Universal Health Care for America

[Guest DOJ]

Brookhaven Memorial Hospital Medical Center, a Long Island, N.Y.-based hospital, has agreed to pay $2.92 million, plus interest, to settle allegations that the hospital defrauded Medicare, the Justice Department announced today.

 

The government alleged that the hospital fraudulently inflated its charges to Medicare patients to obtain enhanced reimbursement from the federal health care program. In addition to its standard payment system, Medicare provides supplemental reimbursement, called "outlier payments," to hospitals and other health care providers in cases where the cost of care is unusually high. Congress enacted the supplemental outlier payments system to ensure that hospitals possess the incentive to treat inpatients whose care requires unusually high costs. The lawsuit alleged that the hospital inflated its charges to obtain supplemental outlier payments for cases that were not extraordinarily costly and for which outlier payments should not have been paid.

 

"Conduct like that alleged here drives up the costs of health care for all of us," said Tony West, Assistant Attorney General for the Justice Department's Civil Division. "The resolution announced today is the most recent in a series of settlements that illustrates the Justice Department's continued commitment to protecting the Medicare Trust Fund from hospitals that knowingly charge more than the law allows."

 

The suit was originally filed in the U.S. District Court for the District of New Jersey by a whistleblower, Tony Kite, in 2005. The United States intervened in the suit in November 2009. Mr. Kite brought his suit under the whistleblower provisions of the False Claims Act, which permit private citizens with knowledge of fraud against the government to bring a lawsuit on behalf of the United States and to share in any recovery. Under the civil settlement announced today, Mr. Kite will receive roughly $613,000, plus interest, out of the settlement proceeds.

 

"This office is determined to root out any conduct that threatens to undermine the integrity of the federal health care programs," said Paul J. Fishman, U.S. Attorney for the District of New Jersey.

 

The settlement is the result of a coordinated effort by the Commercial Litigation Branch of the Justice Department's Civil Division; the U.S. Attorney's Office for the District of New Jersey, Affirmative Civil Enforcement Unit; the Department of Health and Human Services, Office of Inspector General, and the Centers for Medicare and Medicaid Services; and the Federal Bureau of Investigation.

 

This settlement is part of the government's emphasis on combating health care fraud. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover approximately $2.3 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department's total recoveries in False Claims Act cases since January 2009 have topped $3 billion. Since 2006, the United States has recovered over $1.2 billion from hospitals that it alleged engaged in outlier fraud.

[Guest Charlotte Dennett]

It seems like both sides want to stop health care fraud. Why don't they focus on that.

[Guest Small business owner]

Cost containment is an issue that needs to be dealt with. Increase we need to have an open health care free market.

[Guest Rep. Steny Hoyer]

PRESIDENT'S BILL. SO I'M HOPEFUL WE'LL HEAR BACKTRACKING BY THE. THE TO SAY, HEY, IT'S TIME FOR US TO REALLY GET OFF OF THIS BILL AND BEGIN A WAY AND A PATH WE CAN IMPROVE HEALTH CARE FOR FOLKS. >> WHEN YOU -- >> HERE NOW WITH MAJORITY'S EXPECTATIONS FOR THE MEETING, STOYER JOINS US FROM THE HILL. >> GOOD TO SEE YOU. >> I KEEP GOING BACK TO HALFTIME, WHERE THEY TOOK THE COLTS BY SURPRISE, IS THERE ANYTHING IN THE OFFING FROM DEMOCRATS TODAY? >> I DOUBT THAT'S GOING TO BE THE CASE. I THINK THE AMERICAN PUBLIC PROBABLY KNOW PRETTY WELL WHAT TO DISCUSS AND THAT'S A DISCUSSION OF ONE OF THE MOST SERIOUS ISSUES CONFRONTEDING OUR COUNTRY, THAT'S THE COST OF HEALTH CARE, AVAILABILITY OF HEALTH CARE TO OUR FAMILIES AND TO OUR BUSINESSES AND THE COST TO OUR COUNTRY. THE AMERICANS I TALK TO ALL OVER THIS COUNTRY UNDERSTAND THAT HEALTH CARE NEEDS TO BE REFORMED. AND I THINK MOST REPUBLICANS WILL SAY THE SAME. I THINK THE AMERICAN PUBLIC ARE GOING TO HEAR A FULL OPEN DISCUSSION OF EACH SIDE'S VIEWS AND HOPEFULLY THEY'LL SEE SOME AREAS OF ACCOMMODATION AND AGREEMENT. I'M LOOKING FORWARD TO THAT MYSELF. >> YOU KNOW BETTER THAN MOST HOW THE BILL'S BEEN POLLING, TRENDING OVER TIME. I WONDER WHAT WOULD BE WRONG WITH SOME KIND OF SURPRISING ATTENTION-GETTING COMPROMISE, CONCESSION, THAT SHOWS REPUBLICANS YOU'RE SERIOUS AND ALMOST SHAMES THEM INTO COMPROMISING WITH YOU. >> YOU SAY THAT. MANY, MANY OF THE REPUBLICAN IDEAS ARE INCLUDED IN THE SENATE BILL, THE HOUSE BILL AND THE PRESIDENT'S PROPOSAL COMPROMISE, WHICH HE JUST PUT ON THE TABLE MONDAY. SO THERE HAVE BEEN NEW IDEAS PUT ON THE TABLE. THERE ARE SIGNIFICANT AREAS OF AGREEMENT IN TERMS OF DISCRIMINATION AGAINST YOUNG PEOPLE, OF FAMILIES, OF LIMITS, MANY OF THE THINGS WE'VE TALKED ABOUT IN OUR BILL, REPUBLICANS HAVE TALKED ABOUT, AS WELL. I THINK THE AMERICAN PUBLIC WILL SEE THAT. I'M HOPEFUL THEY DO. AND I'M HOPEFUL THERE WILL BE SURPRISES ON THE REPUBLICAN SIDE AS WELL. FRANKLY, THERE'S BEEN NOT MUCH RESPONSE WHEN I'VE TALKED TO SOME OF THE REPUBLICANS ABOUT WHAT AREAS OF REAL COMPROMISE THERE WOULD BE. NOW, THERE ARE OBVIOUSLY VERY LIMITED PROPOSALS THE REPUBLICANS HAVE MADE. I WANT TO TALK TO YOU ABOUT THE POLLING DATA BECAUSE I THINK THE REPUBLICANS TALK ABOUT THAT. AND I THINK AMERICANS ARE RIGHTFULLY CONCERNED THAT THERE'S NOT AGREEMENT, SEEMS TO BE CONFLICT, THEY'RE CONCERNED ABOUT WHAT DIRECTION WE'RE GOING AND WHETHER IT'S GOING TO AFFECT THEM POSITIVELY OR NEGATIVELY. BUT WHEN YOU ASK AMERICANS ABOUT THE INDIVIDUAL ITEMS WE'RE ADDRESSING, UNIFORMALLY WE'RE GETTING 60%, 65%, 70% ON THE INDIVIDUAL ITEMS THAT ARE IN THE BILL, INCLUDING THE FACT THAT AMERICANS THINK IT NEEDS TO BE COMPREHENSIVE. YOU GET VERY HIGH NUMBERS. WHEN IT COMES TO THE PROCESS AND LOOKING AT WHAT'S HAPPENING IN WASHINGTON, THEY'RE NOT PLEASED. VERY FRANKLY, I'M NOT PLEASED EITHER. >> DOES THAT MEAN AMERICANS ARE SEEKING A MORE INCREMENTAL APPROACH THAN OVER A COMPREHENSIONS IVE BILL? >> ACTUALLY, THE POLLING SHOWS THEY THINK IT NEEDS TO BE BIGGER RATHER THAN SMALLER. THEY KNOW THIS IS A BIG PROBLEM. THEY KNOW COSTS ARE ESCALATING FOR THEM, FOR THEIR BUSINESSES, FOR THE COUNTRY. THEY KNOW THAT'S NOT SUSTAINABLE FOR THEIR FAMILIES. SO THEY KNOW THERE NEEDS TO BE BIG CHANGES. THEY WANT TO MAKE SURE THOSE CHANGES DON'T ADVERSELY EFFECT THEM. IF THEY GOT THEIR INSURANCE, THEY LIKE IT, THEY WANT TO MAKE SURE THEY DON'T TAKE IT AWAY AND WE'RE CERTAINLY NOT GOING TO DO THAT. YOU KNOW WHAT THE BILL DOES IS PROVIDE WHAT REPUBLICANS HAVE ADVOCATED FOR. THAT IS A FREE MARKET OPEN, TRANSPARENT MARKETPLACE FOR PEOPLE TO PURCHASE INSURANCE. IF THEY CAN'T AFFORD IT, IT GIVES THEM SOME HELP TO DO SO. SO I THINK THAT AMERICANS BASICALLY ARE SUPPORTIVE OF THE PRINCIPLES OF THE BILL. THEY'RE CONCERNED ABOUT WHAT, I THINK, PERHAPS, IS THE PROCESS AND THE CONFRONTATION, THE CONFLICT, WHICH GIVES THEM UNEASE, AS IT SHOULD. >> YEAH. HOW SERIOUSLY SHOULD WE BE TAKING REPORTS OF A FALLBACK PROPOSAL? A SMALLER BILL, A QUARTER OF THE COSTS TO COVERING 15 MILLION PEOPLE, IF IN FACT THE BIG ONE DOESN'T GET THE SUPPORT IT NEEDS? >> OBVIOUSLY, THE PRESIDENT HAS INDICATED HE WANTS TO HAVE A COMPREHENSIVE BILL TO KEEP COSTS DOWN AND MAKE AFFORDABLE HEALTH CARE AVAILABLE FOR ALL AMERICANS. THAT WILL BRING COSTS DOWN, INCLUDING THOSE WHO HAVE INSURANCE NOW. BUT THE PRESIDENT, LIKE ALL OF US, UNDERSTANDS THAT IN A DEMOCRACY YOU DO THE POSSIBLE. YOU DO WHAT YOU CAN CREATE CONSENSUS ON AND YOU CAN PASS. AND YOU DO THE BEST YOU CAN. SO I THINK THE PRESIDENT'S OPEN TO THAT. THE PRESIDENT, AND I CERTAINLY AGREE WITH THAT, BELIEVES IF WE'RING REALLY GOING TO EFFECT THE REFORMS THAT REPUBLICANS AND ...

[Guest Muleboy]

Hope someone today mentions that the current White House #HCR proposal greatly mirrors the Republican proposal in 1993.

[Guest Soldier of God]

Restore Liberty and Personal Beliefs. Everything else will come.

[Luke_Wilbur]

Strike out the statements in the bill that are not agreed by both sides. An estimated twenty percent. Build on what can be done today. Table that issue for a future bill revision.

Edited February 25, 2010 by Luke_Wilbur

[Luke_Wilbur]

http://www.c-span.org/Topics/Health-Care-Insurance-Reform-Legislation-Town-Hall.aspx

 

Live Coverage by C-Span

[Luke_Wilbur]

Joined CNBC’s Squawk box this morning to discuss health care, the Roadmap, and deficits.

 

[Luke_Wilbur]

Recent poll.

 

Senator Baucus do you believe we are on the cusp of an agreed #HC Bill.?

 

Do you believe the hcr bipartisan summit will be productive in producing a mutually agreeable hc solution for the American people?

 

 

1.) Yes [ 36% (4 votes) ]

2.) No [ 64% (7 votes) ]

 

Twtpoll

Edited February 25, 2010 by Luke_Wilbur

[Luke_Wilbur]

Pre-Existing conditions we all should agree upon. No insurance company should deny coverage to a baby born with a deformation. Insurance should not be a gaming system.

[Guest Bling Bling]

Who should be between you in the doctor?

 

Republicans want a more competitive market.

 

Republicans not want our government to regulate insurance protections.

 

Democrats want to protect the 40,000 Americans who are dying every year.

[Guest Registered Nurse]

Primary coverage for everyone.

[Guest Tea Party Patriot]

Health Care is the shark under water that can feed the way it wants.

[Guest Muleboy]

We all need protection. What is the problem?

[Guest bpanther]

Care delayed is care denied.

[Luke_Wilbur]

How much money is the government hiding?

 

Is Medicare Advantage working well?

 

Taxpayers currently pay the government to distribute insurance $1.15 for every $1.00 of insurance coverage.

Edited February 26, 2010 by wiley

[Guest Tea Party Patriot]

More people are now getting health care from government than the private sector. I agree that we need insurance market reforms. The insurance market needs to be regulated. Allowing small businesses and individuals to be part of a larger pool to reduce prices. Base coverage is an area to be resolved. Opening insurance up is a good idea, but there needs to be something that protects citizens installed.

[Guest Dan]

If you were watching the bipartisan healthcare meeting today, you've seen some people leaning on a talking point that premiums will increase under health care reform. Let's be clear: our approach will lower costs for American families and businesses, and slow the growth of costs for the country as a whole.

 

The non-partisan Congressional Budget Office, the Associated Press and the Wall Street Journal all found that our approach will substantially lower the cost of health care premiums for the vast majority of Americans for three reasons: because it lowers administrative costs, it increases competition, and spreads the cost of health care fairly across millions of Americans.

 

Under our plan, Americans buying comparable health plans to what they have today in the individual market would see premiums fall by 14 to 20 percent. And most Americans buying coverage on their own would qualify for tax credits that would reduce their premiums by an average of nearly 60 percent – even as they get better coverage than what they have today. This is going to encourage people to purchase better coverage.

 

And like families and individuals, the CBO found that small and large businesses, who are struggling to remain profitable and competitive under the status quo, will benefit from lower administrative costs, increased competition, and better risk pooling. More than 3.5 million small businesses could qualify for tax credits to help them pay their premiums, and small businesses that are eligible for these tax credits would see their premiums 8 to 11 percent lower than they currently are.

 

Our plan will end insurance company abuses and provide more affordable options. We must act now, because if we don't, American families and businesses will continue to feel the crushing burdens of skyrocketing premiums.

[Guest Dr. Ferdinand Salvacion]

Based on the scientific evidence, it is my opinion that fetuses possess the capacity to experience pain as early as twenty weeks gestational age.

[Guest Molly Block]

NANCY PELOSI STATED THAT THERE IS NO PUBLIC FUNDING ON ABORTIONS.

"The law of the land is there is no public funding of abortion," she said, in an apparent reference to the Hyde amendment, which has historically barred government funding of most abortions. "And there is no public funding of abortion in these bills. And I don't want our listeners or viewers to get the wrong impression from what you said."

STOP SCARING PEOPLE!!!!!!!!!!!!!!!!!!!!!!!!!

[Guest SinglePayerActivist]

People want choice of provider, not insurance company.

 

 

On Thursday morning, Feb. 25, 2010, a sidewalk summit advocating "Medicare for All," was staged in Washington, D.C., at Lafayette Park, North, not far from the White House. Here are some sights and scenes from that spirited event.

[Guest NRLC]

 

NANCY PELOSI STATED THAT THERE IS NO PUBLIC FUNDING ON ABORTIONS.

 

"The law of the land is there is no public funding of abortion," she said, in an apparent reference to the Hyde amendment, which has historically barred government funding of most abortions. "And there is no public funding of abortion in these bills. And I don't want our listeners or viewers to get the wrong impression from what you said."

 

STOP SCARING PEOPLE!!!!!!!!!!!!!!!!!!!!!!!!!

 

The health bill passed by the U.S. Senate on December 24, 2009 (H.R. 3590) contained multiple, far-reaching pro-abortion provisions. These have been described in a number of documents issued by the National Right to Life Committee (NRLC), including a letter sent to members of the U.S. House of Representatives on January 14, 2010, which is posted here:

http://www.nrlc.org/AHC/HouseLetteronAbortionProvisions.html

 

This memorandum provides more detailed information on just one of the pro-abortion provisions contained in H.R. 3590: The language that will allow direct federal funding of abortion, without restriction, in about 1,250 Community Health Centers.

 

The provision in question was added to H.R. 3590 near the end of the Senate’s amendment process, as part of a 383-page Manager’s Amendment unveiled by Senator Reid on December 19. Senator Reid immediately filed a cloture petition on the Manager’s Amendment, preventing consideration of any revisions to it, and severely limiting opportunities for analysis and debate. The Manager’s Amendment was adopted on December 22, and H.R. 3590 passed the Senate on December 24.

 

Buried deep in the Manager’s Amendment was new language making a direct appropriation of funds for Community Health Centers (CHCs) (which are also called Federally Qualified Health Centers, or FQHCs), totaling $7 billion ($7,000,000,000) over five years. (See Sec. 10503 on page 2355 of H.R. 3590.) Because this is a direct appropriation in the health care bill itself, these funds will not flow through the annual appropriations bill for the Department of Health and Human Services. Therefore, these funds would not be covered by the Hyde Amendment.

(The Hyde Amendment is a limitation provision that has been attached to the annual HHS appropriations bill in past years; this provision, so long as it is renewed annually, prevents the use of funds appropriated through that bill to pay for abortion or for plans that cover abortion, except to save the life of the mother, or in cases of rape and incest.)

 

There is no other language in H.R. 3590 that would prevent the use of the new funds to pay for abortions performed at Community Health Centers. Section 1303 of H.R. 3590 contains certain abortion-related language that is associated with Senator Ben Nelson (D-Ne.), language that was also added by the Reid Manager’s Amendment. This “Nelson language” applies only to a proposed program of tax credits and cost sharing for health insurance for low-income individuals. The Nelson language has no bearing at all on the Community Health Centers provision, Section 10503, which is the subject of this memorandum. (NRLC believes that the Nelson language would result in an unacceptable abortion policy with respect to the programs to which it pertains. This subject is outside the scope of this memorandum, but is explained in other NRLC documents, including the January 14, 2010 letter referenced above.)

 

There is no restriction in the current laws authorizing CHCs that prevents these centers from performing abortions. [see 42 U.S.C. 254b and Section 330 of the Public Health Services Act.] Under these laws, CHCs can only use these so-called “Section 330 funds” for purposes within the scope of their grants, but one can assume that grant applications that included (for example) “reproductive services” would not be deemed objectionable under the Obama Administration, and abortions could be subsumed under various other classifications as well. However, until now, these centers have been largely dependent on federal funds that flow through the annual HHS appropriations bill and that therefore have been governed by the Hyde Amendment. As noted above, the $7 billion appropriated for CHCs by H.R. 3590 would not flow through that pipeline and therefore would not be restricted with respect to abortion.

 

This is not a merely hypothetical concern. There is already an organized effort underway by the Reproductive Health Access Project to encourage Community Health Centers to perform abortions, “as an integrated part of primary health care.” For evidence, see “Frequently Asked Questions About Integrating Abortion into Community Health Centers, Potential Obstacles and Possible Solutions” at http://www.reproductiveaccess.org/getting_started/faq.htm

 

Indeed, the Reproductive Health Access Project and the Abortion Access Project have produced an “administrative billing guide” to help CHCs integrate abortion into their practices within the confines of existing federal and state restrictions. See “Administrative Billing Guide for Medical Abortion at Facilities that Receive Title X, Section 330, and other Federal Funding,” at http://www.nrlc.org/AHC/ReproductiveHealthAccessProjectAdminBillingGuide.pdf

 

On February 22, 2010, President Obama released a list of changes that he recommends to H.R. 3590. Among these, he proposed to increase the direct funding for CHCs from the Senate-approved $7 billion to $11 billion. He did not propose adding any restriction on the use of the funds for abortion, even though the fact that H.R. 3590 would allow the use of the CHC funds to pay for abortion had been widely publicized by NRLC during January and February.

 

The problem described in this memorandum does not exist with respect to the health bill passed by the House of Representatives on November 7, 2009 (H.R. 3962). The House-passed bill authorizes (but does not appropriate) $12 billion for CHCs (see Section 2101), but this provision – like the rest of H.R. 3962 – would be governed by the Stupak-Pitts Amendment (Section 265), which prevents any funds authorized or appropriated in the bill from being used for abortion (except to save the life of the mother, or in cases of rape or incest).

[Guest Douglas Johnson]

If Obamacare is passed it will result in direct federal funding of abortion through Community Health Centers, tax subsidies for private plans that cover abortion (including some federally administered plans), and pro-abortion federal administrative mandates, among other problems.

[Guest Human]

It looks like the disabled community IS GOING to take ANOTHER HIT for the democrats playing politics with the health care bill.

 

All games set aside, you are after the Latino community with universal health care sweet hearts.