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