Here's how 'critical access' hospitals charge more for Medicare

To The Daily Sun,

There is a distinction in the classification of hospitals that is allowed by Medicare. That distinction is called Critical Access Hospitals. This is a term that identifies a hospital that provides health care for rural Americans. Medicare allows the states to designate their own Critical Access Hospitals.

New Hampshire has 13 such classified hospitals. They are: Alice Peck Day Memorial Hospital in Lebanon, Androscoggin Valley Hospital in Berlin, Cottage Hospital in Woodsville, Franklin Regional Hospital in Franklin, Huggins Hospital in Wolfeboro, Littleton Regional Hospital in Littleton, Monadnock Community Hospital in Peterborough, New London Hospital in New London, Speare Memorial Hospital in Plymouth, The Memorial Hospital in North Conway, Upper Connecticut Valley Hospital in Colebrook, Valley Regional Hospital in Claremont, and Weeks Medical Center in Lancaster.

A Critical Access Hospital is allowed to bill more of the cost to the Medicare beneficiary. Much more.

What usually happens is a hospital sends a bill to Medicare and Medicare (like most insurance companies) says we're going to pay this amount and it is a much smaller number (called the Medicare Approved Amount). Medicare then pays the hospital 80 percent of the much smaller number, and the Medicare beneficiary pays the remaining 20 percent of that much smaller number.

For a Critical Access Hospital it's different. The Critical Access Hospital sends the bill to Medicare and Medicare pays their usual 80 percent of the much smaller number (the Medicare Approved Amount), but then it makes the Medicare Beneficiary pay 20 percent of the big number.

Here is a real example of a Critical Access Hospital emergency room bill: Amount facility charged, $10,443; amount Medicare approved, $2,725; amount Medicare paid the facility, $2,180 (80 percent of the Medicare approved amount); amount Critical Access Hospital billed to beneficiary, $1,840 (20 percent of the amount facility charged).

If the facility were not a Critical Access hospital, the amount billed to the Medicare Beneficiary would have been 20 percent of the Medicare approved amount, or $545. That is $1,295 more charged to the person on Medicare who went to a Critical Access Hospital vs. one that did not, such as a person who went to Franklin Regional Hospital's emergency room as opposed to the Lakes Region General Hospital emergency room.

And this is true for any service you receive in a Critical Access Hospital, in-patient or out-patient.

Yet this practice is against the law for private insurance. The federal government is allowing charges to Medicare beneficiaries that states say are unfair. The offices of both New Hampshire and U.S. Senators say they are aware of this problem. Kelly Ayotte was quoted by NHPR as saying "patients of Critical Access Hospitals deserve to know up front how much they'll pay for services. " What, if anything, will be done remains to be seen.

I believe that Critical Access Hospitals should make sure to disclose this information up front. They won't. It is up to us to educate ourselves and spread the word. So now you know, tell everyone.

Louisa Simpson


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Tell us exactly how power has been taken away from the people

To The Daily Sun,

Don Ewing and others use the Tea Party to promulgate their lopsided philosophies. Tea Party adherents argue that their way is the right way and no other political entity is to be believed. The TEA Party demands that laws must apply equally to all Americans, says Don Ewing. He further states: "The TEA Party wants to re-establish our nation's founders' vision of a government near the middle of that spectrum with the primary purpose of protecting everyone's liberties so that each person has the maximum opportunity for achieving his or her own goals."

Very interesting when you consider the following excerpts from the Tea Party webpage:

1. We believe....that our government has grown out-of-control in a death spiral of unsustainable and barely imaginable trillion-dollar deficits.

Mr. Ewing needs to tell us just how this trillion dollar debt developed over the decades. He has to include those wars the U.S. has been involved in since George Bush's presidency. They were carried on without voting for funding to sustain them. The costs of these wars would have totally wiped out the entire national debt. The funds should have been appropriated to programs and crucial needs here in the United States. Keep in mind that President Obama is bringing home the troops from these theaters of war as he pledged to us in his first inaugural speech.

2. The Tea Party also believes that the government "daily drains away the individuality and entrepreneurial spirit of Americans in order to advance a radical, socialist*(see below) policy built on the backs of American taxpayers."

Mr. Ewing needs to tell us just how his Tea Party proposes to support the following entities at the federal and state and Ccty level: a) police and fire departments, b) public education,  c) departments of transportation and public works, d) Department of Justice (FBI, CIA, etc.),  e) a vital military and f) social services.

3. Our mission is to recruit like-minded Americans to the Tea Party Movement in order to advance the principles of limited government, fiscal restraint, and individual liberty at all levels of government through promotion and education.

Mr. Ewing needs to tell us why the Tea Party doesn't specifically target those politicians who work very few days of the year which receiving very good salaries, benefits and other perks. Why doesn't the Tea Party target secret PACs, lobbyists, and mega corporations who are now able to contribute untold millions of dollars to political campaigns without revealing their recipients? Why hasn't the Tea Party cried out about Citizens United which made corporations akin to people and has changed elections from "one person, one vote" into "one dollar, one vote"?

4. The Tea Party Movement is a grassroots movement of millions of like-minded Americans from all backgrounds and political parties. They share the core principles among which is "returning political power to the states and the people."

Mr. Ewing needs to tell us how the political power has been taken away from the states and the people.

During the recent election campaign I had the pleasure of attending a get together for Rep. Carol Shea-Porter. This event was held at a home in a private community. It was most troubling to see Tea Party members not only protesting in front of this community, but trespassing on private property to display their dislike of Rep. Shea-Porter. How does this demonstration further the cause of the Tea Party? What message is being sent by these individuals? At town halls and various meetings and open public forums throughout our region over the past four years, we have seen self-described Tea Party members display rudeness, lack of basic civility, and they have shouted down and talked over others and prevented others from being heard.

Mr. Ewing, the definition of *Socialism: a theory or system of social organization in which the means of production and distribution of goods are owned and controlled collectively or by the government. To say that our country is a socialist government is quite simply absurd and delusional. By the way, government means all of us, right? Aren't "we the people" members of that government? Aren't we a nation Of By and For the People? This nation has in fact evolved to being owned, run and dictated to by corporations and the One Percenters. Is this in fact what Mr. Ewing means when he states, "Our national government has shifted towards the absolute control end of the spectrum." Isn't it these very corporations who have slowly but surely taken away the rights of all Americans?

Mr. Ewing should address these concerns in his next letter to the editor. We are still awaiting an answer from Mr. Boutin concerning the programs and services put into law by the GOP for the good of all Americans: A request that was asked almost a year ago.

Bernadette Loesch


  • Category: Letters
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New Hampshire still ranks as the nation's seventh richest state

To The Daily Sun,

I am writing to respond to letters written Dec. 2 by Mr. Meade and Mr. Wiles.

Mr. Meade writes a half page column to tell us that God gave Adam and Eve all they needed to have a wonderful life, only asking them not to eat of the forbidden fruit.

Mr. Wiles uses a half page to tell us that Julius Caesar crossed that river in 49 BC. The Roman people were out of work and paying too many taxes and wanted the government to help them.

This is what I call up-to-date breaking news that we needed to know.

They could have at least told us that New Hampshire is still ranks as the seventh-richest state, with unemployment under 5 percent, lowest minimum wage in New England states, with gasoline costing $1.02 less than a year ago, fuel oil under $3 a gallon.

I was hoping that at least one right-winger would tell us all the good things we could expect now they have control of both houses of Congress.

Yes, I realize they don't have a clue. I have come to a conclusion (that will be another letter) though. I will say this much only once: that compared to the right-wing Rush Limbaugh wannabes of the Lakes Region, Steve Earle of Hill is a genius.

Henry Osmer


  • Category: Letters
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Thanks to Hart's for turkeys at Veterans Christmas Dinner

To The Daily Sun,

On Saturday, Nov. 29, the Sons of the American Legion Squadron of Meredith Legion Post 33 held its annual Veterans Christmas Dinner. The menu included turkey, ham, smoked venison, potatoes, vegetables and rolls with pie for dessert.

There was a bus full of veterans from the New Hampshire Veterans Home in Tilton and many other veterans present. Some from as far away as Westborough, Mass. They all enjoyed a great meal and also meeting with all in attendance.

Santa sent a very pretty Santa's helper to visit and for photos. Thanks Ms. Dori for your help. The SAL Squadron would like to thank Hart's Turkey Farm Restaurant for donating turkeys every year, George's Diner for donating the gravy, potatoes, and vegetables.

Also a big thank you to the Ladies Auxiliary for their help and support.

We could not do this without your help and support.

Barry B. Weeks

SAL Adjutant


  • Category: Letters
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I hop to see all of you at Saturday's Holiday Bazaar at Belknap Mill

To The Daily Sun,
What do all these towns — Atkinson, Belmont, Canterbury, Epsom, Franklin, Gilford, Goffstown, Gilmanton, Harrisville, Laconia, Loudon, Moultonborough, Northfield, Rumney, Sanbornton, Weare and Wolfeboro — have in common? Not sure how to answer that question? All these communities will be represented at the sixth annual Holiday Bazaar at the Belknap Mill on Dec. 13.

New Hampshire crafters and local businesses will treat shoppers to a wonderful variety of handcrafted items and food. Consider picking up those things you need to fill Christmas stockings, for a Yankee Swap or hostess gift, or for that hard-to-buy-for person on your list ... or maybe something just for you.

Here's some items you will find: Fudge, zucchini salsa, peanut and cashew brittle, spiced nuts, homemade jam, jellies, pickles, relish, chutney, gingerbread trees, soy candles, fragrance products, goat milk soap, lavender and balsam sachets, birch and lichen covered bird, hobbit and fairy houses, jewelry, dog and cat items, catnip mice, stenciled canvas gift totes, baskets, handbags and accessories, fabric and embroidered items, fleece jackets, vests and capes, baby and toddler sewn items, stuffed animals, American Girl doll clothes, oven mitts, potholders and pillows, eyeglass cases, handspun yarn, adult and children's aprons, crocheted snowflakes, doilies and table runners, wooden bowls, pens, wine bottle stoppers, rocking horses, salt and pepper mills, crocheted hats, boot cuffs, cowl and colorful scarves, crocheted pins, sweater mittens, glass block lights, holiday decorations, fabric and wooden ornaments, home décor items and much more. So, there's plenty to select for everyone on your holiday list!

The Belknap Mill Gift Shop offers items year-round, including books by local authors, note, greeting and holiday cards, postcards, artwork, socks made on the Mill's vintage machines, Darn Tough socks, maple syrup products and honey, hot sauce, jewelry, aerial and matted photographs and prints, jigsaw puzzles, walking sticks, Raku pottery, bird and bat houses, candles, soap, mittens, holiday decorations, ornaments created by the Boys & Girls Club of the Lakes Region, and other useful gifts. Young and old alike will enjoy touring the Riverside Gallery, powerhouse exhibit and knitting room where socks are made by volunteers.

I hope to see many friends and new customers at 25 Beacon Street East in Laconia on Saturday, Dec. 13, from 9 a.m. to 3 p.m. Support community crafters and the Belknap Mill — a historic Laconia building with treasures to explore. Our bake sale and craft raffle will benefit the Belknap Mill's historical, educational and cultural programs.

I want to thank the mill volunteers and staff for their assistance, as well as the returning crafters and new exhibitors joining us this year. Many crafters have donated items to the NH1 Children's Auction, so be sure to check out those items available for bidding starting on Dec. 9.

Please contact the Belknap Mill with any questions at 524-8813, visit or email This email address is being protected from spambots. You need JavaScript enabled to view it..

Merry Christmas and Happy New Year to All!

Judi Taggart

No Weare Else, Jewelry & Gifts


  • Category: Letters
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