The Consequences of Shutting Down Grady Hospital and Its Political Implications

As I mentioned earlier, Grady Hospital has joined a dubious category when the JCAHO threatened to revoke its accreditation. Only King Drew in California was ever threatened with such an extreme measure. An investigation by the L.A. Times that was ultimately highlighted by this story forced JCAHO's hand.

Despite a long history of problems at Martin Luther King Jr.-Harbor Hospital, two things set the Rodriguez case apart: the existence of a security videotape showing the woman writhing for 45 minutes on the floor of the emergency room lobby and the public release this week of two 911 calls in which witnesses unsuccessfully pleaded with sheriff's dispatchers for help.

In the case of Grady Hospital, it was community activists, not the media, that alerted JCAHO to problems. Since Grady won't release the findings we don't know what specific problems there are yet. Of course, one only needs to read these pages to know the sorts of horrors that have happened at Grady Hospital.

One night that is what happened. One time he was left in charge of the entire step down unit from 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

I set this context so everyone understands what a total nightmare Grady Hospital is right now. Keep in mind that Grady's current financial crisis is in many ways divorced from the findings of the JCAHO report. In other words, whatever patient nightmares were going on at King Drew, they didn't also experience a financial crisis concurrently. King Drew was ultimately forced to shut down. That is a distinct possibility for Grady as well.

I believe shutting down Grady would create an even bigger nightmare with all sorts of unintended consequences and frankly a situation no one can predict or control. Let's lay out some numbers. Grady Hospital serves roughly one million patients per year. It has five thousand employees and contributes roughly 1.5 billion dollars to the economy in the area. Despite only serving two of Georgia's roughly 100 counties, Grady provides some or all of the training to one quarter of Georgia's doctors. Ninety percent of the staff at Grady is from Emory University with about 400 residents from there on staff at any given time. The entire medical school of Morehouse is trained at Grady Hospital as well. Grady Hospital has about nine hundred beds available. For comparison, South Fulton, the other hospital primarily for poor folks in the area, has 36 beds.

Its important to understand that Grady serves the poor, the indigent, almost exclusively. More importantly, in Fulton, Dekalb, and to some extent the surrounding counties, the poor and indigent are almost exclusively served by Grady. In the case of King Drew there were several other area hospitals that were also already serving the poor. Not so in the case of Grady. Without Grady Hospital the poor would be unleashed on the entire remaining health care system that remains. As a friend in Atlanta once told me

there's no way they will close Grady because the other hospitals don't want their patients

Keep in mind that most of the folks that go to Grady either have no insurance or Medicare at best. In other words, treating them is in no way a for profit operation. Soouth Fulton is the only other public hospital in the area, and there is no way it could handle the entire indigent population of Fulton and Dekalb Counties. Furthermore, Grady is the only level 1 trauma center for hundreds of miles. Severe gun shot wounds, bad car accidents, dismemberments, and other such traumas are all treated there and there only for hundreds of miles. Many times other neighboring states have their level one traumas treated there. In case of a terrorist attack, it would be Grady that would be the only hospital equipped to handle mass casualties in the area.

Furthermore, since Grady is also the main teaching hospital in Georgia, the entire health care teaching system would be traumatized. With 25% of the doctors receiving some or all of their training at Grady, the impact on the medical training is beyond words. Emory's medical school would be the equivalent Northeast Texas State Community College and Morehouse would cease to exist altogether.

I recently pointed out the absurdity of AJC reporter Mike King's column in which he called Grady board members arrogant for making demands not requests in their time of crisis. I doubt very much that you will find anyone in the Atlanta area media that will ever break down Grady's impact the way I just have, however I am certain the powers that be at Grady know full well the numbers that I have laid out. In other words, crisis or not the powers that be know what a vital part of Georgia Grady is and thus they can afford to be arrogant.

This context has political impact and it is also something that I do not believe the Atlanta media will ever explain properly either. Late last month, the Grady board approved a plan that would infuse Grady with much needed cash and make the board quasi private. The timing of this move is very important because it came right before JCAHO's announcement. While this plan purports to deal with Grady's fiscal issues, it in no way addresses the obvious medical care problems currently going on at Grady. Frankly, given the make up of the task force that recommended this plan, as well as other factors, I have already concluded that this quasi privatization plan is nothing more than a stunt that allows the powers that be to continue running Grady the exact same way only with even less oversight.

Now, I believe that the legislators and the Grady board are playing a high stakes game of chicken. It is frankly difficult to surmise which is worse: allowing a corrupt Grady to continue to operate or shutting it down and unleashing its patients on the rest of the medical system and disrupting the states medical education. It is even more dificult to figure out which is the better move politically. So far the politicians appear to be balking at Grady's proposal.

State Senate President Pro-Tem Eric Johnson (R-Savannah) took issue with the demands that state officials support $30 million more a year in funding to Grady and provide state funding for hospital trauma units around the state.

"What? They didn't require us to fund an ice cream cone for every patient?" Johnson said. "I don't think the Legislature responds well to blackmail. ... Grady cannot be treated any different than any other hospital."

I would have to beg to differ with Johnson on one point. Grady can and always has been treated differently than other hospitals. The reasons for this are numerous however most of them have been laid out in this piece. There are very few hospitals in America and the world that are more vital to the community they serve than Grady Hospital. The powers that be at Grady know this all too well and they are now using that fact to try and force the hands of the politicians in Georgia. The politicians can talk tough however if Grady is shut down, that is a situation no one can predict and control. What's going on now at Grady is despicable, corrupt and frankly evil, however it is done almost exclusively to poor folks who really don't vote. By shutting Grady down, on the other hand, the politicians will unleash a nightmare upon everyone else in Georgia, and most of those people do vote.

Thus, we have this complicated and high stakes game of chicken.

EPILOGUE:

If you would like to know how Grady got to this point, please read this summary. Also, please take a look at the recommendations that my colleagues and I have drawn up to fix Grady Hospital.

Rudy On Leadership, the GWOT, Healthcare and More

I had a chance to see Rudy Giuliani speak at the Italian American Sports Hall of Fame in Chicago on Friday. While I don't necessarily have too much reference point, I do believe that in most ways this was much like any campaign towhall meeting and speech. It was still quite illuminating nevertheless.

I believe you can tell a lot about a candidate's agenda by what they focus on during such a meeting. The first policy that Rudy spoke about was illegal immigration and how important it is to finally get a handle on it. His newfound commitment towards combatting illegal immigration will no doubt be met with skepticism and controversy by many of my conservative colleagues. Unfortunately, it is one of those debates that is in many ways pointless. There will be plenty that will look at his prior New York City record and concluded based on past performance that he isn't serious. There will be those like me that will look at his current plan for illegal immigration and say he always gets accomplished what he sets his mind on. His plan involves beefing up the border patrol, building a fence technological and real, and creating a tamper proof ID card. Thus, take it for what it is worth.

His thoughts on the GWOT were no doubt general. His first thought vis a vis the GWOT is that we must stay on offense. This has became his calling cry with regards to this issue. He believes in victory in Iraq and he defined that as an Iraq that is an ally not an enemy in the GWOT. He believes that it is NOT an option to allow Iran to get nuclear weapons. He also mentioned that Pakistan must be worked on though frankly besides vague ideas his plan was short on specifics. Some might take this as a sign that he may not be the right person however I would humbly disagree. Rudy has a long and very successful history in confronting and beating bad guys. As U.S. Attorney, he took on and defeated the mafia in his district. As Mayor of New York City, he took on the criminals and beat them lowering crime dramatically. He has a history of taking on bad guys. He has a history of beating them. While the terrorists may not be a perfect comparison to the bad guys he has a history of beating, his prior accomplishments can't be ignored when determining the best terror warrior.

The most fascinating portion of the meeting, for me, came in his answer regarding health insurance. Rudy's plan to revolutionize health care is entirely conservative. The hallmarks are lower taxes, health savings accounts, and market principles. He believes that much of the problem comes in the fact that people don't usually choose their own health insurance. Since most get it through work, it is essentially chosen for them. As such, when it comes to health insurance, people aren't the dutiful consumers that they are towards other products and services. Through credits, tax breaks, and health savings accounts, Rudy believes that individuals will be able to not only buy their own health insurance but at a lower cost than they normally do. In many ways, Rudy's vision of health care mirrors that of John Stossel's. Consumers drive down the price of everything and drive up the quality, and we must give the consumer choice back to the individual. He does it through health savings accounts, credits, and tax breaks. He also pointed out that our litigious society has created an environment of defensive medicine and higher costs. He proposed that the loser of any lawsuit must pay for the costs of both parties to limit many of the more egregious lawsuits.

On taxes and spending, Rudy tried to wake up the echos of Ronald Reagan. He stressed over and over his commitment to limiting the size of government. It was his solution to a whole host of economic related problems. He pointed out that limiting the size of government is largely done through leadership. He pointed out that none of his deputies in New York City ever came to him asking to make the budget for their respective department smaller. Thus, it was ultimately up to him, the Mayor, to stand firm in limiting the size of government even if he had to take on his own administration to do it.

He spoke about productive and unproductive taxes. An unproductive tax is one that is among the most extreme when compared to the civilized world. For instance, he pointed out that our corporate income tax is one of the highest in the entire civilized world. He said that if we merely lowered our tax so that is closer to the middle not at the top that it would keep a lot of the business we lose. He said his tax policy would focus on identifying and lowering those taxes that he determined to be unproductive.

He ended the meeting with an answer to something dear to my heart, the mortgage crisis. He said that he thought Paulson's plan to freeze rates was a good idea. I was quite put off by this question, and and if you want to know why please read this. He also said something very interesting right afterwards. He said that he believed that it was a good idea especially in light of pending Congressional action. I took this to mean that this was the least of two evils. If freezing rates means halting action on such things as H.R. 3915, then while it is still not a good idea it might be better than the alternative.

He was asked how he would confront the mortgage crisis, and this he answered perfectly. He pointed out that the duty of the President is NOT to focus on any given segment of the market but rather to be a proper momentum builder for the economy as a whole. He believed that shrinking government and waste would not only strengthen the economy but the housing market. One can take this as a canned answer, and to some extent it is, however I personally find it a positive that a Presidential candidate doesn't feel the uncontrollable urge to tinker with every portion of the economy that may be going wrong at any given time.

The meeting was revealing not only for what he said but what he didn't say. There was absolutely nothing about any social issues. Clearly, Rudy is trying to downplay his socially liberal record as much as possible and frankly his supporters didn't much care because there were no questions. I was surprised that he didn't touch at all on judges as well, though I assume his public unabashed support for strict constructionists holds. He also said nothing about guns or the environment as well. Rudy took out a lamenated card that had his twelve commitments. That is where I believe his focus will be in his administration. If you are worried about Rudy's position on any matter, check the twelve commitments. If that position isn't on there that, it is unlikely his administration will spend much time on the issue anyway.

All in all, I found Rudy to be quite charismatic and charming, still maybe not quite Mike Huckabee, but charismatica and charming nonetheless. At one point, a voter revealed that not only was he a supporter but also a registered Democrat. Rudy, spontaneously, came over and gave the man a big bear hug. I continue to maintain my support for him, and all reasons stand. He is a proven leader. He has a proven track record. He has a proven history of shrinking government, cutting waste, cutting taxes, expanding choice, and confronting bad guys. In this day and age, I believe that is exactly what we need.

Dr. Andy: The Follow Up

I will give a very big hat tip to Pharma Fraud. Last week, I published a piece on Dr. Andrew Agwunobi. Dr. Agwunobi has had quite a wild professional ride in the last few years. He took over a subpar hospital in Atlanta called South Fulton and two years later, under his leadership, the hospital went from being merely subpar to failing the standards of the governing board. He then moved onto Grady Hospital, the biggest hospital in Georgia and one of the biggest in the Southeast, and within about a year the HHS finished an investigation of that hospital. The findings concluded this,

an immediate and serious risk to the health and safety of the patients.

Despite a pattern of incompetence or corruption or both, Dr. Andy moved on cross country to run a chain of hospitals in California called St. Joseph's. Despite moving cross country to California, his stint there was short, only about a year, though it is unclear why he left such a lucrative position.

I picked up the story with Dr. Andy now in charge of the AHCA in Florida, which is a government bureau who's job it is to provide quality health care to the poor.

Pharma Fraud found another employer in between St. Joseph's and the AHCA. They pick it up here.

Last December, Andrew Agwunobi ended a brief stint on WellCare's board to become the top healthcare regulator in the company's home state of Florida . Agwunobi now leads the Florida Agency for Health Care Administration, which has partnered with the state's Medicaid Fraud Control Unit - a participant in last week's raid on WellCare - in an effort to stamp out corporate wrongdoing.

Agwunobi foreshadowed things to come, when on Friday October 19, just 5 days before the WellCare raid, he said in a Miami press conference that he commissioned a tough new look at fraud when he took over as secretary for the Agency for Health Care Administration. ''We targeted South Florida,'' he said, "the area with the single largest amount of Medicaid fraud in the country.''

Agwunobi declared that it was now ''open-season'' on anyone committing Medicaid fraud in South Florida. (More Medicaid fraud suspected in S. Fla.)

Here is the most interesting part from Pharma,

Upon leaving WellCare, Agwunobi cashed out options and stocks for a $1 Million profit.

Let's review what Pharma has uncovered. Dr. Andy left a fairly short stint at St. Joseph's to take on another fairly short stint at WelCare. After six months, he leaves and simultaneously cashes out about a million dollars in options. He moves to a position in the state government, and promptly turns around and begins an investigation of the very organization he just lef.

There are three words and phrases that come to mind when reading this: conflict of interest, appearance of impropriety, and in spades. This makes five employers in under six years for Agwunobi and the circumstances of his departures from all of them is well peculiar. Maybe someone in Florida can start asking some questions about his fitness for his job.

SCHIP: Middle Class Guilt

I found this letter in yesterday's Chicago Tribune

She was for it before she was against it. My representative, Judy Biggert (R-Ill.), was one of 16 U.S. House Republicans, including Illinois' Mark Kirk, who originally supported the Senate version of the bipartisan children's health care (SCHIP) bill recently passed by Congress. The compromise hammered out in the House closely mirrors the Senate version, but Ms. Biggert voted against it. She was quoted as saying, "It would push Americans one step closer to socialized medicine."

This despite support from 72 percent of all Americans, according to a recent poll, the health insurance industry, the AARP, the American Medical Association, governors from both parties and many children's health advocates.

What happened? The "socialized medicine" tag is a fallacious argument. The SCHIP bill is a state block grant program that protects our children while still being served through private health care providers.

If this measure takes us down the slippery slide toward socialism, what then of our other "socialized" programs? Would she then recommend we abolish Social Security, Medicare, Medicaid, Veterans Administration services, police and fire protection, libraries or our public schools? Can't these public programs and institutions be better served through the private marketplace?

Fortunately I, and most voters in DuPage County, will not have to take advantage of this health care package for our 10 million uninsured or underinsured children. Most of us already have private health care plans funded through our employers, unlike her own "socialized" government-funded plan.

Regardless of the negative "socialized" tag, isn't this program that was originally enacted by Republicans in our children's best interests? I strongly implore Biggert to change her vote when President Bush's veto sends it back to the House. We owe it to our children.

Chris Wallgren
Downers Grove

Now, for everyone not familiar with the Chicagoland area, Downers Grove is a fairly affluent suburb of Chicago. As this person indicates, they are fairly affluent themselves, and they would probably never come close to needing SCHIP themselves.

Fortunately I, and most voters in DuPage County, will not have to take advantage of this health care package for our 10 million uninsured or underinsured children. Most of us already have private health care plans funded through our employers, unlike her own "socialized" government-funded plan.

Clearly again, the rule of what's in it for me doesn't apply. Here is an individual that cares not about their own situation and wants to the compassionate thing. In fact, they end their letter with this impassioned plea

We owe it to our children.

Not everyone's children of course, this person is perfectly happy with the private health insurance that they get for their entire family through their own employer. In fact, the overwhelming majority of their county, Dupage, will have no need for SCHIP. Yet, this voter wants their representative, Judy Biggert, to support a bill that her constituents will have no use for.

So, what is going on here? SCHIP is a late night infomercial run wild. Instead of helping some poor kids in Africa, the affluent are now ready to help some poor nameless child somewhere in America. Only these children aren't starving, their parents just can't seem to find a way to afford to pay for their own kid's health insurance. The more important difference between the infomercial and SCHIP, is that they don't want this to be optional. No, they want the government to make sure that this is done. As one of my readers put it, it's the Christian thing to do.

In the name of Jesus, what is wrong with helping to provide for the common good? Did Jesus say at the sermon on the mount, "Blessed are those financially well off enough to pay for private medical insurance?" Did He say "Blessed are the ones who only serve their self interests?"

Since when did health become a privelage? Does the Declaration of Independance say "...the privelage of life, liberty and the pursuit of happiness...?" Doesn't the Constitution say "...promote the general Welfare...?"

Charity of course is a choice, and I see none of these so called compassionates in the Middle Class rushing out to pay for someone else's health insurance, which would really be the Christian thing to do, but it is important to note that this sort of nonsensical, yet emotional arguement works.

The polls show it.

A new poll released today by the Robert Wood Johnson Foundation shows that Americans overwhelmingly support the State Children's Health Insurance Program
(SCHIP), which provides states with federal funds to design health insurance programs for vulnerable children.Nearly nine in 10 voters (86%) say they support
reauthorizing SCHIP, with a clear majority (63%) saying they support expanding SCHIP's budget by an additional $35 billion over five years.

Put a poor child in front of someone and they will let all reason and thought go out the window. Most will respond with compassion. Sledding is tough if you are on my side of the debate. All we have is statistics, logic and reason. We don't have the children.

Unfortunately, such is life in the world of elitist thought. They are the compassionate and concerned ones, while the rest of us are money hungry, greedy, capitalists who only think about ourselves. We don't care about the children.

Even words like SOCIALIZED medicine doesn't work on the general public and the polls show that as well .

A new Rasmussen Reports national telephone survey highlights both the opportunity and the challenge for those who want to reform the U.S. health care system . The survey found that just 31% of American voters rate the system as good or excellent. Twenty-eight percent (28%) say fair and 39% poor.

Even among those who have health insurance, just 32% say the system is good or excellent while 38% say poor (NOTE: 83% of those surveyed have health insurance). This supports survey data released last week showing that 62% believe major changes are needed in the nation's health care system.

However, while unhappy with the situation overall, 72% of those with insurance rate their own coverage as good or excellent. Twenty-one percent (21%) say fair and only 6% say poor. Given these attitudes, the vast majority of voters will tend to be wary of any change unless they are completely assured that it will not impact their own insurance coverage.

Again, the old rule of what's in it for me doesn't apply. People are generally happy with their own situation but they think the overall situation is dire. Sure, how many times have the Dems used the number of uninsured, about 40 million, as a political tool. Most people look at their own situation and feel guilty. Never mind of course that about one third of those uninsured are here illegally, another third are uninsured only while they are in between jobs, and many of the the rest choose to be uninsured. Remember, it is for the children and all those poor folks that just didn't have the breaks the affluent got. If you aren't for helping them out, you are standing with those wicked, wicked insurance companies, drug manufacturers, and doctors.

Reality is really wholly unimportant. Let's never mind that socialized medicine has proven to be a failure everywhere it has been tried. If you aren't for every major expansion of government, you aren't for the children. If you aren't for the children, you invariably lose any debate.

So, what is the answer. Well, for one thing, our side needs to be as cut throat as the other side. Every child the Dems bring out as a model of compassion toward children, needs to have their family's finances hyper analyzed just to make sure they really are that needy. The Dems trotted out Graeme Frost to deliver their address vis a vis SCHIP a few weeks ago.

It turns out the parents of this poor needy child, own a home, a business, three automobiles, and each of their four kids goes to a private school. Then, our side needs to make the link. What invariably happens to bloated government programs: CORRUPTION. Which means your tax dollars my tax dollars, won't go to save the children but to support the lazy, the stupid, and the devious.

For instance, did you know that a trust fund baby can qualify for SCHIP in forty six of 50 states? Since those states have no asset test trust fund babies, those that have no jobs, can qualify for SCHIP. Now, when someone is saying that it is for the children, do you think they mean trust fund babies?

Finally, it is time that people like me stop leading on this issue, and the Reps lead themselves. They have been loathed to criticize the Dems and their tactics for fear of further being labeled mean. They continue to perpetuate their much deserved label as wimps. I will say it. The Frost's have corrupted the system, and there are plenty of further Frost's out there. The answer is not to expand the system but to tighten it.

The government is not our friend and anytime it expands then I simply quote from Reagan, "the nine most terrifying words in the English language are 'I'm from the government and I'm here to help'" Even if they are trying to help the children.

Unraveling the Numbers on Universal Health Care

In the comments section of a previous post of mine a liberal reader wrote this

In the name of Jesus, what is wrong with helping to provide for the common good? Did Jesus say at the sermon on the mount, "Blessed are those financially well off enough to pay for private medical insurance?" Did He say "Blessed are the ones who only serve their self interests?"

Since when did health become a privelage? Does the Declaration of Independance say "...the privelage of life, liberty and the pursuit of happiness...?" Doesn't the Constitution say "...promote the general Welfare...?"

I'm sorry I have to disagree with the naysayers who whine about their tax dollars going to pay for the general welfare of our society and our health. That's not big government that's responsible government. That's not the government intruding into your life. That's the government helping its people. A government is only as effective as the people who run it. And as long as we continue to sit idly by and let it "run itself" it's only gonna get worse. If we take the government back into our own hands as a real American society we can curb the corruption that has left us with unregulated pharmaceutacle pricing practices, and rediculous malpractice insurance premiums that doc's have to pay and pass the cost onto the patient to stay afloat.

Seriously it costs enough to maintain a baby. Should it cost thousands to give birth to one? For that matter, why not just have the mother pay the cost up front when she finds out, that way it wouldn't be worth the non-refundable price for 1)negligent pre-natal care, 2) abortion?

Back to my main point. We're a supposedly "Christian" nation (according to most "conservatives") We tried to prove it in the 50's by declaring "In God We Trust" and adding "Under God" to the Pledge of Allegiance, why then the hypocricy in ignoring the following passages?

All that believed were together, and had all things in common; And sold their possessions and goods, and parted them to all men, as every man had need.(Acts 2:44-45)

There was not a needy person among them, for as many as owned lands or houses sold them and brought the proceeds of what was sold. They laid it at the apostles’ feet, and it was distributed to each as any had need. There was a Levite, a native of Cyprus, Joseph, to whom the apostles gave the name Barnabas (which means “son of encouragement”). He sold a field that belonged to him, then brought the money, and laid it at the apostles’ feet. (Acts 4:34-37)

This is what the Lord has commanded: Gather of it, every man of you, as much as he can eat; you shall take an omer apiece, according to the number of persons who each of you has in his tent. And the people of Israel did so; they gathered some more, some less. But when they measured it with an omer, he that gathered much had nothing over, and he that gathered little had no lack; each gathered according to what he could eat.

Now, this is an astonishing statement to make. They begin by proclaiming that there is nothing wrong with giving up personal liberty for the common good. Nothing, that is, if you are a communist. That is communism, giving up something of your own person for the common good. They dress it up by proclaiming that it it is responsible government, however when taxes are taken away from individuals to pay for the "general welfare" of the citizenry then what we have is communism.



I doubt the poster even understands that they actually believe in Communism and the reason that I think so is that they are making a wholly emotional arguement. They have no idea the logic behind their arguement.



Second, they reference Jesus and proclaim that Jesus was the one that espouse giving up things for the needy. That is true, however Jesus expoused that is a personal choice and personal responsibility to be a good Christian. He didn't mean that the government would forcefully take the money from you to give it to others. They totally twist the meaning Jesus' words.



That said, I believe to a common somewhat educated, though not political astute individual, this would a powerful arguement. It would hit at all the proper emotions. Emotional arguements are almost always more powerful then logical ones.



This brings me to an article by Joe Conason

Yet despite that antique quality, the old buzzwords appear regularly in columns, press releases and speeches. Rudolph Giuliani, Mitt Romney and the rest of the Republican presidential pack run around squawking about socialism whenever anyone proposes health care reform. Syndicated columnist Robert Novak warns that the federally financed, state-run Children's Health Insurance Program (SCHIP) is essentially a socialist conspiracy. So does President Bush, who has threatened to veto a modest increase in that program's funding because he doesn't want to "federalize health care."

Although the red threat still triggers an autonomic reaction among GOP true believers, the rest of the country no longer twitches to that high-pitched, far-right whistle. Most polls not only show enormous majorities favoring extension of coverage to every child, but substantial support for a radical change in how we pay and administer health insurance -- including the possibility of a single-payer system.

Now, Conason is an author that I have found plays very fast and loose with the facts and makes assertions that he rarely backs up. (as you will find if you go to the link) For instance, he says this program will increase modestly. Well, I guess that is your definition of modest because it will more than double. As for the polls they are mixed and I will point out just how mixed they are. In fact, in almost every poll there is a dichotomy. There is a healthy majority that are happy with their own health care situation and they are at the same time by a healthy majority concerned about the overall health care situation. Thus, the old rule of what's in it for me doesn't apply.

Now, let's look at the latest Rasmussen poll on health care. It provides some very interesting numbers.

First, as you can see, there is no overwhelming belief toward anything that Conason claims least of which single payer, which is overwhelmingly turned down.

Forty-four percent (44%) of American adults say that health care services should be made available for free to all Americans. A Rasmussen Reports national telephone survey found that 39% disagree and 17% are not sure.

Fifty-two percent (52%) say that reducing health care costs is a higher priority than making sure everyone is insured. Thirty-nine percent (39%) take the opposite view.

A survey last week by Rasmussen Reports have shown that 50% support government guaranteed health coverage and 62% say the U.S. health care system needs major changes.

Here are some more interesting numbers

A survey conducted September 29-30 found that 51% of American adults initially supported the notion that health care should be made available for free to all Americans. The survey also found that most Americans (52%) believed that such an approach would decrease the quality of health care in the United States. Just 29% thought it would improve the overall quality of care.

Forty-nine percent (49%) believe that making care available for free to everyone would increase the nation’s overall cost of providing care. Just 22% thought it would result in savings. Fifty-two percent (52%) thought that, when taxes wereconsidered, the proposal would end up costing them more than they pay now. Just 28% thought their own costs would go down.

It is interesting that people are willing to give up some quality of their own health care for the common good. The common good is a very compassionate arguement, and it tugs at the heart strings. I personally believe that the common good, actually leads to the common bad, however in order to counter that arguement we free marketers must also make emotional arguements. For instance, check out this story

TONY Blair yesterday faced a woman who pulled out SEVEN of her teeth after
failing to find an NHS dentist.Great-grandmother Valerie Halsworth, 64, removed them with her husband’s pliers.

She pulled out a seventh tooth over the weekend before meeting the PM in Coventry yesterday.

That is the model of universal health care. People wait so long that they pull out their own teeth. How about this?

By December 2008, no patient referred to a consultant led hospital service
will be allowed to wait longer than 18 weeks from referral to treatment.

This will apply to all Trusts in the NHS, and represents the coming together of the various waiting time targets for the different elements of hospital services. For the first time, in a similar way to our approach to cancer waiting times, the 18 week target will cover the whole patient pathway. From a patient's point of view, 18 weeks is a fairer and more inclusive target, and from the Trust's point of view, it is a more complete target that should enable us to effectively measure and manage all the timings of the care that we deliver.

How about waiting eighteen weeks for treatment? Do you think that will elicit an emotional response? Then, there is this.

Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment, says a report. Stronach's spokesman, Greg MacEachern, told the Toronto Star that the MP for Newmarket-Aurora had a "later-stage" operation in the U.S. after a Toronto doctor referred her.

That's right, in a universal health care system, even the politicians are forced to come to the U.S. for treatment. How about that for a response. That is the way for free marketers to win this debate so that when we say SOCIALISM it evokes fear again.

SCHIP for Trust Fund Babies

According to a report by Kaiser, 46 out of the 50 states don't have an asset test in the SCHIP program. Now, if you are the typical person, you have no idea what that means however you are very compassionate and you will support something that helps poor children get health insurance. Unfortunately, what you don't know, and what the MSM isn't reporting to you, is that because of this, the SCHIP program is fraught to be exploited by corruption.

The practical effect is this. Without an asset test, anyone living off any passive income (annuity settlements, pension income, social security income, retirement savings, or even trust funds) are still eligible for SCHIP. That means that a trust fund baby who has no job and just lives off the exorbitent wealth of their parents is eligible for SCHIP in 46 out of 50 states. (H/T to Bizzy Blog)

Look at this example,

Husband age 62, wife age 41, two children 2 and 7. The husband receives early social security payments, a mutual fund capital gain of $50,000 and ordinary dividends of $30,000. The wife works part time for about $29,000. Despite having a fairly large asset base and plenty of income, the only income counted by the California version of SCHIP is the wife's part time job. Since she receives no health insurance through work, this particular couple is eligible for S CHIP.

Remember Graeme Frost, poster child for SCHIP, well he and his sister were able to both go to private school, his parents owned a home, a business, and the property on which the business was located, with at least one confirmed tenant. Somehow this family was able to qualify for S CHIP as well. Now, if anyone has ever seen the tax returns of any business owner, they know full well how easy it is to make a business owner's income wind up being less than $40K per year.

Now, I said a little while back on these same pages that the only way for Republicans to win this debate is for them to scream corruption from every corner of the country vis a vis S CHIP. This is not the first time that politicians, of both parties, have held up victims in an effort to expand the size of government and every time that expansion leads to corruption. If business owners, homeowners and trust fund babies can already qualify for S CHIP, what do you think will happen if the program is increased exponentially.

Unfortunately, so far, the Republicans have gotten comfortable letting the right blogosphere point out the massive corruption of the program and furthermore attack Frost, its new poster child

In California…it appears that there’s nothing stopping a trust fund baby, if their ONLY income comes from investment returns (i.e., it’s “unearned”), from qualifying for SCHIP! Paris Hilton and Nicole Ritchie could sit at home and stop boring us with their TV show, appearances, and commercials, have babies by any number of entourage members, and join in the SCHIP party. Is this a great country or what?

...

The Democrats chose to outsource their airtime to a Seventh Grader. If a political party is desperate enough to send a boy to do a man’s job, then the boy is fair game. As it is, the Dems do enough cynical and opportunist hiding behind biography and identity, and it’s incredibly tedious. And anytime I send my seven-year-old out to argue policy you’re welcome to clobber him, too. The alternative is a world in which genuine debate is ended and, as happened with Master Frost, politics dwindles down to professional staffers writing scripts to be mouthed by Equity moppets…

…So executive vice-presidents’ families are now the new new poor? I support lower taxes for the Frosts, increased child credits for the Frosts, an end to the “death tax” and other encroachments on transgenerational wealth transfer, and even severe catastrophic medical-emergency aid of one form or other. But there is no reason to put more and more middle-class families on the government teat, and doing so is deeply corrosive of liberty. And, if the Democrats don’t like me saying that, next time put up someone in long pants to make your case

I shouldn't be reading this on the pages of Michelle Malkin, but it needs to be coming out of the mouths of John Boehner, Trent Lott and Eric Cantor. The S CHIP program is already corrupt and full of loopholes, and what the Dems want to do is make it even bigger, which makes it even more corrupt. The new program makes it easier for illegal immigrants to receive free health care, it raises the income level all the way to $81,000 per year in some states, and it doesn't fix any of the holes already in it. This leads to CORRUPTION...CORRUPTION, CORRUPTION, CORRUPTION.

If the Republicans are going to win this debate, that word must become a fabric of the debate. Graeme Frost must become a symbol of the corruption masquerading as compassion. He put himself out there when he responded to President Bush's radio address. His story must be told. Not just the story of his terrible accident, but the one in which he lives in a 3000 square foot house, goes to private school, while his dad owns a business, and still receives free health insurance on the government's dime. That is CORRUPTION. Say it, say it, and say it again, and don't stop saying it until everyone understands what the Democrats are doing.

Emory: A Follow-Up

First, during the debate that that followed my article when it was posted at Redstate, there was a few skeptics. They raised concerns that Kevin's story far fetched and hard to believe.

these comments seem fishy. Grady may have its problems, but the nurses and
administrative folks working the night shifts wouldn't have allowed the residents to leave a med student in charge. And even if a med student is placed in one of these situations, the proper course is to first do no harm. Which in the case of a med student, who by definition knows nothing and is not medically licensed to do anything, the proper course is to do nothing. If he stuck in a chest tube without supervision, not only should he be expelled, but he should be in jail.

Here is Kevin's response.

the chest tube was placed back in the incision - it was not surgically placed. Secondly, this incident took place at the VA, not Grady. Thirdly, this happened and was documented. Names were named, patients were named, etc. IT is not exactly like there are administrative folks at either hospital at night who have informed knowledge about what is going on on each medical team. Nursing shifts change, and communication is often improper as well. Bad communication happens daily at both places.

The questioner continued...

it's not a matter of "adhering to protocol". Placing a chest tube is a serious procedure which involves using a scalpel to cut through someone's chest wall. No, no, no - you do not do this as a med student. The likelihood of doing more harm is much greater than doing any good. And to believe the other stories requires that everyone in the hospital is in on this stunt. The primary care physicians for the patients coming into the hospital aren't complaining that their patients didn't get cardiac enzymes until 17 hours after going to the ED? This isn't showing up in the joint commission accredidation of the hospital? The emergency room physicians are leaving med students in charge too? There are no radiologists to read the chest x-rays because they are in on the scheme as well?

Here is Kevin's response.

I DIDN'T SURGICALLY PLACE THE CHEST TUBE. It had originally been done by the surgical team. What happened is that the chest tube came out of his chest. The incision was still there. There was no one there to take care of this situation, and I did it alone by taking the old tube and shoving it back in as best as I could since no one was there and his lungs were collapsing. In terms of the cardiac enzyes - the patients going into the hospital don't have primary care physicians. At Grady, you are dealing with the most indigent of indigent people. They havenowhere to go. They don't know what the delay was or means. I documented it and gave it to those in charge. Furthermore, in terms of JCAHO, it went even further - the federal Centers for Medicare and Medicaid services investigated, validated what I said, and stated to the hospital that "all patients are in immediate and serious jeopardy." They gave the hospital 30 days to fix these problems. This was released in a report in August 2005.

This isn't about some scheme that all doctors are "in." I never mentioned the Emergency Room, nor the radiology dept. I simply stated that when I was dealing with the man's chest tube, there was no radiologist in the hospital to read his chest x-ray. There was one on call at home and it would take him 30 mins to get to the facility. I documented this as well.

First, here is further information on the report Kevin mentioned. I should make myself clear. There was a lot of the same type of things going on at the VA hospital that also went on at Grady since the VA was also one with limited income potential.

I would also like to direct everyone to two articles that corraborate Kevin's assertions. Here is the first article. What follows is a detailed account from a doctor that worked at Grady though they wouldn't use their name on the record.

“Grady is a teaching hospital. In such a hospital, doctors in training, interns and residents, as well as medical students, are the first doctors to see and evaluate patients. Attending physicians, doctors who have completed all their training and have a license to practice medicine, oversee their work. For Emory, the attending physicians may be based at Grady, or may be based at Crawford W. Long or Emory, but they are medical school faculty and as such also have other responsibilities—teaching elsewhere, research or seeing private patients. In a healthy teaching environment, the attending physicians strike a balance between oversight and direct intervention. To make this happen, and to comply with state and federal law, the attending physicians must see and examine the patient themselves, and document this oversight in the medical record. Grady pays Emory and Morehouse for these attending physician services.

“Both the quality and quantity of these services was surely an area of concern in the audit. Each medical school, and each department (e.g., internal medicine, orthopedics, radiology) within each school, has discretion regarding how this oversight is achieved.

“One of the areas of serious concern has been the amount of oversight on the Internal Medicine inpatient service. Interns and residents will admit patients to the hospital during a 24 hour period, and then the attending physician is responsible for seeing those patients within 24 hours, and at least every 2-3 days thereafter (if not more frequently), and documenting their exam in the medical record.

“However, most physicians trained at Grady (and that probably means 85% of
the MDs in Atlanta!) will tell you that they “never saw” their attending physician. In other words, the interns and residents took care of their patients without appropriate supervision, meaning Grady paid Emory and Morehouse for “ghost” attendings.

“How much? However many physician salaries plus fringe should staff an 800 bed hospital—millions, if not tens of millions, of dollars a year. What were those attendings doing if they weren’t at Grady? See the paragraph above—“they are medical school faculty and as such also have other responsibilities—teaching elsewhere, research or seeing private patients.

“I was ... appalled by the lack of oversight.

“The dean will undoubtedly say: ‘Oh, it is just that our hardworking attendings don’t document their oversight’ but what the question really should be is, “Were those doctors that Grady paid for actually at Grady seeing and examining patients?’ Or were they elsewhere?”

The part that is of course most interestin to me at least is this "However, most physicians trained at Grady (and that probably means 85% of the MDs in Atlanta!) will tell you that they “never saw” their attending physician. In other words, the interns and residents took care of their patients without appropriate supervision, meaning Grady paid Emory and Morehouse for “ghost” attendings. This frankly is the same story Kevin tells only without the dramatics of a soffocating patient and a dirty chest tube. The second article deals with the convoluted way in which supervision was documented.

At least as recently as two years ago, Grady Hospital wasn’t able to accurately determine how much supervision doctors-in-training at Grady were getting from Emory faculty as they handled their caseloads at the trauma center because the reporting mechanism in place didn’t give them enough detail, a newly-released audit shows.

The audit shows that the information supplied by Emory, indeed, fulfilled the terms of its contract, as Emory has said, but the data still was “too general to allow the hospital to adequately monitor faculty supervision,” the report shows. The audit is dated Feb. 16, 2005 and covers the years 2002 and 2003. It was released Thursday under an Open Records Act request by Sen. David Shafer, R-Duluth.

It continues...

The audit was further complicated by data dumping, the audit said, explaining that “the majority of the medical schools’ information was provided as hardcopy reports. This made trending analysis very cumbersome, and searching for particular items in the historical data was extremely time consuming and susceptible to error,” the report said.

As for monitoring the time (and, thus, the reimbursement to Emory and Morehouse) of supervisory faculty, the report said Emory should check the time records of its doctors at least once per month instead of once per quarter. Morehouse collects time data two weeks each month, the report said.

“An accurate physician faculty time monitoring system is critical for both medical schools’ management and third parties (health system) to effectively measure faculty supervision. We determined that the medical schools perform the contractual minimum compliance requirements (one week per quarter) but it is inadequate for a third party to accurately monitor the actual level of faculty supervision...”

It is important to note that while the audit found that the record keeping vis a vis the amount of supervision provided at Grady was sorely lacking (as shown again here, "the report said Emory should check the time records of its doctors at least once per month instead of once per quarter") it also showed that this same system fulfilled the terms of its contract. Well, it is this diarists belief that the cozy relationship between Emory and Grady lead to this dichotomy, but that is for future diaries.

Corruption at Emory University:Opening a Pandora's Box (UPDATED)

When Erick, at Redstate, published a piece about corruption at Emory University, I thought it was an interesting story and I published a follow up on my own blog. At the time, I had no idea the padora's box that I had opened.

Last night, I had a three hour conversation with a whistleblower by the name of Kevin Kuritzky. Kevin was 41 days from graduating from medical school at Emory University when he was expelled.

Emory claims Kuritzky was dismissed for "plagiarism, repeatedly missing required clerkship training involving patient care, lying to his professors, and engaging in other unprofessional, dishonest and unethical conduct."

But according to a complaint filed Jan. 31 in DeKalb County Superior Court, Kuritzky believes something else was a factor in his expulsion.

Kuritzky claims in the lawsuit that Emory officials kicked him out after he complained about patient safety and possible health care violations at Grady Memorial Hospital and the Veterans Administration Medical Center. Both medical centers are associated with Emory's medical school.

Well, what Kevin told me last night could never be summed up in one blog post. In fact, it is ripe for a book and a movie, and so I will be featuring a series of blogs about this matter.

In my first, I want to talk about how Emory's corrupt practices lead to poor people and Veteran's receiving egregiously below standard care because it was simply unprofitable for Emory to provide good care.

Emory runs a handful of hospitals in their Emory University Health Care System. Grady is the largest however because it serves the indigent, the poor, it is also the most unprofitable. Because of this peculiar relationship in their mix of hospitals, this is what ultimately lead to what Erick described as double dipping. What this meant was that residents and attendings who were supposed to be on call at Grady and the VA hospital would leave and go to one of their more profitable hospitals like the Emory University Medical Center.

At Grady almost everyone was either on Medicare or Medicaid or even worse they had no insurance. This meant that no matter how extensive their treatment their bills were limited. In fact, Grady merely paid Emory University a one time fee once per year regardless of the services provided. At the other hospitals the attendings and residents could charge the patients for their services and since the patients were much more affluent they could afford the extensive services the Emory doctors provided. Emory would then profit much more from extensive care provided at one of those hospitals than they ever would from providing extensive care Grady or at the VA.


What this lead to was residents and attendings who were supposed to be on duty at Grady or at the VA, leaving their posts and heading over to one of the other hospitals like Emory Medical Center. As a result medical students, like Kevin, were left in charge of entire floors of patients. Kevin said that he himself was left in charge on 5 different occasions. Doing this is like leaving a flame on. Most times nothing will go wrong but it is only a matter of time before the flame catches on fire.

One night that is what happened. One time he was left in charge of the entire step down unitfrom 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

On the same night, Kevin, again being the head doctor on the floor, was asked to save a patient from internal bleeding who was recovering from a heart attack. He was first asked to perform a hematocrit level test , which measures the amount of internal bleeding and then perform a blood transfusion on the patient. Again, he did this all without proper supervision.

The most egregious lack of quality health care that Kevin documented came with patients that came in for potential heart attacks. In order to determine whether or not a patient is in fact having a heart attack doctors perform what is known as a cardiac enzymes test. Proper procedure is to perform this test within 90 minutes since of course time is of the essence in a case of a heart attack. According to Kevin's documentation, the average wait time for performing such a test was about seventeen hours.

There is really only two reasons why a test that needs to be done in 90 minutes would be done in roughly 17 hours. The first is simple negligence. The doctors just didn't care or maybe they were incompetent which is also possible since as I documented many times the doctors in charge were themselves medical students.

The second reason is even more nefarious. If it is determined that someone is having a heart attack, then there needs to be a battery of tests, surgery, and weeks of recovery. This would cost a lot of money for the hospital and by extension Emory University. Since the patient on Medicare, Medicaid, or worse without insurance altogether, has limited funds, it is much more cost effective if that patient died.

This is only the first in my series. Anyone that wants to speak with Kevin themselves please contact me and I will get you his information.

UPDATE:
I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

The Politics of SCHIP

Republicans everywhere must start to face reality while vetoing SCHIP in its current form maybe good policy it makes for bad really bad politics. Last Saturday, Graeme Frost, 12, gave the Democratic response to the President's radio address...

Hi, my name is Graeme Frost. I'm 12 years old and I live in Baltimore,
Maryland. Most kids my age probably haven't heard of CHIP, the Children's Health
Insurance Program. But I know all about it, because if it weren't for CHIP, I
might not be here today.

"CHIP is a law the government made to help families like mine afford healthcare for their kids. Three years ago, my family was in a really bad car accident. My younger sister Gemma and I were both hurt. I was in a coma for a week and couldn't eat or stand up or even talk at first.
My sister was even worse. I was in the hospital for five-and-a-half months and I needed a big surgery. For a long time after that, I had to go to physical therapy after school to get stronger. But even though I was hurt badly, I was really lucky. My sister and I both were.

"My parents work really hard and always make sure my sister and I have everything we need, but the hospital bills were huge. We got the help we needed because we had health insurance for
us through the CHIP program.

"But there are millions of kids out there who don't have CHIP, and they wouldn't get the care that my sister and I did if they got hurt. Their parents might have to sell their cars or their houses, or
they might not be able to pay for hospital bills at all.

"Now I'm back to school. One of my vocal chords is paralyzed so I don't talk the same way I
used to. And I can't walk or run as fast as I did. The doctors say I can't play football any more, but I might still be able to be a coach. I'm just happy to be back with my friends.

"I don't know why President Bush wants to stop kids who really need help from getting CHIP. All I know is I have some really good doctors. They took great care of me when I was sick, and I'm glad I could see them because of the Children's Health Program.

"I just hope the President will listen to my story and help other kids to be as lucky as me. This
is Graeme Frost, and this has been the Weekly Democratic Radio address. Thanks for listening."

Meanwhile, the Republicans were countering the sobering stats and concepts.
http://www.redstate.com/blogs/congressman_bill_shuster/2007/oct/05/the_truth_about_schip

First, the Democrat’s SCHIP bill extends benefits to illegal immigrants by
lifting the requirement demanding program applicants prove their citizenship
status. Second, the Democrat’s bill significantly expands SCHIP at taxpayer
expense, inflating the cost from $35 billion to $110 billion. To pay for such a
massive expansion, the Democrats will raise tobacco taxes on cigarette packs by
$0.61 to $1, and taxes on cigars up to $3. Tobacco taxes are an extremely
unstable and inadequate source of revenue for such a large program. In fact, it
is estimated that 22 million people will need to take up smoking over the next
five years to fund SCHIP at the levels passed in their bill.

Democrats
argue that their plan will insure 5.8 million more children. They fail to
mention that of those children 2 million, or 35 percent, would have otherwise
been covered by private insurance. SCHIP was never designed for this. Instead of
covering children whose parent’s incomes are at or below the poverty level, the
Democrat’s plan expands the program far past its boundaries to families in
excess of 300 percent above the poverty line who could make as much as $80,000 a
year.

Gee, raw numbers and sobering statistics and logic versus a twelve year old...gee I wonder which side has the edge politically. Here are the latest raw numbers according to Rasmussen...

Sixty-five percent (65%) of American voters know that President Bush vetoed
a bill expanding the State Children’s Health Insurance Program. A Rasmussen
Reports national telephone survey found that 8% mistakenly thought the President
signed the bill while the rest were not sure.

Of those who knew of the veto, 57% disapproved and 31% supported the
President’s action. Fifty-nine percent (59%) of Republicans approve of the
President’s decision while 88% of Democrats disapprove. Among those not
affiliated with either major party, 33% agree with the President and 50% do not.

Among all voters, 70% say it is Very Important to insure that all children
under 18 have health insurance. This figure includes 83% of Democrats, 71% of
unaffiliateds, and 54% of Republicans. Another 18% of all voters say it Somewhat
Important to provide health insurance for all children.

By a 54% to 35% margin, voters believe it is fair to raise cigarette taxes
to cover the cost of expanding the State Children’s Health Insurance Program.
Sixty-two percent (62%) of Democrats believe this approach is fair along with
51% of unaffiliated voters and 49% of Republicans.

For anyone that supports the Republican party, those are the sobering numbers. Still, most Republicans and their supporters continue to have their heads in the sand. Here is how one blogger thought we should approach the issue... http://theclayempire.com/blog/2007/10/05/cigar-tax-alert/#more-323

This legislation carries an especially punitive tax on handmade cigars - a
tax that will unequivocally cause the cigar industry to atrophy. Don’t
misunderstand, this isn’t about just paying a little more for cigars and showing
a little compassion. With the stroke of a pen, if the House successfully
overrides the veto, this legislation will wipe out many retailers and
distributors, put in jeopardy thousands of American jobs and literally hundreds
of thousands more in Central America. This legislation is the opposite of
compassion, and punitive taxation without representation like this is
tyrannical. This federal cigar tax is the single biggest threat the tiny cigar
industry has ever faced and time is of the essence. Cigar enthusiasts of all
political stripes - and clear-thinking people everywhere - need to band together
right now to sustain the President’s veto.

Pressure your House Representative to sustain the veto - the House vote is
expected to be extremely tight and the threat of overriding the President’s veto
is very real.Click here to take action - urge your Congressmen to sustain the veto -
the House vote is expected to be extremely tight and the threat of overriding
the President’s veto is very real.

Well, with all due respect to this blogger, do they really think that most people are going to side with cigar manufacturers over little kids.

If the Republicans have any hope of turning this into anything but a hopeless loser politically then they must be able to turn the same base raw emotions that the Democrats have been using against them.

Thus, without further adieu, here is my advertisement in support of SCHIP veto.

(Imagine a manly voice over)

Everytime politicians, Democrat and Republicans, want to increase the size and scope of government, they trot out a group of victims, a group that the public at large can't say no to.

1929, when supply of crops was at unreasonably high levels causing the price of crops to tumble, President Hoover established the Federal Farm Board which bought crops from farmers in order to take those crops off the open market. What started as a 500 million dollar program is estimated to cost you the taxpayers 171 billion dollars in 2012.

1973, with many of our wildlife going extinct, President Nixon and the Democratic Congress, created the Endangered Species Act. What was meant as a way to protect endangered species has turned into one of the most powerful government programs. In fact, The government can take away citizens' property rights, prohibiting certain uses and any development if a property is designated "critical habitat."

ESA is "called by many the single most powerful law ever passed," by conservative environmental expert R.J. Smith.

The ESA program received $136.9 million for listing species, studies, and the like in 2004. However, a Fish & Wildlife spokeswoman estimated an additional $51.6 million would be spent in 2004 on enforcement. In 1997, Fish & Wildlife estimated, federal and state governments spent $301 million on "certain expenditures" related to endangered species, but no one has been able to estimate ESA's cost to the economy and personal liberty.

In 1972, President Nixon and the same Democratic Congress wanted to make sure that no one was discriminated based on sex in programs at schools that receive any federal funding and Title IX was born. The law says that if the student body of a college or university is 40% female, then 40% of its student-athletes should be female. The law is also interpreted as requiring equivalent facilities for male and female athletics. The practical result has been the wholesale elimination of many men's sports programs at many colleges.

federal Title IX spending was be $88.3 million 2004. Schools will spend unknown additional millions seeking to comply, or dealing with Title IX lawsuits. Unknown numbers of athletes will not be able to play the sport of their choice.

Finally, after the market crash 1929 took the life savings of many retirees, President Roosevelt and the Democratic congress created a retirement savings plan known as Social Security. It was billed as programthat would provide for seniors who could not independently sustain themselves financially. The government imposes a 12.4% Social Security tax on the first $87,900 earned by every American. The worker pays half, 6.2% and the employer pays the other half. In return for these taxes, the government promises the taxpayer modest monthly payments when they reach retirement age 67.

In 2003, the Social Security Administration spent $509.4 billion, including $9 billion on administrative expenses and the unfunded liability of this program is estimated to be $10.5 trillion.

Now, Congress wants to expand SCHIP, a program that provides free health insurance to kids who can't afford it. The Democrats argue that their plan will insure 5.8 million more children. They fail to mention that of those children 2 million, or 35 percent, would have otherwise been covered by private insurance. Futhermore, SCHIP bill extends benefits to illegal immigrants by lifting the requirement demanding program applicants prove their citizenship status. Second, the Democrat’s bill significantly expands SCHIP at taxpayer expense, inflating the cost from $35 billion to $110 billion. To pay for such a massive expansion, the Democrats will raise tobacco taxes on cigarette packs by $0.61 to $1, and taxes on cigars up to $3. Tobacco taxes are an extremely unstable and inadequate source of revenue for such a large program. In fact, it is estimated that 22 million people will need to take up smoking over the next five years to fund SCHIP at the levels passed in their bill.

Finally, this bill threatens the thousands of cigar manufacturers all over the country that won't be able to afford to stay in business with the new sin tax.

Ronald Reagan once said "the nine most terrifying words in the English language are 'I'm from the government and I'm here to help'". The new expansion of SCHIP is exactly what he was talking about. Please stand with the Republicans in re authorizing SCHIP in its current format. Don't let the Democratic Congress increase the size, scope and ultimately corruption of government by appealing to your kindest emotion.

(Please note most stats came from this left wing web site http://www.pushhamburger.com/ten_worst.htm
Politics does make for strange bedfellows)

All right, that is the advertisement. Let me know if you like it and how it can be approved.

Corruption!!!!:Academia, Health Care, and Hush Jobs

It appears that Grady Hospital of Atlanta is about to go under. The investigation that has followed has uncovered an all to cozy and most likely corrupt relationship between the hospital and my brother's institution. Erick, at Red State, picks it up.

Down in Georgia, the fine folks in the Atlanta area are waking up to the
fact that Grady Hospital, both a trauma center (one of the few in Georgia) and
the hospital for treatment of mostly indigent patients, is about to go under
through reckless mismanagement and bad deals. As legislators and the media have
dug deeper, they've discovered a parasitic relationship between Emory University
and Grady Hospital. Emory, which prides itself on being an elite liberal ivy
league of its own in the south, has been feed off Grady to train Emory's
doctors. While Emory's doctors have been getting their training, Emory has been
billing Grady a/k/a the taxpayers, for those same doctors services. In essence,
Emory is getting money from the medical students for training and also from the
taxpayers to train the same students by letting them practice on indigent
patients at Grady.

In other words, if Erick is right, not only was Grady performing illegal abortions (which he talks about later), they were billed for these abortions by Emory, even though med students were getting their training at the hospital.

That is only the beginning of the story though. This story was picked up by muckraker in training and Emory student, Steve Stein, when he wrote this

It’s not exactly a smoking gun, but the latest revelation in the Grady
hospital saga — that Emory may be taking advantage of its influence with the
struggling trauma center — raises questions the University must answer
soon.

State Senator David Shafer (R-Duluth) went on the attack in a recent blog
post (www.davidshafer.org), implying that Emory doctors improperly bill Grady
for their services. Similar allegations have already been made, but Shafer
outlines the most compelling critique of Emory yet.

Shafer, who based his blog post on a two and a half year old audit of
Emory’s record keeping he acquired through an open records request, writes:
“[I]n a practice that is denounced by the auditors, its faculty physicians
record their time at Grady a mere four weeks each year (one week per quarter)
and then make a guess at how much time they spend at Grady for the remaining 48
weeks of the year, using the four weeks of recorded time as a guide. Emory then
bills Grady for the full 52 weeks of work. Doing the math, that means there is
no documentation for 92 percent of Emory’s bills for supervisory and
administrative services.”

That appears pretty damning to me. Everyone must have been shocked when only a few days later Stein wrote this

A town hall meeting about Grady Memorial Hospital last week served as a
perfect metaphor for the troubled trauma center’s saga: snide attacks
superseded solutions, chaos trumped compromise and Emory became the focus of
unjustified attacks — again.

One thing is certain: The crusade against Emory by people like local
activist Ron Marshall and state Sen. David Shafer (R-Duluth) has officially
turned into a witch hunt.

Last week, I wrote that Shafer had raised important questions in his blog
about the Emory-Grady relationship that the University had to answer. Most
importantly, I wanted to know whether allegations that Emory doctors
improperly billed Grady for their services were accurate.

Emory has answered these questions and has done so convincingly —
the answer is a definite “no.” In a recent press release, School of Medicine
Dean Thomas Lawley and Executive Vice President for Health Affairs Michael
Johns provided evidence to show that the University’s time-recording
practices compare favorably to those at other hospitals. Lawley and Johns
made a more than adequate defense of their position. The attacks, however,
have not abated.

How could this future muckraker do a 180 so quickly? Erick may know why.

First, we learn aboutan Emory student newspaper student editor who
called into question Emory's conduct in the Grady Hospital affair. He was, to be
sure, quite critical of Emory. But then Emory University granted him, very soon
after the article appeared, an internship with Emory Healthcare. All of a sudden
the considered his prior views to be those of folks having a “witch hunt.”

You'll do great in this world young man. Selling your soul to the highest bidder is a great way to get ahead. We will see though. The right blogosphere will expose you for what you are.

There is more. I will let Erick pick it up again.

Now comes the case of James J. Murtagh Jr. v. the Fulton-DeKalb Hospital
Authority. Mr Murtagh, a former Emory professor who worked as a doctor at Grady,
filed, well, let's let the Georgia political paper Insider Advantage tell
us:

Murtagh was a former Grady doctor and Emory University faculty member who
filed a federal lawsuit accusing Emory and Grady of conspiring to defraud the
federal government of millions of dollars.

Murtagh also accused Grady and Emory of subjecting him to a bad-faith peer
review as retaliation against his whistleblowing. The peer review alleged that
Murtagh violated the hospital's do-not-resuscitate policies. The case apparently
was settled under seal after Grady and Emory lost a motion for summary judgment.

A former Grady trustee, William Loughrey, has called sealing of the
settlement “outrageous” and charged that Emory and Grady were using tax dollars
to silence whistleblowers.

David Shafer picks it up.

The silencing of whistleblowers through cash payments and confidential
settlements and the conduct of whistleblower litigation under seal undermines
public confidence in Grady, interferes with the ability of the Georgia General
Assembly to properly investigate the crisis involving Grady, deters the State of
Georgia from financially assisting Grady, and potentially jeopardizes the
survival of Grady.

Last but not least, what of these abortions? As Erick explained, the med students were performing abortions. Is there anything wrong with this? Let's leave the issue of abortions alone for a minute. It is against the law to use public funds for abortions in cases besides incest and rape. According to Erick, this became nothing more than an abortion mill. Money and resources that could have gone to providing health care for poor people instead went to finance abortions. Here is how Congressman Everson put it.

I was disturbed to learn that Emory University has been performing
thousands of abortions at Grady Memorial Hospital and using this taxpayer owned
and funded hospital to train abortionists. Federal and state law prohibits the
use of taxpayer funds for abortion other than in cases of rape, incest and life
threatening conditions. I applaud your decision to shut down this abortion mill
and training facility. If Emory University desires to perform abortions or train
abortionists, it should do so at its own facilities and not at a public hospital
owned by the taxpayers.

I was also quite disturbed to learn that at least one woman ... was killed
by a botched abortion at Grady and that the hospital was forced to pay a $3
million jury verdict to her young son.
As a member of the House Special
Committee on Grady, I would like to know:

1. Whether Emory University has paid rent to the Fulton-DeKalb Hospital
Authority for the operation of its abortion mill and training
facility.

2. Whether the Fulton-DeKalb Hospital Authority paid Emory University for
the faculty members and residents who staffed and taught at this abortion mill
and training facility.

3. What other hospital resources, if any, were used to support this
abortion mill and training facility.

4. What steps the Fulton-DeKalb Hospital Authority has taken to make sure
that Medicaid was not unlawfully billed by Emory University or the Emory Medical
Care Foundation for elective or birth control abortions.

5. To what extent, if any, unlawful billings for abortions were involved in
the $4.5 million refund paid by the Emory Medical Care Foundation to settle the
1998 Medicaid fraud investigation by Attorney General Thurbert Baker.

6. Who paid the $3 million jury verdict in the case of the botched abortion
...

7. Whether any other claims of malpractice have been brought against the
abortion mill or Grady Health System for botched abortions.

8. How much the Fulton-DeKalb Hospital Authority has paid defending or
settling malpractice actions for abortion and whether any of this expense has
been borne by Emory University or its abortionists.

9. Whether any of the aborted fetuses from Grady Memorial Hospital have
been used by Emory University in its highly publicized biomedical research
programs.

Paying off journalists with jobs, performing illegal abortions, illegal billing, intimidating whistle blowers, tuition money is going to such great causes. This will not stand and it cannot stand. If you are as outraged as I am, please go here and make your voice be heard.


UPDATE:

Since I picked up this story, I have come to the conclusion that if anyone picks it up in the middle they may get lost in its twists and turns. I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance.
Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.