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"So What?" Politics
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This Consumer Wants Health Information Transparency (HB2289)
As a Tennessee resident with a chronic medical condition, I welcome the opportunity to know the costs of healthcare procedures throughout the state, as well as factual based information on whether a particular medical provider is actually performing his specialty well or not. I also welcome the ability of policymakers in the state to evaluate outcome data of healthcare programs to determine if the money being spent by the state is actually achieving the desired outcome. These are the primary objectives of HB 2289, known as the "All Payer Claims Database." In the name of consumer protection, we have required food manufacturers to list nutritional information on all packaging, and have advocated for caloric information to be placed on menu items in restaurants. We seek out websites to comparison shop for everything from electronics to housewares. Why should one of our most costly expenses, healthcare, be any different?
If such healthcare cost information was currently available, it would greatly help me as a healthcare consumer to determine the best and most affordable location to receive treatment. Why? My neurologist ordered an MRI on my brain (I have epilepsy); the cost to have it done at his office is roughly $3,000. I cannot afford this. Period. Who indeed has an extra $3,000 on hand to spend on something like this? Anyone? Anyone? Aditionally, because West TN Healthcare manages/oversees a majority of the physicians in this county, there is no consumer choice to have a procedure like this done. I called Blue Cross/Blue Shield to find out how I might find out the prices of MRIs throughout the state who accepted my insurance. They could not do this for me, but told me that I could call EVERY provider of MRIs in the state and make the determination on my own. What consumer is going to take the time to do this? Having a database that will show costs for medical procedures would solve this problem, would it not? Indeed, also knowing what neurologists in the state receive the best outcomes for patients who suffer from epilepsy would also allow me to spend my healthcare dollars in the most effective way. Many people today have Health Savings Accounts with high deductibles, meaning that they are responsible for 100% of their medical care costs up to the deductible amount (which in my case is $5,000). Should I be forced to only seek care within my community, where I have no choice of MRI providers as well as neurologists? Wouldn't competition be a GOOD THING? Wouldn't that also reveal providers who take advantage of their location to jack up prices for the consumer? I found an MRI provider in Wisconsin who offers flat rate MRIs, regardless of insurance, for $600. They publish this price on their website, and as such, physicians can help steer their patients to this very affordable option (and because of increased volume, they can offer this test at a very affordable rate.) Question, would you rather be out of pocket $3,000 or $600? Do I even need to ask this question?
I spent over 30 minutes watching the discussion online in the TN Government Oversight Committee on HB2289. At first, I was biased against this bill because of an email I received asking me to help defeat it. I also read a thoughtful post by Ken Marrero offering his reasons why he thinks this is a bad piece of legislation. Ken sees this bill as giving government access to our private healthcare information, but after watching the committee discussion, I believe his assessment amounts to "much ado about nothing."
The first thing I found interesting when listening to the discussion on this bill is that there is already legislation in TN regarding hospitals and their reporting to the TN Hospital Association that essentially includes much of what this bill desires to monitor. That information hospitals send to TN Hospital Assn INCLUDES personally identifiable information, and has for a long long time. Where is the outrage or desire to change that? (There isn't any.)
Secondly, our state spends billions of dollars on healthcare programs and treatment, yet we have no real means to find out if those programs are working. How might we go about collecting health outcome data as well as healthcare cost information without obtaining information like this? I am all for looking at how we spend our tax dollars and saying, "Is it working?" If we're not willing or able to do this, then I say, "Stop funding these programs NOW!"
Third, the information this database will collect, and that any third-party provider as part of this program will collect, does not in any way include any personally identifiable information to begin with. All that information is, by design of the system, not included in what the insurance companies submit. The TN system won't take it. It won't be part of the information collected period. Have you ever run a report from Excel on only SOME of the information you had stored in a spreadsheet? When you run that report, does data not associated with your report somehow make it into the report at all? Is it connected to the report? Can I get that information without rerunning the report? The answer is no. So not only will the insurance agencies NOT be including that data, but it will be encrypted twice before it ever makes it to the state for analysis.
I hope this bill will not be crippled due to partisan posturing; that would be a shame in my opinion. After watching the discussion within this committee, I also believe that many of those opposed to this bill simply do not have an understanding of technology, and are merely acting out of fear. Perhaps they see this as an "accident waiting to happen" so they want to vote against it and claim that they are "looking out for their constituents."
Just for the sake of argument, if these same legislators were discussing an electronic technology that would allow banks to issue cards to consumers by which they could make purchases at retailers across the state, as well as to obtain cash from these "mini banks" no matter where they are and even after banking hours, do you think that piece of legislation would ever see the light of day from this committee? "You mean to tell me that my constituent’s banking account information is going to be transmitted electronically?" "So what you are telling me, is that if this system were compromised, someone would have access to my constituent's checking account, and they could have all their hard-earned money stolen?" "How can we trust all the hundreds of thousands of retailers in the state to not abuse the information they will have access to when one of my constituents presents them with this card?" "The information is encrypted? What does that mean? Is there some sort of standard in place for this encryption, and if these is, should we really trust it?"
Indeed, electronic banking has been a part of our daily existence for decades, and we don't seem to worry much about this information being compromised, insomuch that we refuse to use a debit card to make purchases or to withdraw cash from an ATM. Sure, we are more judicious in where and how we use it, but for the most part, people do this on a daily basis without much thought. In the same way, the protocols and procedures that will be used to transmit this data (that has already been stripped of personally identifiable information by YOUR insurance company), are the same protocols used in electronic banking (protocol by National Institute of Standards and Technology). Additionally, this system will go above and beyond those privacy mandates outlined by HIPPA Legislation. If we do not trust this protocol for this healthcare information, then perhaps we need to revisit the same with banking.
Again, as a healthcare consumer, I hope this bill passes, as it will mean more affordable healthcare for all Tennesseans. As a taxpayer, I also hope this bill passes because it will create a way to measure the programs that my tax dollars are supporting. I am not a doctor, but I believe that HB2289 will cure what ails us.
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Silent No More: Are We Ready to Listen?
Fri. Apr. 17, 02:24pm EST
One hundred and fifty students gathered in 1996 in silence to echo the silence faced by LGBT people and their allies due to bullying and harrassment. In their silence, they wanted others to notice the voices that were not being heard. On April 15, 2009, more than 200,000 of those in the "silent majority" gathered in cities and towns across the country at Teaparty rallies to be silent no longer and let those in Washington know that they wanted their voices to be heard. Are all voices created equal as individuals and groups exercise their rights to be "heard" without fear of abuse and harassment, and more importantly, are we ready to actively listen?
Today is The Day of Silence, and according to www.dayofsilence.org, it is “a student-led action where concerned students, from middle school to college, take some form of a vow of silence to bring attention to the name-calling, bullying and harassment – in effect, the silencing – experienced by LGBT students and their allies.”
Students at the University of Virginia organized the first Day of Silence in 1996 with over 150 students, and today, according to the website, hundreds of thousands of students from more than 8,000 K-12 schools, colleges, and universities organized Day of Silence events in 2008.
When presented with stories of young students who have taken their lives due to bullying and harassment at school, most people shake their heads in disbelief that such cruelty continues to plague our schools. However, what we often do not do is connect the permission to name-call, harass, and bully that we grant those students with our own actions when we participate in similar behavior toward those with whom we disagree.
Is it possible that by “speaking our minds” to the “opposition” we give license to others to use the same taunting language to others? Does it matter what the taunting, name-calling, and harassing is about? Is it just as damaging to marginalize those with different sexual orientation, religious views, or race as it is to do the same with those who don’t share your same political affiliation or beliefs? Is it all poisoned fruit from the same tree and are we committed to treating ALL men and women with the same decency and respect, or are we allowed to pick and choose what is acceptable harassment and name-calling?
Gays are perverts! Conservatives are racists! Liberals are communists! Jews are….. it goes on and on and on.. fill in the blank. When we label others, we reduce them to mere abstractions and marginalize them. They are no longer individuals deserving of our respect, but are something to be attacked as an enemy. This is dangerous, and it is this sort of behavior that is dividing our nation and giving our youth license to taunt and tease, to pick and prod, to abuse and abandon the commitment we all share as citizens of this country to protect and support the Constitutional rights and freedoms of ALL men.
Perhaps we confuse the specific calls to action each of these individuals make upon our society with our obligation to respect them as people with unalienable rights? Indeed, only 150 students in 1996 assembled for the first Day of Silence. Did that number make their desire to be treated fairly and to be protected from harassment any less legitimate? In the same way, on Wednesday, April 15, 2009, more than 200,000 across the country gathered in cities and towns to stand against out of control spending in Washington, the doubling of the national debt, and a myriad of tax increases. That there weren’t two million or ten million people assembled does not make the cause any less legitimate to those who feel marginalized by both those who have been elected to represent them or by those who are using malicious words and taunts to silence them.
Ours is a country that allows for any individual or group to peacefully assemble and protest to be heard. We all share that right. We do not have to listen, but we all must understand that being heard is a function of our willingness to respectfully listen to others. Listening without the use of name-calling. Listening without the use of taunts and harassment. Treating others essentially how we would like to be treated. It is when we listen that we can understand where the other person is coming from, and we can enter into a productive debate to move the conversation forward, not backward into mistakes and missed opportunities of the past.
Do you agree with the Teaparty Movement? Maybe you do, maybe you don’t. Have you sought to listen, really listen to those on both sides without judgment about why they agree or disagree? Do you understand why they support their position? Do you understand why they feel hurt over the current state of affairs? Do you understand why they believe your protest is “a little too late” to be taken seriously? Does speaking up today negate not having spoken up in the past? Can I join a movement today with sincerity if I didn’t stand up for it yesterday? If not, what would that do to ALL movements who are constantly seeking to educate and inform more people about their cause? Should The Day of Silence have stopped at the original 150 in 1996? What about having the support and help of larger professional organizations? Does that negate the relevance of a movement? In 2001, GLSEN (Gay, Lesbian and Straight Education Network) officially began providing support and funding for The Day of Silence movement; their website provides action toolkits to help organizers at individuals schools launch individual campaigns in their areas. Does this somehow make the cause less important to the person working in their town to end harassment? Should the Teaparty Movement be forgotten forever because several national organizations joined in to offer support to those who desired it? Sure, five years transpired between the first Day of Silence and the support of GLSEN, but in today’s fast-paced, electronically connected world, movements can benefit from a much more rapid speed of organizing than was seen in years past.
No matter the cause and no matter the group, we should think twice about our words, how we use them, and how those words empower others to wage a new war against other marginalized groups. Be silent no more! Speak up! Stand up! We live in a great country; a country where even the few can stand up against the many to be heard. Are you ready to listen? Can you hear us now?
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Schenectady, NY: Public Safety not an "Obligation"?
Tue. Mar. 24, 06:38pm EST
In Schenectady, NY, Mayor Brian Stratton is considering as one possibility implementing martial law after a slew of officers have been charged recently with various crimes. Part of the article is printed below. Outside of the general adiminstrative and human resource failures this story highlights, I was most surprised to see the following comment by the city's corporate counsel, John Van Norden, who said:
"If you abolish the police department you still have a need - not an obligation - but a need to police the community. You would need something in transition. Declaring martial law would be one way to bridge the gap."
So according to Van Norden, providing public safety is simply a "need" and not "an obligation"? This, in my opinion, is what is wrong with our understanding of government and its role in our collective lives. I would wonder what the city deems its "obligations" to the citizens if not public safety? Compared to rural or unincorporated areas, people choose to live in incorporated cities and towns because they desire to pay the additional taxes for the services that those taxes provide: namely, police, fire, emergency, and solid waste collection services. These are things that individual citizens could not provide on their own (or even could not effectively do unless coordinated by a single government entity.) This may be a very simplified definition, but I dare say that there are many many programs that they could easily do away with under the "not an obligation" category in these tough economic times (and even if times were prosperous) that would better position the area for ongoing sustainable success. It is when you add all the "wants" and overtax the citizens, filling city coffers with millions of dollars, that people stop protecting and serving others, and start protecting and serving themselves.
SCHENECTADY, N.Y. -- Schenectady Police Chief Mark Chaires said, "This is unprecedented - all these officers getting in trouble at the same time for all these different reasons.
Five Schenectady police officers recently accused of everything from driving drunk to beating up a man are leading city officials to look at taking drastic action to fix a department tainted by the few who may have acted illegally, like Darren Lawrence and Michael Brown who are accused of driving while intoxicated.
Chief Chaires said, "Those two officers, we're definitely going to seek termination, and we're not ruling it out with any of the officers who are out there.
Police Chief Mark Chaires told us you basically have to fire yourself - essentially a million dollar fine in lost benefits over a lifetime.
Still, Schenectady Mayor Brian Stratton said, "We believe there are five officers now who could face possible termination."
But it's not just the threat of termination. Mayor Stratton told us he's looking at all options, including disbanding the police department - basically starting over.
"It's something we're certainly looking into. I think the public has had it up to here," said the mayor.
Currently, officials are reviewing the legal options and planning to present a full report in early April - options like a consolidated county-wide police force or bringing in the State Police.
The mayor said there is another option - and that would be declaring martial law. The governor would have to declare it and then the National Guard would come in. The mayor said it's more for a transition to a new police force if that were to happen.
He said, "It may be that as a stopgap measure, that you would need military forces - State Police, National Guard."
Mayor Stratton said the temporary measure would last until the new police force took over.
Schenectady's Corporation Counsel John Van Norden said, "If you abolish the police department you still have a need - not an obligation - but a need to police the community. You would need something in transition. Declaring martial law would be one way to bridge the gap. -
Rangel to the Nation: Tolerate THIS!
Tue. Mar. 17, 03:37pm EST
If we were to look up the word "tolerance" in the dictionary, we would no doubt see Rep. Charles Rangel's (D-NY) toothy grin smiling back from its pages.
It is no surprise then that just yesterday Rangel sponsored H.R. 246, Expressing Support for a National Week of Reflection and Tolerance.
Indeed, let us "reflect" up some of the many reasons the Citizens for Responsibility and Ethics in Washington (CREW) named Rangel among its list of "The 20 Most Corrupt Members of Congress."
- Improper leasing of rent controlled apartments in NYC;
- Improperly using Congressional stationary; and,
- Failing to disclose rental income on financial disclosure forms.
Never mind that as Chairman of the powerful House Ways and Means Committee Rangel should have known better.
In an article written by Aaron Kiersh in the Columbia University Spectator on February 23, 2009, Kiersh writes:
Still, Rangel remains unfazed by the controversy. Asked if he was worried about losing his committee chairmanship, Rangel responded with a smile as he walked out of the synagogue, saying, “That is a question that will be decided in 2010,” he said. “That’s an election year.”
Congressional blog correspondent Jason Matera with the DC Examiner got an even more telling response when he confronted Rangel for a piece that appeared on March 11, 2009. Matera was questioning Rangel's use of taxpayer money ($777 per month to be exact) to lease a luxury automobile for his personal transportation. Writes Matera:
Is it too much to ask that he lease this lavish car with his own money and not ours? He is worth between $566,000 and $1.2 million, after all, according to his official financial disclosure reports.
Rep. Rangel, what say you? Why should you drive a Cadillac paid for by tax dollars? He gave us his answer during our recent encounter: “Why don’t you mind your g-------d business?”
It seems clear that "tolerance" takes on a whole new meaning when viewed through the lens of Rangel's past. What we're being asked to "tolerate" is ongoing arrogance, corrupt actions, and a flagrant disregard for the very people whose votes elected them all into office in the first place.
Sure Charlie, we'll take a week and "reflect" on "tolerance" and "diversity" if that be your will, but there is a growing unrest among WE THE PEOPLE who do not like the image that is being reflected back to us in the mirror by you and your Congressional colleagues on both sides of the aisle. Let this be fair warning that we will NOT tolerate this any longer. Yes, we continued to re-elect corrupt Senators and Representatives, but NO MORE! If it is "diversity" you desire, then "diversity" you shall receive as we vote you and your corrupt and ineffective kind out and usher in fresh faces who will represent us and not their own self-interest.
What was that Charlie? You are going to put in a new water line and walking trail in my neighborhood? Oh, and fund a community center up near the old ball park? (The same ball park that is also going to get a new face-lift?) Hmmmm. Yeah, I did visit that jobs training center you funded two years ago when I lost my job. It was really nice. You mean you also gave money to my alma mater ten years ago when they were needing to add that new research and technology park, the one that I studied under when I was getting my degree?
OK Chuck, just PROMISE me that you won't do this again, alright? (And keep those earmarks coming!)
(The above conversation is fictional; however, it represents the real challenge that voters can have when trying to unseat an incumbent due to the practice of budgetary earmarks. It's all fine and well and good when it helps YOUR community, but when it's helping someone else's community, it suddenly seems rediculous. Just who is tolerating whom?)
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The American Spectator : Siegelman Still Guilty
I'm no "Dana Jill Simpson" mind you...
I would like to know what my friend Philip Bryan thinks about all of this. I feel like I need to draw out a flow-chart of the wild tall tales that have taken place over the course of this story. Read the details on the American Spectator's website below.
I will say that my interactions with Gov. Seigelman while working in Alabama were very friendly and positive. He was always good to our community, so I can't complain much in that regard. Also, I NEVER heard any rumors about infidelity to the sort that Dana Jill Simpson claims, and I think it is distasteful for anyone to allege something of that nature of anyone without witnessing it with their own eyes. I also never heard of Dana Jill Simpson. If Karl Rove were so smart, he would have picked someone with better access to Siegelman (which goes to show how absurd the whole story is to begin with).
from http://spectator.org/blog/2009/03/06/siegelman-still-guilty
