So... still sick... determined to hit the gym later, nevertheless!
Have I shared with you folks that I'm back doing cardio after BodyPump? Yep...
Monday-Wednesday-Friday (schedule permitting) I do my one-hour BodyPump class followed immediately with 5 miles on the "big seat" stationary bike and then another 5 miles on the recumbent bike - for a total of 10 miles!
The "biking" takes me about 35-40 minutes all told at tension ranging from 16-18.
My diet? Besides the occasional 18-course champagne brunch I'm doing well with the ongoing "lifestyle change." Small meals throughout the day. Rarely do I "pig out." (Frankly... the stomach just can't handle it at this point!)
Today's breakfast? A "McMuffin" sausage, egg, and cheese sandwich with some homemade corned beef added.
(*WINK*)
Have I ever shared my corned beef recipe? The quick and easy one?
Take a can of "lite" corned beef hash. Fry it up. Spice it up as you're frying it up. When it's nearly done ADD a can of actual corned beef. Chop... mix... continue frying. Crack five or six eggs over the hash mix. After these eggs approximate sunny-side-up, chop and mix 'em into the hash mix. Turn the burner to low... add grated cheddar cheese and grated mozzarella and a big honking tablespoon of ricotta cheese to the mix... stir in till melted and melded... and serve on top of buttered sourdough toast.
Yum... yum... yum; does this boy know how to cook - or does this boy know how to COOK...?!?!
14 comments:
http://www.cnbc.com/id/102324400
* PLUS...
http://www.breitbart.com/big-government/2015/01/09/record-92898000-americans-not-in-the-workforce/
The wealth gap between Main Street and Wall Street continues to grow despite lower unemployment numbers, CNBC's Jim Cramer said Friday.
* PERHAPS BECAUSE...
A record 92,898,000 Americans 16 years and older did not participate in the labor force last month...
(*SMIRK*)
The labor force as a percent of the civilian non-institutional population also dipped back down to 62.7%, from 62.9% in November.
* BUT BACK TO THE ACTUAL WORKER...
"It's ironic because wages are going down," Cramer said on "Squawk on the Street."
The Labor Department also said 252,000 jobs were created last month, but wages declined by 5 cents per hour.
(*SNORT*)
"When you get a tight job market like this, wages are supposed to go up, but they're coming down," Cramer said. "That has to be of great concern because the wages at the top aren't going down."
* NO... THEY'RE... NOT...
* TWO-PARTER... (Part 1 of 2)
http://www.wsj.com/articles/john-c-goodman-how-obamacare-harms-low-income-workers-1420760457
The primary purpose of the Affordable Care Act was to make health insurance affordable for people with modest incomes.
* ACTUALLY... THE PRIMARY PURPOSE WAS TO COLLAPSE THE SYSTEM...
(*CHUCKLE*)
Yet as the employer mandate begins to kick in for 2015, the law is already hurting some of the people it was intended to help. By this time next year, we may find that many workers who earn within a few dollars of the minimum wage have less income and less insurance coverage (as a group) than they did before the mandate began to take effect.
This is the conclusion I draw from my survey in December of 136 fast-food restaurants (franchisees) that employed close to 3,500 workers.
Before 2014 about half the employees were “full time” as defined by ObamaCare; that is, they worked 30 hours or more a week. The potential cost to the employers of providing mandated health insurance to their full-time staff would have been about $7 million a year. But by the time the employers took advantage of all their legal options they were able to reduce their cost to less than 1% of that amount.
The first step was to make all hourly workers part time. That may seem easy to do, but in the fast-food business it’s not uncommon that employees fail to show up for work. Other employees are asked to work additional hours to prevent the restaurant from shutting down. By the end of 2014, 58 employees had crossed the line to full-time status and were eligible for mandated health insurance in 2015.
The companies offered these employees ObamaCare-compliant health insurance—bronze plans — but asked them to pay the maximum premium the law allows: 9.5% of their annual wage. For a $9-an-hour employee working 30 hours a week, the maximum monthly premium was $111. The total premium was $367, and the law requires the employer to pay the difference.
* I STILL DON'T SEE HOW THAT POSSIBLE PASSES CONSTITUTIONAL MUSTER...
The bronze plan has very large deductibles and co-payments — up to $6,600 or $13,200 for a family, depending on the family’s income. But the designers of the Affordable Care Act apparently did not understand that high deductible health insurance with no Health Savings Account is not attractive to young, healthy, low-income workers. They are far more likely to prefer mini-med plans that pay for generic drugs and doctor visits but not catastrophic care.
(Before ObamaCare, these companies offered all full-time, hourly employees a standard Blue Cross health plan as well as a mini-med plan for a much lower premium. No one signed up for the Blue Cross plan. About 200 signed up for mini-med insurance.)
* TO BE CONTINUED...
* CONCLUDING... (Part 2 of 2)
Self-insured employers can still do something similar. They can offer a Minimum Essential Coverage (MEC) plan — basically a type of mini-med insurance that covers preventive care with no annual or lifetime limits and very little else — no hospitalization, no specialist care, etc. Employees who sign up for MEC coverage escape the Affordable Care Act’s fine for being uninsured. Employers also are off the hook for any fine in this case because they offered all full-time employees a bronze plan, even if the employees turned it down. The companies in the survey offered to pay the full premium for the mini-med plans, in order to make that alternative more attractive. If employees choose the bronze plan it costs the employers about six times as much. The result: Only one of the 58 remaining full-time employees enrolled in a bronze plan; the rest will likely be in MEC plans.
What about the families of these workers?
Employers don’t have to pay the premiums for coverage of dependents. So to cover a family of three, the employee in one of these restaurants can face a premium of $805 a month for a bronze plan, almost 70% of his monthly wage. Since ObamaCare considers this offer “affordable,” any family member who turns it down is ineligible for premium subsidies on an insurance exchange.
* YOU'RE READING THIS - RIGHT, FOLKS? (RE-READ IF NECESSARY...)
What about the mini-med plans? Although these plans are offered free to the employees, dependent coverage is not free. An employee has to pay about 25% of his income to cover a spouse and kid. If he doesn’t, the family faces a fine next April 15.
* NICE, HUH?
Let’s return to the workers in the survey whose hours were reduced to part time. They can get subsidized insurance through an exchange, but they will be asked to pay up to 9.5% of their income for what is unattractive coverage. Some of them previously had mini-med plans, but this kind of insurance is no longer available to them.
* CHANT IT WITH ME, FOLKS: O-BAM-A! O-BAM-A! 0-BAM-A!
To recap: Almost half the workforce of these restaurants was involuntarily reduced to part time and has less income as a result. These employees have also lost the opportunity to have the coverage they most prefer: mini-med plans that pay for medical care they are most likely to need.
* BINGO...!!!
Those few remaining full-time employees will get mini-med insurance for themselves, but they are unlikely to be able to afford coverage for any dependents they have. They will not get an ObamaCare bronze plan unless they fork over about one-tenth of their take-home pay, and they won’t be able to get bronze coverage for other family members unless they forfeit more than half their income.
* MORE... THAN... HALF... THEIR... INCOME...
* AND YOU KNOW THAT THE "FIX" WILL INVOLVE NOT LOWERING ACTUAL PREMIUMS, BUT SIMPLY SHIFTING MORE PREMIUM COSTS TO THE TAXPAYER WHOSE TAXES DON'T FUND THE GOVERNMENT AS IT IS!
Out of 3,500 employees, only one that we know of got the kind of insurance that the architects of the Affordable Care Act wanted everyone to have.
* YOUR CHOICE: STUPID OR EVIL? WHICH IS OBAMA...???
* THREE-PARTER... (Part 1 of 3)
http://www.thedailybeast.com/articles/2015/01/09/ex-cbs-reporter-sharyl-attkisson-s-battle-royale-with-the-feds.html
The Obama Justice Department...
* AKA: THE DEPARTMENT OF INJUSTICE...
...and the United States Postal Service have issued carefully parsed denials that they hacked her phones and computers, but Sharyl Attkisson remains unconvinced.
“Unfortunately, the government doesn’t always provide truthful information,” the former CBS News correspondent told the Daily Beast this week. “We can’t just take the word of the government when it says something. I wish we could.”
Attkisson quit the network last March after 20 years in the Washington bureau, a career punctuated by increasing tensions and frustrations with CBS management, but also by journalism awards for uncovering corporate, political and government malfeasance among both Republican and Democratic office-holders.
Now she’s moving ahead with legal actions against the two federal agencies.
A Dec. 26 administrative complaint — a legally required precursor to a federal lawsuit against the sovereign United States — claims $35 million in damages sustained by Attkisson, her husband and their daughter.
The complaint asserts that hackers, using sophisticated software available only to a select few at federal agencies, unlawfully tapped their home phones in Leesburg, Virginia, and stole data from Attkisson’s personal and office computers from 2011 to 2013, a period when she was aggressively investigating a series of Obama administration missteps.
There is little doubt that Attkisson’s computers were hacked by an illicit outside entity; experts hired independently by CBS, Attkisson and just-retired Republican Sen. Tom Coburn of Oklahoma, ranking member of the Committee on Homeland Security and Government Affairs, conducted separate forensic analyses and found evidence of repeated intrusions using unauthorized software.
The big question, essentially, is whodunit?
Coburn, who said he used his staff from the Select Committee on Intelligence to investigate Attkisson’s personal computer, told the Daily Beast: “CBS wouldn’t let us look at the [office] computer, but on the one we did look at, we found programs that are not available anywhere else except to a very few people.” While he stopped short of linking the discovered programs to a federal agency, Coburn said: “I think she [Attkisson] has got a legitimate claim. I think her civil rights were violated.”
* NOTE: CBS NEWS IS APPARENTLY CONSPIRING WITH THE OBAMA ADMINISTRATION IN AN ATTEMPT TO COVER THE PARTISAN GOVERNMENT HACKING UP.
* TO BE CONTINUED...
* CONTINUING... (Part 2 of 2)
But this week the Justice Department and the Postal Service — among the defendants in the case, who also include Attorney General Eric Holder and Postmaster General Patrick Donahoe (both of whom have announced retirement plans), and various “unknown named agents” of the government — pushed back hard against Attkisson’s allegations. “We stand by our statement from 2013,” a Justice Department spokesperson emailed the Daily Beast in response to Attkisson’s claim that she and her family suffered property losses, emotional stress and other injuries as a result of government intrusions, “If it happened, it’s absolutely an abuse of power and it’s also a criminal offense.”
* "IF...???"
“For reference,” the flack continued, “a department spokesman in 2013 issued a statement as follows: ‘To our knowledge, the Justice Department has never compromised Ms. Attkisson’s computers, or otherwise sought any information from or concerning any telephone, computer or other media device she may own or use.’”
* "TO OUR KNOWLEDGE...???"
A spokesperson for the Postal Service, which Attkisson’s court papers say works closely with the FBI and other law enforcement agencies, likewise emailed: "We have not received a copy of the complaint, but we do not believe the allegations reported in the media have any merit.”
* "WE." WHO IS THIS "WE?" CAN WE HAVE A NAME, PLEASE...???
Attkisson is quick to poke holes in the government’s protestations of innocence. The Postal Service’s denial seems purposely vague, she said. “I think I know what they mean by ‘the allegations reported in the media,’ but it’s not specific.”
As for the Justice Department’s statement, “It’s only a qualified denial,” Attkisson said. “I would like to know to whom ‘our knowledge’ refers. Was there an investigation of people at DOJ before they arrived at that conclusion? Or was it just the two guys who wrote the press release? ... And if they take the position that they have ‘no knowledge,’ I would suggest that they should be working a little harder to get to the bottom of this.”
(*NOD*)
Attkisson noted that the Justice Department and the FBI — which she says opened an investigation of her case, but never contacted her, and apparently has amassed a 5,000-page file on the hacking of her communications’ devices and related issues — has either rejected or ignored repeated Freedom of Information Act requests and letters demanding the relevant documents.
(*PURSED LIPS*)
* TO BE CONTINUED...
* CONCLUDING... (Part 3 of 3)
Attkisson said the Feds have basically given her the run-around, initially denying even the existence of such a case file, before acknowledging that, yep, it’s in their possession, but for unexplained reasons she can’t peruse it.
“I don’t think that’s the behavior of people who are trying to help,” she said, contrasting her experience of official obfuscation with the administration’s urgent response to the hacking of Sony Pictures Entertainment, whose top executives include contributors to the Obama campaign and the Democratic Party.
(*SMIRK*)
“They sure took the Sony thing seriously,” Attkisson said dryly. “Don’t they think it’s serious when a national journalist’s computer gets hacked? This is freedom of the press, and they certainly haven’t shown the press the same interest as they did in the Sony case.”
Attkisson's Little Rock, Ark.-based attorney, C. Tab Turner, told the Daily Beast he’s a loyal Democrat who supported Bill Clinton and Barack Obama for president, and will happily vote for Hillary Clinton if she decides to run.
“There was an intrusion with sophisticated software, and according to the investigations we’ve conducted so far, that software is only available to government agencies with the United States,” Turner said. “There is no question it was placed there by government agencies. The question is, who did it?”
He added that he is working for Attkisson on contingency and intends to file a federal lawsuit after the administrative complaint is either accepted by the government or passes the required six-month waiting period.
Attkisson, meanwhile, quoted one of her private forensic analysts — who declined to comment for this story — as telling her that there is harder evidence for government intrusion on her personal computer than the United States possesses for hacking by China.
Coburn, for one, said it’s likely that the answer will be obtained through the discovery process in a lawsuit, including the depositions of witnesses under oath. “These are real issues for our country when a reporter’s computers get hacked using sophisticated software that is only available a few places in the world,” he said. “That’s a pretty scary thing to me in terms of freedoms and liberties. If it happened, it’s absolutely an abuse of power and it’s also a criminal offense … Somebody certainly violated Attkisson’s rights. It would seem to me she certainly ought to be compensated and whoever is responsible for that ought to be in a jail cell.”
* THEY WOULDN'T DARE HAVE DONE THIS WITHOUT HOLDER'S PERMISSION. AND FRANKLY... I CAN'T IMAGINE EVEN HOLDER GIVING IT THE OK ABSENT OBAMA'S NOD.
(*NOD*)
* FOUR-PARTER... (Part 1 of 4)
http://www.forbes.com/sites/jvdelong/2015/01/08/on-the-irrelevance-of-most-administrative-law/
The current term of the Supreme Court is loaded with issues of administrative law – that is, with cases about the rules governing actions by administrative agencies.
The biggest is King v Burwell (IRS rules on subsidies under ObamaCare), but also on the list is Perez v Mortgage Bankers (procedures required to revise a rule), DOT v Association of American Railroads (delegation of regulatory power), and a group of EPA cases (agency treatment of cost data).
Scanning the documents on these matters, it is striking how little the formal arguments have to do with the realities of the contemporary administrative state.
Current government is a paradox. The overall image is that it is large, bureaucratic, and slow. True; but at the same time, it has become selectively hyperactive.
It is vulnerable to small groups of the ideological or the venal (or hybrids combining both) which capture some part of the machinery and then lever the power of government to their own ends.
After capture, the sclerosis of government works to the advantage of the capturers, because it is difficult for anyone to reverse the machinery.
(*NOD*)
Numerous examples spring from the daily press reports. A few of them:
* TO BE CONTINUED...
* CONTINUING... (Part 2 of 4)
The EPA has been seized by hard greens who are determined to remake the US electrical system (which is “an engineering marvel, arguably the single largest and most complex machine in the world”) despite their total lack of qualifications for this task. The effort relies upon “facts” about climate change that are highly uncertain, and upon a legal interpretation that should be a joke. (Indeed, EPA’s entire set of rules on CO2 rests on a Supreme Court opinion that was an embarrassment to that institution.)
* YEP...
But EPA knows that it will take years for the courts to declare their legal view erroneous, and in the meantime the utilities have little choice except to follow the proposed rules, so by the time the law moves, the revamping will be a fait accompli.
The utilities seem to care little as long as they can pass the costs on to the customers, and the potential for disaster is immense.
* YEP. THAT'S THE DIRTY LITTLE SECRET! WE'RE ON THE HOOK - NOT THE UTILITIES, THEIR PERSONNEL, OR THEIR STOCKHOLDERS! THEY'LL SIMPLY RAISE RATES!
* MORE EXAMPLES:
The Department of Justice has decided that anti-discrimination laws apply to the transgendered. So it appears that someone with a penis has a federal right to use a women’s bathroom via a declaration that he feels like a she. What could go wrong?
The Department of Labor and the National Labor Relations Board, now the tools of Progressive ideologues and unions, are revising settled interpretations and extending the reach of labor law to new groups of employees and employers.
(*NOD*)
* FOLKS... UNDERSTAND...
Lobbyists earn their pay by capturing key congressional committees or individuals and inserting provisions to benefit particular clients. Every bill now, including the recent “cromnibus” to keep the government running for a time, consists of hundreds of pages of special provisions strung together with no effort at consistency. As scholar John Goodman said of ObamaCare: ‘Imagine going around a table asking each group what is the one thing they must have in order to support the legislation — the insurance companies, the drug companies, the hospitals, the labor unions, AMA, AARP, etc., and no one making sure that all the separate demands fit together in a sensible way.”
(*NOD*)
* AND HOW ABOUT THE IRS...???
The capture of the Internal Revenue Service by politicized and weaponized bureaucrats may be having a crucial effect on our elections.
(*PURSED LIPS*)
* TO BE CONTINUED...
* CONTINUING... (Part 3 of 4)
The list could be expanded indefinitely, on both the administrative and congressional sides.
A striking aspect of this phenomenon of capture is its anonymity, at least as far as most commentary is concerned. PJMedia ran a series called "Every Single One" documenting the radical takeover of the Department of Justice, and describing the individual attorneys and their resumes...
Close connections between EPA and environmental groups have been documented...
The names and faces of the IRS people have been publicized, and one can dig some names out of government notices and letters. But this information is largely ignored, and as far as the general media is concerned decisions are made by offices or bureaus, not by people.
* WHAT AM I CONSTANTLY RANTING ABOUT, FOLKS...?!
On the congressional side, one yearns, in vain, for a marked-up copy of legislation that identifies the members, staffers, and lobbyists responsible for particular provisions. Congress deliberately keeps things anonymous.
* CONTEMPLATE THAT, FOLKS... JUST... THINK ABOUT THAT...
The anonymity serves a crucial purpose. To say the “The Office of X decided today . . . “ is far more impressive than “Two 30-something lawyers who used to work for an environmental group decided today that EPA should . . . “, and slipping a few lines into a thousand-page bill invokes the full weight of “the intent of the Congress.”
* YEP! (YOU'VE GOTTA UNDERSTAND THIS, FOLKS!)
To identify the individuals at EPA would highlight the incestuous relationship between the agency and major environmental groups, and would cast into doubt the capacity of the agency to make honest tradeoffs between environmental protection and other values; and as for Congress — the adage is true that one hates to see the sausage being made.
* TO BE CONTINUED...
* CONCLUDING... (Part 4 of 4)
A second striking aspect of the phenomenon of capture is the disconnection between formal administrative law doctrines and the realities.
The formal doctrines are built upon a “transmission belt theory,” as described by Professor Richard Stewart almost 40 years ago. In this model, Congress legislates, but often leave gaps to be filled in by the administering agency.
This is all well and good. Congress cannot master the detail and should not try, nor should necessary changes be stalled until Congress gets around to revisiting a topic.
In this context, administrative law is a fail-safe check on the agency. Agency actions are reviewed by courts, but only to make sure that the agency followed the requisite procedures, which are designed to ensure that all interests had a chance to be heard, that the agency stayed within its jurisdictional bounds, and that the action was not totally arbitrary.
(The courts of appeal are important parts of the quality control process.)
* HERE'S THE THING, THOUGH...
Legal nerds can go into paroxysms of delight debating whether agency authority is legislative or executive, interpretive or substantive, but the distinctions do not much matter, as long as the culture of the agency is based on [claimed] deference to Congress, and the agency [can make even a half-cogent argument that it is] carrying out a statutory scheme as best it can.
The basic suppositions do not apply to agencies that have been taken over by outside interests, whether these interests are economic or ideological.
If the lines of loyalty of the agency staff do not run to the constitutional scheme, if the staffers see themselves as representatives of an interest that has captured an agency, then the legal doctrines become perverse.
Deference to agency interpretation of law becomes an invitation to the staff to play games with the language, finding and exploiting ambiguities where none should exist.
Judicial reliance on agency expertise triggers skewed analyses; staff knows how things are supposed to come out, and knows that no judge will contradict it technical conclusions. To the informed, EPA science and risk assessments have been jokes for a generation.
The congressional corruption also breaks the system at the agency level. What agency staffer, however obeisant to the constitutional structure, will feel a strong moral obligation to carry out an intent of one congressman to benefit some heavy-contributing constituent, especially when various provisions do not harmonize? When agency staff knows that the legislative outcome is a pastiche of lobbyists’ contributions, then the drive to make sense of the scheme, ignoring the language to the extent necessary and possible, becomes strong, and perhaps laudable. Even the most punctilious will try to make the overall scheme workable.
So while watching the debates over administrative law doctrines of deference and presumptions and procedures can be entertaining, it is an abstract entertainment, sort of like working crossword puzzles. Intellectually challenging for those so inclined, but not relevant to anything real.
Every once in a while, the Supreme Court will rebel against fictions, noting “there comes a point where this Court should not be ignorant as judges of what we know as men.” We can update that “men” to “men and women.” but ad law needs some new doctrines that fit the realities of modern government.
* AND CONGRESS NEEDS TO HOLD AGENCY HEADS TO ACCOUNT FOR WHAT THEIR AGENCIES DO!
http://caseymulligan.blogspot.com/2015/01/republicans-help-to-socialize-medicine.html
Wow! A widespread failure to consider the economics of health reform has led Republicans to push legislation to (unwittingly, may we suppose?) promote socialized medicine - and Democrats to oppose it!
* I NEED A DRINK...
The new Republican-sponsored bill ("Save American Workers Act") is about changing the "definition of full-time work" from 30+ hours to 40+ hours.
But... we are not really talking about definitions; the federal government does not publish the English dictionary.
What we are talking about is the threshold for getting free stuff: government-financed health care in this case.
Because of the original ACA, it is much more difficult for full-time workers to get subsidized coverage without experiencing an employment penalty than it is for part-time workers or non-workers. So... the new bill aims to vastly increase the number of people who would be deemed part time (for the purposes of getting free stuff), or, could be deemed part time with a trivial change in their work schedule.
As a result...
* HERE IT COMES, FOLKS...
(*DRUM ROLL*)
As a result, the bill will take millions of people off employer coverage and put them on ObamaCare - all at taxpayer expense.
(*GUZZLING MY SCOTCH*)
The bill will put the U.S. dramatically closer to "single payer" than it would be with ObamaCare as originally written.
(*SEARCHING THE MEDICINE CABINET FOR CONTRA-INDICATED MEDICATIONS*)
The great political question is: which party will consider the economics first?
* NEITHER...???
Maybe Democrats? (The White House statement makes me think that they understand the economics pretty well, and the Wall Street Journal editorial suggests that the Republicans may be lagging. Maybe the President will sign the bill, laughing all of the way to the history books?)
Even if they are not concerned about the economic effects, do Republicans really want to bet that the President is not bluffing about veto... willing to bet that he is NOT willing to take another big step toward single payer with a Republican-sponsored bill that increases the deficit?
(*SPLITTING HEADACHE*)
And will they bet that the President is NOT willing to make his Department of Health and Human Services even more powerful than it already is?
And... bet that the President is NOT willing to make a move that makes several 2016 Presidential contenders look like fools?
P.S. The Congressional Budget Office estimates than "only" one million people would change coverage as a result of the bill. With all due respect for their admirable efforts, the CBO is wrong on this. They are using a variant of the Gruber microsimulation model (all of the sudden, even the Wall Street Journal is relying on the nonsense output from the model) which fails to include any market analysis and improperly uses elasticities from an era where the (non-elderly) alternatives to employer coverage primarily were Medicaid or being uninsured.
* TWO-PARTER... (Part 1 of 2)
http://thehill.com/blogs/congress-blog/healthcare/228807-healthcare-for-me-but-possibly-not-for-thee
President Obama recently checked in to Walter Reed hospital with a sore throat. During his visit, it appears he received a suite of treatments to aid in diagnosing his illness, including a CT scan, a fiber optic exam, and ENT consultation. Ultimately, the doctors concluded that he has acid reflux.
As the leader of the free world, Obama certainly deserves top notch medical care. Yet the breadth and quality of medical care that he received starkly contrasts with the diminished care that too many Americans could soon receive thanks to the Affordable Care Act.
As a physician, I strive to give the best medical care to every patient who walks through the door. The ACA has the potential to undermine my ability to do this in a number of ways.
One example is the Patient-Centered Outcomes Research Institute (PCORI), one of the many bureaucratic agencies created under the law.
The institute’s mandate is to conduct government-sponsored research comparing the efficacy of medical and surgical interventions. It draws its conclusions not from individual patient outcomes but on the average outcomes of a pre-set population. Many observers fear that federal regulators might use this research to limit or refuse to cover treatments that it deems “ineffective.” (Medicare, for example, could consider PCORI’s findings when determining what procedures it will or won’t cover and how it will reimburse those interventions. This would limit patients from getting the care that they need and want.)
PCORI’s methodology is contradictory to the ethos of healthcare.
Our profession cares first and foremost for the individual patient, every one of whom is unique.
* THAT WAS PRE-OBAMA, MY FRIEND...
(*SIGH*)
Physicians need the flexibility to treat not the “average” patient but the actual patient.
* YOU'D THINK THIS WOULD BE ACKNOWLEDGED AS COMMON SENSE... BUT NO... NO MORE.
Yet under the PCORI, physicians’ professional judgment regarding treatments for individuals could be replaced with rigid rules set by regulators. This would ignore the crucial differences between different patients as well as the various cultural, religious, and life experiences that patients bring with them to the doctor’s office. It should go without saying that government-set treatment protocols can’t meet the unique needs of every patient.
(*PURSED LIPS*)
* TO BE CONTINUED...
* CONTINUING... (Part 2 of 2)
Another potential patient-harming ACA programs is the Value-Based Payment Modifier (VBPM), which establishes an arbitrary cost limit for physicians involved in Medicare. Doctors who transgress this threshold will be punished with fiscal retribution.
* SOUND FAMILIAR, FOLKS? WHAT DO YOU SUPPOSE THE REAL WORLD RESULT WILL BE?
This also threatens to compromise patient health outcomes and access. A doctor nearing the VBPM limit may face a perverse choice whether to administer a necessary treatment. It will put tremendous pressure on physicians to avoid ordering tests, consults, or medicines that their patients may need — almost certainly resulting in worse medical care.
* YA THINK!
* FOLKS... I HAVE NO PROBLEM WITH GOING AFTER DOCTORS WHO SCAM THE SYSTEM. I DON'T EVEN HAVE A PROBLEM WITH "DEALING" WITH DOCTORS WHO ARE TEST-HAPPY JUST FOR THE SAKE OF BEING TEST-HAPPY. BUT THIS ONE-SIZE-FITS-ALL STATISTICAL MODEL DOESN'T SEEM TO BE THE WAY TO CONTROL COSTS. BASICALLY, IT'S SURE TO ENSURE PATIENTS GETTING SCREWED - PARTICULARLY IF YOU'RE COMING IN AS A NEW PATIENT TOWARDS THE END OF THE "MEASUREMENT" YEAR!
Compounding these problems will be one of the most-controversial bureaucracies created by the ACA: The Independent Advisory Board (IPAB). Composed of fifteen unelected bureaucrats, IPAB has the power to “recommend” legally binding cuts to Medicare in an attempt to hold down spending. Most of these cuts will take the form of lower reimbursement rates for doctors and hospitals.
* SHOULDN'T WE HAVE SOMETHING LIKE THIS TESTED OUT ON... OH... I DON'T KNOW... GOVERNMENT BUREACRACY FIRST...?!?!
* JUST LIKE... WOULDN'T HAVE MADE MORE SENSE TO HAVE BROUGHT THE OBAMACARE EXPERIMENT TO... SAY... DENTISTRY... OR EYE CARE... FIRST? (SEE HOW THE CONCEPT WORKED OUT WHERE THE STAKES ARE GENERALLY LESS...???)
This, along with other provisions of the law, makes it highly likely that many doctors could no longer afford to accept Medicare. As a result, patients will have a harder time finding it. Ultimately, this will result in longer waits for the patients who need care the most.
* YOU'LL BE "INSURED." WHAT YOU WON'T BE IS TREATED! NOT IN A TIMELY MANNER AT LEAST!
At first glance, the three examples I’ve named mainly apply only to Medicare. Yet trends in Medicare inevitably influence — and even dictate — trends in the private insurance market, as studies in recent years have demonstrated.
(*NOD*)
Changes in Medicare reimbursement rates typically lead to changes in private insurance reimbursement rates. Similarly, insurers typically mimic changes in Medicare coverage.
Given these trends, the Affordable Care Act is likely to lead to longer waits, restricted access, and worse health care for a significant percentage of patients.
* WHAT I PREDICTED FROM THE FIRST...
Which puts Obama’s recent medical treatment at Walter Reed in perspective. He received a series of expensive tests and interventions that helped identify and treat his acid reflux. Yet thanks to the Affordable Care Act, John Q. Patient may not be so lucky.
http://www.steynonline.com/6742/jesuischarlie-but-youre-not
So much for national unity:
Just a day after the Charlie Hebdo shooting left 12 dead and had politicians calling for the country to unite, a row between politicians broke out after the National Front were not invited to take part in Sunday's rally for "national unity" in Paris.
In the most recent national election in France, Marine Le Pen's National Front won. So the national unity rally excludes the most popular national party. That seems likely to work.
* UNFRIGGIN'BELIEVABLE...
The French establishment is co-opting these brave men's deaths for their own purposes, and for the most part the world's media are helping them get away with it.
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