Category: Uncategorized

The Fracturing of Pennsylvania – NYTimes.com:

This is less than 20 miles away from my home…

That same day, when Voyles told Range Resources she had developed blisters in her nose, it offered to put her up in a hotel, as it does for all nuisance complaints, but she didn’t want to leave her dogs and horses behind. (Range later said that it had no record of the complaint.) Next door on McAdams Road, Haney and her kids began to have intense periods of dizziness and nosebleeds. Of the three, Harley was the worst off. Haney took him to their family physician, Craig Fox, in the nearby town of Washington. Like most local doctors, Dr. Fox had never seen such symptoms before.

Haney says that Dr. Fox’s advice to her was unequivocal: “Get Harley out of that house right away. I don’t want him anywhere near there, even driving by, for 30 days.” So Haney took Harley to a friend’s house in Eighty-Four, a town named for the lumber company. She took her daughter to her parents’ house in Amity. Each day, she spent about four hours in the car shuttling the kids from school, to and from friends’ homes and driving to the farm to feed the animals, which were O.K. some days and vomiting or collapsing on others. Haney found a cousin willing to take her pigs, but she had nowhere to house the other animals, so they remained at the farm. She stayed home for less than an hour at a time, long enough to put a load of laundry into the washer. Every two days, she spent $50 on gas. Their farmhouse stood abandoned. “Our home has become a $300,000 cat mansion,” Haney said when I visited her in July.

Haney is no left-leaning environmentalist; she is a self-proclaimed redneck who is proud to trace her roots here back at least 150 years. This is not the kind of fight she usually takes on. “I’m not going to sit back and let them make my kids sick,” she says. “People ask me why I don’t just move out, but where would I go? I can’t afford another mortgage, and if I default on this place, we will lose it. ”

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amednews: [interactive graphic] How much do health plans make? – Revenue falls, but stock buybacks boost per-share earnings. … American Medical News: – Sent using Google Toolbar

Patients’ Grades to Affect Hospitals’ Medicare Reimbursements – NYTimes.com: Winning praise from patients has become a pressing — and often elusive — obsession for NYU and for hospitals nationwide. In the coming months, Medicare will start taking patient satisfaction into account when reimbursing hospitals. Disgruntled patients will mean reduced revenue, a frightening prospect for hospitals already facing empty beds because of the recession and pressure from insurers to hold down costs.

Medicare’s new rule, mandated in the Affordable Care Act, pits hospitals against one another in a competition to best satisfy patients; those with the best scores will receive more money.

But some hospitals are worried that assessments from patients like Ms. Schwartz can be influenced not just by the quality of their care, but also by amenities like single rooms, renovated units and tasty food. And hospitals in cities and certain regions, like the Northeast and California, tend to get lower ratings, raising concerns that their revenues will be reduced simply because patients in those places are more disposed to grumble about things that a polite Midwesterner or Southerner would forgive.

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Medicaid funds allegedly misused: U of L doctors used $4.8 million in Medicaid money for bonuses, Shaughnessy says | The Courier-Journal | courier-journal.com:

Doctors at the University of Louisville medical school used about $4.8 million in state Medicaid funds to pay themselves “financial bonuses” — money that was supposed to be used for indigent care, state Sen. Tim Shaughnessy says.

And they used another $5.2 million for an electronic records system that would make U of L doctors eligible for additional bonuses from the federal government, according to new details of a controversial transaction that Shaughnessy said he recently obtained from Attorney General Jack Conway’s office.

A spokeswoman for Conway said Wednesday that the office determined only that the $4.8 million was compensation for U of L doctors. But Shaughnessy insisted that Conway’s staff described the money as “bonuses” at a recent meeting.

“I was shocked,’’ said Shaughnessy, a Louisville Democrat who was the first to publicly question a transfer of about $30 million in surplus health funds in 2008 and 2009 from Passport Health Plan to U of L, University Physicians Associates, or UPA, and others represented on Passport’s board.
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Under a settlement Conway announced in July, UPA will repay the state $9 million over five years. Other groups that received funds from Passport’s $30 million transfer agreed to repay the funds according to various schedules. They include U of L, University Medical Center and local hospitals that provided capital to start Passport.

But Shaughnessy said the repayment doesn’t address his basic concern — that U of L’s board wasn’t involved in major financial transactions involving groups with which it is affiliated, including Passport, UPA and the U of L medical center.

“There was no involvement of the U of L Board of Trustees,” Shaughnessy said. “How did these millions of dollars get allocated without any involvement of the board?”

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Cleared of wrongdoing, Penn State climatologist still sees ‘smears’: Mr. Mann, a doctor of geology and geophysics who serves as director of Penn State’s Earth System Science Center, already was a central figure in the controversy over climate-change science before emails were hacked in late 2009 from the University of East Anglia Climatic Research Unit in the United Kingdom.

Now he’s an even stronger lightning rod for critics of climate-change science, including Texas Gov. Rick Perry, the Republican presidential candidate who continues to claim data was manipulated to prove climate change.

But on Aug. 15, the NSF and the U.S. inspector general concluded that emails did not reflect flawed or fraudulent science and closed the case. It represents the last of seven investigations of the heisted personal emails that included flippant statements and others that were described as reckless and injudicious.

But three investigations in the United Kingdom and four in the United States including ones by Penn State, the U.S. Environmental Protection Agency, the National Oceanic Atmospheric Administration and now the NSF all have dispelled claims that climate-change research by Mr. Mann and others was manipulated to justify false conclusions.

“It’s the seventh investigation that’s arisen out of the leak of emails and false allegations by climate-change deniers who were mining for words and phrases out of context,” Mr. Mann said. “This should be the final nail in their coffin.”

But he said critics of his research continue saying “up is down and black is white in their climate-change denial.”

“I’d be lying if I didn’t say this was a major distraction for me and my colleagues,” he said. “I’ve been wasting a lot of time responding to allegations. That being said, the scientific community has understood from the start that this was a manufactured scandal and smear campaign against scientists.

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The Oregon Health Insurance Experiment: Evidence from the First Year: “In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides a unique opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group.

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Key Provisions That Take Effect Immediately

Health Law Provisions Kicking In; States Prepare For High-Risk Insurance Pool Implementation – Kaiser Health News

A piece from Kaiser health news on the status of the Health insurance High-risk Pools.

New Law Could Help Hospice Patients Continue Aggressive Medical Treatments – Kaiser Health News

But the new health law could lead to a major change in Medicare policy that allows patients to get treatment and hospice care simultaneously.

Experts say this dual approach, known as “concurrent care,” may be especially useful for people using dialysis to extend their lives, and those waiting for organ transplants that may not come in time. More broadly, advocates say, the change may encourage people with any kind of terminal illness to take advantage of hospice care earlier.

“Having personally had to explain what’s good about hospice to families that think I’m about to shove them onto an iceberg, I know it’s a very difficult decision,” says Diane Meier, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York City.

It will be easier to get the terminally ill to accept hospice care, she says, “if you can say to
families, you don’t have to make this terrible choice here — it’s more, not less.”

Medicaid Change

The new law instructs Medicaid, the state-federal program for the poor, to cover simultaneous hospice and curative care for children with terminal illnesses immediately. And it directs the federal Medicare program, which covers seniors and disabled people, to launch up to 15 pilot projects around the country to test the concept. If the experiment is deemed successful and doesn’t increase costs, then Medicare could make the benefit available to everyone in hospice.
Someone with heart disease, for example, could get cardiac drugs that improve blood circulation and at the same time receive hospice’s palliative services. Those include a team of doctors and nurses devoted to easing physical pain and symptoms, and social workers and
clergy who help patients and their families accept death. Hospice staff typically come to a dying person’s house or nursing home a few times a week.

Myths of the Supply Side – Ross Douthat Blog – NYTimes.com

For an example of what I did have in mind, though, read Kevin Williamson’s fine piece on supply-side economics from the last National Review, in which he goes after the panglossian misinterpretation of supply-side theory that’s become dogma among too many Republican politicians and activists — namely, that tax cuts generate so much economic growth (and with it, increased government revenue) that they more than pay for themselves. As Williamson notes, the most prominent supply-side theorists themselves don’t believe this, but they’re tolerant of politicians who do: