INdiana Systemic Thinking

February 17, 2008

One Reason Not to Socialize Medicine

Today, United Press International carried a report highlighting one of the reasons why socialized medicine may not be the way to go.  Long story short, when you put bureaucrats in charge of healthcare (not that they aren’t already in the U.S.), stupid things happen.

Specifically, The British National Health Service decided patients were waiting too long to see doctors at emergency rooms.  So, the Labour party instituted a policy where all patients had to be seen by physicians within four hours of being admitted an Emergency Room.  When hospital administrators could not meet the requirements of the policy, they just stopped admitting people to the emergency room.  According to the story;

…the delays not only pose a health risk to patients, but keep ambulances occupied and unable to answer emergency calls.

“This is evidence of shocking systematic failure in our emergency services,” Lamb said. “As well as thousands of patients being stuck in ambulances when they should be getting urgent treatment, there will be countless others left waiting longer for ambulances to arrive.”

The Mail said current figures show that last year alone, an estimated 43,576 people were forced to wait for more than an hour to enter a British emergency medical unit for treatment.

If you don’t believe me, check out the story for yourself.

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February 8, 2008

State Gets 21k Applications for HIP, But…

Yesterday we got news the state received 21,000 applications for the Hoosier Insurance program.  However, and what really matters is, only a fraction of those have been approved.  According to the Fort Wayne News Sentinel:

While the state took 21,101 applications between mid-December and Wednesday, it has processed only 6,198, Roob said. FSSA is meeting the CMS requirement that applications get processed within 45 days, he said.

Of those processed, FSSA has rejected about a fifth for a variety of reasons, including exceeding income limits or eligibility for employer-sponsored plans, Roob said.

Another 3,392 applications, or more than half of those processed, remain pending approval, and Roob said he expects many of those came from applicants with children, since the state requires more paperwork from them.

Only 295 of the applicants have received full approval, and 1,299 others have conditional approval.

FSSA has hired 46 additional people to staff the health plan, , Roob said. The agency expected to enroll only 50,000 people this year.

At this rate, only about 1,800 will be enrolled by the end of the year.  Hope they get those additional people hired soon as there is certainly demand.

January 25, 2008

Govt. Screw-Ups, Unfair and Inconvenient

Aside from huge tax bills, another thing that gets people madder than heck is when government employees screw-up.  Now everyone is human and we all screw-up from time to time, but when a screw-up ruins someones life or bring to light a hugely unfair system is when people start becoming less and less forgiving.

Look at these two examples, the first if is from the Northwest Indiana Times.  The second, from the Fort Wayne Journal Gazette.

A rural Crown Point man said he learned the hard way Wednesday taxpayers can only depend on themselves to have and hold their property tax deductions.

Norman R. Walters said the county failed to give him credit for his mortgage exemption for the last 13 years, but they still refuse to give him a complete refund.

Dan Repay, tax director for the county auditor’s office, confirmed no taxpayer can be compensated for 13 years of overtaxing.

“The law only lets us go back to correct three years,” Repay said. “I apologize to the gentleman, but I can’t go beyond the law.”

Repay said his office struggles to manage a variety of exemptions on 240,000 separate parcels of land. He said it is ultimately the taxpayers’ responsibility to ensure their exemptions are in order.

The retired steelworker said he has more than an average attachment to his house, sitting on more than an acre in Holiday Creek subdivision southeast of the city limits. He said he has been living there since 1974.

“I built my own home,” Walters said. “I’ve never missed a tax payment, and this last bill went up 26 percent.”

Walters, 66, living on a fixed income, said he began investigating whether to pay off the remainder of his mortgage or keep it and the mortgage exemption — $3,000 subtracted from the property’s assessed value — as a hedge against the rising property taxes.

His investigation led to the discovery he didn’t have a mortgage exemption.

“They told me I hadn’t had one since 1979,” Walters said.

Walters said he couldn’t believe what he was told, so he rummaged through his records and found a receipt, dated 1994, that he had filed for an exemption when he refinanced his home under the administration of former county Auditor Anna Anton.

Walters said he took his 1994 document back to the county complex and was told he is entitled to a refund — but only for the last three tax years, with interest, or about $194.

“It should be four times that amount, and they said I have to pay taxes on my refund,” Walters said. “Look, its not my fault.”

And now the second one:

A Muncie woman says she is trying to make ends meet after the government mixed up her Social Security benefits following her supposed death.

Toni Anderson, 60, said her problems began after her husband, John, died Nov. 8. She went to a local Social Security office to enroll for widow’s benefits and was told that records indicated she, not her husband, had died.

Anderson, who is disabled, already received supplementary security income. The Social Security office secured those benefits for December, she said, but she has not received any more – or widow’s benefits – since that $623 check, which was made out to her husband.

The government also sent a letter to her deceased husband, dated Nov. 16. It begins, “Dear Mr. Anderson: Our condolences on the loss of Mrs. Anderson …”

A Chicago-based regional communications director for the Social Security Administration declined to comment when contacted for a story by The Star Press.

Anderson said the regional official and a manager at the local Social Security office both contacted her this week and said they were working to correct the problem.

“In their eyes, I don’t know whether I’m dead or not still,” Anderson said. “Last I heard, I’m still dead.”

Any wonder why taxpayers are up in arms?

January 24, 2008

Black Marriage Amendment?

Not really, but I betcha that got your attention.  Now before you start sending the blogmeister hate mail, read this story over at the Indy Star.  Which makes more sense, the nonsense about the real marriage amendment currently going on over at the statehouse, or doing something to help a portion of our population that really, really needs it.  From the story:

About eight in 10 black children in Indiana are born to unwed parents — a start to life that sets them up for problems during adolescence and beyond, according to an Indiana Black Expo report.
Indiana’s black youths fare significantly worse than Hoosier youths in general across 18 indicators of well-being, such as graduation rates and poverty levels, and do worse than black youths in the U.S, according to the report being released Friday.
The explosion of births to unwed parents is driving many of the state’s social problems, such as increases in poverty and child abuse and the growing cost of public aid, said Bill Stanczykiewicz, president and CEO of the Indiana Youth Institute.
He added that the problem is not exclusive to any one race.
Indiana’s out-of-wedlock birthrate is at an all-time high, with unwed mothers accounting for nearly 40 percent of all births, he said. Nationally, about 36 percent of all births are to unwed mothers.

Charity Bailey Appealling Release of Records

As most will recall, Charity Bailey, along with Lawrence Green, is accused of beating her daughter, Tajanay Bailey to death back in November.  The case shook the Department of Family Services to it’s core, mostly because Juvenile Court Judge Marilyn Moores ordered the release of records pertaining, not just to TaJanay, but older records of Charity Bailey.  Now, according to the Indianapolis Star, Charity Bailey is appealing that, as well as other decisions, made by Moore.

An attorney representing the mother of TaJanay Bailey has notified the court she will appeal two court decisions releasing juvenile records in the case.

On Jan. 3, juvenile court Judge Marilyn Moores granted The Indianapolis Star’s request to release records in the earlier of two child-welfare cases involving TaJanay. The judge also released the juvenile records of the girl’s mother, Charity Bailey.

TaJanay, 3, died Nov. 27 of apparent abuse. Bailey and her boyfriend, Lawrence Green, both 20, face murder and neglect charges.

Attorney Frances L. Ashton filed a notice last week that Bailey would ask the Indiana Court of Appeals to review Moores’ decision. She also notified the court that she would appeal a Jan. 11 decision by Moores granting The Star’s request for a transcript of the last court hearing before TaJanay’s death.

January 22, 2008

FSSA to Pay For Substance Abuse Program

Finally, someone, somewhere, is looking at treating Substance Abusers.  In an area where money is usually non existent, comes this from the Indianapolis Star about a pilot program in Vigo County.

The Indiana Family and Social Services Administration has been awarded $14.49 million over three years for the Access to Recovery program.

That includes more than $1.44 million annually targeted to people recovering from meth addictions, which will be the focus of the Vigo County program. He said 30 percent of the program’s money must be spent on meth users.

Addiction treatment providers, include faith-based agencies, will apply to participate in the program, Scott said. The agencies are reimbursed for services from state vouchers. Services include care coordination, clinical treatment and recovery support.

January 21, 2008

Anthem CEO Interviewed: Wants MORE Business

From the Indianapolis Star this morning comes an interview with the new CEO of Anthem.  Really nothing new (about Anthem) in the article and the reporter asked a lot of softball questions.  What was new, at least to the Blogmeister, is Anthem’s new buddy-buddy relationship with M-Plan who has apparently decided they cannot compete with Anthem and is giving them a large portion of their business. 

Say what you want about the government running a single payor health system, but it appears Anthem is well on their way to providing a private single payor health system, at least in Indiana.  As you read the quote from the story below, keep in mind WellPoint, Anthem’s parent company, according to CNN, made almost 57 billion dollars in 2006 (2007 isn’t available yet).

Anthem Blue Cross and Blue Shield of Indiana is big and it’s getting bigger.

The healthinsurer, part of Indianapolis-based industry giant WellPoint, provides health benefits for roughly 2.5 million Hoosiers. Anthem controls about 60 percent of the commercial health insurance market statewide, according to an analysis by the American Medical Association.

Robert Hillman took the helm of that insurance behemoth when he was named president of Anthem Blue Cross and Blue Shield in Indiana last October.

These are busy times at Anthem. The insurer has been working — under an endorsement agreement with M-Plan, a 125,000-member Indianapolis health maintenance organization that is shutting down — to gain new members. Anthem also is helping to run Indiana’s Healthy Indiana Plan, which provides coverage for low-income Hoosiers.

But Anthem also is involved in high-profile disputes with two physician practices over reimbursement rates and frequently is criticized for selling coverage that many say is simply unaffordable.

Hillman talked with The Star last week after his first few months leading Anthem in Indiana. This is an edited transcript of that conversation:

Question: What are your biggest priorities?

Answer: The primary goal is to make sure we fulfill our mission, which is to improve the lives of the people we serve and the health of our community. We’re looking at making sure that we continue to deliver products that provide value to our customers and that we’re participating in programs that are really improving the health and wellness not only of our members but also the community at large.

Q: Given Anthem’s large market share, where do you see the biggest potential for growth?
A: We still think the consumer- directed market is a big market opportunity for us. The other, obviously, is the uninsured market, particularly in the two- to 50- employee market, where you have really an alarming number of employers who are electing not to participate in the private health- care market and are dropping their health-care coverage.

It’s an opportunity to develop products that bring those folks back into the private payer market.

Q: How much business did Anthem capture from M-Plan shutting down its HMO business? Has the transition been smooth?

A: Well over 50 percent (accounting for 75,000 to 80,000 new Anthem members) of that business transitioned over from M-Plan.

The transition went really smoothly because the partnership with M-Plan, once they decided to exit the business, the cooperation on their part in working not only with our sales team but also our operations team, you couldn’t have asked for a better number.

Q: Indiana has roughly 750,000 people who are uninsured. As the state’s largest commercial health insurer, does Anthem share in the blame for the large number of people who find health coverage unaffordable and unattainable?

A: I don’t think there’s any single payer that’s to blame. We’re all operating in the system that we’re operating in, which is the private payer system, which is an employer-based system. No employer is required to offer health insurance, nor is any (insurer) required to offer health insurance.

What I do think we have an obligation to do, and it’s a challenge, is to try to develop products that are affordable and that provide value to employers and their employees so they want to participate in the private-payer system.

We have an obligation to cooperate whenever we can and however we can with government, like we have cooperated with Gov. Daniels and his Healthy Indiana program.

10% Laid Off At Dunn MHC

Calling it a “temporary reduction in force”, Dunn Mental Health Center is saying goodbye to 29 employees, according to the Indianapolis Star.  This accounts for almost 10% of their workforce.  Not wanting to sound partisean, here is the whole story from the Star.  Remember, she said it, I didnt.

Twenty-nine employees of Dunn Center Mental Health in Richmond have been laid off, said CEO Kay Whittington on Sunday.Whittington called the “temporary reduction in force” a result of Gov. Mitch Daniels’ proposed cuts in Medicaid and a bill that could limit how much Medicaid communal health centers may offer.
Dunn Center is comprised of a staff of more than 300.”We have had a temporary reduction in staff across (the) seven counties that we provide services to,” Whittington said.The Dunn Center is a Medicaid provider, and the state government has “dramatically reduced what (the center) can do for Medicaid rehabilitation options,” Whittington said.Gov. Mitch Daniels said in early January a new budget forecast that shows state revenue falling below predictions could lead to some cuts “in some of the entitlement programs like Medicaid.””It all relates to that,” Whittington said.Five of the 29 positions laid off are part-time and the rest are full-time, and Whittington said many of the employees were offered a transfer into other positions.

Whittington said she knows of other communal health centers in the state that have laid off workers.

“We’re all faced with the same thing,” she said. “You can’t wait for the ship to sink.”

Whittington will be available for further details about the situation today, she said.

“We wanted to make sure our staff had the weekend to think about (transferring).”

January 20, 2008

New Info on Phoenix Apartments

The Indianapolis Star has an excellent report on the owner(s) of troubled Phoenix Apartments this morning.  It details the rise of the company that owns the apartment complex and it’s founder.  The article is really long and worth reading, but it is difficult to summarize it here.  So read the story for yourself and come on back.

However, in the Blogmeister’s opinion, the people more to blame for the living conditions at Phoenix are the Housing and Urban Development Inspectors who continued to improve the complex’s ratings over the last three out of four years.  From the story:

The complex got new roofs and new windows and scored steadily higher in annual health and safety inspections by contractors working for HUD. The apartments, graded on a scale of 1 to 100, averaged 44 in 2004 when Belfonti took over, then 68 in 2005 and 91 in 2006.
In 2007 it went down to 77 according to the story.  The Blogmeister continues to wonder how a facility can score this high, even at 77, when local officials who toured the facility are quoted as saying it was “unlivable”.

Drug Test Welfare Recipients?

The Evansville Courrier Press has a good story about a Kentucky lawmaker who wants to start drug testing people who rely on various welfare programs.  The argument for this seems to be that many people in the private sector have to undergo drug tests for their money, so why shouldn’t welfare recipients.  The argument against it is what do you do with the children of parents who test positive?  In addition, there is this bit of history:

Michigan briefly required drug tests for welfare recipients in 1999, but was ordered by a federal judge to stop just weeks into the program when the American Civil Liberties Union filed suit. After a federal appeals court in Cincinnati ruled the law unconstitutional in 2003, Michigan officials reached an out-of-court settlement with the ACLU, agreeing to stop the drug-testing program.

So, this legislation probably won’t go anywhere in Kentucky, but if it does, it may come our way soon.

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