Metro Jacksonville

I came across a pretty cool dashboard in terms of Public Health in Florida. It shows the data concerning diabetes, obesity, AIDS cases, etc. I was particulary aghast at the number of AIDS cases for kids under 13 in Florida. Wow.

http://healthyamericans.org/states/?stateid=FL  (http://healthyamericans.org/states/?stateid=FL)

Trying to do a better job at bringing good data to the group.

Quote from: mtraininjax on July 01, 2009, 10:11:51 AM
I came across a pretty cool dashboard in terms of Public Health in Florida. It shows the data concerning diabetes, obesity, AIDS cases, etc. I was particulary aghast at the number of AIDS cases for kids under 13 in Florida. Wow.

http://healthyamericans.org/states/?stateid=FL  (http://healthyamericans.org/states/?stateid=FL)

Trying to do a better job at bringing good data to the group.

Thanks mtraininjax. Clearly the Florida problem of the uninsured is 35% higher than in the nation at large.

In Florida now over 21%

Whereas in the US it is 16%

DAILY, we are adding 14,000 to the uninsured numbers in the US, because of our recession.

And it doesn't go unnoticed. Everone knows someone who is uninsured. The majority however still are working adults, without employer-based healthcare insurance, either because the employer doesn't offer it, or because they work part-time. Sick state of affairs!

In keeping all healthcare related stuff for Florida in one thread, here is part of why Medicare is going broke,........they are being ripped off, defrauded by private business:

QuoteFeds Fight Rampant Medicare Fraud in South Florida
by Greg Allen

November 6, 2007

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Medicare Fraud Acute in South Florida

Oct. 11, 2007Medicare Cracks Down on Power-Scooter Payments

Dec. 1, 2004text sizeAAANovember 6, 2007
It doesn't sound sexy, but amid the bikinis, beaches and palm trees of South Florida, one of the most popular and lucrative crimes now is Medicare fraud, and a team of federal investigators and prosecutors are tasked with putting a stop to it.

The dollar totals are staggering: Law enforcement officials say they've uncovered more than a half-billion dollars in fraudulent claims this year in South Florida alone.

If you want to know how bad Medicare fraud is in Miami, a good place to start is with a study released by federal inspectors. They visited, at random, nearly 1,600 businesses in Miami that bill Medicare for services allegedly delivered to beneficiaries.

The U.S. attorney in Miami, Alexander Acosta, says the inspectors found that nearly one-third of the businesses â€" 481 â€" didn't exist.

"Those 481 businesses â€" so-called businesses that didn't exist â€" had billed $237 million in fraud over the past year," Acosta says.

That study helped focus national attention on the problem of Medicare fraud in Miami â€" especially among shell companies that purport to sell what's known as "durable medical equipment" â€" wheelchairs, walkers, respirators and the like.

Federal Medical Fraud Task Force

As part of a crackdown on the so-called DME fraud, the federal government revoked Medicare billing privileges from more than 600 companies in South Florida. And beginning in March, federal prosecutors and investigators teamed up to create a special Medicare fraud strike force.

In six months, the strike force already has had an impact. The Justice Department official in charge, Kirk Ogrosky, says it has charged 120 people in 74 cases. He says DME claims submitted from the Miami area have decreased dramatically â€" down $1.4 billion from last year.

Ogrosky credits the crackdown and the fact that people convicted of Medicare fraud are now getting stiff sentences.

"That has a big deterrent effect," he says. "We hope that as we continue … the billing will continue to decrease and we'll get more in line with what we see around the country."

Business Owner: Fraud Is 'Nothing New'

Among those watching the crackdown on DME fraud closest are the many legitimate companies that are trying to operate businesses in a field rife with fraud.

One is BayShore Dura Medical, a midsize company in Miami Lakes that has been in business for nearly 15 years.

In the company's 14,000-square-foot warehouse, workers assemble and service motorized rehab wheelchairs. In another area, workers refill oxygen tanks used in home respiratory systems. Three respiratory therapists are on staff, along with two registered nurses and more than 70 other employees.

On the issue of Medicare fraud, owner Robert Mendia and manager Raul Lopez have one question about the government crackdown: Where was the government five years ago?

"This has been going on for years," Lopez says. Mendia chimes in, "This is nothing new, nothing new at all."

Industry Faces Bad Reputation

Although the business is growing, there's a deep frustration there â€" and among medical equipment suppliers nationwide â€" that their industry's image is being dragged through the mud.

There's anger at the government agency that administers Medicare, the Centers for Medicare and Medicaid Services, or CMS. Lopez and Mendia tick down a long list of red flags that they say Medicare administrators either miss or ignore.

"For example," Lopez says, "you have patients receiving two artificial legs in a year … when they never had … an amputation from a hospital."

Another example: sudden tenfold and hundredfold spikes in billing by a startup company â€" all for the same medical condition.

Making an Example of Miami

After federal inspectors detailed the depth of DME fraud, CMS designated South Florida a demonstration project. It's requiring all medical equipment suppliers to re-apply for billing privileges. And Medicare says that in Miami, it will analyze billing data and perform spot inspections with the aim of weeding out fraudulent companies.

Kimberly Brandt, the head of program integrity for Medicare, concedes that until recently, CMS didn't actually look for fraud.

"Part of that had to do with our limited resources, quite frankly," she says. "In the past, perhaps we have not been as vigilant as we could have [been]."

Brandt says that has changed now. "We have definitely recognized the need and we have certainly the desire to make sure we're giving that vigilant oversight in South Florida."

At BayShore Dura Medical, Lopez and Mendia complain that some of the new CMS rules penalize legitimate companies while still not doing enough to weed out fraud.

They don't deny that fraud is a big problem in durable medical equipment. But they worry that while law enforcement and the news media focus on their industry, they're missing much bigger instances of fraud â€" committed by doctors, hospitals and drug companies.

http://www.npr.org/templates/story/story.php?storyId=16045685

Medicare fraud is HUGE. Miami is not alone in being a hot spot for fraud on this level.

http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=ind_focus.story&STORY=/www/story/08-04-2009/0005071362&EDATE=

Quote"Health care fraud is a serious problem with a staggering price tag estimated between $67 billion and $226 billion annually in the U.S. alone. I'm sure the Health Insurance Counter Fraud Group can also attest to the devastating effects of health care fraud on the United Kingdom's health system. In this globalized world, health care fraud knows no boundaries and to beat it we need a co-operative, collaborative approach," says NHCAA Executive Director Louis Saccoccio.

Addressing Medicare fraud is THE way to save Medicare. Also adding those under 65 on a voluntary basis, a demographic with lower healthcare costs, will add to the solvency of Medicare:

QuoteSep. 14 2009 - 8:43 pm | 154 views | 1 recommendations | 10 comments
Healthcare: Could We Get A Moral Commitment?
Is there a simple way to get universal healthcare in this country? In a word, yes. Or rather, in two words: moral commitment. If we were to make a moral commitment to what is, after all, only the fair, humane, equitable thing to do, author/reporter T. R. Reid told an audience at San Francisco’s Commonwealth Club today, there would be no problem.

Reid, a reporter for the Washington Post, documentary film maker and NPR commentator, was in town to promote his new book, “The Healing of America: A Global Quest for a Better, Cheaper and Fairer Health Care .” In it he tells the story of his journey around the world in the company of a painful shoulder, consultations about which were his introduction to personal encounters with health care systems of every sort. He also met with government representatives and policy makers across several continents.  It is an informative and highly readable (no pun intended, that’s just an appropriate adjective) book.

Reid outlined the four primary models of health care currently in existence on our small planet, each with different versions of who pays and who provides. In Britain’s socialized medicine model, health care is the government’s job and it does both. A “mirror image” of this plan is that put into place in Germany shortly after the country was established in the late 18th century, a “National Health System” in which the providers â€" doctors, clinics, etc. â€" are private but the payer â€" government â€" is public. Workers are covered through their employers. One advantage to both, Reid points out, is that everyone buys into preventive care. He told of British ads asking passersby if their feet hurt, and urging them to visit a podiatrist right away if so; “It’s free.” Or commercials featuring a coughing “Mum” and giving a phone number to call so a nurse may visit. “It’s free.” Each is aimed at diagnosing other illnesses early, and/or preventing the spread of disease.

The Canadian Medicare (that’s where Lyndon Johnson got the name for our elder care) system now copied by Australia, Taiwan and others would have had Reid waiting an long as a year for consultation and treatment of his shoulder. Although he proclaimed his pain to be a very present issue, it was not seen as an urgent need to the primary care doctor he consulted. It is this often extensive wait for non-urgent care that is most criticized (especially by Americans) about the Canadian system. But Reid got a Canadian answer to that. “We Canadians,” he was told, “don’t mind waiting, as long as rich Canadians have to wait as long as poor Canadians.”

The fourth model cited is the out-of-pocket model, which Reid illustrated with a story of climbing a mountain in Nepal to seek shoulder relief. At the top of the mountain, in an extremely simple one-room building with its four walls painted in four different colors, the doctor explained his payment was generally in whatever the patient could afford. Someone relatively well off might pay in funds, others in whatever they had. Many of the patients could pay only by painting the facility, the doctor said; they seldom had the same color of paint, and thus the many-hued room.

“We have them all,” Reid told a hushed audience: Native Americans and veterans have the British/NHS; over-65, the Canadian Medicare; working people, Germany’s system. But 40+ million Americans have medical care equivalent to Afghanistan or Angola, and tens of thousands of Americans die every year because they cannot afford medical care.

One audience member called Reid on that issue, saying hospitals were required to treat people who came to them, but he was not backing down. True, he replied, if someone is actively dying or about to give birth, hospitals cannot turn him or her away. But for cases (such as one cited at the beginning of The Healing of America) of lupus, or diabetes, or in countless other instances, the inability to pay for necessary care causes ongoing pain and death for thousands.

Other audience questions raised the illegal immigrant issue. In most countries, it simply would not be an issue, he said. Citing Britain as an example, he said “you get (care) whether you’re a citizen or not.” Reid also said the public option is a non-issue elsewhere, because “you don’t need it.” And he threw in another few illustrations that argue for reform: In Britain, you have to cover everyone, you have to pay every claim, and you have to pay every claim fast. In Switzerland, if a claim is not paid within five days, the next month’s premium is free. In Germany you have a choice of well over 100 insurance companies; if you don’t like one, you simply switch to another.

Having set out to answer the question of how other countries provide health care for all of their citizens, Reid said he then turned to the why. Why every other wealthy, industrialized, developed country in the world has universal coverage and the U.S. does not. Others have it, he said, because “they think it’s fairer, equitable, humane, just â€" and these are moral issues. Health care reflects a country’s moral values.”

It was clear that Reid, like most in his audience, sees the U.S. as having moral values. “If we had the political will,” he commented, “other countries could show us the way.”

But the author was pessimistic about the possibility of universal care coming out of the current reform efforts. Asked how it might somehow come to the U.S., he said it could well be the way Canada’s plan came about; “we might get it state by state.” The Californians listening might have taken heart. Twice that state has passed single payer plans, only to have them vetoed by their governor. Reid suggested that other states might also be ready to implement statewide health coverage.

As to his painful shoulder, its current status was not given. Presumably, it will be necessary to read the book to find out.

http://trueslant.com/franjohns/2009/09/14/it-is-a-moral-issue-it-is-a-moral-issue/