“Proud Up-Yours Tradition”: Arizona Bill Would Require Immigration Checks In Hospitals
Republicans have long claimed that there’s no such thing as an uninsured patient in America since anyone can just go to the emergency room for their health care. Sure that’s inefficient and expensive, but a proposed Arizona law might reduce some of those costs by making clear to undocumented immigrants that they’re not welcome in the state’s hospitals at all.
The latest in the Arizona’s proud tradition of “up yours” legislation, H.B. 2293 would require that to would require hospitals to check the immigration status of patients and report undocumented patients to the authorities. Republican State Representative Steve Smith, who’s sponsoring the bill, said that it’s a way to gauge how much Arizona is spending on care for non-Americans:
The local ABC affiliate reported:
“That’s it, we don’t deny anybody, they don’t come in and not get treated, everything stays the same, we just want it documented,” said Smith.
Smith said his goal is to find out the amount of money hospitals spend to treat undocumented immigrants.
He later said that he has “no clue” about whether hospitals would enforce the law. It’s currently in the early stages of the legislative process but if it passed it would likely dissuade undocumented immigrants from seeking health care since their presence in the emergency room would trigger a call to the cops or feds.
“When does this begin or end?” asked Pete Wertheim of the Arizona Hospital and Healthcare Association to the Arizona Daily Sun. “What other industry should be screening their customers for citizenship verification?”
We cannot detain them,” he said of those suspected of being illegal immigrants. And he said not every one of the 1.2 million uninsured in Arizona — people who would lack the evidence of valid health insurance that triggers what Smith’s bill would require — are here illegally.
Smith has also advocated for citizenship checks in public schools.
By: Alex Halperin, Salon, January 27, 2013
“Another Right Wing Freakout”: Sorry Rush, Gun Violence Is A Health Care Issue
How illogical has the right-wing media ‘debate’ about gun control become this week in the wake of President Obama moving forward on a host of violence prevention measures?
So illogical that conservative media voices expressed outrage, while spreading constant misinformation, about the role doctors might play in addressing gun violence in America. The right-wing Noise Machine cranked up the indignation because the Obama administration wants to make sure health care professional are allowed to communicate with their patients about guns and gun safety.
In other words, the right-wing Noise Machine is furious that the White House is treating gun violence, in part, as a health care issue when it so transparently is one.
Fact: The United States’ life expectancy rate is far lower than most other affluent countries, in part because of our rate of gun violence far outpaces those other countries.
Meanwhile, taxpayers here spend billions each year paying health care costs to treat gunshot victims, the strong majority of whom, research indicates, are uninsured. Taxpayers spend even more money covering societal costs, such as long-term psychological problems, disability, and the loss of productivity suffered by approximately 70,000 Americans who suffer non-fatal gun shot wounds annually.
Following the school gun massacre in Newtown, Conn. last month, Bloomberg News reported:
The cost of U.S. gun violence in work lost, medical care, insurance, criminal-justice expenses and pain and suffering amounted to as much as $174 billion in 2010, according to data compiled by the Pacific Institute for Research and Evaluation in Calverton, Maryland.
That averages out to more than $644 in costs for every gun owned in America. As economist Ted Miller, the Institute’s principal research scientist, told Bloomberg, “Gun ownership is like smoking, an expensive and dangerous habit.”
So yes, gun violence is America represents an epic and costly health care problem, which is why it makes sense to include health care providers in any comprehensive attempt to combat the crisis. (On Wednesday, the White House announced the administration would “issue guidance clarifying that the Affordable Care Act does not ban doctors from asking patients “about firearms in their patients’ homes and safe storage of those firearms.”)
As the Firearm & Injury Center at the University of Pennsylvania has concluded, “Healthcare providers have a vital role in preventing intentional and unintentional firearm injuries and their impact on patients, families and communities.” And that’s why the group Doctors for America applauded Obama’s gun violence imitative this week.
Meanwhile, the far-right allegation that Obama now requires physicians to press patients about gun use represents a complete fabrication. So was Rush Limbaugh’s claim that Obama’s trying to turn doctors into “snitches,” and Lou Dobbs’ fearmongering about the president turning doctors into “an agent of the federal government.”
The right-wing freak-out is built around the fake premise of, how dare Obama recruit doctors to fight his war on gun violence. (Drudge Report headline: “War on Crazy: Obama Deputizes Doctors”) That may be a conservative attempt to keep the gun debate focused on the issue of gun rights and the Second Amendment and away from the catastrophic, real-life costs that gun violence registers each year.
However, the right-wing media’s baseless assertion ignores the obvious fact that the health care industry in this country — doctors, hospitals, emergency rooms, mental health centers -remains inundated with gunshot wounds daily and deals with the life-changing crisis all the time. (Nearly 300 people are shot everyday in America.) Doctors don’t have to go snooping around acting as “snitches” in order to find the problem.
And the financial costs of those gunshots wounds is rising; improved trauma care means hospitals now save more gunshot victims, which in turn adds to larger, long-term health care and rehabilitation costs.
A 2005 study of hospital charges for firearm injuries in Pennsylvania found that the average charge for inpatient hospitalization due to firearm injuries was $30,814. That figure was more than double what gunshot injuries cost hospitals between 1996-1998.
An in-depth investigation on gunshot violence by the Milwaukee Journal in 2006 reported that the average bill for a shooting patient treated at the city’s Froedtert Hospital was $38,000. For gunshot victims who suffered spinal damage, the bill regularly reached six figures.
Truth is, any attempt to reduce gun violence in America must include a health care strategy, no matter how much whining Fox News and Rush Limbaugh do about it.
By: Eric Boehlert, The Huffington Post, January 18, 2013
“Scottie’s Star Trek Tricks”: Rick Scott’s Parallel Universe Of Ideological “Facts”
Via Think Progress, another item from the ever-increasing database of “facts” Republicans use to buttress ideologically dictated positions comes from everybody’s favorite health care expert, Florida Gov. Rick Scott.
Scott has been bruiting it about that his refusal to implement the Medicaid expansion provided for in the Affordable Care Act, which would have supplied health insurance to a cool million residents of that steamy state, was based on its vast cost: $26 billion over ten years in new state costs!
Them’s a lot of dollars, to be sure. But turns out Scott just kinda made the number up, or more accurately, didn’t bother to share the preposterous assumptions needed to generate it. Health News Florida explains:
The state’s chief economist has warned the staff of Gov. Rick Scott that his Medicaid cost estimates are wrong, but Scott keeps using them anyway, according to a series of e-mails obtained by Health News Florida.
Scott says he opposes expanding Florida Medicaid because it would cost too much: $63 billion over 10 years, he says, with the state paying $26 billion of that.
But those numbers are based on a flawed report, according to a legislative budget analyst and State Economist Amy Baker. A series of e-mails obtained by Health News Florida shows the analysts warned Scott’s office the numbers were wrong weeks ago, but he is still using them. He cited them in a Tampa Bay Times op-ed on Sunday and at at a Washington press conference on Monday.
The trumped-up number, it seems, comes from assuming the federal super-match for the expanded Medicaid coverage provided for in the ACA will never actually materialize. Why? Here’s the response from Scott’s “health policy coordinator,” Michael Anway:
Anway said he doesn’t believe the federal funds will come through. “The federal government has a $16 trillion national debt, must borrow 46 cents of every dollar it spends, and in 2011 had its credit rating downgraded for the first time in history,” he wrote in explanation.
So Scott is assuming the feds will renege on their statutory obligation to provide the Medicaid match. That’s a new one, and is particularly ironic since the only threat to the federal government defaulting on its spending obligations comes from Scott’s conservative buddies in Congress.
Truth is, the most authoritative estimate of state costs associated with the Medicaid expansion, from the Kaiser Family Foundation, put Florida’s costs at $1 billion over ten years, and that doesn’t even include potential savings from costs currently incurred by the state in uncompensated care for the uninsured.
So Scott’s costs estimates are off a mere 96%, at least. But what are facts when it comes to the ontological necessity of thwarting Obamacare and saving a million Floridians from the slavery of dependence on government?
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, January 8, 2013
“People Are More Than Numbers On A Page”: The Healthcare Lessons Mark Kirk Learned From His Stroke
Walk a mile in someone else’s shoes.
But how many of us actually do that? At least by choice?
Over a year ago Sen. Mark Kirk suffered a debilitating stroke. And his medical condition has sparked his interest in the experience of people on Medicaid. Kirk reminds me of the character William Hurt played in the movie The Doctor, a tale of a physician with no bedside manner who suddenly cares about his patients, once he himself becomes the patient, suffering with cancer.
Well D.C. isn’t Hollywood and Senator Kirk’s stroke was not something manufactured by Hollywood studios. The Illinois Republican had an opportunity he now realizes not everyone who suffers a stroke has: the opportunity to get his life back. Senator Kirk had that opportunity this week as he returned to Capitol Hill for the first time in a year, joining the new 2013 Senate.
Kirk’s illness made him realize that the unlimited medical care, access, and not to mention ability to have as many rehabilitation sessions as he needed to have a complete recovery from the stroke he suffered, is not available to most people, especially the poor—those who are on Medicaid. In the state of Illinois, if you are on Medicaid, you are only eligible for 11 rehab sessions following a stroke.
In an interview with the Chicago Sun Times, Senator Kirk said, “Had I been limited to that [referring to the 11 rehabilitation sessions], I would have had no chance to recover like I did. So unlike before suffering the stroke, I’m much more focused on Medicaid and what my fellow citizens face…I will look much more carefully at the Illinois Medicaid program to see how my fellow citizens are being cared for who have no income and if they suffer from a stroke.”
Senator Kirk has, by no choice of his own, walked a mile in another’s shoes…but not entirely. As a senator, he benefits from the very best medical care. He had undoubtedly the best doctors and access—and that access included unlimited rehabilitation sessions—as many as he needed. Each of us is unique and individual—our bodies respond differently one from another, even if we share the same illness or injury.
Although it is admirable that Senator Kirk has woken up to the reality that so many Americans face daily and struggle with so frequently, it’s sad that it took a stroke for him to come to this realization. So we must ponder the question: Does every GOP member of the House and the Senate need to become ill or have a family member become ill to fully understand that it is not only a right, but a necessity that any American have access to not only healthcare, but more so, proper healthcare? What type of society are we if only the rich are allowed to survive such things as a stroke? Or dare I say, only a politician?
Senator Kirk realized this. I know there are those critics out there who feel that Kirk is tapping into a group of potential voters that the GOP has largely ignored, and the GOP largely voted against legislation which would help this group of people.
As a liberal, a progressive, and a Democrat, who is married to a physician and who believes that all of us are truly created equal and should have equal access to the best medical care possible, it saddens me that it seems only when it affects an individual or someone they love, especially those politicians on the right, that they can see what we on the left have been speaking of: fairness.
It isn’t fair that a senator has a stroke and returns to work one year later, when so many in Illinois and elsewhere may not be able to return to work or their lives as they knew them; and some don’t survive at all.
Senator Kirk at one time, as his colleagues, never looked at the people behind the term ‘patient,’ for they were just numbers to slash in cutting spending. Let’s hope that those in the GOP don’t need to suffer as Senator Kirk did to come to the realization that people hurting and in pain are more than numbers on a page.
By: Leslie Marshall, U. S. News and World Report, January 4, 2012
“Rejecting Their Own Ideas”: Republicans Are Creating Needless Difficulties For Themselves And The Country
We know that the House of Representatives has been unable to reach a sensible deal to avoid unnecessary fiscal trouble at the first of the year because of right-wing Republicans’ aversion to tax increases.
But there is another issue on which conservatives are creating needless difficulties for themselves and the country: It’s harder and harder for politicians on the right to think straight about health care.
Conservatives once genuinely interested in finding market-based ways for the government to expand health insurance coverage have, since the rise of Obamacare, made choices that are dysfunctional, even from their own perspective.
Start with the decision of the vast majority of Republican governors to refuse to set up the state insurance exchanges required under the law. The mechanisms would allow more than 20 million Americans to buy coverage. They were originally a conservative idea for large, trustworthy marketplaces where individuals and families could buy plans of their choice.
Many liberals preferred a national exchange, in which the federal government could institute strong rules to protect consumers and offer broader options. This was the path the House took, but the final Senate-passed law went with state-level exchanges in deference to Republican sensibilities.
To ensure that governors could not just prevent their residents from having access to the new marketplaces, the bill required the federal government to run them if states defaulted. So, irony of ironies, in declining to set up state exchanges, conservative governors are undermining states’ rights and giving liberals something far closer to the national system they hoped for. As Robert Laszewski, an industry critic of Obamacare, told The Post’s N.C. Aizenman, conservative governors are engaging in “cut-off-your-nose-to-spite-your-face” behavior.
This is one of many forms of conservative health-care unreason. The “fiscal cliff” debate has been distorted because the problems confronting federal finances are consistently misdescribed. We do not have “an entitlement problem.” We have a giant health-care cost problem.
Our major non-military fiscal challenges lie in Medicare and Medicaid. In principle, conservatives should seek to find ways of holding down health-care inflation in both the private and public sectors. In practice, they see most efforts to take on this issue system-wide as examples of big government run wild. They seem to have a vague idea that markets can yet solve a problem that markets have not been very good at solving.
The result is that conservatives would either let government get bigger, or they’d save money by throwing ever more risk onto individuals by undercutting core government guarantees.
Their most outrageous move was the big lie that the original health-care bill included “death panels.” This would have been laughable if it had not been so pernicious. The provision in question would simply have paid for consultations by terminally ill patients — if they wanted them — with their physicians on their best options for their care. Few things are more important to the future of health care than thinking straight about the costs and benefits (to patients and not just the system) of end-of-life treatments. For those of us who oppose physician-assisted suicide, it’s urgent to promote, rather than block, serious, moral and compassionate discussions of the difficult issues raised by high-tech medicine.
Or take the health-care law’s creation of the Independent Payment Advisory Board, known as IPAB. It’s a 15-member body charged with finding ways of cutting the costs of treatment under Medicare. Congress would have the final say, but through a fast-track process. Yet the ink was barely dry on Obama’s signature of the Affordable Care Act (ACA) when a group of Republican senators introduced what they called the Health Care Bureaucrats Elimination Act, to get rid of IPAB. Thus did an innovative effort to save money meet with a slap in the face. Conservatives barely acknowledge other cost-saving experiments in the ACA.
Is it any wonder that our fiscal politics are so dysfunctional? Yes, we liberals are very reluctant to cut access to various government health-insurance programs. With so many Americans still uninsured, we are wary of depriving more people of coverage. But we fully accept the need to contain government health spending.
Yet given the conservatives’ habit of walking away even from their own ideas (the exchanges, for example) and of rejecting progressive efforts to save money, is it any wonder that liberals suspect them of greater interest in dismantling programs than in making them more efficient? We won’t find genuine common ground on deficits until we resolve this dilemma.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, December 26, 2012
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