Comment More things change, more they stay the same (Score 3, Informative) 90
Same submitter, even!
Same submitter, even!
A tentative deal struck late Tuesday between House Ways and Means Committee Chairman Dave Camp (R-Mich.) and Senate Finance Committee Chairman Max Baucus (D-Mont.) would cut federal healthcare spending by $21.1 billion.
The savings would be used to pay for a "doc fix" that would eliminate a scheduled 27.4 percent reduction in Medicare physician payment rates for 10 months.
Savings include:
- A $5 billion cut to the health law's $15 billion prevention trust fund;
- The elimination of $2.5 billion in enhanced Medicaid payments to Louisiana in the wake of Hurricane Katrina;
- A $4 billion reduction in so-called Medicaid Disproportionate Share Hospital (DSH) payments to hospitals that take care of people without insurance;
- A $6.8 billion reduction in federal payments to hospitals that collect "bad debt" from insolvent patients, down to 60 percent; and
- Cuts to how much Medicare pays for clinical laboratory tests.
How is it that reducing the funding by 33% *isn't* an attack on women if reducing the fund by a lesser amount *is*?
Most "void if broken" seals can be easily replicated. It's just a matter of getting a replacement seal in time. For the most part, people are dumb. If you do a good job of cleaning off the seal, they'd never notice it is missing.
I'll go you one further--I seriously doubt that "void if broken" seals would even be honored! If they were, any griefer with an axe to grind could quietly slice a "void if broken" seal and arguably void (nullify) any votes cast on that box up until the point that broken seal is noticed -- possibly all day. Unless (of course) the seals are visually checked in between each voter, right? So next time you go to the polls, watch how the lines move, and see if you think everything is visually inspected and verified between each voter.
And if this sort of vandalism did happen, what would you bet that the votes up till then wouldn't be nullified regardless of the state of the tamper seals? What makes you think that this sort of thing hasn't already happened? In past election, seals have been found missing/cut on machines, it's been reported, and it's been ignored and the votes counted regardless, e.g. as reported here. Nice.
Agree about the lag. The current reporting period is (presumably) 3/1-3/29, but the only way I can get the reported traffic to add up is to include traffic back to 2/27 which (last I checked) came before 3/1. Plus, as of 3/29, AT&T has no detail from 3/25 onward. If that holds true at the end of the month, the reported usage won't help a whole lot.
Pretty tough to manage to "not exceed" 150GB of traffic when (on a 6 megabit connection) you could in theory consume 50GB of traffic in just those 4 missing days. (55+ GB, counting ATM and PPPoE overhead....)
Of course, AT&T doesn't *want* you to be able to manage your own Internet usage, what they want to do is to either scare you into non-utilization, or to charge you extra (note that overages are billed in chunks, as in $10 for each additional
One thing this whole experience has taught me -- no reason to pay for faster Internet access if all that will happen is that you'll hit your caps faster. You folks on 6mbit AT&T DSL -- why not use this change in contract to fall back to 3mbit and save quite a bit each month?
One thing this has done is to convince me to look at Cox again. I left Cox for AT&T when Cox pricing and plans went unrealistic, but now they are starting to offer tiers that compete with AT&T on price while still (at least on paper) beating them on performance. Just need to see what traffic caps are in place...
If I'm paying for PPPoE and ATM overhead, I'm gonna be pissed.
AT&T must be measuring bits at the DSLAM, if what they're reporting is anywhere close to being accurate. If a 150GB "cap" includes the approx.
Sucks.
Also seriously: One of the HIPAA loopholes that patients aren't always told about is that HIPAA privacy rules don't necessarily apply when the government gets involved. One could easily argue that Cignet shouldn't have released those 4,500 unneeded records, you bet...but one could also argue that the release of those records didn't automatically trigger a HIPAA violation, as they were released in response to an oversight request, e.g. "Covered entities may usually disclose PHI to a health oversight agency for oversight activities authorized by law." (source: CDC.gov). If HITECH changed that, it'd be news to almost everyone -- when is the last time that the government willingly adopted rules restricting their own capabilities?
Regardless, IMO if they would've done exactly the same release of information BUT responded in a timely fashion to the Government's demands, there wouldn't have even been a $43 fine. Because that's the way that the Government seems to work.
How many closet dinosaur-language slashdotters are there?
Here's another, although my COBOL programs run on an AS/400 (a.k.a iSeries, system I, whatever the heck IBM has decided to call it today) instead of Really Big Iron. Some of the code that I wrote on a CISC-based System 38 over 2 decades ago is still running on a Power6 RISC-based system today, with nary a recompile involved.
It's hard to argue with "works".
The Portugese system goes further and makes other drivers angry with you for speeding.
I think the Portuguese system is the future. Note that it shames you in front of other drivers, but that it also slows you as a penalty for speeding. People will naturally adopt the behavior that gets them where they are going fastest. If you make 'speeding' the slower option, people will just naturally drive safer.
So what's the likelihood of someone who has no problem breaking one law (speeding) breaking yet another law (running a red light)?
I suppose the next response would have to be something like "red light cameras".
I'm not big on government interference with many parts of our lives, but they are addressing a very real problem and they're doing it with kid gloves. They did not pass regulations requiring hospitals to comply, they just tied federal funding to that compliance and gave the hospitals many years in which to get their shit together. If medical providers have not done so and are rushing about now, that is absolutely not the fault of the feds.
Actually...one of the dirty little secrets here is that the final rule for meeting "meaningful use" still isn't actually final. The "interim final rule" wasn't even available to view until Jan, 2010 (link), comments are accepted through March 15th, and we should have a final rule that we can (hopefully) comply with by the end of this month.
And: We don't have "many years" to do the install. We have a few years...very few, if we want to actually participate in the government incentives. Have to be installed and in production by late 2011 to qualify for the full incentive. Any delay, and the incentives go down drastically.
In our case, this whole thing really bites. We have an EMR, fully deployed, and we haven't maintained a paper chart in years. But, because of the definition of "Certified EMR" (which at this point basically means "Must be certified by CCHIT"), we can't qualify for "Meaningful Use" under these proposed rules. So, we have an EMR, we produce escripts, we do online order entry, we can even exchange imaging information (something that this round of certification doesn't require), but because we can't fill in all of the check-boxes in a CCHIT audit, we have to scrap our homegrown EMR and pay millions to replace it with a "certified" alternative. And the government will give us some of that money back if we cram it in fast enough *and* if we are able to show that we meet whatever standards the final rule eventually mandates...all within the next 18-30 months.
Nice.
It may not be the fault of the Feds that some providers haven't transitioned to digital records, but the Feds certainly aren't making things very easy, either.
We're talking about the US Federal Government here. In particular, the CMMS (Center for Medicare and Medicaid Security). You get all three.
"Ggovernment is bad" sock puppet, we're talking about private-sector insurance here.
"A federal deadline that begins next year and requires hospitals to prove they're meaningfully using electronic health records will lead to technical problems and data errors affecting patient care, say politicians and top IT professionals responsible for the deployments. Physicians and hospitals have until the end of 2011 to receive the maximum federal incentive monies to deploy the technology. If not deployed by 2015, they face penalties through cuts in Medicare reimbursements. 'I think we have nontechnology people making decisions about technology,' said Gregg Veltri, CIO at Denver Health. 'I wonder if anybody understands the reality of IT systems and how complex they are, especially when they're integrated together. You're going to sacrifice quality if you increase the speed [of the rollout].'"
"Private-sector" applies to this discussion
Mathematicians practice absolute freedom. -- Henry Adams