You raise taxes by $500 billion.
Continue reading… “,” By David Merritt In tonight’s first presidential debate, Governor Romney and President Obama will spend 15 minutes discussing healthcare. This is a perilous topic for both, but whoever wins this debate within the debate will take a big step to winning on November 6th. The Affordable Care Act, or ObamaCare as both candidates now call it, will be center stage. The president will offer his standard defense, saying it helps middle-class families by making insurance more affordable and more secure. But the president knows a full-throated defense will not work. A majority of Americans have consistently supported repeal since day one. Rather than defend the indefensible – higher costs, higher taxes, Medicare cuts, government expansion – the president will attack. First, he will tie together ObamaCare and the reform law Gov.
Romney signed in Massachusetts, arguing that they are the same. Gov. Romney should stipulate that there are some policy similarities between the two, but that the differences are what matter. He can deflect this attack and return the spotlight to the president’s unpopular law by clearly saying: “I did not raise taxes. You raise taxes by $500 billion. “I did not cut Medicare. You cut Medicare by more than $700 billion to pay for a new entitlement that the public opposed.
Your cuts jeopardize seniors’ access to care. Continue reading… “,” By Robert Laszewski Let’s take a look at Mitt Romney’s Health Care plan using his own outline (“Mitt’s Plan”) on his website. Romney’s approach to health care reform summarized: “Kill Obamacare” – There seems to be no chance Romney would try to fix the Affordable Care Act––he would repeal all of it. No new federal health insurance reform law – There is no indication from his policy outline that he would try to replace the health care reform law for those under age-65 (“Obamacare”) with a new federal law–his emphasis would be on making it easier for the states to tackle the issue as he did in Massachusetts. Small incremental steps – His approach for health insurance reform for those under age-65 relies on relatively small incremental market ideas when compared to the Democrats big Affordable Care Act–tort reform, association purchasing pools, insurance portability, more information technology, greater tax deductibility of insurance, purchasing insurance across state lines, more HSA flexibility. Getting the federal government out of the Medicaid program – He would fundamentally change Medicaid by putting the states entirely in control of it and capping the annual federal contribution–“block-granting.” Big changes for Medicare – Romney offers a fundamental reform for Medicare beginning for those who retire in ten years by creating a more robust private Medicare market and giving seniors a defined contribution premium support to pay for it.reduslim composizione Continue reading… “,” By Scott W. Atlas, MD Since 2010, when the Affordability Care Act was signed into law, the American mainstream media has insisted that President Obama’s bill provides the most at-risk Americans, low income families and seniors, with better health care. And that must mean, by any logic, better access to doctors, more access to the modern tools of diagnosis and treatment, and ultimately better health outcomes. That poor Americans benefit greatly from the ACA, and that seniors will be more secure under the president’s law, has seemed so obvious to the left-leaning news outlets that this fact has yet to be critically examined by them. President Obama’s ACA law purports to provide new health coverage to upwards of 16 million low income Americans by way of Medicaid. We already see in the wake of the Supreme Court decision that many, if not most, states simply cannot be burdened with massive increases in their Medicaid outlays, regardless of the promise of financial support from the federal government (itself a financially unsustainable funding source). But President Obama’s assertion about new insurance for the poor and all it brings is, in fact, a grand deception. We know that 55 percent of primary care physicians and obstetricians already refuse all or most new Medicaid patients (about four times the percentage that refuse new private insurance patients), and only half of specialist doctors accept most new Medicaid patients.
Clearly, granting poor people Medicaid is not equivalent to providing access to doctors. Continue reading… “,” By Robert Laszewski I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare. As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for the press to try to make sense of it. This blog post is quite long because the subject matter is complicated. If you want to cut to the chase, see my conclusion and summary at the end of this post. Allow me to list a few of the questions people are asking and give you my take on it. Will current seniors suffer under the Romney-Ryan Medicare plan? No. Let me start by saying something that will likely surprise you. If I could be king for a day, I would prohibit anyone over the age of 60 from voting in this election.
This election is really about the future and the big decisions on the table are about the long-term government spending and entitlement issues that should be made by younger voters who will have to pay for them and will benefit or suffer from them. Those in their 60s and older are almost surely going to cruise to the end with the benefits they now have. Whether its Obama’s Medicare plan, based heavily on the Medicare cost control board imbedded in his health reform bill (which doesn’t begin to impact hospital costs until 2020), or the Romney/Ryan Medicare premium support plan (that has no effect on anyone now over the age of 55), today’s seniors’ benefits are insulated from this issue. Continue reading… “,” By Rob Lamberts, MD Us and Them And after all we’re only ordinary men The wanna-be congressman appeared with his neat hair and pressed suit, a competent yet compassionate expression on his face. ”The first thing I am going to do when I get to congress is to work to repeal Obamacare,” he said, expression growing subtly angry. ”I will do everything I can to give you back the care you need from those who think big government is the solution to every problem.” My wife grabbed my arm, restraining me from throwing the nearest object at the television. I cursed under my breath. No, it’s not my liberal ideology that made me react this way; I’ve had a similar reaction to ads by democrats who demonize republicans as uncaring religious zealots who want corporations to run society. I am a “flaming moderate,” which means that I get to sneer at the lunacy on both sides of the political aisle. I grew up surrounded by conservative ideas, and probably still lean a bit more that direction than to the left, but my direction has been away from there to a comfortable place in the middle. It’s not the ideology that bugs me, it’s the use of the “us and them” approach to problem solving. If only we could get rid of the bad people, we could make everything work. If only those people weren’t oppressing us. If only those people weren’t so lazy.
It’s the radical religious people who are the problem. It’s the liberal atheists. It’s the corporations. It’s the government. All of this makes the problem into something that isn’t the fault of the person making the accusation, conveniently taking the heat off of them for coming up with solutions to the problems. Continue reading… “,” By Trudy Lieberman New York Times reporter Abby Goodnough’s piece last week about the health insurance exchange in Massachusetts is instructive—especially since other states are trying to set up their own versions of these shopping bazaars where the uninsured can buy coverage if the health reform law eventually takes effect. For the last three years we have been suggesting there’s an untold story in the Bay State about how the law is working, so we were glad to see Goodnough’s reporting and offer a tip of the hat. Goodnough gets into the subject with a success story: the tale of Peter Kim, who lost his employer-sponsored health insurance in 2005 when he opted for a career as an independent consultant. He found that shopping for insurance in the open market was a complicated affair, and that most plans were too expensive. He eventually chose coverage for catastrophic illness.
Then he discovered his state’s health insurance exchange, called the Connector. After just an hour of research, he found a plan with a monthly premium of only $1,086, a better deal than the coverage he previously had. And ideally, that’s how exchanges should work, Goodnough said. The trouble, she reports, is that so far the Connector has not drawn enough full-paying customers like Peter Kim. As Goodnough notes, the exchanges have drawn little journalistic scrutiny so far, despite their key place in health reform. (And, we note, despite the fact that they grew out of initiatives backed by former Massachusetts governor and current presidential candidate Mitt Romney.) Continue reading… ” “https://thehealthcareblog.com/blog/2011/05/02/health-care-in-the-cloud/”,”200″,”OK”,” By GLENN LAFFEL, MD Amazon Web Services (AWS), “the cloud” for many, experienced a serious interruption in service beginning on April 21st. The problem lingered for at least 6 days. Many websites that relied on Amazon services went down or saw their performance degraded during the event.
The AWS failure disproportionately affected startups like Foursquare, Quora and Reddit, companies that are “focused on moving fast in pursuit of growth, and less apt to pay for extensive backup and recovery services.” One of the affected companies was a health care startup. What follows is a transcription (including typos) of an AWS Discussion Forum that this company initiated 24 hours after the outage began. The company’s contributions are in italics. Life of our patients is at stake—I am desperately asking you to contact Sorry I could not get through in any other way. We are a monitoring company and are monitoring hundreds of cardiac patients at home. We are unable to see their ECG signals since 21st of April. Can you please contact us? Or please let me know how can I contact you more ditectly. Thank you. Oh this is not good. Man mission critical systems should never be run in the cloud.
Just because AWS is HIPPA certified doesn’t mean it won’t go down for 48+ hours in a row. (+30 minutes since comment thread began) Well, it is supposed to be reliable… Anyway, I am begging anyone from Amazon team to contact us directly. Thank you — Go to your backups? Or make a big deal out of it on the forums maybe someone will take a look. In any case anecdotal empirical evidence has shown don’t bother with premium support its a freaking joke. — Thanks for the comments, but we are really desparate. Amazon team – please contact us — (+10 hours since comment thread began) Not restored. Not heard from Amazon. People out there – please take a look at our volumes! This not just some social network website issue, but a serious threat to peoples lives! — Your only option at this point is Premium support. However, they’re just going to tell you to wait. Sorry. — (+ 13 hours) There is some progress.
2 servers are operational and one still not working. Unfortunately, the one on which we have the most patients — Aren’t you braking some compliance laws by not having a highly-available environment? — You put a life critical system on virtual hosted servers? What the hell is wrong with you — Not sure whether you’re plain incompetent or irresponsible. Anyway, you should be ashamed and prepare yourself with lots of money to pay for the lawyers. Would it be so difficult to have a contingency plan? another provider? or even another availability zone? Are you so fsklong dumb as to think that nothing could ever happen to a data center. — (+ 15 hours) This is a home based system, not an intra hospital system. So the promised 99.95% uptime is fine. But this situation showed that the promised 99.95% = fiction… BTW. All three servers are working – hopefuly the situation will remain stable — While I’m not going to suggest Amazon shouldn’t be ashamed of themselves.. I have to admit this is a pretty sickening tale. If I were running a system that could potentially lead to loss of human life.
You’d better believe hot-spare data center would be in my mind. — Your CTO will be a serious liability, and your board is going to crush your C*O staff very soon, if they’re awake. If you haven’t notified doctors and patients already, your liabilities just got worse. If you can’t roll over your IP routing, then you should not be in business. This should be going to a different server and duplicated by your own policies to ensure compliance with ALL regulatory requirements. You’re failing and you probably don’t even know how bad your company is failing. If I were you, I’d beg John Halamka to guide you out of this mess. — “This not just some social network website issue, but a serious threat to peoples lives!” Which begs the question, why did you leave yourself — and your patients — open to this risk in the first place? I hope for your patients’ sake that you begin taking more seriously your IT planning. Since you apparently don’t have a fail-over — and are waiting for Amazon anyway — you might want to think about solving the weakness you built into your own system, i.e., start working on an alternative method of getting what you need.
And if you can’t find a way to do that even now, I submit that you should never have launched your service at all. — Not even your servers are redundant? One of your servers is offline, and there’s not a hot swapable replacement? for a life-critical system? Man, pray God nothing happens, because on contrary, the responsibles for this design are surely going to serve sometime on a nearby prison. — If you were smart, you would have a distaster recovery plan for just this kind of thing. Judging from your lack of said preparations, you lot figured the cloud never goes down, and got greedy by not wanting to spend money on hot standby machines on a different infrastructure. Good going. Hope none of your cardiac patients croak because you’re going to get sued into next week… — (+15 hours) As I wrote, this is not a life saving system.Which does not mean that patient’s life cannot be saved using it.That is all I have to say. Good luck to others — Dude/Dudet.
You put that patients lives are at stake in your title … Don’t try to back track. Just admit it was stupid and move on. — Ah, so the title of this thread was a ruse? Either it isn’t so critical after all, and shame on you for trying to make it seem like it was, or else it is critical, and now you’re lying about it in order to not be shamed by others.
