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Wednesday, May 29, 2013

How do doctors get paid? #tcot

How do doctors get paid?

by Megan Lewis, M.D., a family physician in rural Colorado.  

Imagine going to your favorite restaurant.  You are greeted at the door by the hostess, who seats you and takes your drink order.  You order through your favorite waiter, Andrew, who recommends the special of the day: prime rib with a dinner salad and a chocolate torte for dessert. Soon after, the food is brought out and it is delicious!  You have time to enjoy your food.  You then receive the bill and pay for your meal, returning to your home satisfied, all your dining needs met.  Let’s say, for simplicity's sake, you paid $75 for this meal: $50 for the steak, $10 for the salad and $15 for the dessert.

A change then occurs in the restaurant industry.  A new form of eating out has been adopted.  Your favorite restaurant has now contracted with over 30 different ”restaurant insurance companies.

Anticipating another pleasant dining experience, your return to the restaurant with your new “subscribers card.” You pay your $5 “copay.” You sit in the foyer of the restaurant. You wait an hour, even though you made reservations.  A harried Andrew greets you and quickly takes your order after you briefly glance at the menu.  The food arrives at your table.  As you take your second bite, Andrew informs you that “your time is up” and the table is reserved for another party.  You are escorted outside with your hastily boxed left-overs.

What has happened to the restaurant?  Behind the scenes, the restaurant owner has learned some tough realities of the “new system.”

During the first month of taking insurance, the owner sends a form to the insurance company requesting payment for the $75 steak dinner: $50 for the steak, $10 for the salad and $15 for the torte.  The contract with the insurance company already states that they will only pay $45 for the $50 steak, but the owner decides that the extra customers brought to the restaurant by contracting with this insurance company will more than off-set this small loss.

The first attempt at collecting the $75 dollars for the full meal is returned unpaid with the note that it was rejected due to a “coding error.”  The forms for payment from the insurance company require the owner to list the parts of the meal, not by name, but by the numerical codes. The owner had listed the salad by the wrong numerical code.  No suggestions for the correct code are offered, so the restaurant owner purchases a series of books, at a cost of $500, to learn how to assign the correct code to the different parts of the meals.  These books will need to be bought annually due to the constant changing of the code numbers. After 30 minutes of study, the owner realizes the dinner salad should be coded as a 723.13, not the723.1 the owner originally put on the form.  The salad, it turns out, needed to have two digits after the decimal point, indicating that it was a dinner salad, and not a “main course” salad.  The owner mails the corrected form.

In response to the second request for payment, the insurance company does not send a check, but a detailed questionnaire:  Was garlic used in seasoning the steak?  Was it necessary to use garlic for this particular recipe?  Did the restaurant ask for permission to use garlic from the insurance company before serving the steak? Why was salt, a less expensive alternative, not used instead? The owner submits the answers, emphasizing that the garlic is part of a secret family recipe that made the restaurant famous.  

The owner waits another week (it has now been 3 weeks since the dinner was served).  The check arrives three and a half weeks after the meal was served.  The check is for $20 and states that it is specifically for the steak.  The check also comes with a letter stating that no billing of the patron may occur for the salad, but no other explanation is enclosed.  No mention is made of the $15 dessert.

The now frustrated restaurant owner calls the provider service number listed in the contract. After five separate phone calls to five different numbers (The harried voice behind phone call number four explains that the insurance company has merged with another insurance company and the phone numbers had all changed last week, sorry for the inconvenience…), the owner gets to ask why, when the contract says the steak will be paid at $45, has the check only been written for $20?  And what happened to the payment for the $10 salad and the $15 dessert?  

As it turns out, this particular patron’s insurance contract only pays $45 when the patron has reached their deductible, which this patron has not at this time.  The remaining portion of payment for the steak must now be billed by the restaurant to the patron directly.

The $10 for the salad would have been paid if the patron had ordered it on a different day, but, per page 35 in the contract, because it was billed on the same day as the steak, it is considered to be part of the payment for the steak and no extra money can be collected from the patron or the insurance company.  

The dessert, the owner learns, should have had a “modifier” number put with its particular billing code when billed with the steak and the salad.

Realizing that the insurance billing is quite a bit harder than anticipated, the restaurant owner hires a company, who is paid 5% of any money collected to specifically make sure these coding errors do not occur again and follow up on payment rejections.  For an additional $99 per month, the billing company will “scrub” the forms submitted for payment to make sure specific clerical errors will not cause future delays in payment.  

The owner now must lay off the hostess and the bus boy to pay the billing company, so these duties are now added to the waiter’s other responsibilities.

In the meantime, the restaurant owner has also had the waiter take on the job of answering the phones due to the now high volume of phone calls from patrons questioning why they are receiving bills for meals they ate over two months ago, and why did their insurance company not pay for this portion of the meal?  This extra work is now resulting in longer times patrons must wait to be seated, and grumblings from the waiters who “were not hired or trained to do this kind of work.” 

The owner now realizes that, although the dinner originally cost $75 to make, only $25 has been paid. The remaining $30 billed to the patron is now in its third mailing, with the first two requests for payment going unanswered by the patron.  The restaurant owner realizes a collection agency must be employed in order to have any hope of receiving any portion of payment from the patron.

Each meal served now costs at least an additional $20 due to the added overhead of the billing company, coding books, and the collection agency.  These added expenses have nothing to do with cooking food or providing any direct service to the restaurant’s customers.

Service to the restaurant’s patrons has been compromised with these changes as well. The owner has now over-extended the waiter, who was an excellent waiter, but is now taking on the roles of host, phone answering and table bussing.

In order to even meet the costs of providing fine dining, the restaurant owner now must seat twice as many patrons in the same amount of time.  

What was once an outstanding business that focused on fine dining and customer service has now been turned into a business in the business of trying to get paid.

Alas, I wish this were a fictional tale, but it is not.  The only fictional portion is that this is not your favorite restaurant, but your favorite doctor’s office, which is responsible not for meeting your dining needs, but those of your health.

SOURCE

Tuesday, May 28, 2013

Common Core Education Is Uncommonly Inadequate #tcot

Common Core Education Is Uncommonly Inadequate

SOURCE

http://online.wsj.com/article/SB10001424127887324659404578503561386927962.html

By JAMIE GASS 

AND CHARLES CHIEPPO

WallStJournMassachusetts student test scores on the National Assessment of Educational Progress and SATs were unremarkable in the early 1990s. Then, after a landmark educational reform in 1993, state SAT scores rose for 13 consecutive years. In 2005, Bay State students became the first to score best in the nation in all grades and categories on the National Assessment of Educational Progress. The students have repeated the feat each time the tests have been administered.

How to explain this turnaround? The state's educational success hinged on rigorous academic standards, teacher testing and high-quality tests that students must pass to graduate from high school. All locally developed, these three factors aligned to produce amazing results.

Unfortunately, Massachusetts dropped its own standards in 2010 to join 44 other states (and the District of Columbia) in adopting the flawed standards of the Common Core. This is an educational program sponsored by the National Governors Association and the Council of Chief State School Officers that has been championed by the Obama administration.

Read the article at WSJ.com = if this link does not get you the full article, copy the headline and paste it in a Google search. The resulting link from Google will get you the full article. 

May 28, 2013 
CLICK ON THE PAPER TO GET YOUR COPY OF THE
AMERICAN PATRIOT NEWS

Wednesday, May 22, 2013

The Hill: Sen. Ted Cruz says 'I don’t trust Republicans'

Sen. Ted Cruz: 'I don’t trust Republicans'

link to video

By Ramsey Cox 05/22/13 

Sen. Ted Cruz (R-Texas) said Wednesday that he doesn’t trust members of his own party to negotiate a budget conference report.

Cruz's remark came after Sen. John McCain (R-Ariz.) said he thought it was “bizarre” that a member of his own party was objecting to forming a conference committee with the House to work out a budget. 

 

McCain said the objections suggested Senate Republicans didn’t trust House Republicans to hold the party line in negotiations.


Read more: http://thehill.com/video/senate/301329-cruz-i-dont-trust-republicans#ixzz2U5HxRXgQ 
Follow us: @thehill on Twitter | TheHill on Facebook


Congress is not asking the real question

Lerner

Why is no one focusing on the fact that the IRS Inspector General knew about this illicit activity going on at the IRS in the Spring of 2012 and they allowed it to go unreported until after the November election? Does an "audit" take that long?

IRS in Its Own Words: "Disburse Social Benefits to Target Populations" #tcot

IRS in Its Own Words: "Disburse Social Benefits to Target Populations"

MONDAY, MAY 20, 2013Speak The Internal Revenue Service has been in the headlines for more than a week now as details of its targeting of conservative non-profits have trickled out.Senate hearings this week (via Politico) on Apple's tax strategies have indirectly referenced the IRS as well as Democrats decried the huge tech company's efforts to avoid turning over any more of its money than necessary to Uncle Sam's tax collector.  But a 2011 Annual Report from the Taxpayer Advocate Service (TAS) of the IRS suggests that Apple is simply following the counsel that the TAS offers.
The section of the report in question is called Introduction to Diversity Issues: The IRS Should Do More to Accommodate Changing Taxpayer Demographics. The document begins with some history of the IRS and its mission:
When the federal individual income tax was enacted in 1913, it applied to high-income taxpayers.  At that time, theIRS predecessor to the IRS began as a hands-on collector of various excise and other taxes.  In 1942, Congress enacted the “greatest tax bill in American history” largely to fund the U.S. effort in World War II, expanding the income tax to the middle class.  At this juncture, the Treasury made an historic effort to popularize the income tax, and employed tactics such as famously deploying the Disney cartoon character Donald Duck as a mascot of the public fisc.  Since then, however, the IRS has not made a parallel effort to popularize the income tax to an increasingly diverse population.
Read the whole article here...

Saturday, May 18, 2013

The Larger Implications of the AP Affair


The Larger Implications of the AP Affair

http://ricochet.com/main-feed/The-Larger-Implications-of-the-AP-Affair
Pat Sajak · May 15, 2013
Of all the scandals, mini-scandals, and scandals-in-waiting circling the White House these days, the one that should set off the most alarms in the Oval Office is the AP phone records affair. It’s not so much its relative placement on the egregious overreach scale; it’s the fact that it involves the mainstream press. This is an assemblage  of men and women that has been vital to the political success of the President. This is the group that collectively decides whether an event, or series of events, constitutes a scandal or, for that matter, even a story.
Read the post at Ricochet...

Friday, May 17, 2013

Weiner’s Wife Didn’t Disclose Consulting Work She Did While Serving in State Dept. #tcot

Weiner’s Wife Didn’t Disclose Consulting Work She Did While Serving in State Dept.

Huma Abedin, left, a longtime confidante of Hillary Rodham Clinton.The State Department, under Secretary Hillary Rodham Clinton, created an arrangement for her longtime aide and confidante Huma Abedin to work for private clients as a consultant while serving as a top adviser in the department.

Ms. Abedin did not disclose the arrangement — or how much income she earned — on her financial report. It requires officials to make public any significant sources of income. An adviser to Mrs. Clinton, Philippe Reines, said that Ms. Abedin was not obligated to do so.

The disclosure of the agreement that Ms. Abedin made with the State Department comes as her husband, former Representative Anthony D. Weiner, a Democrat, prepares for a mayoral run in New York City. Politico reported the arrangement on Thursday afternoon.

Read the whole story at NYT...

Tuesday, May 14, 2013

MARTIN COUNTY GOP PASSES RESOLUTIONS AGAINST COMMON CORE STANDARDS AND SEVEN50 #tcot

Martin County GOP passes resolutions against Common Core Standards and Seven50MCREC

Stuart, FL - At the regular meeting of the Martin County Republican Executive Committee Monday evening, the membership voted overwhelmingly to oppose two programs that appear to remove traditional local control over education and private property rights.

Following the lead of the Republican National Committee, the Martin County Republicans expressed their opposition to Common Core Standards promoted by the U.S. Department of Education that proposes to standardize educational goals throughout the nation. Proponents argue that these are not “federal mandates,” but downplay the criticisms of educators and small-government activists that national standards threaten local autonomy in education.


The Resolution suggests a connection between the Obama Administration’s advancement of these programs and the tightly-controlled copyrighted material owned by private organizations which developed the “standards” and stand to profit from their adoption.  Also featured in the statement of opposition is the proposed collection of extensive data on students which evades federal regulations against the development of a national database on citizens of the United States.

In a separate discussion, members unanimously passed a Resolution to express opposition to the latest iteration of Regionalism to appear in South Florida, entitled “Seven50: SE Florida Prosperity Plan.” The Resolution states a popular concern for expansion of government and its attendant erosion of local government authority. Many members commented emphatically that they have always been resistant to the idea of becoming like their densely-packed neighbors to the south. 


While reluctant to embrace more radical theories of a connection to international agendas for standardized governance, members wholeheartedly agreed that Seven50 proposes a policy to reduce the choices available to private property owners and to erode the discretion of elected officials in land-use decisions. 

jjm

COMMON CORE GED BOOK: ’9/11 HIJACKERS WERE POOR AFGHANIS’

By Larissa Scott Atbashian and Oleg Atbashian | May 13, 2013

logo Watchdog WireAdult basic education and GED programs, with about 800,000 students taking GED tests each year, serve a segment of society that escaped government schools, including many homeschoolers. But the national propaganda effort called the Common Core Curriculum is spreading its tentacles to them.While many may not take the GED seriously, calling it the “Good Enough Diploma,” consider that quite a few homeschoolers take GED tests as a way to cancel out high school attendance requirements and lessen the record-keeping burden on home educators caused by compulsory attendance laws in every state.

Thus, aligning GED with Common Core has the potential of erasing all the efforts and sacrifices the homeschooling parents have put in to protect their children from the centralized indoctrination.

Read the story on WatchDog Wire...


Monday, May 13, 2013

The Big Amnesty/ Social Security Lie #tcot

The Big Amnesty/ Social Security Lie

 Daniel Horowitz (Diary)  |  

logoIt looks like we’ve discovered the panacea for all of our economic and social ills.  We’ve found the solution to the entitlement crisis as well.  We’re going to find the poorest countries in the world and import as many of their people as possible within a short period of time.  That way we will have millions of people paying into Social Security, purveying the “trust fund” with endless bounty.  This is what passes for sane analysis from the Social Security Administration’s chief actuary.

In an effort to buttress the Democrat Voting Act of 2013 aka the gang’s amnesty bill, Stephen Goss, Social Security’s independent chief actuary, released an analysis last week opining that amnesty will solve the Social Security deficit and *prevent*future waves of illegal immigration.  Goss finds that by 2024, this bill will have created 3.22 million jobs, and grow GDP by 1.63%.  With regards to Social Security, Goss concluded, “overall, we anticipate that the net effect of this bill on the long-range OASDI actuarial balance will be positive.”

Wow – why didn’t we think of importing mass poverty to save Social Security before?  Oh wait…that’s exactly what we’ve been doing for the past few decades.

This analysis was requested by Marco Rubio and is being bandied about by the open-borders elements on the right. 

Read the whole story on RedState.com...

Documentary exposes the reality of illegal immigration

Zoning Kills Affordable Housing #tcot

Zoning Kills Affordable Housing

How established homeowners use regulations to stop new low-cost homes.

John K. Ross | May 7, 2013logo

Excerpt: Incumbent homeowners have a powerful weapon for vetoing change: zoning. In Darien and other exclusive zip codes, mandated minimum lot sizes kneecap developers who want to build something other than super-sized homes. In the process, they put entire towns out of reach for all but the wealthy. In hardscrabble Ossippee, New Hampshire, where it's not uncommon for the working poor to live in tents during the summer months to save on rent, the zoning code flatly prohibits new apartment buildings.

Read the story on reason.com about a new book by Lisa Prevost called Snob Zones...

Saturday, May 11, 2013

Florida Supreme Court declines to hear case involving sanctions against environmental groups #tcot

Florida Supreme Court declines to hear case involving sanctions against environmental groups

Bruce Ritchie, 05/09/2013theFloridaCurrentlogo

A case that a dissenting appeals court judge says could have a "chilling effect" on citizen participation in land-use disputes was dismissed Thursday by the Florida Supreme Court without a ruling on the merits of the case.

Martin County in 2007 reduced the minimum lot size required on 191,000 acres of designated agricultural land. 1000 Friends of Florida and the Martin County Conservation Alliance filed a legal challenge, contending the decision failed to establish meaningful and predictable standards for protecting environmentally sensitive lands.

An administrative law judge determined that the change won't create urban sprawl.

Read the details here...


REALLY: When did land-use regulations become environmentalist tools to control private property ownership? Who profits from these restrictions?

m912tc

Friday, May 10, 2013

Martin County Promoting Anti-Capitalist Propaganda on Website #tcot

Martin County Promoting Anti-Capitalist Propaganda on Website

On March 31, 2013, we sent this email to Martin County Commissioner John Haddox: 

Commissioner,

A friend just sent me this information featured in the Martin County web portal. This is an example of how leftists infiltrate county administrations and pursue their own agenda.

I am shocked and surprised that you would allow this socialist propaganda on the MC website.  Are we now in favor of a government redistribution of wealth, such as is suggested in this video (and others) featured in a link on OUR website? Are we telling our youth that free enterprise and business is inherently evil and must be suppressed by government? I am sure that you were not aware of this.

http://ap3server.martin.fl.us:7778/portal/page?pageid=352,4041495&dad=portal&_schema=PORTAL

http://www.storyofstuff.org/movies-all/story-of-cap-trade/

What kind of image is that for a Republican officeholder? Whichever staff has been allowed this latitude should be corrected as soon as possible. I can not imagine that you (or your fellow commissioners) would permit this to be a reflection of Martin County administration!

Jim McGovern

It has been almost six weeks since we pointed out to this Commissioner that anti-capitalist propaganda is being featured on the Martin County Website. No response has been received from Commissioner Haddox. I included my personal phone number in the message (not shown here) and relied on cordial past conversations with Mr. Haddox to expect at least a phone call. While I am a voter in another Commissioner's District, I could not expect that Commissioner to be sympathetic to my appeal while promoting the same types of programs herself.

Mr. Haddox had presented himself during his campaign (in a recorded interview) as friendly to business and, as a military veteran and a Veteran's advocate, fiercely loyal to Constitutional principles. We expected him to recognize this contradiction to government service. Giving the socialists a voice on a county outlet appears to endorse their agenda.

We intentionally did not use the name of the Martin 9/12 Committee because we wanted Mr. Haddox to discuss this email among his fellow Commissioners, as from a concerned constituent and not from an “activist group.” Mr. Haddox knows me from the Republican Executive Committee, as well as from the M912TC. Apparently that was not loud enough to get his attention.

There have been six regular meetings of the Board of Commissioners since we sent that email and the offending “educational” material is still featured on the County Website. If I am wrong about the nature of this featured material, then Mr. Haddox should correct me.

PAGE containing the links to "educational resources." Sponsored by The Tides Foundation and George Soros.

LINK to "educational resources" featuring anti-capitalist and environmental extremist lessons for our youth.

ASSOCIATION between the "smart growth" advocates and collectivist rhetoric.

jjm

THE HEARTLESS BUREAUCRACY #tcot

By Kelleigh Nelson
May 7, 2013
NewsWithViews.comHere are the four women who knew the truth and went to hear Education Czar Arne Duncan speak at the University of Tennessee, Kathleen Marquardt, Karen Bracken, Kelleigh Nelson, and Sally Absher.

EXCERPT:

Marginalizing the informed electorate is the way they inhibit any influence we have on our elected officials. We no longer count. These elected officials and politicians are no longer servants of the electorate. They have an agenda and their marching orders. The majority of the public is unaware of what is happening in their county commission meetings, town and city council meetings, and their local and state governments. And most citizens don't care. This is evident by the few letters or phone calls these "servants" receive. It is also quite evident by the number of people who attend these meetings.

READ THE WHOLE ARTICLE ON NWV...

Thursday, May 2, 2013

FOX Nation: Left-Wing Violence Rocks Seattle... Police Attacked... Businesses Destroyed

FOX Nation 

Left-Wing Violence Rocks Seattle... Police Attacked... Businesses Destroyed

KIRO 7 reports: May Day march escalates into chaos, confrontation, violence

SEATTLE 

Police arrested more than a dozen people and used flash-bang grenades and pepper spray after apparent anarchists and May Day marchers converged in downtown Seattle, throwing pipes, fireworks and rocks, lighting flares and sparking confrontations with officers.

Protesters met at Seattle Central Community College at the busy intersection of Broadway and Pine Street and then spilled into the street, blocking traffic.

KIRO 7 Eyewitness News reporter Essex Porter said at first there appeared to be more spectators than participants and the gathering seemed to be more of a party than a rally.

But as the crowd began to move, flares were lit and the crowd became noisy as it made its way toward downtown on Pike Street, flanked by police officers.

Seattle police tweeted that someone in the crowd broke a window at Sun Liquor on East Pike Street and Belmont Avenue.  People clad in black, with their faces covered, were seen in the mix.

As the group of several hundred people moved north on Sixth Avenue after turning off of Pike Street, police said some in the group were throwing metal bars and water bottles at business' windows.

Read more and view clips at KiroTV.com

Immigration Bill Contains Slush Funds for Pro-Amnesty Groups

Immigration Bill Contains Slush Funds for Pro-Amnesty Groups

Groups that helped craft bill to receive taxpayer dollars

Published: Wednesday, May. 1, 2013CIS_logo
WASHINGTON, May 1, 2013 -- /PRNewswire-USNewswire/ -- The pro-amnesty lobbyists who helped craft the Schumer-Rubio immigration bill included within the bill two "slush funds" amounting to $150,000,000 that may be supplemented with additional taxpayer dollars for years to come. Slush fund grantees are "public or private, non-profit organizations" described in the bill as including "community, faith-based or other immigrant-serving" organizations. In other words, the grantees would include many of the groups involved in writing and promoting the amnesty.

"Considering that millions of dollars will go to groups like La Raza, Casa de Maryland, and the American Immigration Lawyers Association, it's not surprising that these groups are cheerleaders for the Schumer-Rubio bill," said Jon Feere, Legal Policy Analyst at the Center for Immigration Studies.

Section 2537 of the Schumer-Rubio bill provides "Initial Entry, Adjustment, and Citizenship Assistance" grants to public and private, non-profit organizations that promise to help illegal immigrants apply for the amnesty. For example, this includes help with "completing applications", "gathering proof of identification", and "applying for any waivers". But the recipients of these funds are given a lot of discretion, as the funds can also be used for "any other assistance" that the grantee "considers useful" to aliens applying for amnesty. The bill appropriates $100,000,000 in grant funding for a five-year period ending in 2018, plus any additional "sums as may be necessary for fiscal year 2019 and subsequent fiscal years."

 



For more info: http://cis.org/feere/immigration-bill-contains-slush-funds-pro-amnesty-groups




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