Posted on 07/30/2009 3:34:15 AM PDT by Man50D
The House health-care reform bill proposes to decrease hospital visits by establishing a medical home pilot program for elderly and disabled Americans.
Such a medical home would not require a physician to be on the staff, and therefore could be run solely by nurse practitioners and physician assistants. Medical homes also would practice evidence-based medicine, which advocates only the use of medical treatments that are supported by effectiveness research.
But physicians groups say the legislation could lead to restrictions on which treatments may be used for certain conditions, despite the fact that some patients might require a unique or unconventional approach. It also may lead to dumping Medicare/Medicaid patients in facilities that are not required to have physicians on staff.
The Center for Medicine in the Public Interest (CMPI) expressed its concerns in a report that explains why statistical evidence does not always reflect reality of effective medicine.
One size fits all rarely does, the report said. From clothes to shoes to hats, few people find that items carrying that label work with their individual bodies. So why do we entrust the health of our bodies -- one of the most important assets we have -- to a one-size-fits-all mentality?
According to CMPI and individual physicians, however, this one-size-fits-all mentality is just what congressional health-care reform suggests.
Unfortunately, policies being advanced under the guise of evidence-based medicine (EBM) could do just that, the CMPI report said. The idea behind EBM, empowering physicians with sound evidence to incorporate into their treatment decisions for individual patients, is a good one.
Unfortunately, EBM now is being distorted by government bureaucrats and HMOs in ways that impose top-down, one-size-fits-all restrictions on patients and their healthcare providers.
Rather than enforcing a formulaic approach to medicine based on statistical and clinical research, CMPI says health-care reform should preserve physicians autonomy to use the research in conjunction with their experience and knowledge of the patient.
It is so critically important for the physician to maintain his or her ability to combine study findings with their expertise and knowledge of the individual in order to make the optimal treatment decisions. Evidence-based medicine in its present, distorted form emphasizes just one aspect of the clinical pie over all the others, the report found.
Kathryn Serkes of the American Association for Physicians and Surgeons echoed the observation.
There is no typical patient, Serkes told CNSNews.com. Every patient is different from a medical perspective. If we have evidence-based medicine that basically says well, we start at treatment one, which leads you to treatment two, to treatment three to treatment four. In practice, that doesnt work for the patient. Thats the art part of the art and science of medicine. Thats what we still need doctors to do, is to figure out whats right for the patient.
In the long run, according to CMPI, evidence-based medicine may not even cut costs as Congress suggests it would.
Evidence-based medicine may provide transitory savings in the short term, but the same patient who takes the cheapest available statin today may very well be the patient costing you -- the taxpayer, the policymaker, the thought-leader, the sister, the spouse -- big bucks when that patient ends up in the hospital because of improperly treated cardiovascular disease, .
The repercussions of choosing short-term thinking over long-term results and cost-based medicine over patient-based are pernicious to both the public purse and the public health, the CMPI report said.
Provisions for the medical home pilot program are an amendment to the Social Security Act, which governs the administration of Medicare and Medicaid services.
The medical home is an approach to medical practice that facilitates partnerships between patients and physicians, according to the proposed bill.
The pilot program targets Medicare beneficiaries who have a high medical risk score or who require regular monitoring, advising or treatment. This currently applies to more than 22 million Americans, according to Kaiser Family Foundation statistics.
At least $1.5 billion would be redirected from the Federal Supplementary Medical Insurance Trust Fund to fund the medical homes, in addition to funds otherwise available, according to the bill.
The Senate health-care reform bill also includes provisions for medical homes, although to lesser detail than the House bill.
If this portion of the legislation passes through Congress, medical homes will be part of the greater health-care reform experiment known as "the public (health insurance) option."
According to the committee, the provisions for medical homes will make the public option a stronger competitor against private health insurance companies.
The public health insurance option will be empowered to implement innovative delivery reform initiatives so that it is a nimble purchaser of health care and gets more value for each health care dollar, the House Committee on Energy and Commerces summary says about the bill.
Medical homes are tied to comparative effectivness research via something called evidence-based medicine.
It will expand upon the experiments put forth in Medicare and be provided the flexibility to implement value-based purchasing, accountable care organizations, medical homes, and bundled payments. These features will ensure the public option is a leader in efficient delivery of quality care, spurring competition with private plans, the committees summary also said.
A statement by the American College of Emergency Physicians (ACEP) said that the effectiveness of the medical home model should be carefully evaluated before applying the model far and wide.
There should be more research to demonstrate the benefits and continuing costs associated with implementation of the full (patient-centered medical home) model, the ACEP statement said.
Demonstration projects being conducted by the Centers for Medicare & Medicaid Services must be carefully evaluated. There should be proven value in healthcare outcomes for patients and reduced costs to the healthcare system before there is widespread implementation of this model.
The proposal, meanwhile, specifically allows for facilities to be run by staff who do not possess medical degrees including nurses and nurse practitioners.
Just as I had guessed. And over a certain age, the only option will be DNR.
Nice post devolve. Yes he’s transparent - we can see all the lies.
People who think like that do not believe in God. They see the source of supply as static, but God is always creating. I feel sorry for folks who don't know our creative Lord.
“I feel sorry for folks who don’t know our creative Lord.”
I would say I feel sorry for them for the same reasons as you also, however they are the self deluded, entirely wrong headed pack of Coyotes whom seek to be our rulers today. They are the enemy. Once we take back control of our lives and our freedoms, then we could possibly have the luxury of feeling sorry for them. Wondering if they could be coaxed to see that creativity that is GOD upon isolation from their pack.
My opinion. Thanks for your response.
Yes, it is as simple as that.
"60,000 Reichsmark is what this person suffering from hereditary defects costs the community during his lifetime. Fellow Germans, that is your money, too. Read 'New People', the monthly magazine of the Bureau for Race Politics of the Nazi Party."
Thank you for doing that, nice job! Here is one done by another FReeper.
Pg 22 of the HC Bill MANDATES the Govt will audit the books of ALL EMPLOYERS that self insure!!
Pg 30 Sec 123 of HC bill - THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you get
Pg 29 lines 4-16 in the HC bill - YOUR HEALTHCARE IS RATIONED!!!
Pg 42 of HC Bill - The Health Choices Commissioner will choose your benefits for you. You have no choice!
Pg 50 Section 152 in HC bill - HC will be provided to ALL NON US citizens, illegal or otherwise
Pg 58HC Bill - Govt will have real-time access to individuals finances & a National ID Health care card will be issued!
Pg 59 HC Bill lines 21-24 Govt will have direct access to your banks accts for electronic funds transfer.
Pg 65 Sec 164 is a payoff subsidized plan for retirees and their families in Unions & community orgs (ACORN).
Pg 72 Lines 8-14 Govt is creating an HC Exchange to bring priv HC plans under Govt control.
Pg 84 Sec 203 HC bill - Govt mandates ALL benefit packages for private Health Care plans in the Exchange
Pg 85 Line 7 HC Bill - Specs for of Benefit Levels for Plans = The Govt will ration your Healthcare!
Pg 91 Lines 4-7 HC Bill - Govt mandates linguistic appropriate services. Example - Translation for illegal aliens.
Pg 95 HC Bill Lines 8-18 The Govt will use groups i.e., ACORN & Americorps to sign up individuals for Govt HC plan
Pg 85 Line 7 HC Bill - Specs of Ben Levels 4 Plans. #AARP members - Your Health Care WILL be rationed
Pg 102 Lines 12-18 HC Bill - Medicaid Eligible Individual will be automat.enrolled in Medicaid. No choice.
Pg 124 lines 24-25 HC No company can sue Govt on price fixing. No judicial review against Govt Monopoly.
Pg 126 Lines 22-25 Employers MUST pay for HC for part time employees AND their families.
Pg 127 Lines 1-16 HC Bill - Doctors/ #AMA - The Govt will tell YOU what you can make.
Pg 145 Line 15-17 An Employer MUST auto enroll employees into public opt plan. NO CHOICE
Pg 149 Lines 16-24 ANY Emplyr w payroll 400k & above who does not prov. pub opt. pays 8% tax on all payroll
Pg 150 Lines 9-13 Biz w payroll btw 251k & 400k who doesnt provide public opt pays 2-6% tax on all payroll
Pg 167 Lines 18-23 ANY individual who doesnt have acceptable HC according to Govt will be taxed 2.5% of income.
Pg 170 Lines 1-3 Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay).
Pg 195 Officers & employees of HC Admin (GOVT) will have access to ALL Americans financial and personal records.
Pg 203 Line 14-15 HC - The tax imposed under this section shall not be treated as tax Yes, it says that.
Pg 239 Line 14-24 HC Bill Govt will reduce physician services for Medicaid. Seniors, low income, poor affected.
Pg 241 Line 6-8 HC Bill - Doctors, doesnt matter what specialty you have, youll all be paid the same.
Pg 253 Line 10-18 Govt sets value of Drs time, prof judg, etc. Literally value of humans.
Pg 265 Sec 1131Govt mandates & controls productivity for private HC industries.
Pg 268 Sec 1141 Fed Govt regulates rental & purchase of power driven wheelchairs.
Pg 272 SEC. 1145. Treatment of certain cancer hospitals Cancer patients - welcome to rationing!
Page 280 Sec 1151 The Govt will penalize hospitals for what Govt deems preventable readmissions. (Incentives for hospital to not treat and release.)
Pg 298 Lines 9-11 Drs, treat a patient during initial admission that results in a readmission-Govt will penalize you.
Pg 317 L 13-20 PROHIBITION on ownership/investment. Govt tells Drs. what/how much they can own.
Pg 317-318 lines 21-25,1-3 PROHIBITION on expansion- Govt is mandating hospitals cannot expand.
pg 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can you say ACORN?!!
Pg335 L 16-25 Pg 336-339 - Govt mandates established of outcome based measures. HC the way they want. Rationing.
Pg 341 Lines 3-9 Govt has authority to disqualify Medicare Advantage Plans (Part B), HMOs, etc. Forcing people into Govt plan.
Pg 379 Sec 1191 Govt creates more bureaucracy - Telehealth Advisory Committee. HC by phone/Internet?
Pg 425 Lines 4-12 Govt mandates Advance [Death] Care Planning Consult. Think Senior Citizens end of life.
Pg 425 Lines 17-19 Govt will instruct & consult regarding living wills, durable powers of atty. Mandatory!
Pg 425 Lines 22-25, 426 Lines 1-3 Govt provides approved list of end of life resources, guiding you in death. Pg 354 Sec 1177 - Govt will RESTRICT enrollment of Special needs people!
Pg 427 Lines 15-24 Govt mandates program for orders for end of life. The Govt has a say in how your life ends.
Pg 429 Lines 1-9 An adv. care planning consult will be used frequently as patients health deteriorates.
Pg 429 Lines 10-12 adv. care consultation may incl an ORDER for end of life plans. AN ORDER from GOV
Pg 429 Lines 13-25 - The govt will specify which Doctors can write an end of life order.
PG 430 Lines 11-15 The Govt will decide what level of treatment you will have at end of life
Pg 469 - Community Based Home Medical Services=Non profit orgs. Hello, ACORN Medical Svcs here!!?
Pg 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment to a community-based org. Like ACORN?
Pg 489 Sec 1308 The Govt will cover Marriage & Family therapy. They will insert Government into your marriage.
Pg 494-498 Govt will cover Mental Health Svcs including defining, creating, rationing those svcs
PG 502 Sec 1181 Center for Comparative Effectiveness Research Established. Hello Big Brother Literally.
Pg 503 Lines 13-19 Govt will build registries and data networks from YOUR electronic med records.
Pg 503 lines 21-25 Govt may secure data directly from any depart or agency of the US including your data.
Pg 504 Lines 6-10 The Center will collect data both published & unpublished (that means public & your private info)
PG 506 Lines 19-21 The Center will recommend policies that would allow for public access of data.
PG 518 Lines 21-25 The Commission will have input from HC consumer reps Can you say unions & ACORN?
PG 524 18-22 Comparative Effectiveness Research Trust Fund set up. More taxes for ALL.
PG 621 Lines 20-25 Govt will define what Quality means in HC. Since when does Govt know about quality?
Pg 622 Lines 2-9 To pay for the Quality Standards, Govt will transfer $$ from to other Govt Trust Funds. More Taxes.
PG 624 Quality measures shall be designed to assess outcomes & functional status of patients.
PG 624 Quality measures shall be designed to profile you including race, age, gender, place of residence, etc
Pg 628 Sec 1443 Govt will give Multi-Stake Holders Pre-Rule Making input into Selection of Quality Measures.
Pg 630 9-24/631 1-9 Those Multi-stake holder groups incl. Unions & groups like ACORN deciding HC quality.
Pg 632 Lines 14-25 The Govt may implement any Quality measure of HC Services as they see fit.
PG 633 14-25/ 634 1-9 The Secretary may issue non-endorsed Quality Measures for Physician Services & Dialysis Services.
Pg 635 to 653 Physicians Payments Sunshine Provision Govt wants to shine sunlight on Docs but not Govt.
Pg 654-659 Public Reporting on Health Care-Associated Infections Looks okay.
PG 660-671 Doctors in Residency Govt will tell you where your residency will be, thus where youll live.
Pg 676-686 Govt will regulate hospitals in EVERY aspect of residency programs, incl. teaching hospitals.
Pg 686-700 Increased Funding to Fight Waste, Fraud, and Abuse. You mean like the Govt with an $18 million website?
PGs 701-704 Sec 1619 If your part of HC plan isnt in Govt HC Exchange but you qualify for Fed aid, no payment.
PG 705-709 SEC. 1128 If Secr gets complaints (ACORN) on HC provider or supplier, Govt can do background check.
PG 711 Lines 8-14 The Secretary has broad powers to deny HC providers/suppliers admittance into HC Exchange. Your doctor could be thrown out of business.
Pg 719-720 Sec 1637 ANY Doctor who orders durable med equip or home med services MUST be enrolled in Medicare.
PG 722 Sec 1639 Govt MANDATES Doctors must have face to face with patient to certify patient for Home Health Svcs.
PG 724 23-25 PG 725 1-5 The same Govt certifications will apply to Medicaid & CHIP (your kids)
PG 724 Lines 16-22 Govt reserves rt to apply face to face certification for patient to ANY other HC service.
Pg 735 lines 16-25 For law enforce. proposes the Secretary-HHS will give Atty General access to ALL data.
PG 740-757 Govt sets guidelines for subsidizing the uninsured (Thats your tax dollars people)
Pg 757-762 Fed govt will shift burden of payments to Disproportionate Share Hospitals (DSH) to States. (Taxes)
Pg 763 1-8 No DS/EA hospitals will be paid unless they provide services without regard to national origin
Pg 765 Sec 1711 Govt will require Preventative Services including vaccines. (Choice?)
Pg 768 Sec 1713 Govt Nurse Home Visitation Svcs (Hello union paybacks)
Pg 769 11-14 Nurse Home Visit Svcs include-economic self-sufficiency, employ adv, school-readiness.
Pg 769 3-5 Nurse Home Visit Services - increasing birth intervals between pregnancies. Govt ABORTIONS anyone
Pg 770 SEC 1714 Fed Govt mandates eligibility for State Family Planning Services. Abortion & State Sovereign.
Pg 789-797 Govt will set, mandate drug prices, controlling which drugs brought to market. Bye innovation.
Pgs 797-800 SEC. 1744 PAYMENTS for graduate medical education. The government will now control Drs education.
PG 801 Sec 1751 The Govt will decide which Health care conditions will be paid. Say RATION!
Pg 810 SEC. 1759. Billing Agents, clearinghouses, etc req. to register. Govt takes over private payment sys.
Pg 820-824 Sec 1801 Govt will identify individ. ineligible for subsidies. Will access all personal financial information.
Pg 824-829 SEC. 1802. Govt Sets up Comparative Effectiveness Research Trust Fund. Another tax black hole.
PG 829-833 Govt will impose a fee on ALL private health ins. plans incl. self insured to pay for Trust Fund!
PG 835 11-13 fees imposed by Govt for Trust Fund shall be treated as if they were taxes.
Pg 838-840 Govt will design & implement Home Visitation Program for families with young kids & families expect kids.
PG 844-845 This Home Visitation Prog. includes Govt coming into your house & telling you how to parent!!!
Pg 859 Govt will establish a Public Health Fund at a cost of $88,800,000,000. Yes thats Billion.
Pg 865 The Govt will MANDATE the establishment of a National Health Service Corps.
PG 865 to 876 The NHS Corps is a program where Drs. perform mandatory HC for 2yrs for part loan repayment.
PG 876-892 The govt takes over the education of our Med students and Drs.
PG 898 The Govt will establish a Public Health Workforce Corps to ensure supply of public health prof.
PG 898 The Public health workforce corps shall consist of civilian employees of the U.S. as Secretary deems.
PG 898 The Public health workforce corps shall consist of officers of Regular & Reserve Corps of Service.
PG 900 The Public Health Workforce Corps includes veterinarians.
PG 901 The Public Health Workforce Corps WILL include commissioned Regular & Reserve Officers. HC Draft?
PG 910 The Govt will develop, build & run Public Health Training Centers.
PG 913-914 Govt starts a HC affirmative action program thru guise of diversity scholarships.
PG 915 SEC. 2251. Govt MANDDATES Cultural & linguistic competency training for HC professionals.
Pg 932 The Govt will estab Preventative & Wellness Trust fund- initial cost of $30,800,000,000-Billion.
PG 935 21-22 Govt will identify specific goals & objectives for prevention & wellness activities. Control YOU!!
PG 936 Govt will develop Healthy People & National Public Health Perform. Standards Tell me what to eat?
PG 942 Lines 22-25 More Govt? Offices of Surgeon General -Public Health Svc, Minority Health, Womens Health
PG 950- 980 BIG GOVT core pub health infrastructure including workforce capacity, lab systems; health info sys, etc
PG 993 Govt will establish school based health clinics. Your kids wont have a chance.
PG 994 School Based Health Clinic will be integrated into the school environment. Say GOVT Brainwash!
PG 1001 The Govt will establish a National Medical Device Registry. Will you be tracked?
http://www.freerepublic.com/focus/f-news/2297439/posts
Totally unacceptable. If that passes, we are out of here. It’s as simple as that. We will sell our business, already have 2 buyers that are interested, and we will move permanently to our vacation home that is not in the US where everything is tons cheaper and taxes are a fraction of what they are here.
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Obama sez he will drink Bud Lite tonight
Almost transparent - and very San-Fran beer
These Kommunist RATS are turning everything good in this country upside down.....
.....Abundant cheap electricity from coal will be crippled and run out of business
.....Cheap domestic petroleum fuel for our vehicles is made inaccessible
.....Food prices are and will rise with energy costs.
.....Freedom to own a firearm and ammunition is being whittled down.
.....Property rights are being destroyed in the name of Imminent Domain for higher property tax revenue, which is an affront to the previous owner who payed the taxes that financed the Lawyers that ran him out of his home.
WHEN will we see the shark Lawyer business turned upside down to get control of skyrocketing costs all around us due to ridiculous lawsuits?
WHEN will we see the liberal NEA and the public schools turned upside down to stop the wholesale indoctrination of children?
WHEN will we see the government financed Universities and Colleges turned upside down to shake out the rotten core of Kommunist Professors on tenure teaching anti-American propaganda?
The combination of the shark Lawyers, NEA/Public Schools, and the Leftist Professors are breeding idiot voters who vote for goodies and support the shark Lawyers, NEA/Public Schools, and Leftist Professors. It is a vicious cycle that must be upset and stopped before it is too late.....
Lol, you’re gonna offend all the ‘Bud Lite’ drinkers!
Glen Beck said something like, ‘hey, he drinks Bud Lite - he’s JUST LIKE US’!! As you know, it was sarcasm..
With all the need for elder care facing our country I’m thinking that Christians are going to have to start acting like Christians. Every one of us can take at least one elderly person and care for them, whether it be a parent or other relative, or a total stranger who would become a “cousin” to fool the Gestapho. Think back to the days of the frontier when people had no doctors to speak of. Use natural cures as much a possible.
SO DEPRESSING!! ALL OF IT
.
I think “Stupity” Obama should stick to his Cranium-Light
This a circus only a moron like Kenny Junior would have caused
H I T L E R reborn and don’t forget his G E S T A P O
Do you think once people start being {essentially} murdered by the Bolsheviks this way, there will be enough protests to change things? Should, HEAVEN FORBID, they somehow pass all of their dream eugenics changes????
He had to invite Biden so he wouldn’t look as stupid, lol.
Heard Crowley is drinking Blue Moon beer, familiar with it?
Also, Obama made another gaff in his meeting with the Philippine prime minister today. Said something about ‘your small country’, when in fact, it is supposedly the 12th largest!
Watching Crowley on Fox News now.
Pfffftttt... I'm 76 and haven't been pregnant in 11 years
My brother, 87 just went into Harvest of Fowler...
I won’t be surprised when he sics his Obama Youth on us. Not only to rat out neighbors but to actually start rounding us up. Probably what the Census is up to with their GPS’ing/Gestapo’ing of our houses. I feel like I have a yellow star on my house already :((
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