health care presentation tea party patriot

8/14/2019 Health Care Presentation Tea Party Patriot

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Jack of ALL

Trades Master ofNone

Disclosure Statement


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Patriots Core Values Fiscal Responsibility

The government has not shown they canmanage healthcare costs and abuses.

Limited GovernmentAny further healthcare bills is not an option.Work on the existing MESS.

Free MarketsThe government has controlled this bysetting reimbursement for far too long andhas gotten our healthcare system into theplace it is today.


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How Did We Get Here? Bureaucracy

Government Micromanagement of HealthCare

Never ending entitlement programs EMTALA

System Abuse

Prescription Drug Abuse

Tort Litigation Self Interests


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BUREAUCRACY Multiple rules and guidelines

Cumbersome paperwork that takes away fromcare delivery

Constant changing of rules and guidelines Inefciency

Limited oversight related to abuse

Lack of business people running this businessof healthcare


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1965 Medicaid (Medi-Cal) Federal entitlement program that

covers health care, home care andlong term care.

60 million covered as of January2009.

$350 Billion projected fiscal year

2008 Government sets what they pay

average is 55-65% of what is


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1965 - Medicaid Program 4 months into 2009 fiscal year over

50% of states were in jeopardy -REVENUES decreased.

Stimulus Bill provided the 3rdBAILOUT of the Medicaid system in10 years.

States are being assisted untilDecember 2010.

2009 & 2010 budget are a mystery


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1965 Medicare Program $453 Billion for fiscal year 2010 Covers 52 million Americans Over the next 75 years this program

is underfunded by $35 TRILLION ++. Government decides what to pay

providers, sets the stage for other

reimbursement. Strict limits on providers doesnt


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1977 Rural Health Clinics (RHC) Intent is to serve rural areas. 1997 Balanced Budget Act made

significant increases in

reimbursement to hospitals anddoctors.

Provides for a special Medicare &Medicaid reimbursement amount.

RHCs will have a 25-75% increase inrevenue compared to private practice


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1977 Rural Health Clinics (RHC) There are 3800 RHCs nationwide It is estimated that approx. 500 are no

longer in rural areas. Currently there are 263 RHCs in California There has been criticism that these clinics

allow enhanced reimbursement even ifthe clinic is no longer in a rural orunderserved community.

Budget is in the Social Security budget -$25 million.

THIS IS AN EXISTING MONEY TREE FOR PROVIDERS


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1991 Federally Qualified Health

Center (FQHC) A benefit under Medicare since 1965 that was

amended under the Social Security Act Omnibus Budget Reconciliation Act

Purpose is to enhance primary care inunderserved urban and rural communities.

3200 in operation in the US. 20 in FresnoCounty, 145 in Los Angeles County.

Budget is $2.2 billion for 2009


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1997 Childrens Health

Insurance Program (CHIP)$40 Billion was spent in the first10 years

Provides matching funds tostates7.4 million people are enrolled

(400,000 are adults)Eligibility is 200% of poverty level famil of four - $44,100.


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2009 Childrens Health

Insurance Program (CHIP) President Obama signed the Childrens Health

Insurance Reauthorization Act of 2009 - 4million more women and children will beadded.

For the first time legal immigrants will haveno waiting period.

Program is now costing $11.6 Billion per year,states are having difculty matching these

amounts.President Obama proclaimed this is a down

payment on my commitment to cover every


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CHIP Enrollment BarriersOver 2/3s of the programs report there arebarriers to

getting people to enroll for the followingreasons:

68% Negative perception of governmentwelfare

59% Immigration status is a concern 41% Complicated Forms to Complete


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1930 - Veterans Health

Administration Budget 2009 is $98.7 Billion Covers almost 8 million people This program provides care for

veterans who have maintained ourNations freedoms.

Care is provided in a VA facility. You

can still have Medicare but only onewill pay for treatment at a time.


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1956 - TRICARECoverage for uniformed servicesof the military, originally was

known as CHAMPUS.$23.6 Billion per year1.4 million people


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Wait What about the

Prisons? California was mandated by the Federal

government to provide prisoners withconstitutionally acceptable level of care.

Federal mandate is not funded. Burdencarried by the State.

California prison system has been in a FederalReceivership since 2005.

California has 170,000 prisoners.

Health care budget 2008 was $1.9 BillionHow many prisoners are covered nationwide and

what cost?


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1986 - EMTALA Emergency Medical Treatment and Labor Act

Congress created a monster with this one.

A Federal Mandate that is UNFUNDED.

Goal was to avoid patient dumping due tolack of insurance.

Anyone that wants to be seen must be treatedand cant be turned away.

No emergency, Noproblem


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What EMTALA Means to Hospitals $35 Billion written o in 2007 for

bad debt and Charity Care fromhospitals nationwide per American

Hospital Association. EMTALA requires Physicians On-Call,

hospitals pay for it. They must increase charge rates so

they can get back what they arelosing to unpaid care.


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What EMTALA Means to You Exorbitant charge rates prices that do not

make sense Increased rates to your insurance company Increased health insurance premiums to YOU Increased wait times Inadequate on-call coverage Decreased quality

Not only do you pay for Governmentprograms via Taxes but you pay for it

inyour existing health care costs.


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Emergency Room Abuse National Association of Emergency Medical

Technicians estimates 20% of allambulance calls were not emergencies.

Medicaid/CHIP enrollees use the ER attwice the rate of the un-insured and fivetimes the rate of persons with privateinsurance.

Medicaid patients visit the ER for non-urgent and semi-urgent problems morethan are persons in any other payer


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Emergency Room Abuse Mental Health issues cause people to

overuse. Mental health system in the USis very poor.

In Texas, 9 people had 2678 visits tothe ER in 6 years. Seven had mentalhealth issues.

Drug Abuse - 8 of those 9 in Texas haddrug abuse problems. Drug abuseaccounts for 13% of all visitsnationwide.


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Overall System Abuse Rural Health Clinics are on the rise, they

provide great reimbursement but limitedcontinuity in care. Definition of Rural

has been expanded. Childrens Health Initiative already has

adults that shouldnt have ever been onthe program.

Provider Abuse limited scrutiny of theseentitlement programs so excessiveprocedures can be done, prescription


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Medicaid Abuse California Medicaid In-Home Support

Services has potential of $2.5 billion peryear of fraud according to multipleGrand Jury reports. Budget for 2010 is

$5.7 billion. Obtaining medical equipment to turn

around and sell. Obtaining prescriptions to sell.

Hiding of assets towards the end of lifeto get on Medicaid so the Governmentpays for Nursing Home stay.


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Golden Egg Pharmaceuticals Ongoing direct marketing to the consumer

encourages symptoms and the need for aRx.

Chemo is a big money maker 1997-2003 spending on prescription

drugs rose from $79 billion to $216billion. 273% increase

Proposed new drug tax would be "allocated" todrug

companies according to their share of sales


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Prescription Drug Abuse2006 Centers for Disease Control (CDC): 2.2 million people 12 and over abused pain relievers. More deaths caused than Cocaine and Heroin combined. 55% 12 and over obtained from a friend or family. Pain pills and antidepressants are some of the fastest

growing prescriptions.

"We are in danger of becoming a nation of pill poppers,"said John Walters, Director of National Drug ControlPolicy.

There is limited oversight ofphysiciansprescribing habits.


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Tort LitigationJournal of the American Medical Association

found that 93% of doctors admit to practicingdefensive medicine.

State level tort reform has reduced premiums.

CBO projects Tort Reform would save theGovernment $54 Billion alone.

Many cases are not legitimate cases but thedefense costs are still there.

Why is Tort Reform not included in anybills?


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Lack of Personal Accountability Most people think healthcare should

be free. We make personal financial choices

and do not make healthcare apriority.

Non-compliance with medical

direction. Vice abuse that impacts healthcare

costs: cigarettes, drugs, alcohol,


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Why This is Happening Encouraging people to rely on theGovernment has long been a pattern.

Using entitlements to win votes throughoutthe years.

Padding pocketbooks of special interests.

Padding pocketbooks of politicians.

We are in huge fiscal hole and theGovernment has NO ABILITY to fix it. Big

band-aids are being used to stop thebleeding and it wont work.

Government does not know how to reduce,


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SEIUwww.seiu.org Fast growing Union in North America 2.1 million workers in 3 service industries

Health Care 1 million

Public Services 850,000Property Service 225,000

56% are women

40% are of color

DATA TAKEN DIRECTLY FROM THEIRWEBSITE


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SEIU Influence on Health CareAndy Stern, President of the SEIU, is helpingto shake up the labor movement by makinghealth care a top priority, and helpingworkers and employers recognize the new

global economic model American businessesoperate under today. www.seiu.com

We spent a fortune to elect Barack Obama

$60.7 million to be exact and were proudof it.

Andy Stern, President of


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SEIU Payback #1HR 2688 Empowered at Home - Introduced6/3/09

Currently in the House Energy and CommerceCommittee.

Medicaid expansion for home care services byincreasing income eligibility from 150% ofpoverty to 300%. Can have upwards of$30,000 in savings.

Gives preference to states that use publicservice provider organizations. SEIU?

This bill is the guideline on how to deliver


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Suggestions/Ideas Mandate statewide or even nationwidedatabase for narcotics dispensing.

Reign in physician prescribing abilities.Monitor and investigate frequent and large

volume prescriptions. Level the playing field by increasing Medicaid

physician reimbursement in their privatepractices.

Evaluate the efciency and accountability for

Federal Qualified Health Clinics. Tie extrareimbursement to a requirement that theyretain extended hours.


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Suggestions/Ideas Bring in healthcare providers to help problemsolve that have business experience.Governmental mentality is not what is neededright now.

Do not allow monopolies of unions to beproviders of In-Home Care. Aging seniors aregoing to cause a volume explosion in this areaand by not opening this up to the private sector itis a huge mistake. Quality issues already exist.

Physicians need to share medical records with

peers so duplication of tests is not occurring. Evaluate the dispensing of Durable Medical

Equipment, wheelchairs, scooters being sold for


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Action Items Talk to everyone you can about this issue. Follow the centralvalleyteaparty.com site.

Look for the area Take Action.

In the next few months act upon what isdirected related to the vulnerable Senatorsand Congressmen.

Talk to your physician. Discuss some of theitems you have learned today. Let them know

No More ENTITLEMENT programs. Write letters, blog, share, whatever it takes to

defeat this.


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Go Forth Patriots

Apprehension, Uncertainty, Waiting,

Expectation, Fear of Surprise, do apatient

more harm than any exertion.

Florence Nightingale

health care presentation tea party patriot

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