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Michelle Malkin - Obamacare's EMR mandate is also a wreck

Dr. Nicholas DiNubile, a Philadelphia orthopedic surgeon, has a timely reminder for everyone encountering the federal health care exchange meltdown: "If you think signing up for Obamacare is a nightmare, ask your doctor how the EMR mandate is going."

Bingo.

The White House finally acknowledged the spectacular public disaster of Obamacare's Internet exchange infrastructure during Monday's Rose Garden infomercial. But President Shamwow and his sales team are AWOL on the bureaucratic ravages of the federal electronic medical records mandate. Modernized data collection is a worthy goal, of course. But distracted doctors are seeing "more pixels than patients," Dr. DiNubile observes, and the EMR edict is foisting "dangerous user-unfriendly technology" on physicians and patients.

Instead of concentrating on care, doctors face exhausting regulatory battles over the definition of "meaningful use" of technology, skyrocketing costs and unwarranted Big Brother intrusions on the practice of medicine.

As I reported last year, Obamacare's top-down, tax-subsidized, job-killing, privacy-undermining electronic record-sharing scheme has been a big fat bust. More than $4 billion in "incentives" has been doled out to force doctors and hospitals to convert and upgrade by 2015. But favored EMR vendors, including Obama bundler Judy Faulkner's Epic Systems, have undermined rather than enhanced interoperability. Oversight remains lax. And after hyping the alleged benefits for nearly a decade, the RAND Corporation finally 'fessed up that its cost-savings predictions of $81 billion a year — used repeatedly to support the Obama EMR mandate — were (like every other Obamacare promise) vastly overstated.

In June, the Annals of Emergency Medicine published a study warning that the "rush to capitalize on the huge federal investment of $30 billion for the adoption of electronic medical records led to some unfortunate and unintended consequences" tied to "communication failure, poor data display, wrong order/wrong patient errors and alert fatigue." Also this summer, Massachusetts reported that 60 percent of doctors could not meet the EMR mandate and face potential loss of their licenses in 2015. And a few weeks ago, the American College of Physicians pleaded with the feds to delay the mandate's data collection, certification and reporting requirements.

Dr. Hayward K. Zwerling, an internal medicine physician in Massachusetts who is also president of ComChart Medical Software, blasted the Obamacare EMR mandate in a recent open letter: "As the developer of an EMR, I sincerely believe that a well-designed EMR is a useful tool for many practices. However, the federal and state government's misguided obsession to stipulate which features must be in the EMRs, and how the physician should use the EMRs in the exam room places the politicians in the middle of the exam room between the patient and the physician, and seriously disrupts the physician-patient relationship." Zwerling's call to arms appealed to fellow doctors to pressure the feds to repeal the mandate. "It is past time that physicians reclaim control of their offices, if not the practice of medicine."
As I've mentioned previously, my own primary care physician in Colorado Springs quit her regular practice and converted to "concierge care" because of the EMR imposition. Dr. Henry Smith, a Pennsylvania pulmonary doctor, also walked away. "Faced with the implementation costs and skyrocketing overhead in general," he told me, "I finally threw in the towel and closed my practice." He said, "As EMRs proliferate, and increased Medicare scrutiny looms, medical documentation is evolving from its original goal of recording what actually was going on with a patient, and what the provider was actually thinking, to sterile boilerplate documents designed to justify the highest billing codes."

Dr. Michael Laidlaw of Rocklin, Calif., told EHR Practice Consultants that he abandoned the Obamacare EMR "incentive" program "when I realized that I spent the first two to five minutes of each visit endlessly clicking a bunch of garbage to make all the green lights show up on the (meaningful use) meter. I said to myself: 'I'm not wasting precious seconds of my life and my patients' time to ensure some database gets filled with data. I didn't go into medicine for this. It is not benefiting my patients or me. I hate it.' I actually refused to take the $10K-plus this year. I have even accepted that I would rather be penalized in the future. What is worth the most to me is AUTONOMY."

Let me underscore that again: Doctors face steep penalties if they can't meet the radical technology goals imposed by the very same glitch-plagued Obamacare bureaucrats who now need an emergency "tech surge" to fix their own failed info-tech Titanic. The Obamacare wrecking ball has only just begun.

(Syndicated columnist Michelle Malkin is the daughter of Filipino Immigrants. She was born in Philadelphia, raised in southern New Jersey and now lives with her husband and daughter in Colorado. Her weekly column is carried by more than 100 newspapers.)

Last Updated on Thursday, 24 October 2013 08:37

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Froma Harrop - Bipartisanship the norm when sugar payoffs rule

Ever notice how some government programs draw the ire of almost everyone? Conservatives, liberals, environmentalists, libertarians, business, labor, consumers and grouchy taxpayers are all opposed. Yet these programs go on as though directed by an unstoppable particle beam from a neighboring galaxy. The public rarely sees who in Washington keeps the outrage in motion, and that's how "they" get away with it.

The sugar support program is one such curiosity. We will get into the "who" and "how," but first an explanation of why almost everyone hates it.

Americans pay about three times the world price of sugar because of a complex farm program designed to greatly enrich U.S. sugar growers and processors, in actuality a handful of families. Among other things, it limits imports of far cheaper sugar from impoverished Caribbean countries. It provides taxpayer-backed loans: If prices slip, the borrowers repay their loans with sugar, which taxpayers must sell at a loss or store at their own expense.

In sum, the policy provides a government-guaranteed income to cane sugar producers in Florida and sugar beet growers in Minnesota and Michigan. Who pays? American consumers, for starters. The manipulated price of sugar amounts to a tax estimated at $3 billion a year.

The domestic sugar industry argues that 142,000 jobs would be lost if the sugar program ended. But the Commerce Department reported in 2006 that inflated sugar prices kill three manufacturing jobs for every sugar-growing and -processing job saved. Many U.S. candy-makers have seen no choice but to move factories and their jobs to countries with normal sugar prices. Among the examples:

— Atkinson Candy Co., of Lufkin, Texas, recently sent most of its peppermint candy production to Guatemala. "It's a damn shame," company President Eric Atkinson told The Wall Street Journal, he had to move 60 jobs to Central America that should have stayed here.

— Jelly Belly Candy Co., based in Fairfield, Calif., has again expanded its factory in Thailand. Sugar makes up half the cost of the product, Jelly Belly President Bob Simpson said. High U.S. sugar costs have forced him to raise his prices several times over the past 10 years.
Reluctant to take their small family-owned businesses to other countries, domestic candy-makers had been reducing the amount of sugar in their product. It is no accident that from 2002 to 2012, imported candy contained 33 percent more sugar.

As Congress debated last spring whether to continue the program, Big Sugar's lobbying force, the American Sugar Alliance, ran an ad in The Washington Post, hotly headlined "Big Candy's Greed." The candy-makers, the ad charged, were trying "to boost their already bloated profits."

In Florida, meanwhile, the giant sugar plantations — propped up by taxpayers and abused consumers — dump fertilizer runoff into the Everglades, threatening the state's precious water sources.

It should surprise no one that the American Sugar Alliance greatly out-spent the confectioners to win the affections of our elected representatives. Thus, in a recent close vote, the House again saved the program. Followers of partisan politics will be intrigued to see so-called liberals combining with so-called conservatives to preserve this travesty.

On the Democratic side, Florida Reps. Debbie Wasserman Schultz and Alcee Hastings both voted for the program. On the Republican side, House Speaker John Boehner and Rep. Frank Lucas, of Oklahoma and chair of the House Agriculture Committee, also voted in favor. As he backed the government shutdown, Lucas was speechifying for a budget "that reduces spending and eliminates waste and abuse in government programs."

How the politicians get away with this is simple: The voters aren't paying attention. Only when they do will this absurdity stop.

(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)

 

Last Updated on Wednesday, 31 December 1969 07:00

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Michael Barone - Unions turn on Obamacare; don't call them hypocrites

It's not just Republicans who are unhappy with Obamacare. Labor union leaders have been complaining too.

In July, the presidents of the Teamsters, United Food Commercial Workers union and UNITE-HERE (combined membership: 2.9 million) wrote a letter to congressional Democrats saying that Obamacare will "destroy the very health and well-being of our members along with millions of other working Americans." "We have a problem," they concluded. "You need to fix it."

Forget for a moment that organized labor supported Obamacare. The union leaders have arguably legitimate complaints.

Obamacare does indeed create incentives for employers to reduce the workweek below 30 hours. It also discourages the high-benefit "Cadillac plans" that unions have negotiated — and that are one thing they can promise workers in organization drives.

Obamacare taxes premiums on non-profit, multi-employer union plans that cover, for example, workers in multiple small restaurants. And the people in these plans won't be eligible for subsidies available to policyholders in for-profit insurers.

The union leaders were understandably ticked at the "huge accommodation for the employer community — extending the statutorily mandated 'December 31, 2013' deadline for the employer mandate and penalties."

Like many other Americans, they are angry that President Obama refused to fulfill his constitutional duty to faithfully execute the law.

On a late Friday afternoon in September — the same timing as the employer mandate delay in July — the Obama administration denied the unions' request that workers with multi-employer health plans receive subsidies on the exchanges. To which Terry O'Sullivan, president of the Laborers International Union, said he wanted the law "fixed, fixed, fixed" and, if not, "then I believe it needs to be repealed."

Consistent opponents of Obamacare might take satisfaction from these complaints. And they might observe that the unions backed legislation that tends to encourage union members to drop union plans and to prevent unions from attracting new members by promising Cadillac plans. They got what they deserved.

I take a somewhat different view. Over many decades, union leaders have supported legislation that extends to non-members benefits unions have secured for members. They have consistently supported higher minimum wages — arguably because they bump up (already higher) union wages — ignoring the strong evidence that higher minimums reduce low-skill employment.

They supported the creation of the Occupational Health and Safety Administration and of the Employee Retirement Income Security Act regulating pensions, even though such legislation, by extending benefits to non-union workers, made them less likely to feel a need for union representation. You don't need a shop steward if you have an OSHA inspector.
And in fact, union representation in the private sector has plummeted in the last three decades. Unions' support of such legislation, and of Obamacare, may have been self-destructive. But it could also be characterized as altruistic. Many union leaders saw extending to non-members what they believed they extended to members. People like to do well, but they also want to do good.

Let me cite two professions that worked to put themselves out of much business, out of altruism.

Firefighters are the first example. Firefighter unions and other organizations have actively promoted safer building codes, restrictions on use of flammable materials and unsafe building materials. These firefighters have lifted the charred bodies of dead children out of burnt-out buildings. They have seen families destroyed by needless fires. They have worked to prevent such tragedies. And worked successfully: There are much fewer fires than there used to be.

Firefighters have done themselves out of business. They spend most of their time now on routine services, which less expensive EMS personnel could handle, and their unions struggle to prevent layoffs.

Another altruistic profession is dentistry. For many decades, dental groups have promoted fluoridation of water. They have vigorously encouraged people to brush — and floss — thrice daily. In their practices, they have seen the pain people suffer from because of defective teeth and painful abscesses. They want to reduce such suffering. As a result, Americans have far fewer cavities and dentists have far less routine work than they did some years ago. In response, they have developed new specialties — peridontry, enamelizing, orthodonture.

Sure, all these professions are out to get, in the words of the classic union leader Samuel Gompers, "more."

But labor leaders, firefighters and dentists have also acted, at risk of losing business, out of altruism, to help others. Let's give union leaders some credit for that, even as they decry a law they supported.

(Syndicated columnist Michael Barone is senior political analyst for The Washington Examiner, is a resident fellow at the American Enterprise Institute, a Fox News Channel contributor and co-author of The Almanac of American Politics.)

 

Last Updated on Wednesday, 31 December 1969 07:00

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Froma Harrop - California conquers partisan warfare

California has found a formula for ending the partisan warfare that once paralyzed its government: Get rid of one of the parties, in this case, the Republican. The state's famously dysfunctional government now hums with calm efficiency.
Democrats there hold a supermajority in the state Legislature, making it well-nigh impossible for Republicans to gum up their plans. The governor, Jerry Brown, is a Democrat, as well.
The nation might avail itself of a similar solution, given the Republican leadership's inability to stop a destructive minority from threatening America's credit rating and turning the country into a global laughingstock (the way California used to be). Moving the House of Representatives into Democratic hands might give us all a needed rest.
But one-party rule can only be a temporary fix. It leads to corruption and arrogance. A Democratic frolic untempered by a sophisticated opposition would soon sour in the mouths of a centrist electorate.
Furthermore, it is California's good fortune that Brown is a business-savvy pragmatist able to fight off liberal excesses in his party. For example, he vetoed a bill that, shockingly, would have let non-citizens serve on juries. Brown has also been careful to keep a moderately tight rein on spending.
Looking long term, the really important thing happening in California is not the partisan takeover but the political makeover. In 2008 and 2010, California voters passed measures that yanked the pencil for drawing political boundaries out of their politicians' grasp. Before then, incumbents could scheme to stuff their districts with like-thinking voters.
The new law also ditched party primaries. The top two vote-getters in an open primary — from whatever party or no party — get to appear on the general election ballot. Thus, a Republican may end up running against another Republican, a Democrat against another Democrat, or either against a Whig.
Ironically, this may be the saving grace for California's much-shrunken GOP. As districts become more politically diverse, Republican right-wingers — with their inflamed imaginings and inexplicable amount of free time — see their power to produce sure losers curbed.
Activists on the left also have a harder time creating safe districts. Gone is the 200-mile snake paralleling the liberal coastline around Los Angeles, custom-tailored for former Democratic Rep. Howard Berman.
Under the reforms, a nonpartisan commission drew the lines in a more squared-off shape. Berman's snake was fattened to include the less liberal inland, represented by another Democrat, Brad Sherman. The two ran against each other in November, and Sherman prevailed. One could envision a temperate Republican doing okay here, especially if the national party takes the asylum back from the inmates.
Sacramento is now a model of quiet efficiency. The state's new health insurance exchange is off and running with minimal drama. And there's even a move to ease some environmental regulations at the behest of business.
Other states have embarked on reforms designed to undo the district lines concocted in their capitals' smoky rooms. Iowa, Washington, Arizona and Idaho have been leaders in this, but California has gone the furthest. Oregon is debating whether to adopt its model.
This new way of conducting elections does more than weaken the partisans' ability to limit our choices in November. It recognizes the growing proportion of unaffiliated voters, 21 percent in California, up from 18 percent in 2005. Over half the states have closed primaries, meaning those belonging to no party have little say until Election Day.
Gerrymandering built safe congressional districts for the most bizarre tea party candidates. Republicans might hesitate to create opportunity for conservative Democrats, but not doing so — look at their nosedive in national polls — should alarm them more.
California's Democrats took the risk. So should they.

(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)

Last Updated on Monday, 21 October 2013 09:30

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Pat Buchanan - Republican cravenness & cowardice has lasted too long

"We told you you would lose!" wail the Beltway bundlers of the Republican establishment.

"We told you you would lose!" moan neoconservative columnists from their privileged perches on the op-ed pages of the Beltway press.

"Look at what Ted Cruz and this Tea Party people did to us," wails the GOP establishment. "Look what has happened to our brand." And 2014 was looking wonderful.

What a basket of wimps.

While the political and communications strategy of the fight to defund Obama seems not to have been thought through, can someone explain what else a moral and principled Republican party could have done in the continuing resolution, other than try to defund Obamacare? Have we lost sight of what a monstrosity this is? It is an immense new entitlement program being hoisted upon a nation whose back is now breaking from Great Society entitlements.

Obamacare forces Catholics to provide sterilization and abortion-inducing drugs that trample upon traditional teachings about how they are to live their lives. Recent days have exposed employers cutting back workers to 29 hours, insurance premiums surging, doctors rebelling. Obamacare moves America inexorably toward a national health care system such as they have in socialist Great Britain.

Finally, the rollout of Obamacare by Kathleen Sebelius' Department of Health and Human Services has made the rollouts of Edsel and New Coke look like marketing triumphs.

How could any principled Republican conservative vote to impose this moral, fiscal, social and technological disaster upon our country?

Here was the recommended Beltway GOP strategy: House Republicans should vote to fund Obamacare in a clean CR. Then exploit the disaster of the rollout to show what a horror it is. This will pump up our polls and improve our field position for 2014. Then we can pick up some seats!

Bottom line: Let's vote to impose Obamacare on America and make Democrats pay the price of the calamity we voted to impose. Now there may be a more cynical strategy than deliberately doing permanent damage to your country to help your party. Right now, I just can't think of it.

A party that would do such a thing would not only not deserve office; it would raise valid questions about the reasons for its continued existence. If this is how Republicans will behave when facing a decision on moral and political principle, why would conservatives want such a crowd representing them?

The Beltway GOP had best step back and take a hard look at the nation they are supposed to defend. A decades-long failure to address mass immigration has brought to our shores scores of millions now being moved wholesale to ballot boxes to vote the Party of Reagan out of power forever. With GOP collusion, the welfare state has grown so immense — with half the nation paying no income taxes and half now reaping benefits — Republicans who stand for fiscal sanity face increasingly insuperable numbers in many states.

With the Greatest Generation and Silent Generations passing on, Baby Boomers, the largest generation in history, are two years into Social Security and Medicare. Those programs are exploding, as the share of our working population is steadily sinking.

Real incomes of Americans are stagnant. Since George H. W. Bush, we have run $10 trillion in trade deficits no one mentions but can be seen in the gleaming cities of Asia and East China and the corroded and collapsing infrastructure of America. Though the debt is hitting $17 trillion and the Fed prints a trillion a year to buy up paper, T-bills and mortgage-backed securities, the U.S. growth rate remains anemic by historic standards.

Query: Did the Tea Party do all this to America, or was this caused by colossal Washington stupidity and legendary Wall Street greed?

Republican cravenness and cowardice before the commands of political correctness has gone on so long that the natural response to capitulate now appears a conditioned reflex of the Beltway Party. Yet, how, without standing and fighting against the inexorable drive to remake our republic into a socialist democracy, where tax consumers are endlessly milking tax producers in a steadily debilitating and dying economy, do Republicans think they are going to stop this? Or is their hidden agenda simply bipartisan comity and smiling acceptance of an endless series of retreats until the outcome is irreversible? Whatever one may say of the House Republican majority at least they fought.

When his troops were in a funk, FDR used to say, "Get me a bill down here I can veto!" What FDR meant was — Let's start a fight with the Republicans; that will get the boys' morale back up. That's what Republicans need now. They should tell the Democrats there will be no new taxes in any budget deal, and if there is no deal, the sequester rolls on. Then they should demand that the incompetent at HHS be fired and her entire entourage with her. Unless, of course, the party fears it might be charged with waging a "war on women."

(Syndicated columnist Pat Buchanan has been a senior advisor to three presidents, twice a candidate for the Republican presidential nomination and the presidential nominee of the Reform Party in 2000. He won the New Hampshire Republican Primary in 1996.)

Last Updated on Wednesday, 31 December 1969 07:00

Hits: 250

 
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