The Strangling Of American Hospitals

By Findalis of Monkey in the Middle

That is what is happening in many of the smaller Hospitals in the United States these days.  So it is being reported by Dr. Thomas M. Hamilton MD, better known as The Grouch.

We had staff meeting yesterday at the hospital. A topic of discussion was RAC audits and a specific case affecting our hospital.

If you don't know what RAC audits are, do a Google Search on it and read about it for yourself. I betcha most of you have never heard of such a thing.

Anyway, I felt compelled to write my Congresswoman, Marsha Blackburn, and my two Senators, Bob Corker and Lamar Alexander over this issue. I know I'll probably get the standard form reply, but it made me feel better anyway. Here it is:

Dear Senator/Congresswoman:

I feel the need to make you aware of the serious situation created for small hospitals under the RAC (Recovery Audit Contractor) program created by Medicare.

I am a physician at our local hospital. During staff meeting yesterday, we discussed a situation concerning a recent surgical case. A patient had a lesion surgically removed. The doctor’s note read as follows, “an eleven blade scalpel was used to remove the lesion”.

The RAC auditor reviewed this chart and stated that the note should have read, “an eleven blade scalpel was used to EXCISE the lesion”.

Because the word REMOVE was used instead of the word EXCISE, the RAC auditor declared that the hospital should refund Medicare an amount of $11,000. The hospital appealed and pointed out to the auditor that there was essentially no difference in the words EXCISE and REMOVE. To no avail, the auditor stated the hospital owed Medicare $11,000.

Senator/Congresswoman, these RAC audits are an exercise in pure lunacy. I hope you can see the obvious stupidity imposed on hospitals by the intrusion of the United States Government by this example above. I would also hope that you would take steps to relieve us of the burden of these nonsensical RAC audits. If you don’t, many hospitals like ours simply will not survive and will end up closing the doors.

It is my understanding that the bureaucrats involved in the RAC audits are entitled to a third of the funds they recover from hospitals. So out of that $11,000 dollars they are squeezing from our hospital over the definition of a single word, the auditors themselves stand to collect $3666.66 for themselves. Senator/Congresswoman, can you truly believe that hospitals will be treated fairly under such a system? If a private entity conducted itself in a manner similar to the RAC auditors, the people in that entity would be jailed.

Of course if Barack Obama has his way we will end up with single payer health care for all which will no doubt be broke like Social Security and Medicare. More and more hospitals will close. So much for universal health care.

Right now our hospital makes about 46 cents for every dollar billed to Medicare. We make 24 cents for every dollar billed to Tenncare (Tennessee Medicaid). I am told under the proposed Medicare cuts and RAC audits we can see our reimbursement fall to 32 cents for every dollar billed to Medicare. You can see we are slowly but surely being strangled by Uncle Sam. Our doctors, nurses, and other hospital staff work hard to provide health care to some very old and very sick people. We deserve honest payment for our efforts rather than a bunch of shenanigans invented by Medicare designed to avoid payment.

Senator/Congresswoman, I implore you to look into this thing called RAC audits. Talk to your constituents in the health care field. They will tell you the same thing I am telling you. We are being strangled by this government nonsense.

I am looking for a personal and thoughtful reply from you on this matter, not the usual form reply provided by a staffer.

Sincerely,

Thomas M. Hamilton MD.

Finish reading here.

I find it troubling that the "auditor" receives a "reward" of 1/3 of all monies collected, thus discouraging a true audit of books since it is in the auditor's best interest to "find" fault in every search.

Thus the word Excise, meaning to cut out or off, as a tumor. And the word Remove, meaning to take away, withdraw, or eliminate is not considered equal in intent.  This auditor has taken it upon his/herself to become the standard exemplary of the English Language.

This is only one example of what is happening now and will happen when Obamacare is implemented in its full force.

Is it no wonder that thousands of doctors are planning to leave the profession.  Where will the government find their replacements?

Will a doctor trained in one of those nations instill confidence in you?

Pass this along to others, this corruption has to be stopped!

Orrin Hatch Declares War on Reconciliation: Permanent Damage to Parties

Senator Orrin Hatch (R-UT) says there will be an "all-out political war" if Democrats turn to reconciliation to pass their health care reform. That's not all. Hatch believes if reconciliation is employed, it will cause "permanent" harm to any hope of bipartisanship.

Senator Hatch is expecting that war; he expects Democrats to "go to reconciliation," and "promised a new high in partisan tensions," if they do.

The day after the President's State of the Union, with Obama admonishing Republicans for their tone, and asking for bipartisanship, Hatch said he didn't believe Democrats will participate in bipartisanship [my interpretation of his remarks]:

"They haven't acted in good faith on this, nor do I expect that they will," he said in an interview with The Salt Lake Tribune . "I expect them to go to reconciliation."...

Hatch said Thursday that using reconciliation would be "one of the worst grabs for power in the history of the country" that would permanently impact relations between the two parties.

"It is going to be outright war and it should be, because it would be such an abuse of the reconciliation rules," Hatch said. "If they abuse those rules it is going to lead to even more heated animosities between not just the two parties, but even between individual senators." 

Reconciliation allows one party to bypass a filibuster and pass legislation with a simple majority - 51 votes, rather than 60 votes needed to avoid filibuster.

Hat Tip to Hot Air - read their commentary, and Senatus

More on Senator Hatch: Government in Control of Everything - Including College Football?

More on "Bipartisanship:"
Marsha Blackburn Questions Obama at Baltimore Conference

Paul Ryan Questions Obama on Budget: Obama Runs for the Hills

Obama Says Health Care Centrist: Angry, Delusional President (videos)

Marsha Blackburn Questions Obama at Baltimore Conference

Rep. Marsha Blackburn (R-TN) questioned President Obama today at the GOP's Issues Conference in Balitmore.

Blackburn got right to it: Republican's have ideas. Here's how that conversation went:

Mr. President.
And thank you for acknowledging that we have ideas on health care. Because, indeed, we do have ideas. We have plans. We have over 50 bills. We have lots of amendments that would bring health care ideas to the forefront.

We would -- we've got plans to lower cost, to change purchasing models, address medical liability, insurance accountability, chronic and preexisting conditions, and access to affordable care for those with those conditions, insurance portability, expanded access, but not doing it with creating more government, more bureaucracy and more cost for the American taxpayer.

And we look forward to sharing those ideas with you. We want to work with you on health reform and making certain that we do it in an affordable, cost-effective way that is going to reduce bureaucracy, reduce government interference and reduce costs to individuals and to taxpayers.

And if those good ideas aren't making it to you, maybe it's the House Democrat leadership that is an impediment instead of a conduit.

OBAMA: Well, no . . .

(CROSSTALK)

BLACKBURN: But we're concerned also that there are lessons learned from public option health care plans that maybe are not being heeded. And certainly in my state of Tennessee, we were the test case for public option health care in 1994. And our Democrat government has even cautioned that maybe our experiences there would provide some lessons learned that should be heeded and would provide guidance for us to go forward.

And as you said, what we should be doing is tossing old ideas out, bad ideas out, and moving forward and refining good ideas. And certainly we would welcome that opportunity.

So my question to you is, when will we look forward to starting anew and sitting down with you to put all of these ideas on the table, to look at these lessons learned, to benefit from that experience, and to produce a product that is going to reduce government interference, reduce cost and be fair to the American taxpayer?

Obama says he has gotten "many" of the Republican ideas, looked at them, considered some of them. He said the idea of selling health insurance across state lines is complicated, and some minimum standards have to be instituted. As an example, he mentioned women must be able to get mammograms - that's after his panel of experts said they are NOT needed annually.

The man wants to control everything. He has no experience in the health care field, yet...I thought this amazing:

If you can show me and if I get confirmation from health care experts, people who know the system and how it works, including doctors and nurses, ways of reducing people's premiums, covering those who do not have insurance, making it more affordable for small businesses, having insurance reforms that ensure people have insurance even when they've got preexisting conditions, that their coverage is not dropped just because they're sick, that young people right out of college or as they're entering in the workforce can still get health insurance -- if those component parts are things that you care about and want to do, I'm game. 

He mentions that there are some "stray cats" in the health care bill that Democrats are working to eliminate - "scrubbing" it, he said. He fails to mention that he pushed for the finished bill on his desk by Christmas. Guess it wasn't necessary for those "stray cats" to be eliminated, if they just could have gotten the darned bill signed.

It was during Blackburn's question that Obama says:

You've given yourselves very little room to work in a bipartisan ashion because what you've been telling your constituents, "This guy's doing all kinds of crazy stuff that's going to destroy America."

And I -- I would just say that we have to think about tone.

See that video here.

More on Republican Action:
Orrin Hatch Declares War on Reconciliation: Permanent Damage to Parties

Rep. Paul Ryan Questions Obama on Budget: Obama Runs for the Hills

Michele Bachmann Tea Party Convention Drop-Out: Marsha Blackburn Tea Party Convention Drop-Out: Breitbart Introduces Palin at Tea Party Convention

Congresswomen Michelle Bachmann (R-Minn-6th) and Marsha Blackburn (R-TN-7th) have dropped out of participating in the February Tea Party Nation Convention in February. Governor Sarah Palin is slated to be the keynote speaker. With Blackburn dropping out, conservative blogger-extraordinaire will introduce Palin.

The convention is a for-profit venture by Judson Phillips, a Tennessee lawyer, who says he hopes to make a profit. Rep. Bachmann was also scheduled to speak at the event to be held at Opryland Resort in Nashville.

A spokesman emphasizes that Bachmann has a problem with this particular event, not the tea party movement in general. In fact, another group—the Tea Party Patriots—is claiming credit. "We put pressure on Bachmann, and we're glad that she didn't go," a coordinator tells the St. Paul Pioneer Press, "I'm glad that she did the right thing."

Bachmann was to speak at a Saturday breakfast event. She would have not have received a speaking fee. 

From pricey tickets to Palin's reported $100,000 speaking fee, tea partiers recently have objected to the convention as out of line with the group's values. Backdahl and other Minnesota tea partiers do not plan to attend.

Rep. Marsha Blackburn (R-TN) was scheduled to introduce Sarah Palin, but said she is bowing out because the "non-profit status" put her in "an awkward position." Look at this twist:

 The decision follows protests over the Feb. 4-6 event's $549 cost and Palin's reported $100,000 speaking fee, which some members of the Taxed Enough Already movement thought was too pricey for grassroots activists. The Mid-South TEA party's spokesman, Jim Tomasik of Cordova, has called the Nashville event an effort by the Republican Party to co-opt the movement.

 The latest report is that Andrew Breitbart will now introduce Palin.

To confuse matters, there is this quote:

A founder of Tea Party Nation recently told the New York Times that it is "not a nonprofit."