program aims to bring better coordinated care to Medicare recipients

By Meredith Cohn, The Baltimore Sun 3:38 p.m. EDT, July 9, 2012

Four doctor groups across Maryland have been chosen by the federal Department of Health and Human Services for a program that aims to cut health costs and better coordinate care for Medicare recipients.

The program named 89 new groups in 40 states to become Accountable Care Organizations under the federal health care reform law. That brings the total already signed up for the voluntary program to 154, according to federal health officials.

The groups share in savings realized through the more coordinated care. Officials estimate the total savings to the federal Medicare program could be up to $940 million over four years.

There are 33 quality measures developed for the organizations related to care coordination, patient safety, preventive health services, patient experience and care for at-risk populations.

In Maryland, the doctor groups include: Accountable Care Coalition of Maryland LLC, located in Hollywood with 109 physicians; Greater Baltimore Health Alliance Physicians LLC, affiliated with Greater Baltimore Medical Center with 399 physicians; Maryland Accountable Care Organization of Eastern Shore LLC with 15 physicians; and Maryland Accountable Care Organization of Western MD LLC with 23 physicians.

Meredith.cohn@baltsun.com

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WE ARE SEEING TIME AND AGAIN THAT THE DEVELOPMENT IN HEALTHCARE IS AT THE AFFLUENT END AS ACCESS BECOMES HARDER FOR MOST. WE ARE SEEING CONSTRUCTION AND INTERIOR COSTS FOR THESE HOSPITALS AND DOCTOR'S OFFICES CLIMB AS FEWER PATIENTS ARE TAKEN. THIS IS A PRIVATE HEALTH SYSTEM AS OPPOSED TO A PUBLIC HEALTH SYSTEM AND IS DRIVEN BY HOPKINS HAVING THE MOST TO GAIN FROM THIS NEW DYNAMIC.

High costs push middle class to concierge doctors
Baltimore Business Journal by Sarah Gantz, Reporter Date: Friday, June 15, 2012, 6:00am EDT - Last Modified: Thursday, June 14, 2012, 3:37pm EDT

Dr. Michael J. Downing, right, with an unidentified patient, will limit the number of patients he sees to no more than 12 each day. Concierge medicine may not be just for the rich anymore.
A doctor’s office model in the past dubbed “health for the wealthy” because it charged a flat fee — now between $1,000 and $2,000 — in exchange for better access to doctors is becoming more popular among patients and physicians.
Some industry experts say that’s because high-deductible health insurance plans, an emphasis on preventive medicine and anticipated congestion in doctors’ offices is pushing more middle-class Americans to concierge practices.
“Patients are paying a lot of money out of pocket anyway,” said Gene Ransom, CEO of MedChi, the Maryland State Medical ...

Johns Hopkins Medicine targets D.C. area’s affluent neighborhoods
Baltimore Business Journal by Ben Fischer, Washington Business Journal Date: Friday, June 8, 2012, 6:00am EDT -

Johns Hopkins Medicine is preparing a major expansion in Washington, D.C., plotting five expanded or new clinics in its biggest strategic move since acquiring Sibley Memorial Hospital Sibley Memorial Hospital

The Baltimore-based health giant’s entities have notified regulators of plans to expand two offices on the Sibley campus, acquire a private practice and open two new clinics, including a large clinic in the heart of downtown Washington.

The locations will likely occupy a few thousand square feet and house just a few physicians, but collectively they will help Hopkins achieve several strategic goals.

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AS JOHNS HOPKINS FIGHTS AGAINST PUBLIC OPTION IN MARYLAND SO IT CAN EXPAND AS A PRIVATE HEALTH SYSTEM, ONE HAS TO WONDER HOW IT MAINTAINS ITS NON-PROFIT STATUS AS IT GOBBLES MARKET SHARE IN GLOBAL HEALTHCARE FOR THE WEALTHY. AT WHAT POINT DOES SPENDING MONEY FOR EXPANSION END AND PROFIT-MAKING BEGIN.

THIS IS A VERY PRIVATE ORGANIZATION I'M TOLD!

Below was Johns Hopkins pitch to the 'New Economy' crowd at this immigration session.

Healthcare and the Next Economy?

The healthcare sector is a huge and important driver of Greater Baltimore's economy. From 2000 to 2009, it added more jobs - over 34,000 - than any ther sector, and in 2009 it was the second-largest employment sector in the region in terms of total employment (government was first). This alone does not make the metro unique, however. Healthcare was the largest jobs generator in 75 of the largest 99 metro areas in the US, and it was the second largest in most of the others. It was also the biggest employer in 14 metro areas and the second biggest in another 45. Jobs in this sector, vast in their overall numbers, span the occupational and pay spectrum and can thus provide good opportuniteis for low-income workers to advance along solid career pathways.

With nationally ranked Johns Hopkins, the University of Maryland, and Union Memorial, Baltimore is on the cutting edge of innovations in patient care and an 'exporter' of healthcare services to individuals living both outside the region and outside the US. Despite this, the cast majority of healthcare in the meto area, similar to that found in other regions of the country, is local serving and thus unsustainable as the primary engine of economic growth. However, the region's exceptional healthcare industry is and should continue to be a "center of gravity" for growth in several key next-economy sectors in the region, including bioscience and information technology (IT), as well as industies like hospitality and tourism. In fact, the use of new diagnostic methods, therapies, devices, and IT applictions for mangaing health and health records are vital to making mire efficient and cost effective the treatment and care of the injured, sick, and elderly, and thus to improving our nation's overall well-being in the decades to come. Given Greater Baltimore's existing prowess in these areas, this region can and should help to lead the nation in this transformation.

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I would like to point out two things that this article below misses:

First, the shift to preventive care over hospital stays as a reduction in cost has proven to be more about waste and fraud than cost savings. Looking back, we see all these annual checkups and Xray/MRI procedures as a money-maker for doctors and medical equipment companies who, often went further by over-charging and falsifying claims to pad profits. One of the first things to go with the healthcare reform will be this routine of preventative tests that are now known to be unnecessary. Entitlement Trusts are greatly diminished by this preventive period.

Secondly, people would take great exception to the idea that reduced hospital stays worked as a policy. Whether the mother just giving birth or a patient not yet free of anethesia, people's health is often jeopardized by this rush to release patients from hospitals.

We all know that waste and fraud is the driver of healthcare costs so that would be the first place to look for reform. What we see is a reduced budget for the justice department's both state and federal with what looks like little interest in bringing back the trillions of healthcare profits lost to the government and the public ovr these few decades. Instead, we listen to the burden of cost reduction placed again on the shoulders of the public

Maryland's hospital rating system in danger of failing State looking to revamp unique method for setting hospital rates

By Andrea K. Walker, The Baltimore Sun June 9, 2012

For 35 years, Maryland has enjoyed a unique exemption from the federal government that allowed it to regulate hospital rates so that patients are charged the same no matter where they seek care.

But the system that state health officials say has created an egalitarian way of charging for health care now faces an unprecedented challenge.

The state has come dangerously close to failing a test it must meet every three months to keep the exemption, under which the federal government gives Maryland larger Medicare payments than other states. To pass, the state must show federal officials that its Medicare costs have grown more slowly than in the rest of the country.

For years, clearing that bar wasn't a problem, but that changed as health care costs in the state soared in recent years. The margin keeps narrowing and is all but nonexistent this year.

The state wants to renegotiate what it calls an outdated waiver test predicated on an old health care model that examines costs based on inpatient hospital stays. Health care today focuses on preventive care and keeping people out of hospitals, which makes overnight stays more costly because they are used only in the worst cases.

To compensate, the Health Services Cost Review Commission, which sets the state's hospital rates, has dictated flat rates for hospital care in the past few years, prompting complaints from hospitals faced with rising costs. The commission has made it a priority to negotiate a new waiver test with the Centers for Medicaid and Medicare Services, which monitors the waiver.

Often at odds, insurance and hospital executives have banded together to help the state come up with a way to overhaul the system to better fit today's health care system.

"We are looking to evolve the system to address changing circumstances in health care," said John Colmers, chairman of the cost review commission. "I think there generally remains support for this among the political leadership, the hospitals and the insurers."

Created in 1971, the commission was a cornerstone of then-Gov. Marvin Mandel's consumer protection package. Set up to operate much like the Public Service Commission, which regulates utilities, it was given the power to set hospital rates in 1974.

The unique rate-setting system became a national model for containing costs and was copied in West Virginia, New York, Massachusetts and Washington state. The federal government issued the waiver in Maryland because the system worked so well at keeping down costs.

Today, Maryland is the only state that still has the waiver. Other states eliminated their systems for various reasons, Colmers said. Some had to get rates approved legislatively each year, which could be cumbersome and acrimonious.

Health officials don't want the same fate for the waiver in Maryland.

The rate-setting system was based on a hospital stay because in the past that is where most care was administered. Now, people often are treated at urgent-care centers or seek outpatient care at their doctor's office. Procedures that once required overnight stays can be done in a couple of hours.

But efforts to reduce hospital admissions to cut costs have made the average cost for inpatient care much higher, those in the industry argue.

Health officials say that losing the waiver could cause problems for hospitals and cost consumers more because prices would rise. Hospitals could receive less reimbursement for the many Medicare patients they serve, forcing them to raise rates for everyone else.

"Our payment system for hospitals provides equity of payment and access to care in ways that significantly benefit the citizens of Maryland," said Robert Chrencik, president and CEO of the University of Maryland Medical Center. "However, the continuation of our payment system in the long term will be difficult if the [cost review commission] cannot provide adequate rate increases and a sustainable long-term solution, which will require that we redefine the waiver test."

Hospitals have had to absorb the cost of inflation the past three years because pressure to meet the waiver prevented significant rate increases. This month, the cost review commission approved a 0.3 percent rate increase for fiscal year 2013, which included a 1 percent cut to inpatient rates — aimed at meeting the waiver test — and a 2.59 percent boost for outpatient services.

"Given the direction of health care, there is no situation in which the waiver test is viable," said Carmela Coyle, executive director of the Maryland Hospital Association, which represents 46 member hospitals. "Maryland will fail the current waiver test and we will revert back to the national Medicare program, and that will have significant adverse consequences for Maryland hospitals."

Thomas R. Mullen, CEO of Mercy Medical Center in Baltimore and a member of the cost review commission, said his hospital is looking for ways to cut $10 million from its budget. Failure to modernize the waiver would make the situation worse, he said
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THE UNIVERSITY OF MARYLAND SEES THIS GEORGE WASHINGTON UNIVERSITY PROGRAM AS A PARTNER PROGRAM FOR MARYLAND. IT IS BEHIND THE SCHOOL-BASED HEALTHCARE PUSHED BY CARDIN AND O'MALLEY. WHAT WE ARE SEEING ACROSS THE BOARD IS A SYSTEM OF GRANTING AGENCIES THAT SEND OUT CALLS FOR FUNDING FOR PROGRAMS LIKE THIS. SO RATHER THAN GOING TO GOVERNMENT COFFERS FOR DISTRIBUTION, AN INSTITUTION LIKE JOHNS HOPKINS OR UNIVERSITY OF MARYLAND DECIDES THE COMMUNITY NEEDS THIS PROGRAM. THERE IS NEVER ANY PUBLIC INPUT AS TO WHAT THEY WANT, NEED, OR HOW THEY RECEIVE IT......IT JUST APPEARS AND THEN CORPORATIONS AND THE WEALTHY, RATHER THAN PAY TAXES, CONTRIBUTE WHERE THEY WANT.

IT'S IMPORTANT TO UNDERSTAND THAT THIS WAS ALL IN DEVELOPMENT THIS PAST DECADE AS THE MASSIVE MORTGAGE FRAUD MOVING TRILLIONS IN MIDDLE/LOWER-CLASS WEALTH TO THESE VERY PEOPLE 'DONATING' OUR MONEY BACK TO US!

THIS SYSTEM TOTALLY REMOVES YOU AND I FROM WHAT OUR SOCIETY WILL LOOK LIKE....AND TAKES OUR TAX MONEY TO SUPPORT WHATEVER IS DECIDED..........IT IS AUTOCRATIC.

The Center for Health and Health Care in Schools (CHHCS)

is a nonpartisan policy and program resource center at George Washington University's School of Public Health and Health Services. The Center's mission is to strengthen the well-being of children and youth through effective health programs and health care services in schools.

Health programs range from those that help students adopt healthy habits to those that foster a physically and emotionally healthy school environment. School-based services include physical and mental health care, dental services, screenings and referrals to community resources, as well as school-located services to support students with special needs.

The Center links educators and health professionals to the information essential to building these programs, through testing new school-connected strategies to achieve better health outcomes for children, and by promoting awareness of successful new directions in school-based programming.

Projects undertaken by the Center include:
    • Helping school and health personnel assist immigrant and refugee children and their families reduce emotional and behavioral health problems through community partnerships
    • Assisting a community service agency and a local department of mental health design an evaluation for their school mental health program
    • Developing a policy options paper for a state considering a school-based health center initiative

Here's my comment to them,

I am writing from Baltimore where the State has adopted a dental program for underserved children. I talked informally with several parents who particiate in the program and they all say that it appears that the service they receive is preventative with cursory checkups, but if work needs to be done, they cannot find a doctor to work with them. I found 4 in the Baltimore area who seemed to be the only sources, all very difficult for the poor to access.

Can you give me some insight as to how you think the program should be working?

Thank you,

Cindy Walsh

Citizens Oversight

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Below is a comment I sent to the University of Maryland School of Nursing....strategic partnership. As you can see it has a Global Office, because that is the point of the strategic alliance----building global businesses...... the Wellmobile program will work much like Ben Cardin's Dental Insurance for underserved children....it will send nurses and medical/nursing students into the underserved communities to offer public health checkups and cursory care, but there will be almost no access to private doctors and hospitals working for profit for followup. This is designed to stop the underserved from using the emergency room of hospitals for treatment, where they were able to see a doctor. Coming from a family of healthcare professionals, some parts of the strategic alliance sounds good......using nurses in more avenues of care and instruction is a good thing. What is not good, is that most people will fall into this uninsured status, whether working or poor, because people are already not able to afford healthcare deductibles. WHAT THIS PRIVATE HEALTH SYSTEM FORMAT DOES IS REMOVE THE EXPENSE OF CARE FOR THE PEOPLE MOST LIKELY TO BE SICK, AND WILL INCLUDE MEDICARE AND MEDICAID ENTITLEMENT PATIENTS. REMEMBER, THESE MARYLAND HEALTH INSTITUTIONS ALREADY REFUSE TO GIVE FOLLOWUP TO UNINSURED/UNDERINSURED......THEY WANT TO EXTEND THIS PRACTICE.

This kind of healthcare format is the same they use in Third World countries like Haiti or Bangledesh. Using the poor to train students and keeping them from mainstream services comes right from the medieval playbook-------are Barbers and bloodletting coming back as well? It's funny that the rich in France find this tiered health system these Third Way Democrats are building 'barbaric' and other European countries use this movement in the US to galvanize people to fight for what they already have.

It is widely thought that the goal of the healthcare reform and these strategic partnerships for public institutions are simply a method of creating global healthcare businesses using taxpayer money, but at taxpayer expense, as many people are becoming unable to access healthcare in America.

Do you think it is fair to say that this is in fact the goal of this strategic partnership being pushed by Governor O'Malley?

CareFirst BlueCross BlueShield: CareFirst provides support to the Clinical Enterprise unit of the Governor’s Wellmobile Program. The purpose of this partnership is to build new models of service linkages during health care reform that advance care and access to the underserved and educate the next generation of nurses.

Abstract
Nurses go on the road to bring primary care to uninsured patients.

Jim Parker (his name and identifying details have been changed), a 26-year-old uninsured U.S. citizen, broke his right forearm while doing some repair work at home. At a local ED, his arm was stabilized with an elastic bandage and he was given a referral to an orthopedic practice. He called for an appointment and was told that the physician did not accept uninsured patients. Jim offered to pay on an installment plan but was refused. He called other offices and received the same response. He had a broken arm and it needed to be set and put in a cast. If it healed improperly, he would be unable to keep his construction job. Then he would be not only uninsured but unemployed.

Why provide primary care services to the uninsured? Many communities have recognized that early detection and treatment of disease and ongoing health management reduce disability, increase productivity, and avoid costly health care services in the long term.

THE GOVERNOR'S WELLMOBILE One such service is the University of Maryland School of Nursing (UMSON) Governor's Wellmobile program. Established in 1994, the program consists of four mobile health care units, each located in a separate area of Maryland. Each unit provides primary care services to uninsured residents, regardless of citizenship status. The services provided are acute and chronic disease management, screenings, preventive services, physical examinations, and immunizations.

Each mobile unit is staffed with a family NP; an RN care coordinator; an outreach worker, receptionist, and scheduler; and a driver with a commercial driver's license. The mobile units visit established sites on a weekly basis. There are no charges for the services provided by staff. The decision to not charge clients was based on the recognition that they would need to use their limited resources to pay for prescriptions, laboratory and radiologic tests, and specialty referrals. Since the clients are all uninsured, there's no need for a billing system, but visits are coded in order to quantify the services.

In fiscal year 2007 (July 2006 through June 2007), the Wellmobile program provided services at 7,262 visits. It's estimated that these visits avoided $2,704,500 in ED fees. In addition, the program is estimated to provide more than $1.5 million in unreimbursed services (ICD-9 codes were used to document the services provided, and cost savings were calculated using the applicable Medicare rates).

Clients are screened for eligibility in health care programs offered by the state, the county, local agencies, and medical systems. If the screening indicates that a client may be eligible for a service, contact information is provided and an appointment is set up, often before the client leaves the Wellmobile. Clients can continue receiving services on the Wellmobile while they are waiting for eligibility rulings. When a client is deemed eligible for a particular program (for example, Medicaid or a breast or cervical cancer program for low-income patients), all subsequent services are managed by that program and all Wellmobile records are forwarded to the new provider.

There are no additional staff members to assist with administrative tasks; each four-person team divides the work to coordinate services for all clients. Each interaction between a patient and a Wellmobile staff member is termed an encounter; an average of four encounters occurs per client per visit. These encounters may include setting up appointments with the Wellmobile's family NP (follow-up appointments may be necessary if laboratory tests indicate that further action is needed) and referrals to outside providers or other agencies. These may include a social services agency that provides help with food stamps or housing, the local health department that provides immunizations and breast and cervical cancer programs, or a charitable organization through which physicians work on a pro bono basis to provide care beyond that offered on the Wellmobile.

PARTNERSHIPS Jim Parker was lucky. He found his way to the Wellmobile in his community. While orthopedic services were beyond the scope of practice offered by the NP, the nurse care coordinator made some calls and found a local faith-based agency that worked with physicians who offered pro bono services. That agency was able to find an orthopedic practice that would provide Jim with the care he needed. Jim came back to thank the team and asked them to sign his cast.

The Wellmobile program's success depends on the network of partnerships and relationships with county health departments, local service agencies, hospitals, faith-based groups, schools, and private organizations in each region of the state.

Figure. One of four Wellmobiles in the UMSON Governor's Wellmobile program.

The program's mission is to provide primary care services to the uninsured residents of the state; to explain that mission, I, as the director of the Wellmobile program, and members of the Wellmobile teams meet with representatives of local hospitals, health departments, and other agencies that provide services to the uninsured, such as the Salvation Army and other faith-based organizations that operate free health care clinics. Sometimes it's necessary to assure these interested parties that the Wellmobile is not entering the community to siphon off clients who have insurance, but rather to offer assistance to those who have problems accessing health care. The Wellmobile program has often been able to negotiate reduced fees with other providers, enabling its clients to obtain laboratory tests, X-rays, medications, and referrals for about the same fees that those who have insurance are charged. Some of these providers offer their services pro bono, with the understanding that only necessary referrals will be made so that the services aren't overused.

Other staff members and I serve on local committees and as partners on grant applications with health departments and agencies such as the American Cancer Society and the Area Health Education Centers. In addition, the staff members of the regional mobile units are residents in the communities they serve. Most of the staff have worked for some time in local health care agencies and have personal and professional relationships with various partner organizations. These relationships play an integral role in finding and securing resources for clients.

In addition to the primary care services it provides to uninsured residents of Maryland, the Wellmobile program serves as a learning opportunity for undergraduate and graduate nursing students in the areas of community health, health disparities, rural health, and primary care. The UMSON is beginning to explore the rich opportunities provided by the Wellmobile program for community-based participatory research throughout the state.

IF OUR PUBLIC INSTITUTIONS WEREN'T INVESTED TO BECOME WORLD-CLASS FACILITIES WE COULD THEN HAVE THE MONEY TO SERVE OUR OWN CITIZENS WITH THE HEALTHCARE EQUIVALENT AS RECEIVED IN FIRST WORLD COUNTRIES.

Global Health Office

The University of Maryland School of Nursing (UMSON) Office of Global Health (OGH) emerged from UMSON’s 2003-2006 Strategic Plan, which called on the School to “establish a global health initiative in education, research, and practice.” In January 2009 the OGH was officially established with Dr. Jeffrey Johnson as director to lead the School’s effort to integrating and fostering global health activities, developing meaningful opportunities for students and faculty, and building sustainable partnerships that focus on strengthening the critical role of nurses in the global health workforce. The Office of Global Health is deeply committed to serving local and global communities through the lens of social justice.

University of Maryland School of Nursing
655 West Lombard Street, Baltimore, MD 21201, USA
Main Campus Phone 410-706-3100
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What they are doing is joining public and private into this funding scheme so you see for-profit hospital systems receiving private grants-----which are charitable deductions------just as the state university in Maryland. They are eliminating the boundary of public and private so that now, your and my tax money will become profits for the shareholders of these private companies. Now, politicians want to assure us that there are mechanisms in place to make sure that these wealthy 'charitable contributions' will not simply be money moved to businesses in which these wealthy people have a personal profit interest........no indeed........THEY ARE GOING TO MONITOR THE SITUATION TO BE SURE THAT THIS IS NOT JUST A MONEY-LAUNDERING SCHEME.......AND WE KNOW HOW WELL THE STATE OF MARYLAND MONITORS ITS WEALTHY CITIZENS!

I WAS TOLD ' WE KNOW BETTER'.....THAT IS JUST WHAT THE ROBBER-BARONS SAID.

Southern Maryland Hospital to Enter Strategic Partnership
March 30, 2012 Michael Chiaramonte, CEO, Southern Maryland Hospital

Southern Maryland Hospital Center has begun discussions to partner with a regional health system as part of its mission to serve the 800,000 citizens of Prince George’s, Charles, Calvert, and St. Mary’s Counties. Aligning with a regional hospital system will give Southern Maryland Hospital Center, which is privately owned, access to additional resources to fund expansion of hospital facilities and clinical services. Hospital officials expect the strategic alignment to be completed by the end of this year.

“This is an exciting moment in the history of Southern Maryland Hospital Center,” said CEO Michael J. Chiaramonte. “Aligning ourselves with a leading regional or national health system will allow us to strengthen our existing service lines, bring new specialty services to the community, expand our facility, and continue to recruit the area’s top physicians. Throughout our history, we have been guided by our vision to be the regional medical center for the citizens of Southern Maryland. This step will help us realize that vision and honor our commitment to serve our community.”

Nearly 35 years ago, surgeon Francis P. Chiaramonte, MD, MPH, FACS, founded Southern Maryland Hospital Center to bring specialty medical and surgical care to the 300,000 people who resided in Southern Maryland at that time. The hospital has grown into a regional medical center with over 20,000 admissions, 68,000 emergency room visits, and 2,000 childbirths each year. It is the flagship of the Southern Maryland Health System, a network of healthcare services and physicians with dozens of neighborhood-based prevention and primary care clinics and a variety of specialty services including community education and outreach programs, rehabilitation centers, and home medical care.

A strategic alignment with another hospital system is part of a larger trend in the healthcare industry that is focused on increasing efficiency and improving clinical outcomes. Southern Maryland Hospital Center will be able to offer a wider range of specialty medical and surgical care close to the community it serves. Capital improvements, such as construction of new facilities will help propel the hospital forward to remain a leader in medical and surgical care.

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THIS MAY BE A GOOD MODEL....WE'LL HAVE TO WAIT TO SEE HOW IT DEVELOPS

Oregon's Medicaid Experiment Represents A 'Defining Moment'
by Kristian Foden-Vencil, Oregon Public BroadcastingMay 30, 2012 by Kristian Foden-Vencil, Oregon Public Broadcasting         NPR

The things that Amy Vance does for James Prasad are pretty simple: She calls doctors with him, organizes his meds, and helps him keep tabs on his blood pressure, blood sugar and weight.

Don Ryan/AP Oregon Gov. John Kitzhaber is leading a $2 billion health care experiment in the state, aimed at changing the way the sickest people in Oregon get health care. Here, he speaks during a press conference in Portland earlier this month.

These simple things — and the relationship between a health coach like Vance and a chronically ill Medicaid patient like Prasad — are a big part of a $2 billion health care experiment in Oregon.

Gov. John Kitzhaber, a Democrat and a former emergency room doctor, has convinced the federal government that he has a way to make Medicaid treatment better, and cheaper, by completely changing the way the sickest people in Oregon get health care.

Here's how it will work: Each city, like Portland, Salem and Eugene, will have its own umbrella group for caring for the Medicaid population, known as a "coordinated care organization." Under these umbrellas will be most of the big hitters in the health sector: hospitals, doctors, mental health providers and dentists.

Kitzhaber's vision is that all those health care businesses will stop competing so directly and will be linked electronically so that the systems can talk to each other — and patients can go wherever they need to get the best care. The sickest people, like 69-year-old cardiac patient Prasad, will have $20-an-hour outreach workers like Vance to help them navigate the system and avoid costly hospitalizations. Workers like Vance will manage a caseload of about 30 patients — with the goal of saving the system hundreds of thousands of dollars.

"I think this is really a defining moment for health care in the state of Oregon, and I think that if we're successful, probably for health care beyond our borders," Kitzhaber said, as he announced the plan that enjoys surprisingly popular support from both Republicans and Democrats.

Indeed, the state's leaders are putting their political reputations on the line for this deal. The Legislature passed its entire budget in the blind faith that the feds were going to come up with the money.

Unions and businesses in the state also back the program. Malia Wasson, the president of U.S. Bank in Oregon, celebrated the news. "Governor, I know that you're not prone to being overly demonstrative," she said at the announcement that the feds were backing the state's experiment. "But would you indulge me with a high-five?"

There are skeptics, though. Republican state Rep. Jim Weidner was one of a few politicians to vote against it. "It doesn't really drive down the cost of health care. It's just shifting costs into different spots," Weidner said. He expects the experiment to end up costing the state money.

But Kitzhaber disagrees. The coordinated care organization will be paid with a lump sum.

Under the current system, hospitals and doctors don't have a financial incentive to make people better. Quite the opposite: If a patient keeps coming back, they keep getting paid. But under the new system, the quicker a patient gets better, the more money the coordinated care organization can keep. Kitzhaber believes that over the next five years, Oregon will be able to save the feds every penny of the $2 billion the state's been promised.

"We estimated that if every state Medicaid program in the country were to adopt this model, the net savings would be about $1.5 trillion over 10 years," he said

To put that into perspective, Congress is looking at $1.2 trillion in cuts after the supercommittee failed to come up with a budget.

Meanwhile, Oregon is pretty pleased with itself. But the feds have said that if the state doesn't show cuts to Medicaid spending by 2 percent next year, all this new money could very well dry up.

This story is part of a project with Oregon Public Broadcasting, NPR and Kaiser Health News.

Here in Maryland our politicians have taken the private health systems approach which necessitates a profit model. So regarding Medicaid, we watch as funding plummets and patients are relegated to cursory, public health style checkups. I bumped into a woman on the street who was yelling at a friend....'I got me a nursing business'. This young lady with whom I spoke was clearly a health certificate holder with little experience and she was driving a Porsche. I say this not to generalize or to deny the lady of opportunity, I say this because millions of low-income and poor people are heading towards a complete loss of healthcare in the US. We already have international aid organizations coming to the US to service the poor and this is a Dickensian moment. I read in the Baltimore Sun about a family member decrying having her parent's longterm caregivers taken away and replaced by what she termed 'temporary staffing'....probably from a business owned by the lady with the nursing business. We already have social workers with sometimes 500 cases who obviously are just numbers on a page and state nursing homes where people speak with fear at having to enter. This is Maryland, the wealthiest state in the country who promotes itself as progressive. Can you imagine what healthcare reform looks like in other states? The article above addresses Oregon which does have a public health system and as such will not run on strictly a profit margin, so it will be interesting to see if they are more caring of their citizens. Vermont does have a public system and they have placed 20% of its citizens in this catastrophic health insurance coverage described below.

As Big Employers Pinch Pennies, Health Savings Accounts Take Off

by Jay Hancock          May 30, 2012 NPR

As employers look to cut spending on health, more workers are being steered to health plans with high deductibles.
Feel like you're paying more out of pocket for medical expenses? You've got company, according to the latest data from health insurers.
Enrollment in health savings accounts grew 18 percent last year as employers continued to steer workers into high-deductible medical plans, an insurance group said this morning.
Membership in HSAs, which are one of two savings arrangements associated with high-deductible insurance, rose from 11.4 million in January 2011 to 13.5 million in January 2012. Most of the growth occurred in plans offered by large employers, according to an annual census by America's Health Insurance Plans, a trade group. Since 2008 HSA membership has more than doubled.
Promoted by Republicans and created by legislation in 2003, HSAs let employers and workers make tax-free contributions to finance out-of-pocket medical costs. They differ from the better-known flexible-spending health accounts because with HSAs unspent money can be rolled over from one year to the next. Leftover money in flex accounts reverts to the plan sponsor.
Also, unlike flexible accounts, HSAs always are paired with high deductible insurance coverage — at least $1,200 for individuals and $2,400 for families. Deductibles are what patients spend before insurance kicks in. The idea behind HSAs is to contain medical inflation and make patients smarter consumers by giving them a bigger stake in health-care purchases. Critics, however, contend that such "consumer-directed" health plans are simply a way for employers to shift costs to workers.

Today's AHIP report doesn't include health reimbursement arrangements, another kind of spending account that's usually paired with a high-deductible plan. So it doesn't measure the full growth of high-deductible insurance. Last year 17 percent of U.S. workers with employer-based insurance were enrolled in an HSA or an HRA, according to the Kaiser Family Foundation.. (KHN is an editorially independent program of the foundation.)
States with the highest portion of HSA enrollees were Vermont, at 20 percent; Minnesota, with 14 percent; and Montana and Utah, both with 12 percent. Fifty-nine percent of HSA enrollment was in large-group plans, up from 55 percent last year. AHIP surveyed 97 insurance companies for its census.

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As President Obama and Third Way Democrats tell you that healthcare reform is all about access, we see more and more policy moving us in just the opposite direction. You will not get strong public healthcare by consolidating and creating mega-institutions.....you will not get it from private health systems....and you will not get it with an ever smaller corporate tax base. All these thing work against public access. We see here in Maryland that Johns Hopkins and Medstar are creating 'health enterprise zones' which again are taxpayer funded and again are setting up health clinics in affluent and luxury communities in Washington DC and across the State of Maryland. There is no shortage of nurses....there is an efficiency drive for profits and the best nurses and medical staff are going to these first to be built affluent 'health enterprise zones'. The difference in the level of serve is stark. I spoke of examples here in Baltimore of average people going to mainstream hospitals getting horrible care....and these were patients who were Medicare or had a private policy with restricted coverage to keep costs down.  THAT IS MOST OF US.

The nurses union is one of the most vocal of protest groups and they lead powerful demonstrations for union labor rights and patients rights. These are middle-class workers, as are teachers, as are police and fire.....so it is all workers under attack, not just low-income hospitality workers like United Workers.org. All this impoverishment affects you, if not in wages, then in service, cost, and quality of life.
O'MALLEY , BROWN, RAWLINGS-BLAKE, GANSLER, FRANCHOT AND YOUR DEMOCRATIC OFFICIALS ARE VOTING FOR THESE POLICIES.......VOTE OUT INCUMBANTS@!

Need A Nurse? You May Have To Wait
by Patti Neighmond        May 25, 2012      NPR

Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched too thin.

iStockphoto.com Some fear that with rising medical costs and an aging population, the country's nursing staff will be stretched too thin.

Nurses are the backbone of the hospital — just ask pretty much any doctor or patient. But a new poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health finds 34 percent of patients hospitalized for at least one night in the past year said "nurses weren't available when needed or didn't respond quickly to requests for help."

Since nurses provide most of the patient care in hospitals, we were surprised at the findings. We wanted to find out more. We wanted to know what was going on from nurses themselves. So we put a call-out on Facebook.

We received hundreds of responses and read them all: piles of stories about nurses feeling overworked, getting no breaks, no lunches and barely enough time to go to the bathroom. Even worse, many nurses say breaks and lunchtimes are figured into their salaries and deducted, whether they take them or not.

When we asked nurses who responded to our call-out if we could interview them for broadcast, most said no. They worried about their employers' reaction. Many would be interviewed only anonymously.

"We're always afraid that something will happen to our patients during the time we're off the floor," one nurse says, "and I personally don't feel comfortable leaving them unless I know that a co-worker is actually looking after them during the time that I'm off the floor."

This nurse says she rarely stops. Not for 12 hours. She's an emergency room nurse in a busy urban hospital. The ideal, she says, would be one nurse for every three patients in her ER. But she typically cares for five patients or more — often eight, if she's covering for a colleague taking a lunch break. She says there are times when she can't leave patients' bedsides.

"Maybe I was injecting medication that you have to push slowly over five to 10 minutes so it doesn't harm them," she says, "and I can see the call bell going off in the hallway, and there's no way I could respond to that."

The only option is to literally yell down the hallway and hope another nurse hears her and responds to the patient call bell. There have been times when she has driven home at the end of her 12-hour shift, white-knuckling the steering wheel and wondering whether she "missed something."

Another nurse likens her job to "spinning plates," just "praying," she says, that one doesn't fall. "And these are human beings," she says, "not products on conveyor belts."

Stories like this suggest there's a shortage of nurses. But Linda Aiken, a researcher and professor of nursing at the University of Pennsylvania School of Nursing, says that's not the case. There was a shortage about a decade ago, she says. Today, that has changed. The number of RNs graduating has increased dramatically over the past decade, but many can't find jobs.

"There's not an actual nursing shortage," Aiken says. "There's a shortage of nursing care in hospitals and other health care facilities."

Nancy Foster, a vice president with the American Hospital Association, says hospitals are facing big financial challenges.

"In part, it's because our patients are sicker — coming to us with more intense diseases and disorders than they did 25 years ago," she says. "In part, it's because there's so many more medications and devices and other interventions at our fingertips; we can help many more patients and restore them to health."

That is terrific, of course, but it's not cheap. Any reduction in nurse staffing at a time of increasing patient demand jeopardizes patient care, Aiken says.

"Nurses are the surveillance system in hospitals for early detection and intervention [to save patients' lives]," she says.

According to one nurse, little clues from patients are critical.

"I mean, you might walk into a room, and they are breathing and answering your questions," the nurse says, "but if you look at their neck and the jugular vein is slightly distended ... taking the time to pick up on the small details like that are the early warning signs that somebody is getting sicker fast."

In our poll, 47 percent of those who were hospitalized overnight in the past year said they were "very" satisfied with their care. Another 39 percent said they were "somewhat satisfied" — some things could have been better. Only 16 percent said they were dissatisfied.

It's not all bad news, but with a rapidly aging population, the fear is that the nursing staff will be stretched even more thinly. Plus, while our call-out to nurses on Facebook was not scientific, the NPR/RWJ/Harvard poll is, and it does point to significant problems when it comes to the availability of nurses at the hospital bedside.

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A study places over 1/4 of Americans unable to access the healthcare they need.....whether privately insured or through entitlements. This is because of the co-pays and deductibles that both the government and business have thrust on the public to boost corporate profits for business and to save more money for government to give as business tax breaks.......your healthcare is being taken away, not by cost, but by politicians working for corporate profits.

HEALTHCARE FOR ALL PEOPLE WHO ARE NOT SHOUTING OUT AGAINST THE PRIVATE HEALTH SYSTEMS BEING PUSHED BY O'MALLEY AND JOHNS HOPKINS ARE NOT WORKING FOR THE MIDDLE/LOWER CLASS HEALTH COVERAGE! WE KNOW THERE WILL BE NO COVERAGE WITH A PRIVATE SYSTEM.

County makes damaging cuts to Medicaid program
3:00 p.m. EDT, May 22, 2012 Baltimore Sun Opinion

Either County Councilman David Marks and county Chief of Staff Don Mohler are untruthful or they are sadly misinformed about the Baltimore County budget ("Balto. Co. Council poised to adopt 'bare-bones budget,'" May 17). The county is laying off the entire staff of the Medicaid Waiver Program.

This is a program committed to keeping the elderly who qualify for nursing home care in their own homes or those of relatives. Instead of retaining the current staff, the case management responsibilities will be farmed out to temp agencies.

Continuity of care is crucial to these clients, yet now a revolving door of caseworkers will check off boxes on a form and be gone regardless of the clients' needs. It is unfortunate that the county and its officials are not honest about the status of these employees' future.

Rosemary Catalana, Towson

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Family health-care costs breach $20,000
Joe Raedle/Getty May 21, 2012   NPR

Full Story

Health costs are among the many reasons family finances are under strain. For the first time, the total bill for the typical family of four with an employer-sponsored health-care plan (a preferred provider plan with co-pays and deductibles) breached $20,000 in 2012.

Specifically, the average cost for the family of four in 2012 is $20,728, a hike of $1,335 or 6.9 percent from 2011, according to the Milliman Medical Index.

The rate of increase is down over the past 2 years, but the dollar amount keeps climbing higher. (The figures are only for people who receive health care via their employers. The health insurance market for people who have to get it on their own is much worse.)

Employers still shoulder the main cost burden with health care. But the employees' share of the bill -- out of pocket costs plus payroll deductions -- is on the increase at $8,584 for 2012.

There is a great deal of uncertainty surrounding health care. First of all, none of these figures includes the impact of the Obama Administration's signature health-care legislation, the Patient Protection and Affordable Care Act. Secondly, while the Supreme Court has heard oral arguments on a major legal challenge to the Affordable Care Act, the Court hasn't yet issued a decision.

Nevertheless, numbers such as these emphasize that how we pay for health care will continue to be a major public policy issue. Reform is critical.

The cost burden weighs heavily on ordinary family finances, and the employer price tag for offering the benefit keeps moving higher. This is before even considering the terrible health-care market for those without access to an employer-provided plan and the realization that at the core of the federal government's long-term budget deficit is spiraling health care costs.

The bottom line: The status quo is simply unacceptable.

As we watch the airlines and banks pummel us with business fees rather than list one price for a product, we see healthcare with fee for service. Both policies are meant to extract maximum gain for the business. Fees aren't taxed as heavily as fares, so businesses use this policy. If we want to reverse fee for service with healthcare, which is not making much progress with these health systems being developed, we simply need to tax the bad policy more heavily to change the profit model. That is, of course, not the only solution....healthcare costs are rising as waste and fraud increase for example, but our society is strengthened by strong corporate tax policy. Those pushing this free market/new economy mantra had better look towards Europe as citizens fight the powers-that-be trying to remake society in their 5% image. The people do not want it!

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At a time when we are discovering that many drugs on the market are not effective in treating the medical ailment for which they are prescribed and when medical devices are failing and having to be removed, all which occurs because the FDA does not require clinical trials and data for these before they are released to the public.....after all, the public is the clinical trial....forget medical ethics! So, as Medicaid/Medicare patients get the first try of these untested drugs and devices, the doctors who can be sued may want to wait to see if they work before prescribing these fast-tracked medical products. This is corporate medicine.....not patient medicine!

FDA’s $6.4 Billion Plan for Quick Reviews Moves to Senate
By Anna Edney - May 21, 2012 10:25 AM ET   Bloomberg Financial

A $6.4 billion effort to speed U.S. reviews of new drugs and medical devices is a step closer to law as the agreements Mylan Inc. (MYL), Pfizer Inc. (PFE) and other companies struck with regulators wind through Congress.

The Senate is set to begin voting as soon as today on more than $2 billion in new fees that drug and device companies will pay regulators through 2017 to review products for safety and efficacy. The figure includes $1.56 billion from generic-drug companies such as Canonsburg, Pennsylvania-based Mylan, which had been exempt from such fees.

Enlarge image FDA’s $6.4 Billion Plan to Rush Reviews Hits Senate ‘Sweet Spot’

Medtronic's capsure sense lead, a device that is inserted into a heart pacemaker. Fees for device makers will more than double to $609 million, according to the Congressional Budget Office. Photo: Munshi Ahmed/Bloomberg

Medtronic's capsure sense lead, a device that is inserted into a heart pacemaker. Fees for device makers will more than double to $609 million, according to the Congressional Budget Office. Photo: Munshi Ahmed/Bloomberg

Mylan, the largest U.S. generic-drug company, led the effort for its industry to quicken review times and deal with a backlog of applications, as well as to ensure the Food and Drug Administration has the resources to inspect foreign plants. The legislation also would speed approval of treatments for life- threatening conditions, enhance safety monitoring of devices after clearance and mitigate drug shortages.

“To get lifesaving drugs and devices to the patients that need them as quickly as possible, Congress must give the Food and Drug Administration the tools it needs to review and approve these products,” Senate Majority Leader Harry Reid, a Democrat from Nevada, said May 17 on the Senate floor.

Brand-name drugmakers will pay $4.1 billion, 6 percent more than the previous five-year period, while fees for device makers will more than double to $609 million, according to the Congressional Budget Office’s cost estimate. The device makers negotiated the new fees with the FDA in February, while drugmakers reached their agreement in September.

Biologic Drugs Companies making generic versions of complex biologic drugs, a process not allowed until passage of President Barack Obama’s health law in 2010, also will pay a user fee, which the budget office determined would total $128 million through 2017.

The fees will “translate into greater transparency, efficiency and accountability from the FDA, certainly that’s the hope,” said John Manthei, a health-care lawyer and lobbyist at Latham & Watkins LLP in Washington.

Pharmaceutical companies have paid user fees since 1992 and device makers began their system in 2002. The current five-year program must be reauthorized by Oct. 1. Fees from brand-name drugmakers fund about 60 percent of FDA reviews, while the increase in device payments will support about 35 percent.

‘Sweet Spot’ The measure is a bipartisan compromise that Senator Tom Harkin, a Democrat from Iowa, said was built through consensus from both major political parties to ensure passage. Washington- based industry lobbying groups, the Pharmaceutical Research and Manufacturers of America and the Advanced Medical Technology Association, said they support the Senate legislation.

“We have hit the sweet spot,” Harkin, who is chairman of the Senate’s health committee, said during debate May 17. “We did not allow our differences to deflect us from the critically important goal of producing a bill that everyone could support. As a result, this is a truly bipartisan bill, and it is broadly supported by the patient groups and industry.”

The Senate will meet at 2 p.m. local time today to resume consideration of the bill. Reid scheduled a procedural vote today to limit debate on The Food and Drug Administration Safety and Innovation Act. A final vote on passage may happen this week, based on the typical timeline for Senate proceedings. The House of Representatives plans to take up its bill the week of May 28, Laena Fallon, a spokeswoman for House Majority Leader Eric Cantor, a Virginia Republican, said in an e-mail.

The Senate bill is S. 3187, and the House version is H.R. 5651.

Finding Value In the legislation, the device companies, including Minneapolis-based Medtronic Inc. (MDT), and drugmakers obtained additional meetings with the FDA throughout the review process so companies can attempt to deal with concerns rather than receive a rejection letter. The legislation also directs the agency to help companies with medicines for life-threatening diseases plan clinical development programs that will most likely gain speedy approval.

“Drug developers feel there really is value in getting FDA’s perspective early to avoid surprises in an application review,” Nancy Bradish Myers, president of Catalyst Healthcare Consulting Inc. in McLean, Virginia, said in a phone interview.

Lawmakers sought to adjust device oversight, requiring post-market studies and pushing the FDA to implement a system to electronically track devices. Drug companies also would be required to report potential drug shortages to give regulators time to find alternate sources. Shortages, including cancer treatments, almost tripled to 178 in 2010 from 61 in 2005, according to a FDA report released in October.

Vaginal Mesh Device companies successfully fought proposed language that would have barred clearance of low-to medium-risk devices if a similar device have been voluntarily recalled for a safety reason. The majority of devices go through a clearance process that requires proof they are similar to a product already on the market.

Vaginal mesh made by New Brunswick, New Jersey-based Johnson & Johnson (JNJ) -- linked to internal injuries, incontinence and painful sex -- was approved despite concerns about safety with earlier versions. Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, said he supports a legislative fix for the “loophole.”

“It may carry the same intrinsic defect that poses the same safety threat to patients,” Michael Carome, deputy director of the Health Research Group at consumer advocacy organization Public Citizen, said in a telephone interview.

Political Message J.C. Scott, the chief lobbyist for the Advanced Medical Technology Association, said the prohibition would have had “a pretty devastating impact on the ability of companies to make incremental improvements on existing products.” The FDA has the power to determine a device is unsafe and reject its application, Scott said in a telephone interview.

Myers, of Catalyst Healthcare, said she doesn’t expect any surprises or major changes to the legislation.

“Most members of Congress want to go home with a satisfying health-care bill under their belt,” she said. “It is a good political message to say ‘I streamlined some of the regulatory process.’”

THIS MEANS THAT GOVERNMENT NO LONGER PROTECTS YOU.....IT PROTECTS A COMPANY'S ABILITY TO MAKE A PROFIT!

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It is good to mention that the Maryland Assembly just voted protections for landlords of rental property known to have lead contamination. By framing the issue around 'registration' into a program of abatement and oversight of progress in lead cleanup, Maryland landlords are able to rent units known to be dangerous to the health of families without fear of lawsuits. Everyone knows that little or no oversight follows, so these families are left with exposure and later limited rights to sue for damage. This effort was led by Maggie McIntosh of Baltimore, one of the leading offenders on this issue.

CDC lowers lead poisoning threshold A sixfold increase in Maryland children potentially at risk
By Timothy B. Wheeler, The Baltimore Sun 9:19 p.m. EDT, May 16, 2012

The number of young children deemed at risk of lead poisoning in Maryland and nationwide expanded drastically Wednesday as a federal health agency declared it would effectively cut in half its threshold for diagnosing the environmental illness.

Acknowledging mounting evidence that children can suffer lasting harm from ingesting even minute amounts of lead, the Centers for Disease Control and Prevention said it would reduce the level at which it recommends that doctors, families and health authorities act to lower a child's exposure to the toxic metal.

Officials estimate the CDC's adoption of a new "reference level" for assessing low-level exposure to lead could add 200,000 children nationwide to 250,000 considered poisoned under the old threshold. In Maryland, the percentage increase is probably even greater. Under the new standard, 3,500 more children statewide would have been added to the 531 who tested positive for lead poisoning in 2010, the most recent year for which figures are available.

But the federal agency's move comes even as its own funding for fighting lead poisoning has been slashed, leaving state and local governments with fewer resources to tackle what has now been recognized as a much bigger problem.

Baltimore's Health Department, for instance, received $300,000 from the CDC this year to track poisoning cases and help families reduce their children's exposure. Since last summer, according to spokesman Brian Schleter, the department has contacted about 270 families of children whose blood showed levels of lead below the old CDC threshold, offering to visit their homes and share tips on how to reduce exposure.

But those federal funds are due to run out by September, as Congress this year slashed the CDC's budget to fight lead poisoning from $29 million to $2 million. Schleter said the loss presents "significant budgetary challenges" that could force cuts in staff assigned to deal with a drastically increased caseload.

Since 1991, the CDC's "level of concern" had been a level of lead in a child's blood as low as 10 micrograms per deciliter – as little as 100 parts per billion. But Christopher J. Portier, director of the agency's Center for Environmental Health, said in an interview that studies have shown for years that children with even lower levels can suffer adverse effects, such as learning and behavior problems.

By dropping its threshold, Portier said, the agency is emphasizing what it has been saying for some time: There is no safe level of exposure.

Though poisoning cases occur statewide, the bulk of the lead problem in Maryland has long been in Baltimore, which, according to the Health Department has eight times the nationwide incidence of poisoning cases.

The vast majority of Maryland cases have been linked to ingestion of dust and flakes from lead-based paint, which at one time was widely used in housing. Baltimore banned its use in homes in 1950, and the federal government outlawed its residential use in 1978, but the paint remains in many older houses. Other possible sources include older water pipes, lead dust in soil and imported toys or jewelry made of lead or coated with lead-based paint.

Under the old threshold, the number of lead-poisoning cases in Maryland has declined 98 percent since the mid-1990s, when state law began requiring that owners of pre-1950 rental housing take steps to repair and clean their units to reduce the risks to young tenants of ingesting lead paint dust or flakes.

State officials say they are already talking about how to respond to the CDC's action. Maryland's lead poisoning laws are based on the old poisoning threshold, officials note, so the law might have to be changed before the state can take regulatory action to further reduce exposure levels.

"There are practical barriers to doing that, but lower lead levels are better for kids, and the best level for kids is zero," said Dr. Clifford S. Mitchell, head of environmental health in the Maryland Department of Health and Mental Hygiene.

One concern is that the state's current blood testing procedure might not be good enough to reliably measure lead at levels below the old CDC threshold, said Horacio A. Tablada, land management director of the Maryland Department of the Environment, who oversees state efforts to reduce lead exposure.

Without more funds, Tablada said, his office might be unable to follow up on a vastly expanded number of new poisoning reports without diluting the attention they give the most serious cases. Ten inspectors now check on pre-1950 rental housing across much of the state, he said, though Baltimore's Health Department handles its own cases.

State health officials, meanwhile, say they are trying to figure out what to advise pediatricians and health-care providers to do with children who show lead below the 10 microgram level in their blood. The new reference level would effectively lower the standard for poisoning to about 5 micrograms per deciliter.

The CDC's Portier said his agency wants doctors to recheck the files of children not previously considered at risk of poisoning.

"It's going to have to be handled on a case-by-case basis by physicians, but our recommendation would be to revisit those cases," Portier said. Doctors should routinely ask families of children 6 years old and younger for an environmental history, he said, including asking whether they live in a house built before lead paint was banned.

Though acutely dangerous levels of lead in the blood can be reduced through chelation therapy, health experts point out there is no effective treatment for reducing already-low lead levels, other than removing the source of the poisoning — or the victim. The best treatment, they say, is preventing exposure in the first place.

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Now, forgive me if I'm skeptical, but it seems to me that these institutions are more private profit orientated than their non-profit status places them. What we have is the beginning of a mega-healthsystem industry with Hopkins using all its non-profit status to reap taxpayer money along the way. Think these mega-institutions, once they turn profit are going to work with the poor and elderly? NOT A CHANCE IN THE WORLD....THEY WILL BE AS GREEDY AND UNACCOUNTABLE AS WALL STREET AND MOST PEOPLE WILL NOT GET CARE OR WILL GET CURSORY CARE! HEALTHCARE FOR ALL AND MEDICARE ADVOCATES KNW THIS......IF THEY AREN'T SHOUTING OUT FOR CONTROLLING THE SIZE OF THESE HEALTH SYSTEMS...THEY ARE NOT WORKING FOR MIDDLE/LOWER CLASS.

MedStar, Hopkins to roll out new D.C. health clinics
Premium content from Baltimore Business Journal by Ben Fischer, Washington Business Journal, Washington Business Journal Date: Friday, February 24, 2012, 6:00am EST

Washington, D.C., will soon see another influx of basic-service health clinics as MedStar Health and Johns Hopkins Medicine eye well-to-do neighborhoods with doctor shortages.

Columbia-based MedStar, the region’s largest health system, has asked D.C. regulators for permission to launch two new primary care clinics in the Northwest portion of the District, continuing its efforts to build a distributed network of access points outside of major hospitals and clinics.

MedStar, which owns Washington Hospital Center and Georgetown University Hospital in D.C., wants to spend $860,000 to create the two small clinics.

“Part of MedStar’s strategic plan is to improve access to health care,” said spokeswoman Jean Hitchcock in a statement. “D.C. has a shortage of physicians and these will provide more access to care for patients.”

Hitchcock and MedStar Executive Vice President Eric Wagner declined interview requests until the District acts on its application for a certificate of need. In October, Wagner said the system was in the early phases of a five-year plan to redesign its business model for primary care, by leasing new space and renovating existing offices.

Both new and old offices will feature extended evening and weekend hours and include more customer-friendly designs and workflows.

Meanwhile, Johns Hopkins Medicine — MedStar’s chief competition throughout much of its service territory — is also planning new primary care offices, said Dr. Steven Kravet, president of Johns Hopkins Community Physicians, a wholly owned subsidiary.

Johns Hopkins’ primary doctor group will further develop its new office location on the Sibley Memorial Hospital campus in D.C. this year, Kravet said. Also, Johns Hopkins will expand into new locations in both the District and Montgomery County, Kravet said, declining to discuss details prior to a formal announcement.

If you don't believe that this financial crisis had multiple goals, watch how your Third Way politician is now going to make access to healthcare impossible for most of us. Besides moving all the wealth to the top 1%, the goal of this massive fraud was to weaken the government's financial stance to such an extent as to force entitlements away...you see this playing out in Europe as we speak. You can't have all the wealth at the top and the top paying no taxes if a nation still has silly things like entitlements and social programs to pay. The last goal of the massive fraud was to break corporate America from any tether of domestic law as it expands into global markets. We all watched as our government allowed the business sector to commit massive fraud with no penalty.....what's a few billion to a corporation earning tens of billions a quarter? Nothing. This is important because it sends a message to middle/lower class Americans that they will be subject to the corporations, not the Rule of Law. Your elected official, by not saying anything through this process, told you that you no longer have rights equal to corporations.

The funds are tight for Medicare because of massive fraud over decades not because of any payment schedule. A government that went by Rule of Law would see retrieving those government assets as paramount. Believe me, the Justice Deaprtment goes after the smallest crime involving loss of commercial revenue. Maryland's O'Malley worked hard to see to that massive fraud's success. Attorney General Gansler will no doubt reap great Wall Street rewards for his handing of Maryland 's assets to the banks. Think of where Maryland would be if the Justice Department worked for the people, not profits.....just the State of Maryland would see tens of billions of dollars clawed-back from banks, realtors, accountants, and lawyers. My friend said 'you aren't going to get lawyers to sue for private damages because they are the ones committing the fraud for the banks and pocketing the money with them. You know that is the case when so much evidence of fraud is easily available and a lawyer doesn't follow it. This corruption was complete in Maryland!  WHEN YOU ARE IN YOUR EIGHTIES AND CAN'T GET HEALTHCARE....THINK ABOUT THE BANKS AND THESE MARYLAND POLITICIANS.
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WE KNOW THAT ARE MEDICARE/MEDICAID SHORTFALL IS A RESULT OF DECADES OF FRAUD AND WASTE SO WHY NOT CHARGE A SURCHARGE TAX ON THE INDUSTRY TO START TO RECOVER FUNDS LOST TO FRAUD FROM THE HEALTHCARE INDUSTRY? IS YOUR DEMOCRATIC OFFICIAL SHOUTING TO GET THAT MONEY BACK? IF NOT.....THEY ARE NOT WORKING FOR MIDDLE/LOWER CLASS.

HHS IG report highlights docs' questionable billing of Medicare
Headquarters for the Department of Health and Human Services in Washington, D.C. Matt Bisanz/Wikimedia Commons Thousands of physicians charging at rates far above their peers By Fred Schulte email 8:30 am, May 9, 2012 Updated: 8:30 am, May 9, 2012

Thousands of doctors across the country are billing Medicare for routine medical care at rates far above their peers, potentially costing taxpayers tens of millions of dollars in overcharges, according to a new government report.

The audit released today by the U.S. Department of Health and Human Services Office of Inspector General stopped short of accusing the high-billing doctors of ripping off the government health plan for the elderly. But it stated that Medicare’s payment scales for doctors have been “vulnerable to fraud and abuse” in recent years.

The doctor payment scales are known as “Evaluation and Management” or E/M codes. Doctors choose from five escalating payment levels for treating patients based on the “amount of skill, effort, time responsibility and medical knowledge required for the service.” In 2010, almost 370 million E/M services were provided by about 442,000 doctors nationwide.

The code the doctor chooses can make a big difference to the bottom line. For instance, the Medicare fee for treating a new patient in 2010 ranged from $36.62 to $190.56, depending on the level of service provided by the doctor, and the code chosen for billing.

Using these codes, Medicare paid doctors and other health professionals $33.5 billion in 2010 for services ranging from routine office care to hospital or nursing homes visits.

That billing total represented a 48 percent jump since 2001, though the number of services delivered over the same time period grew only 13 percent. What the data reveal is that many doctors have been gravitating toward the codes that pay them higher fees for these routine services, a practice officials have struggled to understand and curb.

While billing for a higher code than warranted—a practice known as “upcoding” in medical circles—can be a crime, most of these cases are settled by asking the doctor to refund any overpayments. And given the sheer number of Medicare E/M claims, officials say they can do little more than trust the bills they receive are accurate and honest.

The inspector general’s audit suggests that officials have much work to do in policing the system and protecting tax dollars from doctors who take advantage of the lax oversight, however.

For instance, Medicare paid almost $108 million to some 1,669 physicians who billed the highest possible code for almost all of their visits in 2010, according to the audit. That amounts to a payment of $43 more than the average per service —even though there was little difference in the ailments they treated or the sickness of their patients, according to the audit.

In the same report, the federal Centers for Medicare and Medicaid Services said it had identified 5,000 physicians across the country who have “consistently billed for high level” codes and would notify them this month in hopes of preventing “improper billing and payment in the future.”

Yet CMS officials noted that their inquiries were “not intended to be punitive, or as an indication of fraud.”

The inspector general audit, though it mentioned previous cases of fraud involving the E/M codes, offered no explanation for the upward shift in billing by so many doctors.

“We did not determine whether the E/M claims from these physicians were inappropriate,” the report said. It said that later evaluations “will determine the appropriateness” of these payments.

The auditors found abnormally high billing doctors in all parts of the country, but said they were most common in California, New York Florida and Texas.

The audit comes amid growing controversy over how to compensate doctors, particularly those who provide routine medical services in their offices.

In 1989, as Congress was struggling to control rising physician fees, it set up a Medicare physician payment schedule that used a complex formula to hold spending in check. The rates are adjusted to reflect differences between spending targets and actual outlay.

But every year, in what is known as the “doctor fix” Congress steps in to prevent doctor fees from being reduced. Many critics argue that Medicare should move away from the system that pays doctors a fee for every service they provide and begin paying them based on the quality of care they provide.

The Center for Public Integrity is conducting an in-depth reporting project examining Medicare spending and its consequences for the quality of medical services to the elderly.

How the Banks Endangered Medicare

By SIMON JOHNSONSimon Johnson is the Ronald A. Kurtz Professor of Entrepreneurship at the M.I.T. Sloan School of Management and co-author of “White House Burning: The Founding Fathers, Our National Debt, and Why It Matters to You.” The world’s largest banks have been accused of many things in recent years, including taking excessive risk in the run-up to 2008, doing great damage to the American economy by blowing themselves up and then working hard to resist any sensible notions of financial reform. Today’s Economist Perspectives from expert contributors. All of this is true, but it misses what is likely to be the most profound negative impact of the banks’ behavior on most Americans. The banks’ actions led directly to an increase in government debt, which in turn has made the reduction of that debt by “cutting runaway spending” a centerpiece of the Republican presidential campaign to date. As a result of this pressure, Medicare now stands on the brink of being eliminated as a viable form of social insurance. Yet the executives who lead these banks – and the politicians with whom they work closely – will not be held accountable this election season. How is this possible?

The economic mechanism through which a bank-led financial crisis has a broader adverse fiscal impact is straightforward. The recession that deepened sharply in 2008 implied a deep loss of tax revenue, mostly because people lost their jobs. Lower revenue means larger government deficits, particularly when the government also provides unemployment insurance, so spending also goes up. (In comparison, the Bush stimulus of 2008 and the Obama stimulus of 2009 added relatively little to the cumulative additional total debt, according to the Congressional Budget Office.) This deficit implies a surge in government annual borrowing and in its stock of debt. The Congressional Budget Office estimates that the total increase in federal government debt because of the severe financial crisis will end up around 50 percent of gross domestic product. Let’s call that $7.5 trillion in today’s money (our G.D.P. per year is currently around $15 trillion). Here’s how that calculation works. In January 2008, when almost no one expected a financial disaster, the C.B.O. forecast that by 2018 federal government debt would be just over 20 percent of G.D.P. Once the severity of the problems brought on by the credit contraction after the collapse of Lehman in September 2008 became clear, the C.B.O. redid this medium-range forecast — now taking a view on what debt would be after a difficult economic recovery to trend growth. In its forecast of August 2009, the C.B.O. expected that debt would reach nearly 70 percent of G.D.P. in 2018. The change in this C.B.O. forecast for 2018 — to 70 percent of G.D.P. from 20 percent — is the likely total fiscal impact of the 2008 crisis and deep recession. To be clear, there was already a potential fiscal issue looming in the distance, in the 2020s and beyond – with the retirement of the baby boomers, increase in life expectancy and, most of all, our collective failure to control health care spending. But until 2008 we had time to deal with this — and gradual solutions seemed most likely, preferably including ways to control the growth of health care spending more broadly across the economy. But the perception of a “fiscal crisis” brought the longer-run budget issues forward in time and the jump in government debt created a sense of panic in some quarters, so measures to “fix” the budget in a drastic fashion are now on the front burner in Washington. Ironically, although the main reason for the recent increase in public debt was the financial crisis, brought on by extreme deregulation, the situation has strengthened the hand of people who want, above all, to cut spending. Medicare had been in the sights of conservatives for some time, but providing health care for Americans at age 65 is a very popular program, and with good reason. Before Medicare was created, it was very hard for people in their 70s, 80s and 90s to buy health insurance. If Medicare in its present form were ended, the adverse impact on older Americans with limited resources, including almost everyone who is not very wealthy, would be significant. Yet that is what those committed to reducing the size of government and its programs are prepared to do. Whether they can convert this popular theme in the Republican primaries into political momentum that carries through the general election and gives the G.O.P. the presidency and control of Congress remains to be seen. It is not surprising that Paul D. Ryan, Republican of Wisconsin and chairman of the House Budget Committee, is suggesting that we radically alter Medicare over the next decade or so, turning it, as The New York Times reported, “into a subsidized set of private insurance plans, with the option of buying into the existing fee-for-service program.” “The annual growth of those subsidies would be capped just above economic growth, well below the current health care inflation rate,” The Times said. (For details of how this would happen, see this commentary by my colleague James Kwak, drawing on the analysis of the C.B.O.) The surprise should be that his proposal is being so warmly welcomed by many people who see themselves as centrists in American politics; in the past they would have been more skeptical. It does not have to be this way. Social insurance programs like Medicare can be kept in place at the same time as the federal budget is brought under control. To be sure, we need to adjust Medicare’s terms and some features of how it operates, but moderate and gradual changes would be sufficient, along with returning tax rates to where they were in the mid-1990s, as Professor Kwak and I discuss in our new book. Few people want to engage with this issue in a substantive way. The right is focused on not raising tax revenue. The left wants to protect Medicare and Social Security but for the most part does not discuss the details of how this can be done while limiting debt relative to G.D.P. over the next two decades. This is a tactical mistake, opening those on the left to charges of fiscal irresponsibility. In fact, it was the administration of George W. Bush that oversaw big tax cuts, two foreign wars and a runaway banking system. Part of the problem is that the Obama administration saved the failing big banks in 2009 and then defended them against being broken up in 2010 — the president’s top advisers consistently asserted that we needed highly leveraged and very large financial institutions, irrespective of the damage they cause. It will be very hard for the president to change his narrative at this point. And it may be too late; many in the center have become enamored of Mr. Ryan, who also appeals to the Republican base and may even become Mitt Romney’s vice-presidential running mate. Certainly his ideas are likely to become a prominent part of the Republican platform for the general election. In financial crises, it is people at the bottom of income distribution who end up being hurt; most of the rich do fine. When I made this point in “The Quiet Coup” in April 2009, some commentators shrugged off the comparison of the United States and emerging markets that had experienced crises, such as Russia or Indonesia or Brazil. Surely, they argued, the United States had a much stronger democracy. But while the precise mechanism differs across countries, the link from financial elite misbehavior to squeezing the lower half of society is present everywhere. In the United States, it most likely will take the form of ending Medicare in its present form. To many people, the financial crisis of 2008 seems but a distant memory. If you kept your job or found another, you might feel that the adverse consequences are behind you.That would be a mistake. The worst is yet to come. When you are 85 and cannot afford decent health care, think about the banks.

The healthcare reform is well under way in Maryland and is private as would be expected from a corporate state . The organization below has taken the lead in developing the public approach. Of course, the director is from the Johns Hopkins School of Public Health. You probably know my feelings already----but go to this website and contribute to the discussion. It is a broad coalition with many voices.

Physicians for a National Health Program have my support with their concerns for the low income/uninsured as outlined in the article below . They, like I support the extended Medicare form of single-payer healthcare. The private health system will leave many people without coverage despite what those writing the legislation are telling you.

I sent my list of concerns to Healthcare for All below:

HEALTHCARE FOR ALL -- HEALTH INITIATIVE

I am in complete support of Healthcare for All. These are my concerns/questions regarding your organization's advocacy:

These health systems are already consolidating like the banking industry in the 1980s. It's safe to say that with Wall Street formulating earning projections for the global entities that these health systems plan to come, we will have the Wall Street banks of Healthcare Industries....no accountability, profit-driven, greedy, no conscience. We don't want this because rather than healthcare for all, we will have healthcare for the very few. If groups like yours are not shouting out against the size of these health systems, how can you advocate for coverage for all?

You seem to be working within the Maryland policy of establishing a private health-system rather than public. You cannot achieve full coverage in a private, profit-driven system. Even with government subsidy, the care will be cursory...a public health check.

We see no evidence of any market competing with other members of an industry. Watching the adds on TV you see each company charging the same price for the product/service. The US rarely enforces price-fixing laws. There will be no price savings from competition with the private model.

You are assigning to the Governor and the Attorney General the oversight and accountability function. Maryland ranked at the bottom for corruption (40th of 50 states), no oversight or enforcement, and assignment of agency heads who routinely side against the public and for corporate/shareholder interests (Center for Public Integrity Study on State Corruption). This is why we have the most fraud and a huge income inequity in the state. You wouldn't want a oversight system that depends on the very people who will distort its intentions.

The Maryland legislature and the Federal government has already cut Medicaid spending by hundreds of billions and promises more cuts. The state just cut a chunk again. Service for the Medicaid patients is disappearing...in Maryland, Medstar will withhold treatment and send the patient away with minimum care if not covered. You don't define 'level of care' in your coverage for all mandate...it seems we are already at a deficit in care before we hand it off to private-systems to design according to profit margin.

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Is the Basic Health Program option a good idea?

Posted by Don McCanne MD on Thursday, Apr 19, 2012 This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

The Role of the Basic Health Program in the Coverage Continuum: Opportunities, Risks and Considerations for States By Deborah Bachrach, Melinda Dutton, Jennifer Tolbert and Julia Harris
Kaiser Family Foundation, March 2012

The Basic Health Program (BHP) is an optional coverage program under the Patient Protection and Affordable Care Act (ACA) that allows states to use federal tax subsidy dollars to offer subsidized coverage for individuals with incomes between 139-200% of the federal poverty level (FPL) who would otherwise be eligible to purchase coverage through state Health Insurance Exchanges. States can use the BHP to reduce the cost of health insurance coverage for these low-income consumers, a highly price-sensitive population with high rates of uninsurance. Depending on how it is designed, the BHP also can help consumers to maintain continuity among plans and providers as their income fluctuates above and below Medicaid levels.

As states weigh whether to implement a BHP, they face significant questions and challenges. Critical among these are how to design the BHP to enhance continuity of coverage as people move among Medicaid, the BHP, and coverage through qualified health plans (QHPs) in the Exchange; how to assess the BHP’s impact on the viability and effectiveness of state Exchanges; and how to estimate revenues and costs to evaluate the financial feasibility of the BHP.

Conclusion

Federal officials have yet to provide details about how the program will be financed, administered and certified, and states are struggling to evaluate the BHP’s impact on the viability and effectiveness of state Exchanges. Federal regulations will inform state deliberations, but are unlikely to fully resolve the complexity or eliminate the risk. Ultimately, states that opt for a BHP will want to design BHP programs so as to minimize the state’s financial exposure and address any negative impacts on the Exchange. States in which a BHP is not a viable option may want to consider alternative strategies to advance affordability and continuity goals.

http://www.kff.org/healthreform/upload/8283.pdf

The Basic Health Program is designed for individuals with incomes between 139-200% of the federal poverty level – a population that otherwise would be very vulnerable to cost sharing provisions of purchasing and using plans in the state insurance exchanges.

This report explains the moving levers that are required to construct such plans while being sure that benefits are adequate while costs are controlled for both the beneficiaries and the state and federal governments. With eligibility frequently shifting between Medicaid, the Basic Health Program, and the state exchange plans, it is clear that stability cannot be achieved. It is highly unlikely that plans can even be constructed that would meet the various goals for the patients, providers and state and federal governments, and, regardless, they would create an administrative nightmare.

Since the purpose of the Basic Health Program is to remove financial barriers to care for this vulnerable group, it only seems logical that this highly flawed plan should be discarded and replaced with an administratively simplified plan that removes access barriers not just for them, but for everyone – an improved Medicare for all.
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About PNHP Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program. PNHP has more than 18,000 members and chapters across the United States.

Since 1987, we've advocated for reform in the U.S. health care system. We educate physicians and other health professionals about the benefits of a single-payer system--including fewer administrative costs and affording health insurance for the 50 million Americans who have none.

Our members and physician activists work toward a single-payer national health program in their communities. PNHP performs ground breaking research on the health crisis and the need for fundamental reform, coordinates speakers and forums, participates in town hall meetings and debates, contributes scholarly articles to peer-reviewed medical journals, and appears regularly on national television and news programs advocating for a single-payer system.

PNHP is the only national physician organization in the United States dedicated exclusively to implementing a single-payer national health program.