Where Are You Doctor? Where Are You Nurse?

Harlingen, Texas, August 31, 2009:  When ABC and NBC Television refused to accept the League of American Voters ad critical of the Obama healthcare plan, the two broadcast giants not only provided solid proof they endorse the Administration’s radical agenda, they also brought into the light a question most healthcare providers have been asking themselves. Where do we find all the doctors we will need?  Taking it one step further, where do we get all the nurses we will need?  These are very serious questions to ask, considering there is already both a doctor and nursing shortage in the United States.

The 33-second ad was voiced by a doctor who posed a simple question, “How can Obama’s plan cover 50 million new patients without any new doctors?  It can’t.”

Why would that claim be made?  At this time the United States finds itself thirty-second in the world for doctor to patient ratios.  At one doctor per every 390 people in the United States we are already behind countries such as Cuba, which has one doctor per 170 people, Russia with one doctor per 230 people and Mongolia with one doctor per 380 people.

As our population grows and doctors now in practice retire, replacements are always in demand.  Currently we graduate about 25,000 doctors each year and this does not even meet our current needs.  It is estimated that just to stay where we are at this time, another 4,000 to 6,000 doctors must be added to the 25,000 entering the healthcare field. 

The numbers can be a bit misleading, because each doctor does not attend to 390 patients.  Actually, each doctor is attending to the health needs of about 100 people during any fixed period of time.  To keep the same level of care under Obama’s plan to cover an additional 50 million people we need to have an additional 50,000 doctors in place…. today.  From that point onward, it means we will need to increase our medical school output upward to perhaps 40,000 new doctors every year.  That is a huge demand and an even greater challenge for medical educators.

It could be strongly argued that with such a large medical recruitment effort being required, the same thing would happen to the medical field that happens in the military when people are drafted into service.  The quality declines markedly.

What will happen to the quality of care when we are faced with increased doctor shortages, combined with the nursing shortages that already exist all across the United States?  When it comes to hospitals with low staffing levels, we already know the answer.  Those hospitals report higher rates of poor patient outcomes, including shock, pneumonia, cardiac arrest, urinary tract infections, slowed recovery and mortality.

At this time under our current medical and healthcare environment, we are facing a decline in the number of nursing personnel that will continue for at least the next two decades.  Healthcare providers now estimate that by the year 2020 there will be 800,000 hospital vacancies or a decline of 29% from today’s nursing workforce.

There have been multiple studies done related to job satisfaction and patient workload.  With an ever-increasing number of patients to serve, nursing job satisfaction plummets.  A full 40% of nurses claim they are unhappy with their working conditions.  Only 35% of nurses surveyed rated the quality of care they provide as excellent.  Almost 45% of these nurses indicated the quality of service in their hospital had declined over the past year.  An astounding 83% of nurses in the survey indicated they had their patient workload increased during the past year.

If all of these problems exist now, what will it be like a year from now if another 50 million patients are added to an already overextended nursing force?

So, again we will ask the same question the doctor in the League of American Voters ad posed, “How can Obama’s plan cover 50 million new patients without any new doctors?’ To that we will add, “How can Obama’s plan cover 50 million new patients without any new nurses?” It can’t!!!

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Forgotten Hero Remembered

Harlingen, Texas, August 25, 2009:  The Second Squad of Company G, Second Battalion, Seventh Marine Regiment was participating in a combat patrol from which they might never have returned, because they became victims of an enemy ambush. The rain of bullets seemed to come from everywhere at the same time.  The Marines found themselves pinned down by the explosions of hand grenades and withering small arms fire.  Nobody could move from cover.  The Third Squad moved up in support of their fellow Marines who had been overwhelmed by a strong enemy force.

According to the citation, it was a lone Marine who helped turn the tide of battle. With complete disregard for his own safety, Lance Corporal Steferino Rodriquez took the initiative and exposed himself to intense enemy hand grenade and automatic weapons fire.  He moved from position to position delivering a high volume of M-14 rifle fire.  He relaxed that fire only to toss hand grenades at the enemy positions.

During the firefight, the Second Squad Leader was severely wounded and was lying in an exposed position.  Though already wounded himself, and in severe pain, Lance Corporal Rodriquez immediately came to his fellow Marine’s aid.  At the same time he kept up a high volume of suppressive fire against the enemy forces only short yards away, eliminating several enemy soldiers.

What happened in this brief combat action sounds as if the events enfolded only yesterday.  They really occurred on March 24, 1968 in the Republic of Vietnam, during Operation Worth.  As it sometimes happens during the many rapidly changing events of combat, the recommendation for a medal in recognition of Lance Corporal Rodriquez’s valor was misplaced.

On August 25, 2009, friends, family and fellow Marines gathered to celebrate a special event in front of the Iwo Jima Memorial at the Marine Military Academy. A grey haired Seferino Rodriquez from Rio Hondo, Texas stood at attention as Marine Brigadier General Stephen Chaney read from the citation, which stated in part “Lance Corporal Rodriquez’s quick thinking, courageous actions, inspiring initiative and complete dedication to duty were instrumental in breaking the enemy ambush.”

Just 41 years, 5 months and one day from the time those first shots were fired, the former Lance Corporal Rodriquez was awarded The Bronze Star with a Combat “V” for Valor in recognition of his heroism.

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The KISS (Keep It Simple Stupid) Formula To Healthcare Reform

Harlingen, Texas, August 23, 2009:  There are many who accuse me of being on a tirade when in comes to writing about healthcare reform or healthcare insurance reform or whatever the politicos are calling it today.  Having spent the last ten years of my active working career as a senior healthcare administrator and the past six years as a consultant for the Texas Department of State Health Services, I have stored up a little information on the subject.  Thus I feel qualified to rant.

First of all, 1117 pages of Washington Speak is not a healthcare bill, but a collection of words designed to mislead or deceive.  Any logical, fair-minded legislator wanting to enlighten and encourage support would have developed a much shorter bill.  It would also have been written in language easily understood by the majority of the population.

Next, the bill would have been well researched utilizing the experts from the medical profession.  There is no lawyer, politician, governmental staffer, or lobbyist who knows more about how to effectively deliver and control medicine and treatment, than the practitioner.

At the top of the list in addressing cost savings or control would be trot reform.  This is not even mentioned by the Obama Administration or Congress.  That is understandable because no American locale has more lawyers per square inch than the congressional chambers of Washington D.C.  It is also well documented that the trial lawyers of the United States are extremely generous contributors to the Democrat Party.

One example often cited about how out-of-control malpractice law has become is the former Democrat candidate for President, the former Senator and the current defendant in a paternity case, John Edwards.  During a 12-year period, Edwards won $175 million in malpractice judgments.

Malpractice litigation has created skyrocketing medical costs for the past three decades.  One doctor that I visited has been the defendant in 10 malpractice cases.  His liability insurance costs went through the roof…and he was never convicted of a single charge.

It was so bad in Texas that medical practitioners fled the state in droves.  This deplorable situation remained a serious problem until 2003 when the Texas State Legislature passed a sweeping set of medical liability reforms.  It also offered the citizens a constitutional amendment to validate a non-economic damage cap in the state constitution.  Caps on non-economic damages were limited to $250,000 per occurrence.  Since the passing of that legislation more than 7,000 doctors have returned to the Lone Star State and costs have stabilized.  If such reforms were adopted nationwide, former New York Mayor Rudy Giuliani estimates medical costs would drop a minimum of 10%.

I often write about the Rio Grande Valley of Texas, which because of its proximity to the Mexico border is one of the most economically depressed areas in the country.  There are literally thousands of uninsured people making their homes in the delta region of the state.  They also crowd our emergency rooms to the tune of millions of unpaid dollars in care being provided annually.

But, again, the state has recognized the problem and is attempting to reduce the heavy burden our hospitals have been carrying.  Rio Grande State Center (RGSC) in Harlingen has an outpatient clinic that has been serving the indigent population and the working poor of a four county region for the past decade. Nobody is ever denied services.  Currently RGSC is in the process of having a new $10 million outpatient facility built which will be open this winter and will provide modernized and enhanced care.

RGSC serves the public to the tune of 50,000 outpatient visits a year.  All are accepted and are charged fees based upon their ability to pay.  Services are sometimes covered by insurance, but most often are pro bono. If the state outpatient clinic system were to become the operational model for healthcare reform across the United States, everyone in need could be served.

The third way to reduce costs and improve services would be to get third party payers (insurance companies) out of the billing process.  If patients paid their medical expenses out of their own funds and then sought reimbursement from their insurers, they would make sure every dollar expended purchased a dollar’s worth of value.

So, that would be my KISS formula. 1. Reduce the size of the bill, have it researched by medical experts and simplify the language.  2. Require meaningful national trot reform.  3. Establish statewide outpatient clinics for the poor and underserved.  4.  Have all payments made by patients to their doctors, and reimbursement sought after payment is made.  This may sound way too simple, but then, most solutions are never that complex.

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How To Hide The Truth - Washington Style

Harlingen, Texas, August 22, 2009:  We have all seen that motion picture and televised legal dramas.  One side is seeking important information and the other is attempting to keep that same information hidden.  The court orders full disclosure…and what happens?  The side wanting to keep a particular topic hidden provides the opponent with thousands and thousands of pages containing useless information.  The important words are hidden deep inside everything that was placed on the table.

Isn’t this the same tactic being used by Congress today?  A healthcare reform bill, renamed a healthcare insurance reform bill is offered to the public that is 1117 type written pages long.  Since the average type written page contains about 250 words that means the bill before any new amendments are added is already more than 28 million words long.  Those searching for its true meaning must dig deep into the pages to locate where the essence of the bill lies hidden, before they can make rational decisions.

It is estimated that the average person writing technical papers can generate between 1,000 and 1,500 written words a day of good researched text.  We all know that Congress spends as little time as possible in Washington.  It would be generous to say they have spent 150 days at work since the new Administration was formed in January of this year.  With that as a base point, Congress would need to have generated more than 187,000 words a day of well researched text to create the current bill being circulated.  That would mean each of the Democrat majority, since Republicans were not invited to participate, would have been required to contribute about 110 thousand well researched words to make up this grand total.  Considering the average number of good researched word work that can be generated, this would mean each Democrat in the House of Representatives would have been required to spend 73 to 75 days of work since January doing nothing but healthcare research and development of text.  If you believe they spent half their working days doing nothing but healthcare…you deserve anything they can pass into law.

Any thinking individual will realize this massive text is the combined work of lobbyists, lawyers, unions, pharmaceutical groups and other special interests that feel they can profit from nationalized healthcare legislation. Congressmen and women, who spend little time reading anything and less time writing their own copy, did not assemble it.  It was put together with cut and paste input by an army of staff personnel, each of whom has had the opportunity to mold the words in the particular direction he or she desire.

Americans, before accepting this 1117 page monstrosity would do well to reflect on some of the very important documents that impact their lives.  The Constitution of the United States of America was created through the input of 55 delegates from the 13 states in a Constitutional Assembly that met for 116 days from May 25 to September 17, 1787.  It contains just 4543 words, which would average out to less than 83 words per delegate and we know many of them had little input on the final document.

Even the most significant document in the history of our nation was very short for having a message of such significance.  The Declaration of Independence is the reason we are all here today as Americans, yet it is only 1458 words in length.

Those who believe in the Word of God as the ultimate law could also remind us that The Ten Commandments, written in the English language, contains only 331 words.

With so much at stake, do we really need to accept this massive healthcare reform/healthcare insurance reform legislation designed to confuse and deceive, rather than protect and serve the American people?  Most would answer…no.  Good, meaningful legislation should always be clear, concise and in a form the average American can readily understand.

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America's Leaders - Or Congressional Cowards?

Harlingen, Texas, August 19, 2009:  They came from across the Rio Grande Valley.  Citizens of every stripe, Democrats, Republicans, Independents and even non-voting youth from three counties were there. They gathered at a Town Hall meeting in Harlingen, Texas last night. 

A meeting room in the city library was filled to capacity with a standing-room-only crowd of more than 150 people.  Speakers were also placed in an outside patio area next to the meeting room, where another hundred taxpayers assembled to hear information on healthcare reform and other Administration proposals.  Everyone showed up, except the two individuals elected to represent those same voters in Washington D. C. 

“Here in Texas”, said one man, “we appreciate people with backbone, but that seems to be a missing body piece on the two members of Congress representing the southern tip of the Lone Star State.”

Though Texas is a very conservative state, the strength of the Democrat Party rests in the southern counties, all with majority Hispanic populations.
The 15th Congressional District stretches from the Rio Grande Valley to the Coastal Bend.  Voters have sent Ruben Hinojosa to Washington seven times since 1996, but he couldn’t be located to answer four separate Town Hall invitations, sent over several weeks to his office by constituents asking him to attend their scheduled gathering.

The Congressman, who is known for being a frequent flyer at taxpayer expense, was off on another junket to China.

When told of this latest “fact finding tour”, one Town Hall participant said we shouldn’t be too hard on Hinojosa.  “After all” said the man from McAllen, “he is our best representative – for Nancy Pelosi.”

Representing the 27th Congressional District of Texas is Solomon P. Ortiz. Though his district covers an area from Corpus Christi to the Rio Grande Valley, he is rarely seen in Brownsville or Harlingen and only appears when he is handing out money from a pork laden piece of legislation or running for reelection.  Still, voters have sent him back to Washington repeatedly since 1982. 

Ortiz not only refused to attend the Town Hall meeting, but also had his aide, Jose Borjon, insist to the media that only a member of Congress had the right to schedule such an event. “We feel that town hall meetings should be held by elected officials,” said Boejon.

Borjon said the Congressman also objected to his political challengers being members of the Town Hall panel. “Why can’t the constituents just talk to the people who are going to vote on health care reform.  What is the point of having others there?  He later reversed himself saying, “We want to make sure all parties are included”.  But, the Congressman still had no plans to attend the meeting.

Ortiz has also said that he might answer some questions via telephone, but would not be yelled at by voters.

How did this “no show event” come to pass?  First of all, it did not happen for lack of trying.  One man made repeated attempts to gain their participation.

Art Cohan served more than 20 years in the Marine Corps before retiring to help teach young men about leadership at the Marine Military Academy.  He is now fully retired and spends his days making sure his 13 grandchildren and 9 great grandchildren, along with everyone else he can reach, understand the Constitution of the United States of America.  He feels it is his responsibility to educate everyone about the Constitution and how our elected officials, almost from its inception, have violated it.

On four separate occasions, Cohan and the other meeting organizers sent letters to the two congressmen who represent Cameron County.  Because congressional mail takes at least two weeks to get into the hands of representatives due to security concerns, each mailed invitation was followed up with emails also requesting the elected officials to attend.

Congressman Ruben Hinojosa not only ignored the request from his constituents, but also refused to acknowledge the invitation and turn it down in writing or by telephone.  He then had his aide call The Valley Morning Star newspaper to tell the editor constituents should not organize Town Hall Meetings and that representatives of other political persuasions should not be present.

The reason Republican candidates Willie Valden and Eddie Zamora along with Independent candidate Douglas Purl were invited was to make certain some panelists would be present when the elected representatives refused to acknowledge their invitations.

Says Cohan, “I do condemn the two representatives for hiding from constituents.  I attribute part of it to arrogance, and a lot of it to fear.  They simply do not want to face the music, and answer constituent’s questions.  Perhaps they cannot.”

During the two-hour question and answer event everything was addressed from the Second Amendment to excessive spending. The majority of the questions and statements, however, were on the subject of healthcare reform.  Everyone in attendance remained very civil, but it was evident that the audience was extremely angry when they faced the podium and two empty chairs.

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The Enemies List Aftermath

Harlingen, Texas, August 9. 2009:  Hateful rhetoric is wrong, be it from the far left or the far right of the political spectrum.  It is wrong for citizens at town hall meetings to shout out denigrating slurs at their elected and appointed officials.  It is even a greater wrong for the Administration in power and political leaders to call concerned citizens “Nazis”, “mobs”, and other degrading identifiers.

It is true that Americans are very angry at just about everything taking place in Washington.  They are angry at excessive spending; a poorly structured nationalized health plan and the elite snobbery or self-righteous attitudes displayed by people who are sent to the nation’s capitol to be servants of the people.

By far the most angering incident I have witnessed was the White House call for Americans to report all “fishy” comments, misinformation or aggressive speech to Washington.  Be this a call for citizens to police the conduct of their neighbors or an action reminiscent of similar practices by totalitarian regimes, it has been another wrong-headed move that has enraged the country.  I have written hundreds of political commentaries over the years, but nothing in the past has generated such strong public response as an article last week titled “Making The Enemies List”. Public anger to that White House request is mammoth to say the least.

Dozens upon dozens of notes and comments have been filling the mailbox all week.  Among some of the more interesting is this one from John Sutherland of Portland, ME.  “Boy did I misunderstand the intent of the disinformation czar’s chatter. I thought, in the interest of keeping everyone honest, that we should send along reports that are providing misinformation.  I’ve already turned in the Hawaii Department of Health for their disinformation efforts.  I guess I really screwed up that effort to be open, honest and transparent.”

The American Center for Law and Justice writes, “Make no mistake, this outrageous attack on free speech is designed to stifle public debate about health care issues – including growing concerns from Americans opposed to making abortion services mandatory health benefits.”

Louise Wilson of St Louis, MO says “Give me liberty or give me death is ingrained in our DNA.  I too, have sent Washington an email so they won’t have any trouble finding me.”

Jerry Jackson, writing from Hawaii says, “The only thing I sent the flag address is a tea bag.” Another who thinks he too is on “the list” is retired Marine Colonel F. Phil Torres.  He writes “I am honored to be in the company of real critical-thinking American citizens.  I detest the Chicago mafia gone national.  I want the sheeple to wake up before it is irreversible.” Another friend, Colonel Wayne Morris, USMC (Ret) comments on the “Making The Enemies List” commentary saying “Another great article smack dab in the middle of the V-Ring!!!!” For those of you who do not support the Second Amendment, that means right in the center of the target.

Bob and Lucy Sewell think they have already made the White House enemies list.  They say they have been sending out emails because they are “Standing up for their rights and for the rights of American citizens.

Jo Dermody is a Marine widow.  Her husband was a Major who flew combat missions in Vietnam.  Writing for Little Meadows, PA she says, “I spend every week day calling congress people, governors, etc.  I am a conservative GOPer.  However, if they don’t shape up soon, I will become an independent.” She agrees with the article and thinks she is on that infamous list.

Michael Boldin of the Tenth Amendment Center reflects, “Remember the good old days, when one only had to watch out for the Federal Government’s twisted interpretation of the commerce clause to justify tyranny?  Well those days are long gone.  The Obama Administration has been employing an old tactic lately –what some might call an imperial threat – and they’re not doing it overseas, either.”

William Bloomfield had a very interesting thought.  “I, too, have reported myself to the “brown shirt” central at the White House”, he said. “The great thing about this is that the White House MUST keep a record of all correspondence in or out of the White House.  So, these words will become a matter of public record.”

Robert William Butler, Jr. knows the White House has tagged him.  Commenting on sending emails containing “fishy” comments to flag@whitehouse.gov he says, “Needless to say this is direct violation of 1st Amendment rights. It is highly unethical and insulting”.  He concludes with “These are truly difficult times.  We need to take back our future from the wrong hands in America.”

To be fair to all concerned, not everyone agreed with the article about making the enemies list.  Thomas A. Richards, a retired Marine Lieutenant Colonel from San Diego California took acceptation to the conversations we have over lunch at Rotary.  He feels I violated some Code of Rotarians by suggesting our President should refrain from collecting the First Amendment protected words of fellow citizens. He charges the article reveals, “A significant amount of blatant hatred that I cannot help but attribute to racism.  Sad and shameful.” He concludes by remarking the article suggests, “All Rotarians are in agreement with his ignorant, racist, and paranoiac rants.”

Another writer from the Floresville area of Texas, who only identifies himself as “Joey” says, “The good thing about healthcare reform is that they still won’t be able to extend the life expectancy of old white people long enough to save the GOP.” Along with that comment comes a similar one from John Ewstat of San Antonio, TX who writes, “The demographics are against the Republicans.  There are not enough dumb people to replace your generation.”

Ken Semlinger of Poth, TX has this suggestion for the writer.  “You should write your articles under phony names like your detractors.  At least it would take the goon squads longer to find you.  Oh, I forgot, you speak the truth.”

Louis Hall says, “Most of us are on the list.  Time to band as one unit.” Franklin Rogers requests, “Add my name to the list.  We are in good company with those who signed the Declaration of Independence.” Tom Knight reports, “I am on the enemies list, too!” Craig Roberts agrees and says, “Roger that! I’m sure I’m on the list multiple times.” On the same topic Jeff of Right Side News.com reports “Concerned Americans are taking their voices collectively to D. C. four buses are booked just from our local groups here in Richmond, Virginia and it is growing…yes sir!”

Finally, my friend, author and fellow former combat correspondent, Charles W. Henderson of Colorado sent this thoughtful and worrisome note.  “I was in LA
This spring doing an ABC News 20/20 segment.  The producer, a Columbia journalism grad, told me that their background on me revealed that I was on Obama’s watch list.  I told her I had zero clue.  I love America and would defend our President with my life, no matter who he is.  I am certainly no threat to any of our leaders duly elected or legally appointed.  I then told her about a similar list created by Joseph Stalin.  During the 1930’s he had those people executed in two major purges.  This is one aspect of Stalin that drew him together with Hitler and kept them close until Hitler attacked Russia on June 22, 1941.  Even then Stalin could not believe that his friend had betrayed his years of support and good faith.”

I seriously doubt The Administration has any plans close to those historical similarities, but I will continue to follow the Reagan doctrine when it comes to those we have placed in high office… “Trust but Verify!”

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Making The Enemies List

Harlingen, Texas, August 6, 2009:  Those of you who tuned in to television or radio news in the past two days have now heard about the new target of the Obama Administration---You!  I have read that message from our President and the White House.  It is now very clear to me that I am right up near the top of the Enemies List the administration seems to have been collecting during its short time in power.

First, I made the list when Homeland Security sent out a message that veterans, along with those who held close to their beliefs by clinging to God and guns were a danger to America.

It is also clear to me that since I have attended some Tea Party meetings and nobody in the audience had anything good to say about the government, that we all were tagged as enemies.

Most of my fellow Rotarians and me are surely on the White House list. At our meetings we have many casual conversations about what we view are the wrong-headed decisions made in Washington.

I am guilty of sending my friends interesting videos from Youtube.com and other sources. Most of them have been very critical of the Washington elite.  I also forward emails on the same topics.

The only thing I can see wrong in their message to America and the attempt to form a communist-style citizen watch of informants, is the claim everyone involved is a GOP operative.  I take as many shots at the Republicans as I do the Democrats.  In fact, if the White House will view what I have said in detail, they will find I believe we only have two major parties in the United States…Democrat and Democrat-Lite.  Those of us who are really angry have no political party.  We are American Conservatives.

According to President Obama and his band of experts, I must be guilty of disinformation.  So far, in 2009, I have written a total of 34 commentaries totaling multiple thousands of words…all critical of what is taking place in our nation’s capitol.  According to this new band of Chicago Politic Police, the claim is I am a member of this organized mob pretending to be angry at plans for nationalize healthcare.  Well, they have missed the target by miles.  I am part of that unorganized band of patriots who hate seeing what is being done to the country we love.  So, Mr. President, today I will send a copy of this commentary to flag@whitehouse.gov just as you requested.  If you need more information about my misconduct, I refer you to my service record book.  You will find a 26-year history of everything I did as a United States Marine.

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We Didn't Elect You To Do This!

Harlingen, Texas, July 31, 2009:  Well, Mr. and Mrs. Congressional Member.  You are now heading home for another month-long holiday at taxpayer expense.  A few of you may even have enough backbone to face your constituents on the issue of this massive healthcare takeover.  You might even answer some of the questions that are really bothering us out here in the flyover states.

Do you really think we sent you to Washington so you can have mandatory audits of employers who self-insure their workers?  Do you think we placed you in office so politicians can ration our healthcare?  Do you really believe a government committee should decide what healthcare treatments and benefits we receive?

As one of the Washington elite, do you really think you are qualified to name a Health Choices Commissioner who can rule on our care, and even deny us the right to appeal?  And can you tell us just when we authorized you to provide free health care to every legal and illegal immigrant in the United States?

We don’t remember telling you we wanted every person in the United States to carry a National Identification Health card.  We also don’t remember telling you we wanted the government to have access to all of our individual bank accounts and money transfers.  While on that subject, when did we tell you that we wanted the government to subsidize the healthcare of organizations such as the United Auto Worker Retirees and ACORN with our tax dollars?

Perhaps you can explain to us why all private healthcare plans must conform to government rules and participate in a healthcare exchange.  While explaining, please tell us why you will be paying ACORN and Americcorps to sign up people for the Government Healthcare Plan.

When did the government become so knowledgeable it could determine the wages of doctors, nurses and other providers?  How are you improving care when your bill calls for every doctor, regardless of specialty, to receive the same pay?  How does it improve services to have the government reduce medical and physician services for Medicaid?  How did you arrive at the idea of the government deciding just who can rent or purchase a power-driven wheelchair?

While on the subject of patient care, when did the government become experienced enough in medical treatment to know what a preventable re-admission to a hospital is…and fine hospitals for such readmissions?  Oh, and by the way, we notice that doctors who treat those unauthorized hospital re-admissions will also be penalized by the government.  Some of our better hospitals and clinics are owned and operated by doctors, but your bill pointedly prohibits such ownership.  You have also decided to make it a Washington D. C. decision to even expand the number of hospital beds anywhere in the United States. Why?

Among the many wrong-headed provisions in this gigantic, pork laden bill we notice the government will now instruct us on advance care planning, living wills, durable powers of attorney, and other legal concerns, Oh yes, these consultations will also be mandatory. But, we see you have found a good cost saving measure by rationing mental health services.

When you get home, please tell us just how you arrived at having the government give us a list of end-of-life resources and mandating a program that orders what end-of-life treatment we will receive.

We all realize you will be unable to explain any of this, because you haven’t bothered to read the 1017 page bill that authorizes everything reported on in this commentary.  But, maybe, just maybe, you can take the time to read up on these items.  They, and many more just like them, can be found on the first 494 pages of this unbelievable document.

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