THE US REPORT

The chair of the nutrition committee for the American Academy of Pediatrics is recommending cholesterol screening and drugs if needed for children with a family history of high cholesterol or heart disease. The new policy says screening should take place after age 2 and by age 10. If the numbers don’t look good, the policy suggests that for children older than 8, “cholesterol-reducing medications should be considered.” The thing to bear in mind is this is suggested in children believed to be in a high risk group or those who are obese. Is this more medical hype or is it a good idea?

I’d be hard-pressed to put my young child on any kind of drugs unless they’re vital to his or her staying alive. I’d ask my doctor, if I had young children, to be sure to only prescribe a drug tested for use in children. This would narrow the field, perhaps to zero. I would ask my doctor a whole lot of questions.

I’m not even sure about the screening. Have numbers been adapted to children, and how do you measure those numbers against growth spurts, something no parent can predict the timing on?  How about this money-saving idea?  If parents have a truly obese child or a child whose screening shows high cholesterol, would a modified diet and exercise help? And more important, would a nutrition class for the parents help? You can find a lot of information about the food pyramid and physical activity at the US Department of Agriculture website.

It seems to me because of the costs associated with healthcare, we’ve become a society obsessed with prevention. I understand trying to live a healthy lifestyle. But I don’t understand the increasing number of screenings I see recommended and in some cases, mandated. Is this more hype to create another line item in the Medicare revenue chain? One media outlet says "cholesterol drugs for kids could reduce heart attacks in adulthood." Really? Please cite the study that proves this claim. The studies the AAP based the new policy on, as far as I can tell, were done via autopsy for the most part. So if a person died accidentally and happened to have clogged arteries, can conclusions be applied to all children? Were there other risk factors?

The fact we’re even talking about screening a toddler for cholesterol and giving an elementary school aged kid drugs to reduce cholesterol seems to me like killing a mosquito with a cannon ball when a fly swatter works just fine. [Text filed by Kay B. Day; graphic courtesy USDA website.]

 

The Wall Street Journal's article about a new focus in the Salmonella-Tomato investigation is being picked up by many newspapers. This investigation has really hit Florida's tomato growers hard. I wrote about this at Covering Florida. I never believed the Salmonella was related to our state's crop simply because my family and I have eaten them in salads, homemade salsas (I grew my own Cilantro), and other dishes. We're fine.  Florida has had 2 cases of Salmonella. So I figure if this really had anything to do with The Sunshine State crop, we'd have way more cases than 2. Goes to show you an investigation like this can really be difficult. I hope the FDA is analyzing data carefully. I just don't understand how this can be such a difficult case. References below include links to a variety of articles and to the FDA page on the Salmonella serotype Saintpaul, which FDA says is uncommon. We probably have problems with Salmonella more than we realize. The illness isn't usually fatal for most of us and symptoms mimic what many refer to as "stomach flu."  The WSJ says now the FDA is looking at the possibility jalapeno peppers are the culprit in the Salmonella situation. Stay tuned, but make note of the numbers of Salmonella Staintpaul cases in each state on the CDC map below.

I keep hearing presidential candidates talk about change. I have to say it's high time the federal government changes. Gov. Mitt Romney's 'Washington is broken' tagline is an ever-present echo.

I ask myself if there's a candidate who can bring about change. So far, the Democrats have promised to raise taxes. No change there. The Republicans have promised to do something about securing the border, but declare (as do the Dems) something must be done about the millions already here illegally. No change there except for the millions in healthcare expenditures. 

In my opinion, the parties are  missing the boat. Candidates have promised change since the country was founded. What we need to do is go back to basics and do the job of running this country efficiently, eliminating fraud, waste and earmarks. Instead of change, I'd like to hear the word, 'Shrink.' We've built a monstrosity of government with structures canny administrators have grown into power blocs. Consider the relatively young US Dept. of Education. Consider the tons of money spent on nonessentials.

Our children cannot possibly fund the government we are building at present. Meanwhile, every time an American walks into a meeting at the UN, it costs the American taxpayer.

Change. That's the oldest pickup line in politics.

(filed by Kay B. Day)

Come see me today at the Ponte Vedra Beach, Fla., library, where I'll talk about writing during the panel sessions for the annual book fair. Full details are at Covering Florida.

The latest alleged US healthcare dollars ripoff occurred in Puerto Rico, to the tune of $922,882.00. On May 1st, a grand jury returned a 27-count indictment charging four doctors and two other individuals with conspiracy, health care fraud, soliciting and receiving kickbacks in relation to the Medicare Program, false statements and forfeiture allegations.  This is a drop in the mega bucket of wasted dollars.

Healthcare dollars wasted in virtual barbecue
I’ve often pointed out that if the federal government was a more responsible steward of our tax dollars, the money saved could fill many needs, such as health insurance for the working poor. The alleged Puerto Rican healthcare grifters worked in a similar manner to some Medicaid thieves in South Florida. Government officials say recent reports show as much as $2 billion a year may be lost in Florida’s $16 billion Medicaid program to fraud and abuse. So we’re talking one US government territory and one US state and more than $2 billion in fraud. Take a look at any other state and you’ll find your tax dollars are being burned with pleasure. In New York in 2006, indictments were issued for a Medicaid fraud ring involving a doctor, pharmacists, several city pharmacies, millions in fraudulent Medicaid billings and large monetary transfers to individuals in Pakistan. Sixteen individuals and five corporations have been indicted in the ongoing investigation and a civil action has been filed against twenty individuals and entities freezing assets and seeking the recovery of more than $22 million.

Consider this—these are the fraudulent bucks we know about largely thanks to cooperative investigations among top-notch law enforcement agencies and basically every level, from local cops to the US Justice Dept. Wanna have some fun? Enter the name of any state or US territory in your search bar and add the words, ‘Medicare fraud.’ Have fun and have lunch, dinner and breakfast the following morning while you’re at it. It’ll take you that long to read all the results for Medicare fraud in a single state.

Puerto Rican company sold durable medical equipment
In the Puerto Rico case, Doctor's Medical Supplies was a durable medical equipment (DME) company authorized to do business in Puerto Rico with its business office located in Luquillo, Puerto Rico, and registered as an authorized Medicare Part B DME supplier. Doctor's Medical Supplies submitted claims to Medicare, seeking reimbursements for DME, including oxygen services, motorized wheelchairs, and hospital beds, that were allegedly provided and medically necessary. During the time period listed in the indictment, Doctor's Medical Supplies submitted false claims for DME and received approximately $922,882.00 in Medicare reimbursements.

The main defendant, Rabindranaut Amrud-Ríos, also known as Rabin, submitted and caused the submission of false and fraudulent claims to Medicare. He is the owner and president of Doctor's Medical Supplies. Amrud-Rios oversaw the business and financial operations of Doctor's Medical Supplies. The "Physician Signers," as used in the Indictment, would sign prescriptions and certificates of medical necessity (CMNs) and were paid kickbacks by Amrud-Rios to sign the false CMNs. Amrud-Rios along with the other defendants listed in the indictment falsely and fraudulently represented that the medical conditions of the Medicare beneficiaries were such that DME, which included oxygen services, power wheelchairs, and hospital beds, were medically necessary when in fact the Medicare beneficiaries were either dead or did not suffer from such medical conditions and did not qualify to receive the DME under the Medicare regulations.

The names of the four doctors involved in the conspiracy are: Jaime Belardo, Narciso Reyes-Carrillo, José Figueroa-Pacheco, and Rafael Esteva-Heal. Also charged is Gladys Avilés, an employee of Doctor's Medical Supplies. The licensed doctors are charged with signing blank or previously completed false prescriptions and CMNs for Doctor's Medical Supplies. Each of the doctors was paid kickbacks by co-defendant Amrud-Ríos in exchange for signing blank or previously completed false CMNs for Doctor's Medical Supplies. Defendant Gladys Avilés was the employee of Doctor's Medical Supplies who completed blank and false CMNs for Doctor's Medical Supplies and submitted claims to Medicare based on those false CMNs.

Why aren’t the presidential candidates talking about this issue?
Health insurance is a hot topic as our presidential election draws near. Until the feds can manage the money we taxpayers already ante up, I really hope members of congress steer clear of raising income taxes. It’s like the same hope I have to win the lottery—ain’t gonna happen. But I’m already paying for mistakes that can actually be corrected at a basic level. That’s why we have federal government workers. It’s obvious Medicare needs better oversight. Why aren’t the candidates doing something about the fraud that could help those who need healthcare and can’t afford it? Sen. John McCain is a Republican. Here's a wakeup call, GOP—this is an issue handed to you on a silver platter. Especially since we read Sen. Barack Obama’s lips and he guarantees us he’ll raise our taxes. We anticipate he'll have lots of  help from the tax loving members of congress.

Why shouldn’t we focus on saving these dollars? Why don't politicians ever talk about it? Because it’s easier to just tax us? What do you think should be done to stop the burning of US tax dollars in healthcare fraud?

--filed by Kay B.Day

(Washington, DC)-A Wall Street Journal article by Scott Gottlieb caught my eye because it’s the first article I’ve seen that explores a specific policy area, healthcare, of the Dem presidential frontrunner Sen. Barack Obama. The article, ‘Obama’s Health Care Record,’ analyzes the impact of mandates on health insurers and the higher costs passed on to consumers. Gottlieb notes, “By my count, during Mr. Obama's tenure in the state Senate, 18 different laws came up for a vote and passed that imposed new mandates on private health insurance. Mr. Obama voted for all of them.”

I’ve had personal experience with mandates, though I don’t know if the mandate was facility-driven or government-enacted. When my younger daughter was 13, we took her to the emergency room. She had symptoms of appendicitis. The very first test my daughter had: a pregnancy test. We told them our daughter wasn’t sexually active. Didn’t matter. “We give them to all girls who are old enough to menstruate,” the nurse told us.

I was glad to see the WSJ article because for months now, I’ve been asking repeatedly why no one is willing to look not only at Obama’s specific record of deeds and actions, but also at every candidate’s history. Not the one you read on official bios, or the one you hear in campaign speeches, but at what the candidate actually did.
I keep reading about the senator’s work on behalf of the poor in Chicago. Specifics, please?

I did an archive search. By way of an article in the University of Chicago Chronicle, I did learn Obama participated in a panel on juvenile justice in 1997. One of Obama’s fellow panelists was William Ayers who at the time had a new book out. Ayers is known for his intense activism during the 1970s, a kind way to describe those who advocate setting off bombs to deliver a political message. Obama and Ayers were two of four speakers talking about the juvenile criminal justice system. Obama was described as “working to combat legislation that would put more juvenile offenders into the adult system.”

As an aside, I’d like to note I harbor some anger towards Ayers. The actions he and his fellows set in motion when I was in college had an impact even at our university in a small Southern state. In the early 70s our campus was conflicted by riots over the Vietnam War, out-of-state activists and rumors the Weather Underground Organization was coming to set off bombs. I remember someone setting off fireworks. Several students fainted. For weeks we were under a curfew mandated by the governor. Add in the fact we were having midterms. On every corner there was a soldier, actually a member of the National Guard, standing at attention with weapon ready. Going to class, work, the library or anywhere was a royal pain for weeks. Ayers was never convicted, but the Washington Post mentions a quote from September, 2001, from a story in the New York Times, “Although never convicted of any crime, he [Ayers] told the New York Times in September 2001, ‘I don't regret setting bombs...I feel we didn't do enough.’ That’s a great perspective to deliver to juvenile justice, right?

As a voter, I want to know more about a candidate who may well be our next president. When Obama worked for a law firm, what did he work on? Who’d he help sue? The Chicago Sun-Times did a think piece on Obama’s work there and elsewhere, in April, 2007. Were questions posed in the article ever answered?

As a voter, I want to believe we can have a candidate who will put aside racial prejudice, who will govern for the benefit of all (even those of us who work hard) and who will work to rise above partisan politics. But what I’m seeing is mostly campaign rhetoric.

The WSJ article notes, “The burden of paying for state mandates is usually borne by individuals who buy their own insurance, small employers and others not covered by ERISA. In total, about half of the people who have insurance bear the brunt of the cost of state mandates.” So I’d like to know why I am bearing the cost of those mandates, whether they’re testing 13 year old girls for pregnancy or extending coverage to unmarried dependents under the age of 30. I’d like to know the specifics, the nitty gritty and the down and dirty for every single presidential candidate. Isn’t that why we have a free press?

In 1990, as he was being interviewed after becoming the first black to head Harvard’s Law Review, Obama told the New York Times, “''I personally am interested in pushing a strong minority perspective. I'm fairly opinionated about this. But as president of the law review, I have a limited role as only first among equals.''

Tell us more about every candidate. And if we’re smart, we voters will ask for more.

(--filed by Kay B. Day; photo of White House grounds from White House website)