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#11
December 28th 04, 10:52 PM
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Subject: Problem for boaters and APRS?
From: Date: 12/28/2004 1:59 PM Central Standard Time Message-id: .com Steve Robeson K4YZ wrote: Subject: Problem for boaters and APRS? From: Date: 12/27/2004 12:12 PM Central Standard Time Message-id: . com K4YZ wrote: N2EY wrote: The only thing that would clean this up is to do a complete survey of everyone receiving SSI or Medicaid. That's not a shutdown at all, just a review. Sounds like a good idea to me. I don't believe I ever said "shut them down"...I beleive my words were to the effect of getting Note that the income taxes a married couple pay when both work are greater than the sum of the income taxes of two single working people making the same money and living together. Which was partly fixed by Carter and then unfixed by Ronald "family values" Reagan. Yeah...fixed by Mr. 15% Inflation Carter. Uh huh...I remember. He enacted a 17.5% one time parity raise for the Armed Forces, then taxed the bee-jeebers out of us. and perpetuate drug seeking behaviour. How? Because they have "insurance" that allows them to go to almost any ER unfettered. Federal regulations under HIPPA, The Health Insurance Portability and Protection Act, enforces astronomical fines for healthcare workers who cross-communicate information about patients without their consent. Now that's just plain wrong, because medical personnel need as much pertinent data as possible, for purely medical reasons. Well...This was how Mrs Clinton was going to "fix" healthcare. It was the one and only bit of legislation to get through These "patients" know that they can go to the ER, complain of "back pain", and in all likelyhood will get an Rx for atleast 3 days worth of Lortab just to get them out of the ER, and it's technically illegal for us to warn other ER's that Joe Schmo is getting drugs here. Is that one way Rush Limbaugh got his Oxycontin? I work in four different ER's within a 65 mile radius, Jim, and I personally know of at leat 12 people who frequent all four of them for the same "complaint". How is Doc B supposed to avoid prescribing a med that is incompatible with meds prescribed by Doc A if Joe S. won't release medical info? Exactly. Again, it's part of the tail that the healthcare hound dog get's to chase. And MANY of the "maladies" that patients suffer is due to seeing "Doc A" about one problem and "Doc B" for another. Whenever I go to the doc, there's always a form allowing release of medical info to other healthcare personnel and institutions "just in case". I always agree and sign it, on the theory they should have the info and I have nothing to hide. That's because you're smarter than the average bear, BooBoo, and probably have "real insurance" that requires your PMD to manage your care. I spent this afternoon at a surgeon's office and will have to go to sugery soon...but all the Doc's know who is doing what. Oh...yes...JCAHO, the Joint Commission for the Accredidation of Healthcare Organizations, has made it mandatory that we post signs telling people it's their right to demand pain medicine. There's nothing on those same "notices" that says the healthcare provider has the right to say "no" after having examined you and determined that narcotics are not in your best interest. That's messed up, too. I guess nobody could say "no" to Rush, either... Basically. Lastly, every Medicare/Medicaid participating facility is required by law to post signs in the ER that tell the world that it is again their "right" to receive "free medical examinations regardless of your ability to pay". Examinations, or complete care? It becomes complete care. Under Medicare/caid laws, the facility must "address" the problem, which means do it for free or else. It just becomes cheaper to write the person a script and sent them on their way. Of course it's usually narcotics...You can always tell the real abusers...They eat the narcs like M&M's, then wind up stopping the intestinal tract. Then they develop a bowel obstrcution for which they ahve to go to surgery. And of course surgery means more meds...See where this goes...??? These facilities have the "right" to demand payment later, of course, but what do they (the "patients") care? They just toss those deamnds in the trash since they are not obligated to pay them. Mr 28 has an outstanding debt to my full time employer of almost $40K just for ER visits alone in the last 3 years. Because the ER can't toss anybody out. One facility I worked at performed "Triage" for a while...Local MD's would allocate "X" number of appointments in the day for ER referals. We actually did "just" what the Medicare rules required, examined the patients, then gave them an appointment referal to participating MD's. Inappropriate ER usage dropped by 53% and collections improved by a quantum leap because we weren't wasting time on what were charity cases. No one didn't get to see a doctor, either, since the local docs would work out payments for the truly indigent. Then the ACLU got involved. We were "inconvieniencing" the patients. Get Social Security back to what it was supposed to be..."Security" for people in thier latter years against retirement. Not a freeloaders ticket to the Pot-O-Gold. What about people who really are disabled? What about them? Have I said "No Social Security for ANYone", Jim? Clean house, Jim. A total top-to-bottom survey of every enrollee. And legislation that allows us to cap their benefits or entitlement periods. We have to allow ourselves the freedom to say "NO", and to demand that people carry their own weight. That's a start. But who gets to make the critical judgements, as in Person A is really disabled but Person B isn't? Medical Review Boards. Make these people show up at a prescribed time with copies of their records in hand. How do you *make* people "carry their own weight"? That's what has to be worked out. Me? You get "x" weeks of benefits as "benefit of the doubt", after that, you have to prove you need long term care...and that long term care is more than one MD's opinion. Also, your disability is "scored". Below a certain level, you go to work or you go without. Your choice. So, Jim, please do NOT presume to ask me "where" we are in reference to the current state of Social Security... I see it every day. You're welcome to join me for a shift if you're really, REALLY prepared to leave mad... You are lumping all entitlement programs together, as if they're all the same. They're not. They're not all the same, but they are all being abused. It's clear that *some* people manipulate and abuse the systems. They obviously need fixing. But how do we fix them? One step at a time. I agree 100% with your first step. -- Here's one way abuse in a related area was stopped big-time: The local transit agency *used to be* a target for injury claims. A bus with capacity of 65 people would get in a midday minor accident, and they'd get 90 injury claims from alleged riders. Etc. Couple years ago they got tough in various ways. One was the installation of cameras in various vehicles that would show who was onboard. Of course not all the cameras were real - but who would take a chance? They also sent out plainclothes investigators to follow people with hard-to-disprove injuries like "back pain". Then they'd go after fakers for fraud, like the guy with back pain who couldn't work at all but could singlehandedly unload his new bigscreen TV from the car and carry it up a flight of steps into his house - while wearing the soft collar. Both collar and TV paid for by guess who. Most of all, they made a point of publicizing their efforts and successes. Not only did folks lose their payments - some were sued successfully for fraud. OTOH, their efforts have actually helped people with real injuries file successful claims. And the claims have dropped substantially. Of course the initial efforts cost serious $$ and were not 100% successful. But the long-term results were impressive. And it did not take changes in the laws. Maybe something like that is step two. Step three might be "bounties" for persons accused of and subsequently found guilty of fraud. Personally, I am all for "all of the above". I would add a whole section of the Sunday paper with a full color mug shots of those convicted of bilking assistance programs because that's stealing from you and I. Peer pressure and a bit of humiliation go a long way towards modifying undesired behaviour. 73 Steve, K4YZ |
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