Wednesday, May 30, 2007

Letter to John Edwards...(Too bad your staff did not contact me)

Senator Edwards:

I realize your staff will be reading this, but I sure hope they will present this to you for your own personal perusal. I believe it is vital to assist you with your message regarding Health Care for ALL in this great country of ours, America!

After hearing Hillary & Barack's solution to our National Health Care's
"Catastrophic State”, I noticed they both missed the opportunity to address the reason WHY we are in this crisis! They both failed to address the ROOT CAUSE of this disaster, FRAUD! Layers, upon layers of fraud is why we are where we are TODAY!

Can anyone remember when we went to a family doctor and paid for the visit or treatment, or even work out a payment plan? What happened to that system?

Well, think about it for a second. Back in late 70’s early 80’s, it was the goal of a few individuals that had the grand idea to transform our health care system into a model similar to the “Holiday Inn” concept. Thus began HMO’s, the cocktail of hospitals, doctors and most importantly, INSURANCE companies.

The plan was diverted after their greed was exposed by many whistleblowers, but by then they were well on their way to many other endeavors circumventing the system with their greed. Our health care system is a result of a few people with an idea back in the late 70’s & early 80's which was a total restructuring of our entire health care system. Now, our BROKEN health care system is a result of decades of FRAUD that continues to this day. FRAUD & GREED has overthrown our HEALTH CARE!
Is anyone going to address this? Will anyone address WHY we are where we are? Too many people dropping out of the “pools” , I doubt it.

Both Clinton & Obama have recently commented on their health care proposals and mentioned improving and controlling HMO’s and PRIVATE INSURANCE COMPANIES! They now advocate involving the employer, employee, health care providers and government in their proposals. Why are they continuing to bridge Health Insurance with the EMPLOYER? WHY?

I have a problem with both of their plans. It is almost like they are talking about fixing a boat with a hole in it, while it is in the water!

Maybe it is the same logic we have with education in our country. We base our Federal Public Education dollars across the nation on real estate tax! And we see how well that works! So, instead of revamping the core problem, poor federal funding, we offer school vouchers as an alternative, not a solution to fix the existing problem. Maybe our logic or reasoning is the result of our ranking in the world of education, # 28!

Back to health care!
Have you asked yourself, or are aware that most dental plans have ceased within employer sponsored insurance? Why is that? Could it be that they were a group of people in the medical field that would not allow themselves to fall prey to this system?

I do like Hillary’s concept and promise to implement electronic health records which will not only be life-saving and a cost savings, but…..she should have continued to explain HOW the electronic capability for oversight in the fraudulent behavior in the system would be monitored much better, i.e. billing, upcoding, duplicate and triple charges as well as for the actual variety of services, some received some not. But mind you, she should have emphasized the need for oversight with fraudulent behavior. (The fraud will not stop with electronic monitoring, but at least it is a start)

A few years back, I sent a ‘group email’ to many, if not most of the Senators in Congress at that time. Many, including Hillary Clinton, replied with an automatic response: “Contact my own Congressional Leaders.” I then began writing exclusively to my two Senators, Barack Obama and Richard Durbin. (See attached responses)

I also contacted Center for Medicare Advocacy, Inc. regarding their litigation with health care fraud. I received a response from the legal department which also advised me to keep contacting my Congressional Leaders but also referred me to other sources which may be interested with addressing the blatant, fraudulent behavior and waste across all spectrums in our health care industry.

Please, let’s not be coy. The attempt to link the failing system to the malpractice litigation couldn’t be farther from the TRUTH, but I guess it sounds good and simple. Not enough of us hear or are aware of the small percentage of malpractice litigation that is actually argued in a court room. Most cases are settled out of court, so there really is no trial.

Barack announced his health care reform and mentioned the bill signing for our seniors and low income citizens in Independence, Missouri by Pres Johnson, which was started by Harry S Truman. Yes, he was correct. We did do that and the idea was the American thing to do, take care of our seniors and under privileged. However, what shortly followed is the disaster we have today, FRAUD!

However, Barack failed to address the reason for the near collapse of Medicare/Medicaid today, FRAUD! The Medicare/Medicaid idea was great, but the greed and corruption was and is the true reason this system is failing. No one talks about this. What they do talk about is the future of this system and the reason is the baby boomer population, not the real reason, FRAUD! There were so many loopholes for years on end within the Medicare/Medicaid system offering ample opportunity to financially drain the system into the ibis. Once a readers digest investigative reporter wrote: “The government has given the open door to allow entities to blatantly defraud the system without any oversight or consequence.
Now Hillary and Barack want to improve and fine tune the insurance companies! Bring costs down. Have a variety of ideas that will save families $2400.00-2500.00 yr with their premiums. Is that discount off of the already astronomical costs that exist already? Wow, what a deal!

My God, just look at this pharmaceutical industry! Consider all their contributions to the political parties. Now, WHY IS THAT? WHAT COULD THEY POSSIBLY WANT? Thus, we have a pharmaceutical bill for seniors. We all know how well that works!

Just take a look at the ex-Senate Leader, Bill Frist, the doctor, when the pharmaceutical bill was passed for seniors. Ironic, this is the leader that was from the same family that revamped our Health Care System which is in such dire straits today. This is abominable!

Is anyone aware of the amount of dollars involved in this fraudulent system that has continued over decades within our health care system? While you are out on the campaign trail and are asked how you will pay for the plan that you propose might include the collection of overdue payments that are a result of fraud within the system. Who knows, that could pay for it all! Note: Many settled cases by the government have yet to collect one dime from the settlements.

Please do not hesitate to contact me......Good Luck!
Susan Golden

Letter from Senator Richard Durbin, (D-IL)
October 17, 2006

Dear Ms. Susan Golden:

Thank you for contacting me to express your concerns about HCA Inc. and Medicare and Medicaid fraud. I appreciate hearing from you.

Health care providers who defraud the government and the taxpayers violate a public trust and cause the health care of all Americans to suffer.

It is especially important that we hold companies like HCA accountable for their actions at a time when the federal government is running enormous deficits. Many observers believe the Administration settled the HCA case for an amount lower than was justified by the level of fraud and abuse with which HCA was charged.

The overwhelming majority of Medicare providers and suppliers are
legitimate, honest, and ethical. The illegal activities of unethical providers hurt legitimate health professionals and damage the reputation of the entire medical profession. Given current projections about the increasing demand for Medicare and Medicaid as baby boomers age, we can't afford to look the other way. The Majority in Congress, however, has not chosen to use its oversight powers to shine a brighter light on this case.

I will keep your views in mind as I continue to work to strengthen these programs. Thank you again for contacting me. Please feel free to keep in touch.

Richard J. Durbin
United States Senator

Letter from Senator Barack Obama (D-IL)

Dear Susan:

Thank you for sharing with me your concern over Majority Leader Frist's involvement with the Hospital Corporation of America. I appreciate hearing from you.

Many Americans share your concern over conflict of interest with regard to Majority Leader Frist and HCA. In June of 2005, Senator Frist ordered his trustees to sell all of his stock remaining in the company, which went under investigation by the Securities and Exchange Commission. Personal profit must not hinder the making of sound policies that benefit all Americans, and I hope each of my colleagues operates with similar convictions.

With regard to medical libability reform, no one can deny that malpractice insurance premiums are going up in Illinois and nationally, and that this trend is affecting medical care. It is becoming increasingly expensive for doctors to provide the care our citizens need in many areas, forcing some to close their doors and shut down their practices. That is neither fair to physicians nor good for patients. Congress must address the root causes of the medical liability problem. But unreasonable lawsuits are only part of the problem, and other issues, particularly the lack of regulation of the insurance industry, also require attention. A successful, long-term solution to the medical liability problem will be comprehensive and multifaceted.

The goal of our health care system is to provide quality, affordable patient care, and that care is unquestionably being affected by the escalating cost of malpractice insurance. That concern, however, is no justification for arbitrarily denying victims of negligence the redress the jury system affords them.

Furthermore, it seems reasonable to me that any serious effort to address the medical liability problem should seek to reduce insurance premiums for doctors. Yet the insurance industry has consistently refused to commit to reducing premiums if jury awards are capped by law.

As you know, S.22, the MCAP Act, was considered by the Senate on May 8, 2006. After a motion to limit debate on the bill fell 12 votes short of passage, Senator Frist (R-TN), the Senate Majority Leader, pulled the bill from further consideration.

Due to a delay with my flight from Chicago, I did not arrive back in Washington in time for this vote. Had I been in attendance, I would have voted against the motion to limit debate. I expressed this sentiment on the Senate floor and have attached a copy of my remarks from the Congressional Record for your review. I also voted against shutting off debate on S.23, a proposal that would apply liability reform only to OB/GYN professionals, as it, too, fails to address the core problem of escalating malpractice costs while restricting the rights of patients who have been the victims of medical malpractice.

To help address the underlying problem, I have introduced the National Medical Error Disclosure and Compensation (MEDiC) Act (S.1784), which offers a proven model for reducing the number of medical malpractice suits filed. With medical errors resulting in nearly 100,000 deaths every year and physicians shouldering escalating malpractice premium costs, this legislation will improve patient safety and the quality of health care while protecting patients' rights, reducing medical errors and lowering malpractice costs.

A number of hospital systems and private liability insurance companies around the country have adopted a policy of robust disclosure of medical errors with thorough analysis and intervention, apologies for such errors, and early compensation for patient injury. Overall, these initiatives have resulted in greater patient trust and satisfaction, more patients being compensated for injuries, fewer numbers of malpractice suits being filed, and significantly reduced administrative and legal defense costs for providers, insurers and hospitals. I am pleased that the University of Illinois Medical Center is in the process of implementing a system of disclosure, and I applaud their hard work at addressing this issue.

The chief risk officer at the University of Michigan Health System reported that his university has seen its litigation caseload cut in half and has realized savings of more than $2 million since instituting this program. The National MEDiC program will build on efforts underway at the local level by encouraging adoption of this model across the country and providing grant money and technical assistance for doctors, hospitals, and health systems to help them implement the program. This legislation will encourage honesty and accountability, and, most importantly, improve care for patients and reduce costs for doctors.

I have also joined as an original cosponsor of the Medical Malpractice Insurance Antitrust Act (S.1525), which is intended to ensure that insurers do not overcharge physicians for their malpractice insurance. Today, malpractice is the only part of the insurance industry that is not regulated, allowing malpractice insurers to manipulate the market, drive out competition and raise prices. Since 2000, medical malpractice insurance premiums have more than doubled despite stability in claims payments. A study of the nation's 15 largest malpractice insurers suggests that physicians have been repeatedly overcharged.

The insurance industry should not be allowed to continue pursuit of ever-increasing profits at the expense of patients and health care professionals. Competition in the marketplace is a proven economic force and will drive down the cost of medical malpractice premiums. The Medical Malpractice Insurance Antitrust Act serves this end by applying existing Federal anti-trust laws to insurance companies just like all other industries.

It is time for all of the stakeholders in this issue i.e. doctors, insurers, patients and attorneys i.e. to come together to work seriously to address the rising cost of malpractice insurance while preserving a patient's right to bring valid claims before a court of law. There is no room for hidden agendas in a debate that holds such significant consequences for patients and providers.

Again, Susan, thank you for contacting me on this critical health care issue. Please stay in touch in the days ahead.


Barack Obama
United States Senator

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