In Cleveland, ex-hero LeBron James now seen as zero -

December 2, 2010 · Posted in The Capitol · Comments Off 

In Cleveland, ex-hero LeBron James now seen as zero
The anti-LeBron James feeling that has been building up in Cleveland will almost certainly be on display when the Heat play the Cavaliers. Derrick Tatum, left, and Ralph Reynolds hold up shirts and buttons they created and are selling under the label
Return of LeBron James Spurs Cleveland Fans to Open Their Wallets Not ArmsBloomberg
He's back: King James returns to ClevelandSeattle Times
In Akron, fond feelings remain for longtime hometown hero LeBron JamesPlain Dealer
Austin American-Statesman -The Detroit News -Kansas City Star
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Sports - Google News

In Cleveland, ex-hero LeBron James now seen as zero -

December 1, 2010 · Posted in The Capitol · Comments Off
In Cleveland, ex-hero LeBron James now seen as zero
The anti-LeBron James feeling that has been building up in Cleveland will almost certainly be on display when the Heat play the Cavaliers. BY ISRAEL GUTIERREZ CLEVELAND — This city no longer bows to one man. Instead, driving into this blue-collar
Cavaliers and LeBron meet again on Thursday nightKansas City Star
Cavs owner hires firm to prove Heat tampered in pursuing
On to Cleveland: James, Heat beat Pistons 97-72USA Today
Detroit Free Press
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Sports - Google News

Jimmy Carter: Palin is one of the most dynamic speakers I’ve ever seen

November 30, 2010 · Posted in The Capitol · Comment 

I am no fan of Jimmy Carter. The guy was a horrible president, and we see President Obama following the same path of his disastrous presidency.

However, in an interview, Carter shocked me with his complimentary comments about Sarah Palin.

He called her a dynamic, eloquent, and formidable candidate.

Liberty Pundits Blog

The Reality of 24/7 Home Care of a Loved One With Alzheimer’s: The Family Caregivers who are front line soldiers doing all the work, are seen by government as only ‘informal support…’

November 24, 2010 · Posted in The Capitol · Comment 

During this holiday, we can be thankful for those who labor 24/7 to care for our elderly and our broken mind ones. This is a Guest Contributor on The Reality of 24/7 Home Care of a Loved One With Alzheimer’s: The Family Caregivers who are front line soldiers doing all the work, are seen by government as only ‘informal support…’

by Carol Wright
Far from the purple banners of the recent “Alzheimer’s awareness” events sit an estimated 6.6 million family caregivers for an estimated 5.5 Alzheimer’s sufferers (nobody really knows the exact figures for either group.) Compare that with 300 million people in the US total +/-. It’s a lot of disabled people, a lot of caregivers who cannot work outside the home while caregiving in the home.

Some of these caregivers include supportive extended family, but all too many caregivers are toiling alone and unpaid, caring for a frail senior suffering from dementia. This often means, an aging woman caring for her elderly parents, a senior spouse struggling to keep their loved one home, out of the nursing home just one more month.

The recent “Shriver Report: A Woman’s Nation Takes on Alzheimer’s,” emphasizes that it’s the women who overwhelmingly take on caregiving duties.

But some light should fall in the corners too: More than a few families have forsaken their own. Often just a single brave, compassionate soul steps forward for that end of life walk with the afflicted one. Their other relatives, their own children, their own sisters, brothers, former friends, even spouses, turn away or come around only once in a very long while for a very few minutes.

“Informal support.” This is what we 24/7 caregivers are most recently called by government and parroted by media, we who tend to our loved ones day in and day out.

“Informal.” Inferring not serious work, when in fact each day caring at home for an Alzheimer’s patient is deadly serious work of lifting, hauling, hefting, guiding, feeding, issues of urine, feces, medicine, cooking, cleaning, bathing, laundry and so much more.

Sole caregivers are especially brutalized by this burden, and they catch the flack, the very bulldozing brunt impact of frontline dementia care. The hours can be 24 on and zero off. Days are seven on and on and on.

Perhaps a neighbor comes for a few hours to seniorsit so the caregiver can get a break that is not a break. It’s scramble to shop for groceries, medicines. To rake up the leaves so the grass doesn’t die. Take dying cat to the vet and have put to sleep. Get back before patience of friend wears thin, or person with dementia gets out of control. Hope for no sudden feces situation, or friend will not return again.

“Informal support.” Caregiverscannot snag a full night’s sleep. Often their charges are up half the night, pulling out drawers and emptying on the floor. There is assistance needed always with trips to the commode and changing protective pads on the bed. Start first load of laundry for the day at 3 am. In our house, my mother wakes up screaming about something “out there…out THERE!…oh gawd gawd!” Last night it was a fire she saw, which was really a shiny birthday hat. I spent hours extinguishing a birthday hat, reassuring my mother, and even after removing such and other items from environs, my mother continues to no longer be able to tell the real from the imagined.

“Informal support.” Communicating with someone who has dementia is often like herding cats, and one has to, in order to help with the most simple actions, give repetitive instructions for every phase of aid. “Put foot through here, no through …. the pant leg…this here. Put your foot through here. Your FOOT. Point your TOE, now foot…”

“Informal support.” Often the day comes when the outbursts need more meds (some will say). This happened to my mother. She had unexplained nausea after a fall, and I took her for many tests in the ER. No answers, and not better. Finally a four-day stay in the hospital. She had a few delusional/puzzled episodes while there, and she pushed away prodding, hurtful hands. She was labeled “combative; they said, We’ll try Seroquel.”

Two months later, my mother slumped to the side her chair so much I had to tie her in to keep her from falling. I stood guard so she wouldn’t be hurt while she thrashed in bed, now padded everywhere. Sometimes she stiffened, slid from her chair like a 2×6 board. Now on the floor, face contorted, tongue choking, eyes rolling.

I see a Seroquel TV ad with voice-over droning “Not for use by elderly dementia patients.” I see Mom writhing on floor. Is this advancing Alzheimer’s demanding a larger dose or ?? Who will tell us? I plead. Doctors don’t know. Or different docs give different answers. I research online. So many of the bad side effects -she has them! Her doctors have made my mother straightjacket insane. We stop the Seroquel, but Mom is switched then to Ativan to stop paranoia. The Ativan leads to chilling paranoia as Mom channels cold eyes up from the DeadZone.

“Informal support.” Each family caregiver is front line to strong daily challenges like these, often complicated by illnesses anyone might come down with. Deafness and dementia. Leukemia and diabetes…and dementia. Colon cancer…and dementia. Congested nasal passages and dementia.
“Informal support.” Caregivers carry the brunt of the work at great personal sacrifice on every level, their health and dental go downhill, they are not able to earn income, a certain amount of sanity that one has charge of one’s own life goes out the window. A social life; there is none. An eroded future occurs because a dedicated caregiver has no idea when this vigil might draw to a close, and can only plan to remain in situ.

For caregivers, there is little outside direct assistance available. We’re not even in the system noted as having a need. No cash grants, no benefits, no medical or dental coverage for us in any quarter; there are no unemployment checks. Some benefits overshoot the caregiver; the patient is qualified (vets qualify for some home caregiving hours) but payments go to licensed caregivers only, not to family members. Government sees the home caregiver as a resource until worn out, then tossed aside when parent dies or is placed in a nursing home. The governments, state, local, federal…the corporations… call it “informal support.”
I cannot quite tell you what it is like to be surrounded on almost all sides by government ‘officials,’ people who say do this or that with what meagher resources are left to us, medical personnel of many different and often opposing ideas, deadbeat relatives, drug companies… too often many wear a smug face of impunity. Something goes wrong, say a bad drug reaction, or financial abuse by a government employee who is supposed to have squeaky clean and timely oversight… it is only the sole caregiver who is cornered, totally responsible for others’ errors, lateness, underperformance. It’s the caretaker who has to scrounge, beg, step up threadbare. Everyone else walks free.

The Shriver Report and Alzheimer’s Association step up their action plans. I poked around the Alzheimer’s Association website to see if there was a hint of direct aid to family caregivers. In the report at
I read the summary report and recommendations. There I could finally see myself. Twice was I, the unpaid family caregiver, mentioned as “informal support.” Unpaid family caregiver. Excuse me, INFORMAL?? Recommendations to help us, even informally? There was nothing written to help us. Nothing. Big report, but nothing’s changed. Things are stable and predictable according to report writers. No support will be given to ‘informal support’ that is, human beings who nearly single-handedly are giving all they’ve got, now, again or it seems ever.
I wondered: Was this moniker “informal support” commonly used in studies, theses, and legislation. I Googled the term, and found this to be true. Basically, it means our caregiving is a “contribution.” Not a life and death necessity to keep a loved one as safe as possible, clean and fed and helped in whatever way we can… and without leave.
And as Maria Shriver points out in “The Shriver Report: A Woman’s Nation Takes on Alzheimer’s,” three-fifths of the US caregivers are women. “The truth is,” she writes, “it’s women who are the ones who generally do the hands-on grunt work of caregiving—cleaning their parents or spouses and changing their diapers, feeding them, babysitting them, dispensing medicine to them. While men do represent about a third of family caregivers, they tend to arrange or supervise outside services.”

The time is now for direct support for the family caregiver.
Researching the cause and treatments for Alzheimer’s or other diseases tends to draw the most attention and official funding.
But please, it is now time to actively support the real FORMAL caregivers on the front lines of eldercare, the family caregiver. Caregivers need assistance with respite care (typically the only aid offered), and though there is now some protection for caregivers to some day, perhaps, return to a job they may have left to take on caregiving duties… that assumes a short duration and no pay throughout. But, Alzheimers disease, is not a killer like cancer per se. It is a disorder that makes a person eventually as helpless to care for themselves as a new born infant, though often combative as well but with the body of an adult. And a person with dementia and no other illness can live to be in their nineties, as my mother is presently, and beyond.
What about people like me with so far over eight years sacrificed of sole caregiving? We need help with medical and dental, and with reentry into the work force.
I suggest a few simple approaches to help the formal family caregiver continue in their important duties and caregiving. One idea is to give the family caregiver payments in a “like amount” in a kind of disability pay. If their loved one is fully disabled from dementia, then the caregiver is also “disabled from being able to earn a living”—which is so true—anyone who has ever cared for a person with dementia, in home, knows one has to stop even a home business, for the loved one needs constant aid and supervision.
Another solution is to make the family caregiver eligible for welfare, full Medicare and Social Security benefits while care giving. If the caregiver returns to the workforce, then benefits are stopped until normally eligible at x age. This kind of approach does not add a whole layer of bureaucracy, no new programs; it just extends eligibility to a new level, to a new recipient.
But, how to replace the phrase “informal support” that so covers over the often desperate reality? I note a visible name change in the daily news is the change from “illegal alien” to “undocumented immigrant.” However, the immigrant issue is always hot news, where family caregiver headlines (until last month’s of Maria Shriver’s media appearances) are nonexistent. The term “Informal support” generally shows up in studies, scholarly theses, and reports; and these reports and studies are often the basis for legislation and grant requests, and carry the profound bias of naming THE essential caregiver as some seeming ‘nice but not necessary’ support. But what an impact this diminuizing term has had on the real front line for PFCG? That’s me, primary female caregiver.)
My next article will deal with what is called the Beers Criteria, a list of medications and protocols for weaning elderly patients off some of their prescription drugs. This drug free approach has resulted in a dramatic improvement in my mother’s mental and physical condition for periods of time. Three months ago, she was slumped over and headed for hospice. Most recently, she is attentively watching a DVD about a Cuban jazz musician while reading “National Enquirer.” This past week, we had to go to the ER, however. It is as they say, a roller coaster ride, of needs and aid to the one who has Alzheimers. It does not have an ending point.
Guest columnist Carol Wright was 54 when she left her home where she’d lived for the past eighteen years, to travel across three states to care for her mother in her final few months of life. That was 8.5 years ago. Carol has been primary, sole caregiver for her mother all this time, and has had some respite caregiver assistance only for the past year. She recently was honored as Caregiver of the Month by the Caregiver’s Voice here.

You can read and see more about her caregiving experience at her blogs here and here, and at and at YouTube

The Shriver Report’s book, written with the Alzheimer’s Association, is titled “A Woman’s Nation Takes on Alzheimer’s”; it is available in ebook format for $ 9.99. You can read excerpts here.
Government report from 1998 showing expectation that women shoulder the burden and take on the sacrifices of eldercare, and that their growing preference to stay in the workplace will rock the boat. Basically, the government assumes women will/should contribute this service, and their choice to now stay at their careers is a troublesome trend. Read more here.
There are a few programs to help pay family caregivers, and resources will vary from state to state. Read this article from the Alzheimer’s Association website.

The Moderate Voice

Obama Seen As Biggest Impediment To Middle East Peace

November 22, 2010 · Posted in The Capitol · Comment 

There isn’t much that unites the leadership of Israel and The Palestinian Authority these days, but they do all seem to agree that the President of the United States has been more of a hindrance to peace than a help:

Vowing to change a region that has resisted the best efforts of presidents and prime ministers past, Barack Obama dove head first into the Middle East peace process on his second day in office.

He was supposed to be different. His personal identity, his momentum, his charisma and his promise of a fresh start would fundamentally alter America’s relations with the Muslim world and settle one of its bitterest grievances.

Two years later, he has managed to forge surprising unanimity on at least one topic: Barack Obama. A visit here finds both Israelis and Palestinians blame him for the current stalemate — just as they blame one another.

Instead of becoming a heady triumph of his diplomatic skill and special insight, Obama’s peace process is viewed almost universally in Israel as a mistake-riddled fantasy. And far from becoming the transcendent figure in a centuries-old drama, Obama has become just another frustrated player on a hardened Mideast landscape.

The attitude among Israeli leaders shouldn’t be all that surprising. Ever since the Netenyahu government began his second tour as Prime Minister only a few months after Obama himself too office, there have been reports of tension and of an attitude among Israelis that Obama couldn’t be trusted the way previous American Presidents could.  That situation has, it seems, only gotten worse:

The American president has been diminished, even in an era without active hostilities between Israelis and Palestinians. His demands on the parties appear to shrink each month, with the path to a grand peace settlement narrowing to the vanishing point. The lack of Israeli faith in him and his process has them using the talks to extract more tangible security assurances — the jets. And though America remains beloved, Obama is about as popular here as he is in Oklahoma. A Jerusalem Post poll in May found 9 percent of Israelis consider Obama “pro-Israel,” while 48 percent say he’s “pro-Palestinian.”

Other polling in Israel shows a growing gap between aspirations for peace and the faith that it can happen. One survey last month found that 72 percent of Israelis favor negotiations, while only 33 percent think they can bear fruit. (Palestinians show a smaller gap, primarily because a smaller majority favors negotiations.)

Obama has resisted advisers’ suggestions that he travel to Israel or speak directly to Israelis as he has to Muslims in Egypt, Turkey and Indonesia.

“Israelis really hate Obama’s guts,” said Shmuel Rosner, a columnist for two leading Israeli newspapers. “We used to trust Americans to act like Americans, and this guy is like a European leader.”

Many senior Israeli leaders have concluded that Hillary Clinton and John McCain were right about Obama’s naiveté and inexperience.

“The naive liberals who are at the heart of the administration really believe in all the misconceptions the Palestinians and all their friends all over the world are trying to place,” said Yossi Kuperwasser, a former high-ranking military intelligence officer who is now deputy director general of the Ministry of Strategic Affairs.

Kuperwasser, like other Israelis, bridled at the suggestion that the country’s dislike of Obama draws from the Muslim influences of his heritage — or even his name.

“It drives me crazy. Who cares that his middle name is Hussein? It’s the last thing we care about. [To suggest that] is just anti-Semitism,” he said. “There is one reason why we are hesitant about this guy: He doesn’t understand us.”

And the Palestinians don’t have any more faith than the Israelis that the process that Obama has set them down holds any possibility of succeeding:

Palestinian leaders say they, too — for different reasons — are losing faith in the political talks.

“[Netanyahu] has a chance, and he’s wasting it,” said the chief Palestinian negotiator, Saeb Erakat. “Given the chance between settlements and peace, he’s always chosen settlements.”

The advocacy director of the American Task Force on Palestine, Ghaith al-Omari, said the frustration in Ramallah isn’t only with Netanyahu.

Abbas and other Palestinian leaders are “personally fed up with the whole thing,” he said, and “losing faith in the process, both with the Israeli willingness to deliver and the Americans’ ability to deliver the Israelis.”

And, it seems President Obama’s insistence on focusing on the settlement issue is what has virtually guaranteed that his peace process will fail:

“If Obama wanted to be a transformational figure, he would never have led with the settlements,” said Eyal Arad, the architect of Livni’s campaign for prime minister. He argues - like most Israelis - that Obama inadvertently got talks hung up on a matter of irrelevant principle, rather than engaging the reality that some settlements can stay while others must go.

“The settlements were pushed by a bunch of left-wingers who were out of sync with the realities and were out of government too long,” he said. “The irony is that Obama went directly back to the place where George Bush the father left off.”

Jackson Diehl picks up on this point in today’s Washington Post, arguing that Obama is spending far too much time trying to repeat the foreign policy mistakes of the past:

The Obama administration is devoting a big share of its diplomatic time and capital to curbing Israeli settlement construction in the West Bank - most recently, offering Israel’s right-wing government $ 3 billion in warplanes in exchange for a 90-day moratorium. Meanwhile, it has committed much of its dwindling domestic political capital to pushing a new nuclear arms control treaty with Russia through a reluctant Senate.


The same might be said about Obama’s preoccupation with stopping Israel’s settlement expansion in the West Bank and Jerusalem - a campaign that even Palestinian and Arab leaders have watched with bafflement. True, almost everyone outside Israel regards the construction as counterproductive, and only a minority supports it inside Israel.

But that is just the point: The dream of a “greater Israel” died more than 15 years ago. Even the Israeli right now accepts that a Palestinian state will be created in the West Bank. The settlements have become a sideshow; the real issues concern how to create a Palestinian state in a Middle East where the greatest threat is not Israeli but Iranian expansionism. What to do about Hamas and Hezbollah and their Iranian-supplied weapons? How to ensure that the post-occupation West Bank does not become another Iranian base? Those issues did not exist in 1983 - and the Obama administration seems to have no strategy for them.

So instead of dealing with the issues that matter, not to mention the ones on which real progress could be made, the United States is trying to force the Israelis and Palestinians to reach a deal on an issue that has been on the table for twenty-seven years with no real sign that compromise is any closer now than it was when Ronald Reagan was President and Menchahem Begin,  Yitzhak Shamir, and Yassir Arafat were in charge. It’s truly a puzzle as to why Obama would be going down this path when there are better avenues for real progress.

Jennifer Rubin at Commentary posits several explanations for Obama’s current policy bent in the Middle East, all of which she ultimately find unsatisfying:

Obama’s foreign policy is made all the more curious by the fact that sometimes he gets it right. Obama, however reluctantly, has followed the Bush approach in Iraq and attempted to duplicate it in Afghanistan. In these areas he’s departed from the leftist playbook and to a large extent followed the advice of the one truly expert national security guru he has: Gen. David Petraeus. So go figure.

Perhaps it comes down to this: only when faced with the prospect of a massive loss of American credibility (e.g., a defeat in Afghanistan), a severe domestic backlash (American Jews’ falling out with him), or resolute opposition (from Israel on Jerusalem) does Obama do what is smart and productive for American interests. In other words, only when exhausting all other opportunities and trying every which way to force his ideologically driven preferences does he stumble upon a reasonable outcome. This, if true, contains a powerful lesson for Israel, for Obama’s domestic critics, and for our other allies: hang tough, be clear about the Obama administration’s errors, and don’t blink. Chances are, he will instead.

Not that Rubin’s theory should be a comfort to anyone, of course. It describes a rudderless foreign policy being led by a man who, deep down, doesn’t really care too much about the issues he’s dealing with, perhaps because he prefers to concentrate on domestic and economic issues. That’s foolish even in the best of times, and dangerous if and when things turn bad.

Outside the Beltway

Cher - You Haven’t Seen The Last Of Me

November 21, 2010 · Posted in The Capitol · Comment 

The album version of Cher’s first single from Burlesque is rather standard Diane Warren bombastic schlock. This Almighty mix is actually pretty great.

Joe. My. God.

Seen Pumping Septic Tanks in Bismarck

November 12, 2010 · Posted in The Capitol · Comment 

On a tip from wingmann.


Matthews: Had You Seen This Hillary Clinton in 2008 She Might Be President

November 10, 2010 · Posted in The Capitol · Comment 

Chris Matthews is suddenly getting a thrill up his leg for somebody other than Barack Obama.

On Tuesday's "Hardball," before playing a video clip of the Secretary of State joking around with some comedians in Australia, the host told his viewers, "Had you seen this Hillary Clinton back in 2008, I think a lot of people would have made her president" (video follows with transcript and commentary):

read more blogs

Matthews: Had You Seen This Hillary Clinton in 2008 She Might Be President

November 10, 2010 · Posted in The Capitol · Comment 

Chris Matthews is suddenly getting a thrill up his leg for somebody other than Barack Obama.

On Tuesday's "Hardball," before playing a video clip of the Secretary of State joking around with some comedians in Australia, the host told his viewers, "Had you seen this Hillary Clinton back in 2008, I think a lot of people would have made her president" (video follows with transcript and commentary):

read more - Exposing Liberal Media Bias

The Seen and the Unseen

November 5, 2010 · Posted in The Capitol · Comment 

By Sallie James

Quote of the day from outgoing Chairman (and soon-to-be Ranking Member) of the House Agriculture Committee, Collin Peterson (D., MN):

“I’ll be able to take care of sugar, that’s not even a question,” Peterson said. “We’ll keep the same program; it doesn’t cost anything. That won’t be hard.”

(Source: the North Dakota InForum, which has many more gems from the Chairman about why the election is not a problem for Big Ag)

Au contraire, Mr Peterson.  The U.S. sugar program costs sugar consumers, including food manufacturers, billions of dollars a year, by the government’s own figures.

I just love the way that so many politicians (and bureaucrats) assume that if something doesn’t show up as a line item in the budget, then it is essentially free.  Tens of thousands of pages added to the Federal Register every year, placing staggering regulatory burdens on business? Costless! The immense inconvenience to travellers and business people from debilitating lines at airports because of security measures? No need to consider them against any supposed security benefits; they’re paid for by the fairies. And the sugar program, which shifts the burden of supporting sugar prices onto consumers rather than taxpayers? Well, it simply “doesn’t cost anything.”

For more of Cato’s work on sugar policy, see here,  here, and here.

The Seen and the Unseen is a post from Cato @ Liberty - Cato Institute Blog

Cato @ Liberty

OTB Exclusive: No Black Panthers Seen at Polling Place

November 2, 2010 · Posted in The Capitol · Comment 

***OTB Exclusive - Must Cite OTB - OTB Exclusive***

I just returned from voting in Virginia’s 11th Congressional District.   At my polling place, there were no New Black Panthers, Old Black Panthers, or Refurbished Black Panthers.  In fact, there didn’t appear to be any black animals of any sort.

There was an African American woman manning the M-Z book, but she wasn’t wearing a beret or otherwise intimidating.   She was sitting next to an elderly white lady who had the A-L book.

Oddly, however, there was a black man at a precinct in Philadelphia.

Outside the Beltway

OTB Exclusive: No Black Panthers Seen at Polling Place

November 2, 2010 · Posted in The Capitol · Comment 

***OTB Exclusive - Must Cite OTB - OTB Exclusive***

I just returned from voting in Virginia’s 11th Congressional District.   At my polling place, there were no New Black Panthers, Old Black Panthers, or Refurbished Black Panthers.  In fact, there didn’t appear to be any black animals of any sort.

There was an African American woman manning the M-Z book, but she wasn’t wearing a beret or otherwise intimidating.   She was sitting next to an elderly white lady who had the A-L book.

Oddly, however, there was a black man at a precinct in Philadelphia.

Outside the Beltway

“The Spookiest Jack-o’-lantern I’ve Ever Seen”

November 1, 2010 · Posted in The Capitol · Comment 

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The Daily Dish | By Andrew Sullivan

147,000 Rail Riders in Entire Year in Ohio Seen as ‘Demand for Transportation Choice’

October 29, 2010 · Posted in The Capitol · Comment 

Buckeye State residents are supposed to be impressed with media reports like this one from WXIX in Cincinnati telling us that passenger rail ridership increased 14% last year to almost 147,000.

That's just over 400 people a day. In the whole state. Spread over seven station stops in multiple cities. You've got to be kidding me.

Context, people.

read more - Exposing Liberal Media Bias

Once Seen As Victors Of Health Reform, Hospitals Now Turning Against Democrats In The Midterms

October 21, 2010 · Posted in The Capitol · Comment 

hospitalmoneyJon Walker notices that the American Hospital Association — which had agreed to accept $ 155 billion in payment reductions over ten years if health reform covered at least 94% of Americans and didn’t include a public option — is now turning against the administration and “spending hundreds of thousands of dollars to help elect Republicans this November.”

On one hand, the news is not too surprising. The industry believes that helping elect Republicans will probably bring about looser regulations and less strenuous spending cuts from the Independent Payment Advisory Board (IPAB), which the GOP has promised to repeal. On the other hand, while all of the health care interest groups won important concessions from the new law, none were more successful than the hospital industry. During the 15 months beginning in January 2009 and ending in March, when Congress passed the Affordable Care Act, hospitals spent approximately $ 108 million on lobbying and got a lot for their effort.

Here are the cuts they accepted:

- Lowering the annual update rates paid to hospitals.

- Reducing Medicare payments for excessive and preventable readmissions.

- Lowering bonus payments for hospitals who treat the undeserved: Currently the government pays about $ 45 billion dollars a year in DSH payments to help hospitals afford uncompensated care. Since health care reform will insure 34 million Americans over a 10-year period, the number of ‘uncompensated’ care cases will decrease by as much as 80%, but DSH payments will only be cut by some 15%.

But, as the Tennessee Hospital Association’s (THA) concluded, the above cuts would still allow hospitals to net about $ 16 billion from reform. “The breakdown estimates that the industry will receive additional money of about $ 171 billion over those same 10 years as a result of reimbursements for newly insured patients…In other words, the hospitals would give up $ 155 billion in cost cuts, but take in $ 171 billion in new money — a net gain of $ 16 billion. What’s more, the Tennessee association notes that the deal delays most of the industry’s cost givebacks until the second half the agreement’s 10-year year period — well after the hospitals have enjoyed some of the benefits of the new money they’re expecting from expanded insurance coverage.”

“[T]he bond prices and stock prices will tell you that most hospitals are winners, at least in this bill,” Thomas Scully, who ran CMS from 2001 to 2004, explained at a recent roundtable for Health Affairs. “Assuming there are no subsequent bills, hospitals are probably the biggest winners. They got hardly touched and got a lot of new money,” Scully said.

Hospitals are also protected from cuts under IPAB through 2019 — but as their latest political manoeuvrings suggest, that still wasn’t good enough. After all, why tolerate any cuts — no matter how far into the future — when you there is a good chance that you can help elect a party that will make them all go away?

Wonk Room

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