Sma' Talk Wi' T

Current world events, politics, news, history, culture, trivia, religion, and the quirky

My Townhall Question

with 5 comments

UPDATE: 10/2009 AMA states publically that breast cancer and prostate screenings may be overrated. Could it be that the AMA (Obama minions) may be setting the American people up for less services, less access to mammograms and PSA tests due to the costs and time of these exams?

Senator Grayson stated that services for women would not be cut. The AMA begs to differ with the pompous Grayson.
~~~~~~~~~~~~~

Senator Grayson: The townhall meeting was at a venue that only held 125 people.  Over 800 anti-ObamaCare voters showed up.   You were full of misinformation and misused statistics to get your opinion across. You said you read HR 3200 yet you didn’t understand what I was referring to in the bill.

Let me explain if I can. This is what is in Bill HR 3200 Page 483 ‘‘(iii)(1) Subject to the succeeding provisions of this 13 subsection, the term ‘Medicare covered preventive services’
14 means the following:
15 ‘‘(A) Prostate cancer screening tests (as defined 16 in subsection (oo)).

 
 Page 484 ‘‘(K) Screening mammography (as defined in 19 subsection (jj)).
20 ‘‘(L) Screening pap smear and screening pelvic
21 exam (as defined in subsection (nn)).  

There is no (oo)) or (nn) in HR 3200 but it’s in the Medicare bill  but there is a (jj) in HR 3200

Subsection (jj)
(2) ELIMINATION OF COINSURANCE IN OUTPATIENT HOSPITAL SETTINGS.—
11 (A) EXCLUSION FROM OPD FEE SCHEDULE.—)) is
14 amended by striking ‘‘screening mammography
15 (as defined in section 1861(jj)) and diagnostic
16 mammography’’ and inserting ‘‘diagnostic
17 mammograms and Medicare covered preventive
18 services
(as defined in section 1861(iii)(1))’’.
 
Here are some definitions of diagnostic and screening:
Diagnostic mammography is an x-ray exam of the breasts that is performed in order to evaluate a breast complaint or abnormality detected by physical exam or routine screening mammography. Diagnostic mammography is different from screening mammography in that additional views of the breast are usually taken, as opposed to two views typically taken with screening mammography. Thus, diagnostic mammography is usually more time-consuming and costly than screening mammography.

The goal of diagnostic mammography is to pinpoint the exact size and location of breast abnormality and to image the surrounding tissue and lymph nodes. In many cases, diagnostic mammography will help show that the abnormality is highly likely to be benign (non-cancerous). When this occurs, the radiologist may recommend that the woman return at a later date for a follow-up mammogram, typically in six months. However, if an abnormality seen with diagnostic mammography is suspicious, additional breast imaging (with exams such as ultrasound) or a biopsy may be ordered. Biopsy is the only definitive way to determine whether a woman has breast cancer.

Medical screening and medical surveillance are two fundamental strategies for optimizing employee health. Although the terms are often used interchangeably, they are quite distinct concepts. Medical screening is, in essence, only one component of a comprehensive medical surveillance program. The fundamental purpose of screening is early diagnosis and treatment of the individual and thus has a clinical focus. The fundamental purpose of surveillance is to detect and eliminate the underlying causes such as hazards or exposures of any discovered trends and thus has a prevention focus. Both can contribute significantly to the success of worksite health and safety programs. However OSHA “medical surveillance” requirements are generally clinically focused (e.g.,medical and work histories, physical assessment, biological testing) with information obtained from the clinical processes used in the monitoring and analysis elements of medical surveillance.
  
This is what Medicare pays for:
 This is the Medicare ruling says that women enrolled can receive a mammogram once a year.

HCFAR 96-2-6

…physicians’ services. Section 1848(j)(3) defines “physicians’ services” for the purposes of section 1848, “Payment for Physicians’ Services.” Section 1848(j)(3) provides that the diagnostic x-ray tests, including diagnostic mammography, described in section 1861(s)(3), are physicians’ services.
Therefore, because diagnostic mammography services are considered physicians’ services, the refund requirements of section 1842(l) apply to claims for diagnostic mammography services submitted on an unassigned basis and denied under section 1862(a)(1)(A) as not reasonable and necessary. The physician or supplier/mammography center which furnishes a diagnostic mammography service may be required to make refund under section 1842(l). Where the service was ordered, but was not furnished, by an attending physician, the ordering physician cannot be required to make refund. Screening mammography is defined in section 1861(jj), not in section 1861(s)(3), and, therefore, is not a physicians’ service. Because screening mammography is not considered a physicians’ service, however, the refund requirements of section 1842(l) do not apply to claims for screening mammography services submitted on an unassigned basis and denied as not reasonable and necessary. Furthermore, limitation on liability under section 1879 cannot be applied to such denied unassigned claims for screening mammography services on the basis of a denial under either section.

There is nothing like denied as not reasonable and necessary in the prostate cancer screening. There is nothing regarding changes in technology and standards of medical practice, availability, effectiveness, costs. 

80.5 – Prostate Cancer Screening
(Rev. 1, 10-01-03)
Sections 1861(s)(2)(P) and 1861(oo) of the Act (as added by §4103 of the Balanced Budget Act of 1997), provide for coverage of certain prostate cancer screening tests subject to certain coverage, frequency, and payment limitations. Effective for services furnished on or after January 1, 2000, Medicare covers prostate cancer screening tests/procedures for the early detection of prostate cancer. Coverage of prostate cancer screening tests includes the following procedures furnished to an individual for the early detection of prostate cancer:
Screening digital rectal examination; and
Screening prostate specific antigen (PSA) blood test
Each test may be paid at a frequency of once every 12 months for men who have attained age 50 (i.e., starting at least one day after they have attained age 50), if at least 11 months have passed following the month in which the last Medicare-covered screening digital rectal examination was performed (for digital rectal exams) or PSA test was performed (for PSA tests).
Payment is made under the clinical diagnostic laboratory fee schedule.
80.6 –

Screening Pap Smear; Screening Pelvic Exam

(nn)(1) The term “screening pap smear” means a diagnostic laboratory test consisting of a routine exfoliative cytology test (Papanicolaou test) provided to a woman for the purpose of early detection of cervical or vaginal cancer and includes a physician’s interpretation of the results of the test, if the individual involved has not had such a test during the preceding 2 years, or during the preceding year in the case of a woman described in paragraph (3).

(2) The term “screening pelvic exam” means a pelvic examination provided to a woman if the woman involved has not had such an examination during the preceding 2 years, or during the preceding year in the case of a woman described in paragraph (3), and includes a clinical breast examination.

(3) A woman described in this paragraph is a woman who—

(A) is of childbearing age and has had a test described in this subsection during any of the preceding 3 years that indicated the presence of cervical or vaginal cancer or other abnormality; or

(B) is at high risk of developing cervical or vaginal cancer (as determined pursuant to factors identified by the Secretary).

Prostate Cancer Screening Tests

(oo)(1) The term “prostate cancer screening test” means a test that consists of any (or all) of the procedures described in paragraph (2) provided for the purpose of early detection of prostate cancer to a man over 50 years of age who has not had such a test during the preceding year.

(2) The procedures described in this paragraph are as follows:

(A) A digital rectal examination.

(B) A prostate-specific antigen blood test.

(C) For years beginning after 2002, such other procedures as the Secretary finds appropriate for the purpose of early detection of prostate cancer, taking into account changes in technology and standards of medical practice, availability, effectiveness, costs, and such other factors as the Secretary considers appropriate.

I was asking about the disparity between the wording between female diseases and male diseases.  What is wrong with a 1300 page health care reform bill that is so complex lawyers can condescendingly say that they are the only ones that can explain it?  What’s wrong with a health care reform bill that just says:

If you’re an United States legal citizen: You will be allowed to be born healthy and stay healthy.  Sen Grayson, if you’re so worried and cry easily over 18,000 or 80,000 people (whatever it is…right?) dying because of lack of health coverage, just think of the millions of babies in the United States that die due to abortion every year.   Well, let’s just say more than 80,000 babies. That sounds better.

You can buy insurance from any health insurance company in the United States.  Competition is good. Just ask Fed Ex and UPS.  Don’t ask the Post Office.

If you cannot afford the insurance you want, you will not be denied health care. Period. That’s what Medicare and Medicaid are there for.  Sign up.

If a doctor carves his initials on your stomach – he will go to jail.  Sen. Grayson, how often does this happen? You cited unreasonable examples of medical malpractice that are rarities.  I googled the Zarkin case and it only happened once.
Tort reform, stopping Medicaid and Medicare fraud should come first. Between tort reform and stopping corruption that 1% you scoffed at, Sen. Grayson, will save our country $60 billion every year. 

~ You cited Canada, Great Britain, and Europe’s national health care plans as doing well, but you did not inform your stacked audience that Canada’s citizens sued in 2005 to be able to go to private doctors because patients were waiting over a year before a doctor could see them and Europe has been trending towards privatization of health care since 2005 because government health care has not been effective.

You didn’t say that there was no need for “end of life” counseling in HR 3200 because its’ already in Social Security 1861.  

 I did not appreciate being asked at the first door I tried to enter if my name was on “the list” and when I replied “what list” I was told to go wait on the other side of the building.

Sen. Grayson, I did not appreciate that your staff stacked the townhall with over 70 (seating capacity 125) of Obama voters, some who were not from District 8, others who were union members, who were allowed to get into the room before 5pm for 7:45pm meeting, others who were allowed through the back door while hundreds of District 8 voters were out front and kept outside.  
I did not appreciate you bringing up the billions of dollars being spent on the Iraq war that the majority of Democrats voted for to begin with at a health care reform bill.
 
HR 3200 will not go into effect fully until 2013.  There is no need to sign a bill now.
 
In this townhall, you gave us very little specifics and a lot of specious opinions. 
 
Your lack of humility is what you are known for and your condescension will not be forgotten.
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Written by smalltalkwitht

August 18, 2009 at 12:43 am

Posted in Uncategorized

5 Responses

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  1. Excellent observations!!! It is also proven that men of color are more likely to develop prostate cancer as well, due to the genetics…Wonder if Barry will be screened soon?? It is apparent from what you have mentioned and what I have viewed via cable news outlets that they ( the Democrats) are running scared and using plants like Barry did with the use of that poor child and closing the doors in the faces of the very ones that sent them to DC. Oh how exciting it will be to see 2010 roll around, The nation is trending more conservative as we speak, they should be prepared to sign up for the type of care they are trying to force on us! For when this is over, they too, will know what is like to stand in the unemployment line!

    Erica

    August 18, 2009 at 1:20 am

  2. Smokin work! Nice job.

    klsouth

    August 18, 2009 at 1:38 am

  3. The only reason the Government wants to get into the health care business is to be able to funnel over another 14% of our total economy through DC. Understanding that will help one to understand why they will say or promise anything to implement that agenda. In the end, the government will have to cut a multitude of corners to save costs because the public will see any losses/overages for what they really are, another bill ( spelled “new tax”) taxpayers will have to pay. What is needed in Health Care is more competition. Health care companies have merged at such a pace as to be considered oligopies.

    Celtmann22

    August 18, 2009 at 8:50 am

  4. Enjoyed this. I hope you will read my post on OSHA at the doctor’s office. (the bluegrass way)

    drtombibey.wordpress.com

    drtombibey

    September 20, 2009 at 7:30 pm

  5. […] is Arizona Sen John McCain or lunatic Alan Grayson who told me at union and Democrat-stacked townhall meetings that Medicare services would NOT be […]


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