Tuesday, August 30, 2005

Word

"Don't write anything you can phone. Don't phone anything you can talk. Don't talk anything you can whisper. Don't whisper anything you can smile. Don't smile anything you can nod. Don't nod anything you can wink." ~ Earl Long

Missouri Lacks Way to Track Medicaid Cuts' Impact

LESLIE YINGLING, COLUMBIA MISSOURIAN - As thousands of Missouri adults lose Medicaid coverage because of cutbacks, Missouri’s welfare agency says it does not have a plan to track the impact of the cuts on those who lose medical coverage...

The state will track Missouri adults who have lost eligibility because of changes to Medicaid only if they re-enter the system by meeting eligibility requirements in the future, said Deborah Scott, a spokeswoman for the state Social Services Department. The department does not have a system in place to follow up on those who lose coverage permanently, but “we are going to do all we can to refer people,” she said...

“If we’re going to craft and fund a health care vision for the state, part of that is to see what happens to the nearly 350,000 folks who have lost their Medicaid,” Jeff Harris (D-Columbia) said. “There’s nothing in statute to allow us to find out where they are and what will happen to them.”

Case-in-point: Medicaid Cuts Force People to Quit Jobs

Another example of Republicans 'helping the economy.'

XIN LI, COLUMBIA MISSOURIAN - Alice and Jeff Vandyke have faced their share of hardships during their 19 years of marriage. Jeff has a developmental disability that’s left him with limited mobility from his neck down; Alice suffers from a back injury... The Vandykes are among 18,000 Missourians with disabilities, including 488 in Boone County, who will be affected by elimination of medical assistance for workers with disabilities.

The program, which the Vandykes have been enrolled in for four years, has served as a major incentive for people with disabilities. It has let them hold down a job by providing Medicaid coverage and allowing a monthly income of up to 250 percent of the federal poverty level, or $1,994.

That’s about to change.

More than half of Missourians with disabilities who were enrolled in the medical assistance program, amounting to 9,529, will lose their Medicaid coverage altogether. Another 4,700 people with disabilities in the program, including the Vandykes, are being forced to choose between losing their Medicaid coverage or enrolling in a program known as “spend-down,” the main Medicaid program for people with disabilities who are not employed.

But enrolling in spend-down comes with a price of its own: many people with disabilities who have part-time jobs would lose their incentive to keep working...

“They are doing their best with their jobs. They try to be productive. They feel good about themselves and put something back to the system,” Hendren said. “But now all that will be gone.”

Under spend-down, individuals must pay their own medical expenses until their income drops to 85 percent of the federal poverty level, or $678 a month. At that point, the state will pick up the tab. The more someone earns, the more medical expenses they would need to shoulder. That leaves the Vandykes in what they see as a no-win situation.

Moving to spend-down would allow them to keep their Medicaid benefits. But no matter how much they earn, $1,300 a month is the most income they could keep. After paying for rent and utilities, the couple would only have about $54 a month for food.

At mid-week, the Vandykes were leaning toward enrolling in spend-down. Otherwise, they will both lose their entire Medicaid coverage and have no way to afford their medical bills...

Benefit specialists and Medicaid case workers offered the couple some solutions, but the Vandykes consider some of them unacceptable. One suggestion, getting a divorce and living in separate residences, would allow Jeff, who has the highest medical expenses, to continue his Medicaid coverage and would allow Alice to return to work.

(Guess that's the Republicans way of promoting the 'sanctity of marriage' nowadays....)

“We just live day by day,” Alice Vandyke said. “The legislators and governor have no idea the effects they will have on people. Maybe they don’t know the impact, or they just don’t care.”

Cuts at Hospital Create Confusion

Compassionate conservatism, my ass. The fact that the word 'conservative' needs an adjective to make it appear friendlier ought to be a tip-off to people that there is nothing 'compassionate' about said ideology. For as much as Republican politicians go on-and-on about a 'culture of life,' I think it's telling how inhumanely they treat the living poor. Their mantra seems to be: "Save the fetus, forget the child."

DEBRA SKODACK, KC STAR - It was standing room only Monday in Truman Medical Center’s financial counseling center as the main health provider for the area’s poor made cuts in services.

The changes include the elimination of the hospital’s prescription assistance program and the requirement that nonemergency patients who live outside Kansas City or Jackson County make a down payment on their anticipated bill (at LEAST 25%) and commit to paying the balance. And Truman eliminated dental services at its Lakewood facility for adult patients who lack dental coverage, unless they work out a payment plan in advance.

Most days, 100 to 150 people seek financial counseling at Truman. On Monday, about 250 did so. And it’s possible the counseling center will become more hectic as cuts in Missouri Medicaid take effect Thursday, said Shelly Phinney, corporate manager of Truman’s financial counseling center.

More than 300,000 Missourians are expected to be affected by those changes, which include the elimination of adult dental coverage, a reduction in rehabilitation services and changes in Medicaid coverage for children...

There are concerns about what will happen because of the Medicaid changes, including the possibility that some people will simply go without medical care.

Phinney said a man who came in for legal aid assistance last week said he hadn’t been taking his medication because his Medicaid coverage had been terminated.

“He had a seizure right there,” Phinney said. “He went to the emergency department.”

“We don’t know what it will mean,” said Sheri Wood, executive director of Kansas City Free Health Clinic. “There will be people with no insurance. They will be struggling to find new providers and new medical homes.

"We turn away hundreds of people each week,” Wood said. “It’s just going to more hundreds.”

More Americans Uninsured, Living in Poverty

FORBES - An additional 800,000 people in the United States found themselves without health insurance in 2004, new government figures show. In a report released Tuesday by the U.S. Census Bureau, 45.8 million people were without medical coverage in 2004, an increase of 859,000 people from the year before. The percentage of uninsured people hovered at 15.7 percent in both 2003 and 2004.

Meanwhile, the median household income was unchanged in real terms from 2003, leveling off at $44,389 in 2004. There were also no changes in the most commonly used measures of income and equality...

At the same time, the nation's poverty rate rose from 12.5 percent in 2003 to 12.7 percent in 2004. That means 1.1 million more people were living in poverty in 2004, for a total of 37 million. The poverty rate for children remained unchanged at 17.8 percent.

Heard on Fox News

SHEPARD SMITH: You're live on FOX News Channel, what are you doing?

MAN: Walking my dogs.

SMITH: Why are you still here? I'm just curious.

MAN: None of your fucking business.

SMITH: Oh that was a good answer, wasn't it? That was live on international television. Thanks so much for that. You know we apologize.

Saturday, August 27, 2005

Urban Spies

Fly like a bird...

The Roll-Back of Civil Rights

AP - The Justice Department on Friday approved a controversial Georgia law requiring voters to show photo identification at the polls, and opponents immediately vowed to challenge the measure in federal court... The Republican-backed measure sparked racial tension during the state's legislative session last spring. Most of Georgia's black lawmakers walked out at the state Capitol when it was approved.

Democrats had argued the idea was a political move by the GOP to depress voting among minorities, the elderly and the poor -- all traditional bases for Democrats. The measure would eliminate the use of several currently accepted forms of voter identification, such as Social Security cards, birth certificates or utility bills...

Nineteen states require voters to show identification, but only five request photo ID's, according to the National Conference of State Legislatures. Those states -- Arizona, Florida, Louisiana, South Carolina and South Dakota -- allow voters without a photo ID to use other forms of identification or sign an affidavit of identity.

"The decision to clear the measure now gives Georgia the most draconian voter identification requirement in the nation," said Daniel Levitas of the American Civil Liberties Union's Voting Rights Project in Atlanta.

Gov. Sonny Perdue, like other Republicans, has said the measure is aimed at preventing voter fraud. "It will not be a hardship on any voter," Perdue said when he signed the bill.

The new Georgia law also allows people to vote absentee without an excuse, and for a longer period. Those votes by mail would not require a picture ID. Political observers say Republicans tend to benefit the most from absentee balloting.

Monday, August 22, 2005

"Tagged"

Thanks Sam.

1. Total number of books you own: Pfft. I'm not counting. More than two, less than a million.

2. What was the last book you bought? Spanish for Healthcare Professionals, 2nd Edition

3. What's the last book you read? Essentials of Family Medicine, 4th Edition

4. List 5 books that have been particularly meaningful to you (in no particular order): Watership Down, Nightmares and Dreamscapes, The Brothers Karamazov, The Lovely Bones, One Hundred Years of Solitude

5. Tag 5 people and have them fill out this quiz on their own blog: Umm... do it if you like. Win brownie points from me.

No Rest for the Wicked....

Friday: remembered how fun just sitting around playing video games w/ the guys can be.

Saturday: White Coat Ceremony - learned which new students our docent group was getting. Hooray for Leah! Also... Chiefs Game!!! (Thank you, Slaten - the last time I had been to a game was Oct. 10, 1993.)

Sunday: Sojourner Health Clinic, Keith's 21st B-Day! Woot!

Today: Center 2... 7 a.m. comes awfully early. Happy B-Day to my MOM!!! =D

Friday, August 19, 2005

My New Favorite Quote

Stolen from Sam:

"If you treat an individual as he is, he will remain as he is. But if you treat him as if he were what he ought to be and what he could be, he will become what he ought to be and could be." ~ Johann Wolfgang von Goethe

More Approval Ratings

Senator-by-Senator

No More Textbooks

AP - Students at Empire High School here started class this year with no textbooks -- but it wasn't because of a funding crisis. Instead, the school issued I Books -- laptop computers by Apple Computer -- to each of its 340 students, becoming one of the first U.S. public schools to shun printed textbooks. School officials believe the electronic materials will get students more engaged in learning. Empire High, which opened for the first time this year, was designed specifically to have a textbook-free environment.

Teachers Ready to Skip Class

AP - Forty percent of public school teachers plan to exit the profession within five years, the highest rate since at least 1990, according to a study being released today. The rate is expected to be even greater among high school teachers, half of whom plan to be out of teaching by 2010, according to the National Center for Education Information.

Retirement is the dominant factor, as the public teaching corps is aging fast, say surveys of teachers in kindergarten through grade 12. In 1996, 24 percent of teachers were age 50 or older. In 2005, 42 percent of teachers are... In 1990, 74 percent of teachers predicted they would still be in the classroom five years later. In the surveys, that total dropped to 66 percent in 1996 and 60 percent this year.

Bush Approval Ratings

State-by-State Rating

Wednesday, August 17, 2005

U.S. Losing Its Public Hospitals

MARGUERITE HIGGINS, WASHINGTON TIMES - Public hospitals are vanishing at a much faster rate than U.S. hospitals overall, according to a report. While the number of U.S. hospitals has decreased over the past decade, public hospitals in the nation's 100 largest cities and nearby suburbs recorded the sharpest drop, said the report by the State University of New York's Downstate Medical Center, a Brooklyn municipal hospital and medical college. The number of public hospitals declined by 27 percent in major suburbs, from 134 in 1996 to 98 in 2002, the report said. The number of public hospitals declined by 16 percent in major cities, from 83 to 70, said the report, the fifth in a series the center has done on hospitals in large cities and suburbs.

Monday, August 15, 2005

No More Rickshaws in Calcutta

BBC - Calcutta's famous hand-pulled rickshaws will soon be banned, according to the chief minister of the Indian state of West Bengal. The rickshaws had long been considered "inhuman" and did not exist anywhere else, Buddhadev Bhattacharya said. The rickshaw, immortalised as a living symbol of Calcutta in films such as City of Joy, will be phased out in four to five months... Some trade unions are demanding adequate compensation and an alternate livelihood for all the pullers before their licences are cancelled and the mode of transport banned.

Getting on with his life

DAILY KOS - Bush is annoyed that Cindy Sheehan is forcing him to think about the families his actions are destroying.

President Bush, noting that lots of people want to talk to the president and "it's also important for me to go on with my life," on Saturday defended his decision not to meet with the grieving mom of a soldier killed in Iraq.

Bush said he is aware of the anti-war sentiments of Cindy Sheehan and others who have joined her protest near the Bush ranch.

"But whether it be here or in Washington or anywhere else, there's somebody who has got something to say to the president, that's part of the job," Bush said on the ranch. "And I think it's important for me to be thoughtful and sensitive to those who have got something to say."

"But," he added, "I think it's also important for me to go on with my life, to keep a balanced life."

The comments came prior to a bike ride on the ranch with journalists and aides. It also came as the crowd of protesters grew in support of Sheehan, the California mother who came here Aug. 6 demanding to talk to Bush about the death of her son Casey. Sheehan arrived earlier in the week with about a half dozen supporters. As of yesterday (Saturday) there were about 300 anti-war protesters and approximately 100 people supporting the Bush Administration. In addition to the two-hour bike ride, Bush's Saturday schedule included an evening Little League Baseball playoff game, a lunch meeting with Secretary of State Condoleezza Rice, a nap, some fishing and some reading. "I think the people want the president to be in a position to make good, crisp decisions and to stay healthy," he said when asked about bike riding while a grieving mom wanted to speak with him. "And part of my being is to be outside exercising."

I couldn't give a shit if Bush is healthy. And I'd be willing to give him the benefit of the doubt if he had made at least one "good, crisp decision".

What Bush fears is considering the consequences of his actions. Because even his own people are coming to terms with the multitudes of bad, shitty decisions.

The Bush administration is significantly lowering expectations of what can be achieved in Iraq, recognizing that the United States will have to settle for far less progress than originally envisioned during the transition due to end in four months, according to U.S. officials in Washington and Baghdad.

The United States no longer expects to see a model new democracy, a self-supporting oil industry or a society in which the majority of people are free from serious security or economic challenges, U.S. officials say.

"What we expected to achieve was never realistic given the timetable or what unfolded on the ground," said a senior official involved in policy since the 2003 invasion. "We are in a process of absorbing the factors of the situation we're in and shedding the unreality that dominated at the beginning." [...]

The ferocious debate over a new constitution has particularly driven home the gap between the original U.S. goals and the realities after almost 28 months. The U.S. decision to invade Iraq was justified in part by the goal of establishing a secular and modern Iraq that honors human rights and unites disparate ethnic and religious communities.

But whatever the outcome on specific disputes, the document on which Iraq's future is to be built will require laws to be compliant with Islam. Kurds and Shiites are expecting de facto long-term political privileges. And women's rights will not be as firmly entrenched as Washington has tried to insist, U.S. officials and Iraq analysts say.

"We set out to establish a democracy, but we're slowly realizing we will have some form of Islamic republic," said another U.S. official familiar with policymaking from the beginning, who like some others interviewed would speak candidly only on the condition of anonymity. "That process is being repeated all over."

So Casey and 2,047 US and allies have died to establish an anti-women, anti-Israel, terrorist-harboring Islamic regime that is actually less free than Saddam's Iraq. How the hell they managed that is beyond belief, incompetence of breathtaking proportions. And nearly four Americans are dying every day to help establish Iran's new client state.

But Cindy needs to understand -- Bush is ready to move on. The hell with all the families of the dead, wounded, divorced, and mentally messed up thanks to his war. He's got a Little League game to attend.

250 miles per gallon? Tinkerers do what automakers won't

AP - Politicians and automakers say a car that can both reduce greenhouse gases and free America from its reliance on foreign oil is years or even decades away. Ron Gremban says such a car is parked in his garage.

It looks like a typical Toyota Prius hybrid, but in the trunk sits an 80-miles-per-gallon secret -- a stack of 18 brick-sized batteries that boosts the car's high mileage with an extra electrical charge so it can burn even less fuel. Gremban, an electrical engineer and committed environmentalist, spent several months and $3,000 tinkering with his car... The extra batteries let Gremban drive for 20 miles with a 50-50 mix of gas and electricity. Even after the car runs out of power from the batteries and switches to the standard hybrid mode, it gets the typical Prius fuel efficiency of around 45 mpg. As long as Gremban doesn't drive too far in a day, he says, he gets 80 mpg...

University of California, Davis, engineering professor Andy Frank built a plug-in hybrid from the ground up in 1972 and has since built seven others, one of which gets up to 250 mpg. They were converted from non-hybrids, including a Ford Taurus and Chevrolet Suburban. Frank has spent $150,000 to $250,000 in research costs on each car, but believes automakers could mass-produce them by adding just $6,000 to each vehicle's price tag.

Instead, Frank said, automakers promise hydrogen-powered vehicles hailed by President Bush and Gov. Arnold Schwarzenegger, even though hydrogen's backers acknowledge the cars won't be widely available for years and would require a vast infrastructure of new fueling stations.

"They'd rather work on something that won't be in their lifetime, and that's this hydrogen economy stuff," Frank said. "They pick this kind of target to get the public off their back, essentially."

Sunday, August 14, 2005

Good News/Bad News

Good News:
Dennis & Jennifer Schwartze

Bad News:
I caught the garter. :p

Wednesday, August 10, 2005

ACLU Joins Wiccan Supreme Court Suit; Lower Bench Said Only Single God Religions Count in U.S.

AP - Civil liberties lawyers have appealed to the U.S. Supreme Court to allow a Wiccan priestess to offer prayers before a public board's meetings. Cynthia Simpson was turned down in 2002 when she asked the Chesterfield Board of Supervisors to add her name to the list of people who customarily open the board's meetings with a religious invocation. The 4th U.S. Circuit Court of Appeals sided with the suburban Richmond county. In their petition, received by the court yesterday, American Civil Liberties Union lawyers accuse the federal appeals court of trying to "obscure with legal smoke and mirrors" Chesterfield's preference for mainline religions. "Although Establishment Clause jurisprudence may be beset with conflicting tests, uncertain outcomes and ongoing debate, one principle has never been compromised ... that one religious denomination cannot be officially preferred over another," ACLU attorneys wrote in their 13-page filing. County officials said they had the right to limit the prayers to Judeo-Christian beliefs and religions based on a single god.

To me, this doesn't make any sense... how can this decision possibly jive with the Establishment Clause? Religious bias in government is - and ought to be - unconstitutional. Simple as that.

Tuesday, August 09, 2005

Military Plans for Assuming Control of U.S.

This possibility I file under the category of "REMOTE," but I thought it was relevant for today. Remember, two months plus the number of days until the 22nd, 2 p.m. Under the Rainbow Bridge. I might be carrying a stick.

----

[SAM SMITH, UNDERNEWS - As you read this and similar stories, bear in mind that there is no provision in the Constitution for martial law. Further, the Constitution clearly grants to the states those powers not enumerated in it. Therefore, in the event of a large disaster, power would properly - and wisely - devolve to the governors of the 50 states, those best politically and technically qualified to run their jurisdictions during such periods. These, after all, are the officials with the most experience dealing with disasters in their own areas. But every major disaster plan since the 1980s has - like this one - involved some sort of illegal takeover, whether by the military or by an unconstitutionally chosen group of individuals. This story is not about saving America; it is about a military coup.]

BRADLEY GRAHAM, WASHINGTON POST - The U.S. military has devised its first-ever war plans for guarding against and responding to terrorist attacks in the United States, envisioning 15 potential crisis scenarios and anticipating several simultaneous strikes around the country, according to officers who drafted the plans....

The war plans represent a historic shift for the Pentagon, which has been reluctant to become involved in domestic operations and is legally constrained from engaging in law enforcement. Indeed, defense officials continue to stress that they intend for the troops to play largely a supporting role in homeland emergencies, bolstering police, firefighters and other civilian response groups.

But the new plans provide for what several senior officers acknowledged is the likelihood that the military will have to take charge in some situations, especially when dealing with mass-casualty attacks that could quickly overwhelm civilian resources...

The Pentagon's new homeland defense strategy, issued in June, emphasized in boldface type that "domestic security is primarily [sic] a civilian law enforcement function." Still, it noted the possibility that ground troops might be sent into action on U.S. soil to counter security threats and deal with major emergencies...

Civil liberties groups have warned that the military's expanded involvement in homeland defense could bump up against the Posse Comitatus Act of 1878, which restricts the use of troops in domestic law enforcement. But Pentagon authorities have told Congress they see no need to change the law.

According to military lawyers here, the dispatch of ground troops would most likely be justified on the basis of the president's authority under Article 2 of the Constitution to serve as commander in chief and protect the nation. The Posse Comitatus Act exempts actions authorized by the Constitution...

One potentially tricky area, the admiral said, involves National Guard officers who are put in command of task forces that include active-duty as well as Guard units -- an approach first used last year at the Group of Eight summit in Georgia. Guard troops, acting under state control, are exempt from Posse Comitatus prohibitions.

Monday, August 08, 2005

Hahahahahahaha

I soooooo earned my nickname from Year 1 tonight. 12:1 ratio ain't bad. ;^D

Goodness...

It's late. Poor Peter. Still behind on my reading. Wake up, stop by the med school to print off my CAM paper, drive, 7:00 visit patients, OB rounds, lots of day...noon conference... more OB, and back again. Happy b-day, Alicia!

Thursday, August 04, 2005

Bush Laziest President on Record

WASHINGTON POST - President Bush is getting the kind of break most Americans can only dream of: nearly five weeks away from the office, loaded with vacation time. The president departed Tuesday for his longest stretch yet away from the White House, arriving at his Crawford ranch in the evening for a round of clearing brush, visiting with family and friends, and tending to some outside-the-Beltway politics. It is the longest presidential retreat in at least 36 years.

The August getaway is Bush's 49th trip to his cherished ranch since taking office and the 319th day that Bush has spent, entirely or partially, in Crawford — nearly 20 percent of his presidency to date, according to Mark Knoller, a CBS Radio reporter known for keeping better records of the president's travel than the White House itself. Weekends and holidays at Camp David or at his parents' compound in Kennebunkport, Maine, bump up the proportion of Bush's time away from Washington even further.

Bush's long vacations are more than a curiosity: They play into diametrically opposite arguments about his leadership style. To critics and late-night comics, they symbolize a lackadaisical approach to the world's most important day job, an impression bolstered by Bush's two-hour midday exercise sessions and his disinclination to work nights or weekends.

Meanwhile, the month of August has already seen 28 soldiers killed in Iraq. 1827 American soldiers dead to date. Asshole still hasn't attended a funeral for one. Guess he's too busy....

Wednesday, August 03, 2005

On-Call Last Night in OB

Observed a cesarean section and delivered my first baby.

Annnnnnnnd done.

Time to study now. Ha.

Monday, August 01, 2005

Hell's Kitchen

So tonight I watched the finale to Fox Television's "Hell's Kitchen."

It is important to note that, generally speaking, I am not a huge fan of reality TV. I watched the first season of Survivor, and after that, kinda lost interest in the whole genre. But for the past couple of months, I've been absolutely captivated by this show. It gave purpose and meaning to my life in a way that nothing else was capable of... and I don't even like to cook.


I was pleased with how the whole show shook out. I felt like the three most talented chefs made it the farthest, and the two that went head-to-head tonight were the very best of the bunch. Long story short, Michael, a 27 year-old chef from Fort Collins, CO beat out Ralph, a 36 year-old chef from Livingston, NJ. It was a tough call, but I think it was probably the right one.

Okay, I'm done blathering about my culinary distractions now. I just wanted to share the joy with y'all.... and to point out that my Monday evenings are once again free. =D