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Why hospital closings are “not dramatic”

[preamble]Resilience – flexibility – redundancy. People have these virtues. If a store closes, they goto another one. If a doctor closes or moves, they find another one. If a product they like is no longer available, they like another one. Hence, closing hospitals is not that dramatic as our current system has redundancy in it.
Now closing hospitals has a great media cry. How patients will be dying in the streets, care will go down – the world will end. But in actuality, who is making these arguments? The unions? Well yea – because they have the most to lose. Unions are designed to keep failing institutions open to maintain their monetary income (and yes they are the cause of MANY failures – St Vincents Hospital anyone?).
As in all things, there is a tipping point where closing & cutting back will begin to effect the very nature of the “thing” it serves. Hence, yes closing to many hospitals or to many fire stations will eventually cause a reduction in service – maybe.

However, the “dramatics” we here are simply exaggerations. Lets quickly review a few hospital closures.
Victory memorial in Brooklyn – No effect on care – people simple went elsewhere
St Vincents in NY City – No effect on care – people simply went elswhere
Coney ISland Hospital – after Storm Sandy, it is effectively closed – guess what – no effect on care – poeple went elsewhere.
LICH, the article below – when it closes – no effect on care – people will go elsewhere

We the people are far more self sufficient and resilient than we are led to believe. Why should we be wasting money on non needed failing institutions? Why do we always give – in to the union cry of “it will endanger people – safety” their famous public scaring outcry – when in realty they are just protecting themselves., and don’t give a darn about us or where the money is coming from.

St Vincents is vacant as well as most of Victory – what a waste of realestate – no tax income, no jobs generated – hence i say lets rethink hospitals and stop the status quo and “this is how its always been done”  – its time to reinvent how care is delivered and turn it from a money loser into a money maker delivering better care at sustainable prices. I propose an experiment: Give me 1 hospital – allow me to be free of the unions and to run it as a business – 1 year is all i ask. I accept no salary. If after a year i make a profit, I want 60% of the profit as a bonus. If I fail, I will step down in defeat.

That said, I say let LICH close and turn that property into something profitable!
Trust me – you wont feel a thing![backtopost]
Long Island College Hospital Update (HT: The MSSNY Daily)


Long Island College Hospital officials pledged Wednesday to step up its search for a new operator for the Cobble Hill healthcare facility.

 Officials at the State University of New York — which is trying to close LICH — vowed to go statewide or possibly nationwide with their hunt for a hospital to take over LICH.

Their new promise to get serious about looking for another operator for LICH instead of selling off its estimated $1 billion in real estate may be a nod to mounting political pressure: “It’s a big change from their prior position,” a source said.

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CMS News – A “BOGUS” Record of Progress on Health Information Technology

[preamble]Government Misinformation and misdirection. All designed to justify their existance. As such here are the facts:
Without CMS and OBAMA care: 18.8% increase in degrees awarded to computer science
Without CMS and OBAMA care 29.2% of new under graduates computer science majors
Even With CMS and OBAMA care – Jobless rate soars for electrical engineers with a decline of 40,000 jobs a 6.5% increase in unemployment
Without CMS and OBAMA care demand for IT is strong with 4.4 million jobs in March (14,800 increase)
Demand for IT is strong BUT we have shortages of people with the skills – this is in direct contrast to our governments claims.
For a country to have wealth, you need engineers, people who can make something out of nothing. out of nothing – meaning we need people who are innovative and are incentivized to work – whci is in direct contrast to Obama.

What IS on the rise is the applications of H-1B visas – 124,000 to be exact.
The H-1B is a non-immigrant visa in the United States under the Immigration and Nationality Act, section 101(a)(15)(H). It allows US employers to temporarily employ foreign workers in specialty occupations. If a foreign worker in H-1B status quits or is dismissed from the sponsoring employer, the worker must either apply for and be granted a change of status to another non-immigrant status, find another employer (subject to application for adjustment of status and/or change of visa), or leave the US.

Yes more NON AMERICANS getting jobs and government money.

My company has contacts with hundreds of physicians in the NY, NJ tri-state area and not one, a single one of them have made use of CMS anything. Jobs have been created? You mean government positions have been created and being funded by US. There is no product or service that is self-sustaining in their entire equation – its ALL government funding. Sustainability is a key factor and they cant find how to implement it – hence – we are simply spending and wasting money.

We “gave” hospitals 52 billion dollars? Really? I thought we were in a “crisis”. Why woudl we pay companies that have bad business practices and survive only because they are funded by a government? 52 Billion dollars is half a trillion – that alone is enough to end sequestration (a new term that our government made up) and to end this fake “crisis”.

Show me the money. Show me how yo will sustain this, show me who you trained and at WHAT COST. Show me who has jobs and at what COST?

Yes i want to know the cost of every job yo so called “created” and i want to know the cost of every person trained. Than we compare this to what the “free” market and good ol’ American Business sense would have charged. Would you be surprised if the cost was 20 times that of normal business? Hence, these jobs and these “tings” CMS says they done are not sustainable and can never be paid back. Government waste at its highest.

Shame they simple did not put that money back into the economy and support real businesses. Businesses that woudl have hired people, provided better services at a lower cost, been sustainable, and by default these companies and their hiring would have put money back into the economy as now we have real jobs.

Will someone define “affordable”? Affordable care – how much is affordable and who determined that I can afford ANYTHING?

When this folly ends![backtopost]
A Record of Progress on Health Information Technology


In 2009, the Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of the Recovery Act, created the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs to promote the adoption of EHRs in support of the ultimate goals of improving the quality of patient care and reducing health costs. Through this program, eligible hospitals and doctors earn incentives by demonstrating “meaningful use” of certified technology, which means that health care providers use EHRs in ways that improve care and lower costs. Examples of “meaningful use” include electronic prescribing of medications and ensuring patients have access to their digital records.

In addition to providing incentive payments, the HITECH Act calls for assistance and technical support to help providers implement EHRs, enables coordination within and among states to support the implementation of EHRs, and develops a properly trained health IT workforce to support providers in becoming meaningful users of certified EHRs.

These programs, administered by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator of Health Information Technology (ONC), are building the foundation for every American to benefit from an EHR as part of a modernized, interconnected, and improved system of care delivery. By putting in place EHR systems that meet rigorous functionality and ease-of-use standards, providers and patients will reap tangible benefits in quality and affordability. These include easy access to health records and data, reminders and alerts for providers and patients, and reductions in medical errors.

The Affordable Care Act includes numerous reforms to improve the quality of health care and lowers costs for taxpayers and patients. Health IT is critical to implementing and making these new payment and delivery models work. Health IT provides the kind of smart data and analytics that is already helping programs such as Accountable Care Organizations, bundled payments, patient-centered medical homes, and value-based purchasing. For example, CMS has reported a significant decrease in the hospital readmission rate of Medicare patients returning to the hospital after being discharged. After fluctuating between 18.5 percent and 19.5 percent for the past five years, the 30-day all-cause readmission rate dropped to 17.8 percent in the final quarter of 2012, preventing 70,000 readmissions last year. Health IT enabled hospitals to measure and achieve these results.

•        Robust Participation in the EHR Incentive Programs:

o       Hospital Participation: More than 85 percent of eligible hospitals are participating in the Medicare and Medicaid EHR Incentive Programs, and more than 75 percent have received incentive payments for meaningfully using EHR technology as of March 2013.

o       Physicians and other Health Care Provider Participation: More than 388,000 of the nation’s eligible professionals have registered to participate in the Medicare and Medicaid EHR Incentive Programs, representing 73 percent of all providers eligible to participate. More than 230,000, or 44 percent of all eligible professionals, have received an EHR incentive payment for meaningfully using EHR technology as of March 2013.

o       Assistance from Regional Extension Centers: HITECH funds established 62 Health Information Technology Regional Extension Centers (RECs) to offer technical assistance and guidance that is critical to accelerating the provider adoption and meaningful use of EHRs, particularly in rural areas and other underserved settings.

§         RECs are providing assistance and support to more than 44 percent (130,000) of primary care providers and 48 percent (20,000) of Nurse Practitioners nationwide.

§         More than 80 percent of all Federally Qualified Health Centers are enrolled with a REC.

o       Effect on the Health IT Marketplace: Federal investment and standard setting have helped to create a robust market for eHealth IT products. As of March 2013, there are 941 vendors providing more than 1,700 unique certified EHR products.

  • Rapid Adoption of Advanced Technology: Survey data shows that the HITECH Act has dramatically accelerated providers’ use of key health IT capabilities nationwide:

o       E-Prescribing: Office-based physicians’ use of e-prescribing has increased from 0.8 percent in December 2006 to 53 percent through January 2013, and more than 94 percent of all pharmacies are now actively e-prescribing.

o       Hospitals:  between 2008 and 2012, the number of hospitals using EHR systems with certain advanced functionalities that go even beyond the requirements of Meaningful Use Stage 1 (including physician clinical notes and electronic imaging results) more than quadrupled from 9.4 percent to 44 percent.

o       Doctors: Physician adoption of EHR systems with the same advanced functionalities more than doubled between 2008 and 2012, from 17 percent to 40 percent.

Economic Impact:

o       According to the Bureau of Labor Statistics, more than 50,000 health IT-related jobs have been created since HITECH was enacted.

o       As of January 2013, community colleges have trained 17,049 professionals in health IT, and as of September 2012, universities had graduated over 820 post-graduate and masters-level health IT professionals. This is the result of four ONC-supported workforce development programs that are helping to train the new health IT workforce to meet the increased demand for these workers.

o       As of February 2013, the Medicare and Medicaid EHR Incentive Programs have paid $12.6 billion in incentives to hospitals, doctors, and other health care professionals.




  • Beacon Community Program: This grant program funds 17 pioneering communities across the country that are using health IT as a foundation for bringing together doctors, hospitals, local health program administrators, and patients to achieve measurable improvements in health care quality, safety, efficiency, and population health. For example, the Beacon Communities in the Mississippi Delta and Southeast Michigan are working to improve diabetes care through the use of IT-enabled care management and coordination strategies. The Keystone Beacon in Pennsylvania and the San Diego and Maine Beacon Communities are using health IT to reduce emergency department visits and hospital admissions and readmissions.
  • State Health Information Exchange Program: This grant program supports efforts in 56 states and territories to set up health information exchange (HIE) capability among clinicians and hospitals within and across state lines.  The 56 HIE entities are increasing the connectivity of health information between providers to help improve the quality and efficiency of care.
  • Medicaid funding for Health Information Exchanges: This program provides administrative funding to help states build HIT infrastructure and support enrollment of providers in the Medicaid program. States must demonstrate a sustainable HIE business model to qualify for funding.  This program facilitates the adoption and use of HIE and helps Medicaid providers meet meaningful use criteria.
  • Strategic Health IT Advanced Research Projects (SHARP) Program: This grant program funds innovations in health IT to address well-documented problems that have impeded HIT adoption in areas such as health IT security and the secondary use of EHR data.




HHS recently announced a plan to accelerate health information exchange (HIE) development and build a seamless and secure flow of information essential to transforming the health care system in 2013.  Steps include:


  • Setting Aggressive Goals for 2013: HHS is setting the goal of 50 percent of physician offices using EHRs and 80 percent of eligible hospitals receiving meaningful use incentive payments for using EHR technology by the end of 2013.
  • Increasing the Emphasis on Interoperability: HHS will increase its emphasis on ensuring electronic exchange between providers and across settings of care. We will leverage HHS programs and resources to promote interoperability through multiple channels.  Recently, we issued a request for information (RFI) seeking public input on policies that will strengthen the business case for electronic exchange between providers to ensure that patients’ health information will follow them seamlessly and securely wherever they access care.

Enhancing the Effective Use of EHRs through Initiatives similar to the Blue Button Initiative:  Today, Medicare beneficiaries can access their full Medicare records online.  HHS is also encouraging Medicare Advantage plans to expand the use of Blue Button to provide beneficiaries with one-click secure access to their health information. An HHS challenge facilitated the creation of an app that makes information downloaded from Blue Button easy for a patient to understand and use. HHS is also working with the Veterans Administration and more than 450 different organizations to adopt initiatives similar to Blue Button to make health information available to patients and health plan members.

  • Implementing Stage 2 of Meaningful Use:  HHS is implementing the next stage of the Medicare and Medicaid EHR Incentive Programs, which focuses on increasing health information exchange between providers and promoting patient engagement by giving patients secure online access to their health information.


  • Highlighting Program Integrity: HHS is taking new steps to ensure the integrity of EHR Incentive Programs and that technology is not being used to promote fraudulent activity. For example, CMS has implemented audits of providers and hospitals who have adopted health IT.  CMS is also working with state program integrity directors to establish new strategies focused on claims and clinical data from these providers. In addition, EHR technology is creating spillover benefits for program integrity in other federal programs: the Social Security Administration reports that Disability Insurance initial decisions are 21 percent faster for cases based on electronic medical evidence, with greater accuracy than paper records.

CMS has also launched its eHealth initiative to align existing Medicare and Medicaid quality measurement programs (e.g., Physician Quality Reporting System, Hospital Inpatient Quality Reporting), EHR standards and usage requirements through the EHR Incentive Programs, ICD-10 implementation, and other health IT-focused efforts to better support the ultimate goals of improving the quality of patient care and reducing health costs. With the increased use of EHRs, providers now have the ability to use standardized processes to send quality clinical data to Health Information Exchanges, state Medicaid agencies, and CMS.


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Codecademy gives up the Valley for the Alley

[preamble]You ask what is wrong with this economy. You ask why am I complaining i have no confidence in my government, You ask why I and almost every other small business person is angry and feels taken advantage of and let down, You ask why I am tired of working for my business, hiring employees, paying taxes, advertising, selling products and in general keeping this dead economy on life support. Banks won’t lend me money to expand, suppliers only want payment up front either cash or credit card, credit card companies rewarding my 20 + years of good service by charging me a fee and cutting my credit line to that of a welfare recipient.

Why you ask? Well myself and others of the OLD dead generation who believe that a good product and service at a reasonable price that generates a reasonable PROFIT and is successful because it has value that others realize and want hence PAY for. Yes my friends the age old business of COST-SELL=PROFIT without government assistance!

God forbid we discuss PROFIT – real hard profit not total sales or “maybes” or yea lot of hits but real cold hard profit after expenses that we use to purchase other items we need that keep others employed that keep the economy moving that keeps AMERICA ALIVE!

Well, here is what our wonderful politicians are spending our money on. FREE services to a company that cant possibly make a profit or be sustainable unless they keep getting FREE money from us. The city is broke, my business and neighborhood are under siege by the citys inspectors, ticket agents and ever increasing parkign meters (.25cents for 10 minutes) and a bridge toll thats now $15! YET we can give $500,000 tax credits to a company that has NO profitable product and can most probably never repay anyone. FREE is a 4 letter word. FREE is not good business. facebook, twitter and these companies are driving REAL businesses, the life blood of America, out of business by conditioning people that everything is and should be FREE.

Wait – this sounds familiar! Obama! Yes our president has started this dead end alley atmosphere. Entitlement and FREE – this is the Root Cause of it.
When this Folly Ends!{backtopost]


The company that teaches novices how to write software expands into spacious new headquarters in the Flatiron district, thanks in part to state tax breaks and New York roots.

Codecademy, an online service that teaches tech novices how to write software, is trading up its Silicon Valley digs for a new headquarters in Manhattan.

The company, which received a huge boost when Mayor Michael Bloomberg made a New Year’s resolution in 2012 to subscribe to the technology, is moving to a new headquarters in the heart of New York’s growing technology sector in the Flatiron district. The new space will allow Codecademy to grow its ranks too, with the firm hoping to add 70 new positions in the coming months.

“We were looking for a big enough space for us to grow into, and found something really awesome,” said Zach Sims, one of the company’s two co-founders. “It speaks to the continued growth of the company. And we will fortunately continue growing in the future as well.”

Codecademy is receiving help from Gov. Andrew Cuomo’s administration in the form of $500,000 in tax breaks through the state’s Excelsior Jobs Program, which will go toward helping the company with the renovation of 9,000 square feet of leased space near 27th Street. Empire State Development CEO Kenneth Adams said the firm’s decision to grow is a sign of New York’s growing dominance in the tech sector.

“Codecademy is a perfect example of the type of companies New York needs to be successful in the growing innovation economy,” Mr. Adams said in a statement. “It is vital to keep companies like Codecademy here, and we are excited to see them creating jobs and expanding in New York.”

Despite its California ZIP code, Codecademy has always retained its Big Apple roots. Mr. Sims started the company with his partner Ryan Bubinski in August 2011 when both were students at Columbia University. Last year, the company partnered with New York University’s Steinhardt School’s Department of Media, Culture, and Communication to offer a 10-week course to students who want to learn how to code.

“It’s a world of difference from when I first started working at tech companies in New York,” Mr. Sims said. “It’s changed for the better.”

Codecademy has secured over $12 million in capital funding in just the last two years, and it has been named one of TIME Magazine’s 50 Best Websites and won a Crunchie Award from TechCrunch as the “Best Education Startup.”

But sticking with the firm’s weekly sessions can be difficult: a writer for New York magazine penned a “public apology” to Codecademy last December after failing to meet the company’s “Code Year” challenge. And as for Mr. Bloomberg? His office would not respond to questions about whether the mayor has stuck with his resolution—or learned how to code.

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ACO’s – Big Brother and citizens must watch and report on citizens

Yes, i know – conspiracy. Bigh brother – i am crazy for even thinking this. However, at a recent lecture in Atlantic City regarding ACO’s, it WAS SAID by a speaker that in their ACO, doctors must “watch out and inform” their colleagues if they are over ordering tests or doing anything that will effect the money their ACO can receive. hmmmm – doctors watching doctors. Not one word, not one sentence was focused on HOW this will improve any form of care. Generic drugs, fake doctors and less care is the gist of all this – hence – Obama care will destroy our health care system. By lowering the price doctors get paid you will lower the quality of doctors.

All we here is how bad doctors are – i have never heard that they give good care – only expensive bad care.

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HHS seeks to amend HIPAA to strengthen background checks

[preamble]This means HIPPA regulations on our privacy is gone. Everything we do will be reported to the government. Lets be realistic – if you opt out of sharing your medical data – is the data REMOVED from the government databases? I think not. Its already a norm that hospitals share your data no matter what you say or opt out of.

“While this background check system is the most efficient and effective way to keep guns out of the hands of dangerous individuals, it is only as effective as the information that is available to it,” HHS said in a statement.It stressed that in background checks, NICS reports solely whether the would-be buyer should be approved or denied–no medical information is disclosed

NO medical info is disclosed? Do only a recommendation? Based on what criteria? Is the person notified of WHY? Is the person than arrested for not taking his meds? Will the store owner be liable if he does not report or notify authorities about this person? I am not liking big brother advising all of us to watch each other – sound wayyy to familiar.[backtopost]
by Susan D. Hall

Though a Senate bill to expand background checks on firearms sales was defeated last week, the U.S. Department of Health & Human Services is examining how HIPAA regulations may keep states from reporting dangerous mental patients to a database used in background checks.

The HHS Office for Civil Rights has issued an advanced notice of proposed rulemaking that seeks public input on how the privacy regulations prevent reporting to the National Instant Criminal Background System (NICS). OCR is looking to address these barriers without discouraging mental health patients from seeking treatment, reports

In particular, we are considering creating an express permission in the HIPAA rules for reporting the relevant information to the NICS by those HIPAA-covered entities …” the notice says.

NICS is designed to keep guns out of the hands of felons, those involuntarily committed to a mental institution, those deemed a danger to themselves or others and those prohibited by law from possessing firearms.

However, a 2012 Government Accountability Office report found that 17 states had each submitted fewer than 10 reports based on mental health records, according to the notice.

“While this background check system is the most efficient and effective way to keep guns out of the hands of dangerous individuals, it is only as effective as the information that is available to it,” HHS said in a statement.

It stressed that in background checks, NICS reports solely whether the would-be buyer should be approved or denied–no medical information is disclosed, according to The Hill‘s Healthwatch.

In the aftermath of the Sandy Hook school shooting, physician professional societies and medical journals made pledges to put more time and effort into addressing mental illness and its link to gun violence.

In February, then-FierceHealthcare Editor Karen Cheung-Larivee dinged the president after his State of the Union address for mentioning “guns” eight times in support of stricter controls, but not focusing on mental health care as part of the solution.

The U.S. Department of Veterans Affairs, meanwhile, which has been at the forefront of providing remote mental health services, was criticized along with the U.S. Department of Defense last month in an Institute of Medicine report for failing to integrate their systems and failing to track the effectiveness of their mental health interventions.

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Draft bill aims to take electronic drug tracking nationwide

[preamble]Since when did we, the people, ever have a problem with our drugs? I understand there are a few instances where drugs in pharmacies were tampered with by nefarious individuals, however when have we EVER been worried, notified or even concerned about our medications? This is a made up problem like most government issues. An expense to us, the tax payers, to a perceived problem OR is it that our government want to monitor all medications that we take or dont take and this is just another way of tracking us?[backtopost]
by Dan Brown

Efforts to track prescription drug distribution, thus far, have been left up to states, and have produced marginal results, at best. A draft bill unveiled this week by four U.S. senators, however, aims to change all of that.

The bill–written by Sens. Michael Bennet (D-Colo.), Richard Burr (R-N.C.), Tom Harkin (D-Iowa) and Lamar Alexander (R-Tenn.)–calls for the creation of a national electronic tracking system over a 10-year span that would serve as a replacement for the “patchwork of state product tracing laws,” according to an announcement. It would shift tracing efforts from “lot-level” to “unit-level.”

It requires that the entire drug supply chain, from manufacturers to dispensers, electronically provide transaction information during changes in ownership, and also calls on the U.S. Food and Drug Administration to keep a database of wholesale drug distributors, for whom licensure requirements would be strengthened. The database would be hosted on the FDA’s website and accessible to the public.

Bennet cited a “record number of recalls” in championing the bill. Currently, he said, “we know more from a barcode on a gallon of milk than from a barcode on a bottle of pills,” which he added “could mean the difference between life and death.”

Harkin, meanwhile, said the bill helps to ensure both the integrity and security of the prescription drug distribution system. “To ensure consumers know that the medications they take are safe–not adulterated, counterfeit, or otherwise compromised, it is important to know where these drugs have been at every step of the way–from the manufacturer to the pharmacy,” he said.

The Institute of Medicine, in a report published in February, calls for data tracking and technology to combat counterfeit drugs. It recommends that FDA establish a public database similar to what is proposed in the draft bill, although the agency has been working since at least last spring on such efforts.

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Will obama care make insurance premiums skyrocket?

[preamble]YES! YES! YES! but its ok – obama has $600,000,000 of our dollars to play with to ease the cost – yea so we pay 8x’s. When this folly ends! [backtopost]
from across the country walked out of a session on Obamacare Sunday during a national conference being held in San Francisco.
Putting Lipstick on the Obamacare Pig
Even formerly enthusiastic Democrats now predict a “train wreck.”

ByJohn Fund

The Department of Health and Human Services has just handed out a $3.1 million PR contract to improve the public image of Obamacare. Advertising Age reports that the firm Weber Shandwick will help “roll out a campaign to convince skeptical — or simply confused — Americans the Affordable Care Act is good for them and convince them to enroll in a health plan.”

Obama officials insist the ads won’t be political, but critics recall that just before the 2010 midterm election, HHS spent $3.2 million on “educational” TV ads praising Obamacare. The spots featured the late actor Andy Griffith, a favorite of seniors, who told his fellow retirees that “more good things are coming” from Medicare. But FactCheck, a nonpartisan project of the Annenberg Public Policy Center, noted that the ads made no mention of the dramatic cuts to 10 million Medicare Advantage recipients, who are likely to see their privately managed care scaled back. “The words in this ad ring hollow, and the promise that ‘benefits will remain the same’ is just as fictional as the town of Mayberry was when Griffith played the local sheriff,” FactCheck concluded in July 2010.

Indeed, the facts today are that Obamacare remains as unpopular now as when it was passed in 2010, and Democrats are increasingly worried it will return to haunt them in the midterm election next year, the first to take place after the stepped-up implementation of the law. Reporters at the Cook Political Report, a respected Washington watcher of election trends, noted this month that “almost all” of the Democratic insiders they talked to “voiced concern about the potential for the issue to hurt Democrats in 2014.” At no point since its passage has Obamacare been viewed favorably by more than 45 percent of voters, and the latest Kaiser Family Health Foundation poll pegs its nationwide support at only 37 percent.

The administration is already preparing its excuses if insurance premiums skyrocket next year and parts of Obamacare miss key start dates. HHS secretary Kathleen Sebelius complained this month that “no one fully anticipated” the difficulties involved in setting up Obamacare. She blamed obstructionist Republicans for engaging in “state-by-state political battles” to slow down the creation of health-care exchanges.But many of her fellow Democrats aren’t exactly following her line. West Virginia senator Jay Rockefeller, one of the main architects of Obamacare, calls the bill “probably the most complex piece of legislation ever passed by the United States Congress.” Referring to the implementation of the bill, he says, “If it isn’t done right the first time, it will just simply get worse.”

Senate Finance chairman Max Baucus of Montana has an even gloomier assessment. “I just see a huge train wreck coming down,” he told Sebelius in a hearing last week. “When I’m home, small businesses have no idea what to do, what to expect, they don’t know what affordability rules are, they don’t know what penalties may apply. They just don’t know.”

Some backers of Obamacare are even jumping ship completely. Kinsey Robinson, the president of the 22,000-member United Union of Roofers, issued a public statement last week calling for “repeal or complete reform of the Affordable Care Act.” He explained that his union’s “concerns over certain provisions in the ACA have not been addressed, or in some instances, [have been] totally ignored.” Many of the bill’s quickly drafted provisions, he added, “are inconsistent with the promise that those who were satisfied with their employer-sponsored coverage could keep it.”

The train wreck that Senator Baucus foresees could push young people into “rate shock” as their premiums increase to subsidize care for older Americans. Obamacare’s “community rating” rules and benefit mandates might prompt employers to drop coverage or avoid hiring new employees. “I talk with a lot of businesses that are thinking of self-insuring or finding any loophole they can to avoid the most onerous parts of Obamacare,” says pollster Scott Rasmussen. A study last month by the Society of Actuaries predicted that medical claims per policyholder will rise by 32 percent in the individual plans offered by Obamacare’s health-care exchanges. In some states, the increase could be as much as 80 percent.

The Obama administration is preparing for the worst. Michael Cannon of the Cato Institute reports that it is getting ready to spend $600 billion that Congress never authorized on federally run state exchanges in order to ease any sticker shock for consumers. But that may not be nearly enough.

Henry Chao, deputy chief information officer at the Centers for Medicare and Medicaid Services, admitted his doubts to a group of health-care executives recently. “We are under 200 days from open enrollment [in Obamacare], and I’m pretty nervous,” he said. “The time for debating . . . is it a world-class experience, that’s what we used to talk about two years ago. Let’s just make sure it’s not a third-world experience.”

Such comments must send spasms of fear down the spines of several red-state Democratic senators who will be up for reelection for the first time since they voted for Obamacare in 2010 — Mary Landrieu of Louisiana, Mark Begich of Alaska, and Mark Pryor of Arkansas among them. They and other Democrats in the Senate have already voted to repeal key portions of Obamacare, such as the CLASS Act long-term-care program, and the Senate also passed a nonbinding resolution to oppose the tax on medical devices.

Don’t be surprised if many Democrats in Congress join with Republicans later this year in calling for a one-year moratorium on the implementation of Obamacare. There’s even a chance the Obama administration will join them if the behind-the-scenes chaos at HHS gets bad enough. That wouldn’t be the kind of bipartisanship deal the establishment media has been calling for lately, but it might just be one of the most popular moves Washington could make.

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How much are doctors worth?

[preamble]All I keep hearing is how bad doctors have cared for us, how many mistakes they make causing us injuries and how much they overcharge us. I can also bet a quick search will find hundreds of lawyers willing to sue you, the doctor, into oblivion. It seems in the “new” world of doctor bashing and reduced payments for their services, a doctor is worth nothing UNLESS he is sued, than he is worth millions.[backtopost]
In May 2012, a New York State Supreme Court jury concluded that Ms. Martin had been a victim of hospital negligence, and awarded her $120 million in damages. The verdict is considered among the largest medical malpractice awards ever made in New York. The city planned to appeal.

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Deadline to comment on CMS proposals to ‘accelerate’ HIE fast approaching

[preamble]Industry stakeholders – who are these stakeholders? The doctors? The patients? I don’t hear doctors advising on this nor do i hear patients – so who is driving the bus here?[backtopost]
April 14, 2013 | By

Comments from associations, practitioners and others have been adding up in response to the Centers for Medicare & Medicaid Services’ Request for Information issued last month to accelerate and improve health information exchange and interoperability among providers.

The RFI, published in the Federal Register March 7, seeks comments on a myriad of options to encourage HIE “that collectively result in a more coordinated, value driven healthcare system.” The options include requiring providers to engage in HIE as a condition of participating in the Medicare program, collaboration on new electronic-specific measures of care coordination during transitions of care, and testing of different payment programs to align providers and share data. So far 23 responses to the RFI have been filed.

The RFI asks commenters to respond to 10 different questions, such as which policies and programs would most encourage data exchange among competitors, how to engage long term care providers in HIE, and how to use existing authorities to better support HIE.

Industry stakeholders have long expressed concern about interoperability, including the cost of data sharing, inadequate security, and lack of vendor readiness. Patients also have questioned the ability of HIEs to protect their data, whether they can restrict the sharing of their data to others–such as payers–and if they can keep their data out of HIEs entirely.

The Office of the National Coordinator for Health IT already has stated that it will not issue regulations regarding HIE governance, opting instead to provide voluntary guidance.

Comments on the RFI are due by April 22.

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Computational model predicts cancer survival rates

[preamble]Brilliant! Again my concern is that insurance companies and our government will begin using this data to deny treatment based upon survival rate – don’t think its far-fetched. Again all the markers are here for this to happen – it already happens in England and Europe.

They dont have to force socialism on the US, just inject a little her and there and soon we will wake up a socialistic state.[backtopost]
By Ashley Gold

A new computational model highly predictive of breast cancer survival has been developed by Columbia University engineering researchers. Their work is outlined in a study published this week in Science Translational Medicine.

Lead researcher Dimitris Anastassiou–a professor of engineering at Columbia’s Fu Foundation School of Engineering and Applied Science–and his team identified “attractor metagenes,” which are gene signatures present in identical form among many types of cancer, according to an announcement from the school.

Anastassiou and two PhD students tested the signatures in the Sage Bionetworks/DREAM Breast Cancer Prognosis Challenge, a “crowd-sourced effort for accurate breast cancer prognosis” using molecular and clinical data. A prognostic model was developed showing that these certain signatures of cancer, when combined, were “strong predictors for breast cancer survival,” according to the announcement.

“These signatures manifest themselves in specific genes that are turned on together in the tissues of some patients in many different cancer types,” Anastassiou said. “And if these general cancer signatures are useful in breast cancer, as we proved in this Challenge, then why not in other types of cancer as well? I think that the most significant–and exciting–implication of our work is the hope that these signatures can be used for improved diagnostic, prognostic, and eventually, therapeutic products, applicable to multiple cancers.”

He noted that currently, widely used biomarker products look at specific genes in cancer patient biopsies to decide if certain treatments are appropriate, and some of those genes are related to the tested signatures, so it’s “worth finding out if replacing such genes with our specific ‘pan-cancer’ signatures will improve the accuracy of these products.”

Added Anastassiou: “The hallmarks of cancer are unifying biological capabilities present in all cancers, as described in some seminal papers. We think that we have now reached the point where systems biology can also identify such hallmarks.”