Thursday Mashup 10/18/12

October 18, 2012
  • I give you The Daily Tucker (here)…

    Thursday marks the 40th anniversary of the Clean Water Act. No doubt, the billions spent on the act have improved overall water quality. Yet as someone who regularly rowed on Washington, D.C.’s Potomac River during college, I know that the Clean Water Act and the EPA are still in murky water.

    The author then goes on to lament the fact that storm runoff (i.e., trash) ends up in the Potomac, which he encounters while rowing. So, for that reason, he considers the Clean Water Act “40 years of inefficient solutions.”

    Seriously.

    Now I don’t know how culpable the D.C. Water and Sewer Authority (DCWSA) is for this circumstance (that is where the author squarely lays the blame). However, the author also tells us that he’s a member of the Property and Environment Research Center (note the order of “property” and “environment,” by the way) which, as noted here, “(is linked) to a long list of the country’s most powerful right-wing foundations and organizations committed to deregulation of industry and to the privatization of public assets” (David Currie, the author of this piece, keeps harking back to “market-based solutions,” which for our purposes here is wingnut code for letting business do whatever it wants).

    However, I think it’s still idiotic to consider the Clean Water Act to be a “failure” focus solely on the ongoing pollutions challenges not addressed by the Clean Water Act (here); Obama Administration EPA head Lisa Jackson, citing the Act’s accomplishments here, said it “has kept tens of billions of pounds of sewage, chemicals and trash out of the nation’s waterways during the past 40 years. The federal law, which includes regulations governing drinking water and requiring improvements in the environmental health of rivers, lakes and seas, has dramatically improved both human health and the environment.”

    Also concerning the Act, this tells us that the American Society of Civil Engineers (ASCE) has encouraged Congress to reauthorize the CWA; I guess Boehner, Cantor, Mikey the Beloved and their pals won’t do it because they consider it to be an unwarranted regulatory intrusion, or something. In addition, the National Clean Water Network tells us here what new assaults the life forms running the U.S. House are planning against the Act and the environment overall (with this Romney advisor telling us he, and by extension, his party’s presidential nominee, wants to “reverse this trend of ownership of public lands,” as if that’s supposedly so awful).

    I guess this is par for the Repug course when you consider that the law was originally vetoed here by then-president Richard Nixon because it was supposedly too expensive, which prompted a statesman-like response from Sen. Ed Muskie, asking what the “cost” was for our health and a safe environment.

    And while I wish Number 44 would distance himself from his electoral opponent on this issue, this tells us that “stim” funds were committed to cleanup of our waterways, and here, Dem Rep. Earl Blumenauer of Oregon, introduced H.R. 6249 – the Water Protection and Reinvestment Act in the House of Representatives, legislation to “establish a Clean Water Trust Fund, which is revenue neutral, does not add to the federal debt, (and raises) approximately $9 billion a year for the Trust Fund.”

    However, given this, do you honestly believe “Orange Man” and his pals will budge one inch in favor of doing the right thing?

  • Also, did you know that Mr. “Binders Full of Women” is supposedly better on LGBT Issues than Obama? The author of this piece says so anyway (sticking with The Daily Tucker)…

    While we applaud President Obama for supporting the repeal of Don’t Ask, Don’t Tell — a failed policy that Governor Romney and his running mate Rep. Paul Ryan have said they will not reinstate — and while we give President Obama credit for coming to the Dick Cheney position on marriage equality, the truth is that Obama’s administration has been devastating for average gay people and their families.

    Really? Why, just stick a rainbow decal from that Toyota Sienna minivan on my forehead and Color Me Shocked!

    How can that be, given that Romney and his running mate, Mr. Puppy-Dog-Eyes-With-The-Shiv, both support the ridiculous Defense of Marriage Act, as noted here (well, Mitt was better on this in 1994, as noted here, opposing “Don’t Ask, Don’t Tell” and supporting the Employee Non-Discrimination Act – I guess he “shook that Etch-a-Sketch” and came up with a new answer…and isn’t this interesting concerning DOMA?).

    This takes us to a Think Progress post asking Romney six questions on LGBT issues that he should answer (and answering in the affirmative would definitely go against his party’s platform, such as it is). But until Romney does answer them (and holds to that answer without changing his mind for at least five minutes), there’s no reason to take him seriously on this subject.

    And as long as we’re discussing the Repug presidential nominee, I think this column asks a very good question (and one that definitely should be discussed in the debates – maybe for the last one I hope), and that is how Willard Mitt feels about torture (he can even call it “enhanced interrogation” if he wants – I have to tell you, though, that I think the answer is here, and it’s not a good one).

    Related to that item, I give you this, telling us about some of the “war heads” who would likely comprise a Romney foreign policy team, including PNAC’s Eliot Cohen, “Baghdad” Dan Senor, and Cofer Black of the aptly-named (but no longer – currently “XE”) Blackwater, along with former Bushie John Lehman and someone named Pierre Prosper.

    But as far as Romney and foreign policy goes (and tied to his utter debate flameout on Libya), this tells us about more of Willard Mitt’s “do as I say, not as I do” BS.

  • Further, I give you “Pastor” Gerson of the WaPo, lecturing the Dems (Biden in particular) on “civility” here (a bit behind in the news cycle on this, I’ll admit)…

    At the height of a close election, it is worth a reminder that civility is the essential democratic virtue. Civility is not the same thing as niceness. The high stakes of politics can produce intense disagreements. But manners — even cold, formal ones — communicate a modicum of mutual respect and preserve the possibility of cooperation. John Stuart Mill called democracy “government by discussion.” Biden has left our discussion more toxic — and Obama’s task more difficult.

    Of course, this was written before the Tuesday debate, it should be noted.

    This is the same Michael Gerson, by the way, who once said here that President Obama was “delusional” and the reconciliation process (used by both parties and embraced by that fine, upstanding Roman Catholic Repug VP nominee) was “dirty.” Also, the same Gerson held up “Straight Talk” McCain as a supposed model of civility here, even though McCain once asked “how do we beat the bitch?” in reference to Hillary Clinton (when “Senator Honor and Virtue” thought she would be the ’08 Dem presidential nominee), and said that Chelsea Clinton was “ugly” because “her father was Janet Reno.”

    I give you another lesson in wingnut code; when Gerson and his ilk talk about “civility,” what that means is a Democrat is supposed to sit down, shut up, and let a Repug take charge.

  • Finally, turning to sports, this tells us that Spencer Hawes, who I believe is still with the Sixers (haven’t found evidence to the contrary), has taken to the Twitter thingie to endorse Romney.

    Which I would care less about, were it not for the fact that he did it like this:

    Hawes made it clear earlier this year that he is not a supporter of noted basketball fan President Obama, or of the president’s signature legislation, the Affordable Care Act. When the Supreme Court handed down its ruling that the healthcare reform legislation is constitutional in June, Hawes tweeted: “Ronald Reagan is spinning in his grave. We might as well be in Russia in 1983.”

    He went on to refer to the Obama administration as communist in several tweets, and added:

    Just drove by a bald eagle who appeared to be crying. Coincidence @BarackObama?

    Ha and ha, wingnut.

    Oh yes, Hawes is so “established” that they traded for Andrew Bynum and his questionable knees and signed the human punch line that is Kwame Brown (here).

    When it comes to playing center for the Sixers, if Hawes is the answer, then the question is too scary to contemplate (just add him to the list of failed centers for that team – Matt Geiger, Jeff Ruland coming off injury, etc.).

    In the meantime, tells Hawes to try driving the lane against Dwight Howard the next time he opposes the Lakers.

    And then let me know when I should call 911.

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    Time For Thursday Health Care Hackery (And More)

    August 13, 2009

    Santorum_Card
    If you’re thinking that all I ever do is post about health care anymore, I should tell you that that’s not correct, though you are close to the truth.

    In today’s Philadelphia Inquirer, Former Senator Man-On-Dog laments the cost of the health care reform legislation here (as a former U.S. Senator, I’m sure he has no coverage issues concerning his own health care) and tells us the following…

    Even after all this new spending, almost half a million Pennsylvanians would still be uninsured, according to the Lewin Group, a health-care consulting firm. And if a government plan modeled after Medicare became available to everyone, the firm predicts that a majority of privately insured Pennsylvanians would move to the government plan.

    Oh, by the way, as Media Matters notes here, the Lewin Group is owned by United Healthcare, so don’t expect anything approximating a “fair and balanced” point of view (the Media Matters post also tells us of another sky high – and incorrect – enrollment estimate from Lewin…I would say there’s quite a difference between 88 million and 2 million.)

    And here’s more from our former “family values” senator…

    The health-care proposals could be financed partly through cuts in Medicare reimbursements to health-care providers. Pennsylvania ranks third, behind West Virginia and Maine, in the share of the population on Medicare. So not only would our doctors and hospitals be hurt disproportionately, but other insurance rates would go up as costs are shifted to the private sector.

    Philadelphia also would feel a disproportionate impact. A proposed surtax on the “rich” to pay for expanded coverage would disproportionately strike higher incomes in the region. But the biggest hit would be to the region’s bioscience industry.

    American health care was born in Philadelphia. The city boasts a list of national health-care firsts: first hospital, children’s hospital, medical school, cancer center, and more. Not surprisingly, those institutions are also among the nation’s best. This region leads the country, and our country leads the world in innovative medicine.

    Why? Because private markets reward excellence and innovation. Government-managed systems won’t pay for either. With more than 40,000 people employed in bioscience jobs in the Philadelphia area, a shift away from quality and innovation would disproportionately penalize the region.

    As noted here, the Philadelphia life sciences industry is funded also by the city and the state (I have no information on federal funding, and Santorum’s argument that enrollment in a government-funded public option could mean less for the life sciences industry from Uncle Sam is nothing more than typical propaganda).

    But wait, there’s more!…

    As to the climate bill, it would make coal Public Enemy No. 1, slapping enormous taxes on states that produce it and burn it for electricity. Pennsylvania is among the top five coal-producing states. More than 900 active mines employ more than 20,000 workers in the Commonwealth, in addition to almost 60,000 other jobs related to mining.

    Taxing poor people in Appalachia for the benefit of California, New York, Connecticut, and New Jersey may be politically appealing to Democrats.

    But is it change Pennsylvanians can believe in?

    Demagoguery aside, Santorum actually has a point, shockingly enough. And that’s why ten Democratic senators, including PA’s Bob Casey and Arlen Specter, signed off on a letter that stated as follows (here)…

    In a letter to Obama, the senators asked for a strong “border adjustment mechanism” to help U.S. industries adjustment to higher energy costs. Such a “mechanism” might include a tax or tariff against foreign manufacturers whose costs aren’t affected by the legislation.

    “Any climate change legislation must prevent the export of jobs and related greenhouse gas emissions to countries that fail to take actions to combat the threat of global warming comparable to those taken by the United States,” the senators write.

    And as long as I’m taking note of Little Ricky, this tells us that he’s been “making the stops” in Iowa. To do some ground work. For three years from now. Contemplating the “big chair” at 1600 Pennsylvania Avenue.

    It’s almost too scary for words.

    JDMullaneOh, and since it is Thursday, that means that it’s time once more for J.D. Mullane of the Bucks County Courier Times to inflict more nonsense on our public deliberation on health care reform (here…and by the way, read commenter “my2cents” for the reality-based perspective).

    And today, that means attacking something else in the House version of the bill, and that would be Section 1233 (and in so doing, Mullane singles out Dem Congressman Earl Blumenauer of Oregon)…

    Blumenauer, a lawyer, insists that Section 1233 is “carefully crafted” and “bipartisan” and that the “advance planning” it promotes is “voluntary.”

    Yet, the word “voluntary” does not appear in the law. To be fair, neither does the word “mandatory.” This leaves the legal intent vague.

    Blumenauer has denounced critics as “unhinged.” He has issued a “myth vs. fact” paper, insisting that Section 1233 “merely provides coverage under Medicare to have a conversation once every five years if – and only if – a patient wants to make his or her wishes known to a doctor.”

    In fact, Section 1233 says more than that. A patient’s wishes may be “known” and “respected,” but the treatment a patient receives will be “guided by a coalition of stakeholders.” These include doctors, nurses, emergency medical technicians, long-term care facility managers, lawyers, hospice caregivers and state departments of health.

    I read through Section 1233 from the bill (here), and I can’t find evidence of what Mullane is talking about. But in case I missed something, here is Section 1233 of the bill…

    SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
    6 (a) MEDICARE.—
    7 (1) IN GENERAL.—Section 1861 of the Social
    8 Security Act (42 U.S.C. 1395x) is amended—
    9 (A) in subsection (s)(2)—
    10 (i) by striking ‘‘and’’ at the end of
    11 subparagraph (DD);
    12 (ii) by adding ‘‘and’’ at the end of
    13 subparagraph (EE); and
    14 (iii) by adding at the end the fol15
    lowing new subparagraph:
    16 ‘‘(FF) advance care planning consultation (as
    17 defined in subsection (hhh)(1));’’; and
    18 (B) by adding at the end the following new
    19 subsection:
    20 ‘‘Advance Care Planning Consultation
    21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
    22 term ‘advance care planning consultation’ means a con23
    sultation between the individual and a practitioner de24
    scribed in paragraph (2) regarding advance care planning,
    25 if, subject to paragraph (3), the individual involved has
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    1 not had such a consultation within the last 5 years. Such
    2 consultation shall include the following:
    3 ‘‘(A) An explanation by the practitioner of ad4
    vance care planning, including key questions and
    5 considerations, important steps, and suggested peo6
    ple to talk to.
    7 ‘‘(B) An explanation by the practitioner of ad8
    vance directives, including living wills and durable
    9 powers of attorney, and their uses.
    10 ‘‘(C) An explanation by the practitioner of the
    11 role and responsibilities of a health care proxy.
    12 ‘‘(D) The provision by the practitioner of a list
    13 of national and State-specific resources to assist con14
    sumers and their families with advance care plan15
    ning, including the national toll-free hotline, the ad16
    vance care planning clearinghouses, and State legal
    17 service organizations (including those funded
    18 through the Older Americans Act of 1965).
    19 ‘‘(E) An explanation by the practitioner of the
    20 continuum of end-of-life services and supports avail21
    able, including palliative care and hospice, and bene22
    fits for such services and supports that are available
    23 under this title.
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    1 ‘‘(F)(i) Subject to clause (ii), an explanation of
    2 orders regarding life sustaining treatment or similar
    3 orders, which shall include—
    4 ‘‘(I) the reasons why the development of
    5 such an order is beneficial to the individual and
    6 the individual’s family and the reasons why
    7 such an order should be updated periodically as
    8 the health of the individual changes;
    9 ‘‘(II) the information needed for an indi10
    vidual or legal surrogate to make informed deci11
    sions regarding the completion of such an
    12 order; and
    13 ‘‘(III) the identification of resources that
    14 an individual may use to determine the require15
    ments of the State in which such individual re16
    sides so that the treatment wishes of that indi17
    vidual will be carried out if the individual is un18
    able to communicate those wishes, including re19
    quirements regarding the designation of a sur20
    rogate decisionmaker (also known as a health
    21 care proxy).
    22 ‘‘(ii) The Secretary shall limit the requirement
    23 for explanations under clause (i) to consultations
    24 furnished in a State—
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    1 ‘‘(I) in which all legal barriers have been
    2 addressed for enabling orders for life sustaining
    3 treatment to constitute a set of medical orders
    4 respected across all care settings; and
    5 ‘‘(II) that has in effect a program for or6
    ders for life sustaining treatment described in
    7 clause (iii).
    8 ‘‘(iii) A program for orders for life sustaining
    9 treatment for a States described in this clause is a
    10 program that—
    11 ‘‘(I) ensures such orders are standardized
    12 and uniquely identifiable throughout the State;
    13 ‘‘(II) distributes or makes accessible such
    14 orders to physicians and other health profes15
    sionals that (acting within the scope of the pro16
    fessional’s authority under State law) may sign
    17 orders for life sustaining treatment;
    18 ‘‘(III) provides training for health care
    19 professionals across the continuum of care
    20 about the goals and use of orders for life sus21
    taining treatment; and
    22 ‘‘(IV) is guided by a coalition of stake23
    holders includes representatives from emergency
    24 medical services, emergency department physi25
    cians or nurses, state long-term care associa-
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    1 tion, state medical association, state surveyors,
    2 agency responsible for senior services, state de3
    partment of health, state hospital association,
    4 home health association, state bar association,
    5 and state hospice association.
    6 ‘‘(2) A practitioner described in this paragraph is—
    7 ‘‘(A) a physician (as defined in subsection
    8 (r)(1)); and
    9 ‘‘(B) a nurse practitioner or physician’s assist10
    ant who has the authority under State law to sign
    11 orders for life sustaining treatments.
    12 ‘‘(3)(A) An initial preventive physical examination
    13 under subsection (WW), including any related discussion
    14 during such examination, shall not be considered an ad15
    vance care planning consultation for purposes of applying
    16 the 5-year limitation under paragraph (1).
    17 ‘‘(B) An advance care planning consultation with re18
    spect to an individual may be conducted more frequently
    19 than provided under paragraph (1) if there is a significant
    20 change in the health condition of the individual, including
    21 diagnosis of a chronic, progressive, life-limiting disease, a
    22 life-threatening or terminal diagnosis or life-threatening
    23 injury, or upon admission to a skilled nursing facility, a
    24 long-term care facility (as defined by the Secretary), or
    25 a hospice program.
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    1 ‘‘(4) A consultation under this subsection may in2
    clude the formulation of an order regarding life sustaining
    3 treatment or a similar order.
    4 ‘‘(5)(A) For purposes of this section, the term ‘order
    5 regarding life sustaining treatment’ means, with respect
    6 to an individual, an actionable medical order relating to
    7 the treatment of that individual that—
    8 ‘‘(i) is signed and dated by a physician (as de9
    fined in subsection (r)(1)) or another health care
    10 professional (as specified by the Secretary and who
    11 is acting within the scope of the professional’s au12
    thority under State law in signing such an order, in13
    cluding a nurse practitioner or physician assistant)
    14 and is in a form that permits it to stay with the in15
    dividual and be followed by health care professionals
    16 and providers across the continuum of care;
    17 ‘‘(ii) effectively communicates the individual’s
    18 preferences regarding life sustaining treatment, in19
    cluding an indication of the treatment and care de20
    sired by the individual;
    21 ‘‘(iii) is uniquely identifiable and standardized
    22 within a given locality, region, or State (as identified
    23 by the Secretary); and
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    1 ‘‘(iv) may incorporate any advance directive (as
    2 defined in section 1866(f)(3)) if executed by the in3
    dividual.
    4 ‘‘(B) The level of treatment indicated under subpara5
    graph (A)(ii) may range from an indication for full treat6
    ment to an indication to limit some or all or specified
    7 interventions. Such indicated levels of treatment may in8
    clude indications respecting, among other items—
    9 ‘‘(i) the intensity of medical intervention if the
    10 patient is pulse less, apneic, or has serious cardiac
    11 or pulmonary problems;
    12 ‘‘(ii) the individual’s desire regarding transfer
    13 to a hospital or remaining at the current care set14
    ting;
    15 ‘‘(iii) the use of antibiotics; and
    16 ‘‘(iv) the use of artificially administered nutri17
    tion and hydration.’’.
    18 (2) PAYMENT.—Section 1848(j)(3) of such Act
    19 (42 U.S.C. 1395w–4(j)(3)) is amended by inserting
    20 ‘‘(2)(FF),’’ after ‘‘(2)(EE),’’.
    21 (3) FREQUENCY LIMITATION.—Section 1862(a)
    22 of such Act (42 U.S.C. 1395y(a)) is amended—
    23 (A) in paragraph (1)—
    24 (i) in subparagraph (N), by striking
    25 ‘‘and’’ at the end;
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    1 (ii) in subparagraph (O) by striking
    2 the semicolon at the end and inserting ‘‘,
    3 and’’; and
    4 (iii) by adding at the end the fol5
    lowing new subparagraph:
    6 ‘‘(P) in the case of advance care planning
    7 consultations (as defined in section
    8 1861(hhh)(1)), which are performed more fre9
    quently than is covered under such section;’’;
    10 and
    11 (B) in paragraph (7), by striking ‘‘or (K)’’
    12 and inserting ‘‘(K), or (P)’’.
    13 (4) EFFECTIVE DATE.—The amendments made
    14 by this subsection shall apply to consultations fur15
    nished on or after January 1, 2011.
    16 (b) EXPANSION OF PHYSICIAN QUALITY REPORTING
    17 INITIATIVE FOR END OF LIFE CARE.—
    18 (1) PHYSICIAN’S QUALITY REPORTING INITIA19
    TIVE.—Section 1848(k)(2) of the Social Security Act
    20 (42 U.S.C. 1395w–4(k)(2)) is amended by adding at
    21 the end the following new paragraphs:
    22 ‘‘(3) PHYSICIAN’S QUALITY REPORTING INITIA23
    TIVE.—
    24 ‘‘(A) IN GENERAL.—For purposes of re25
    porting data on quality measures for covered
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    1 professional services furnished during 2011 and
    2 any subsequent year, to the extent that meas3
    ures are available, the Secretary shall include
    4 quality measures on end of life care and ad5
    vanced care planning that have been adopted or
    6 endorsed by a consensus-based organization, if
    7 appropriate. Such measures shall measure both
    8 the creation of and adherence to orders for life9
    sustaining treatment.
    10 ‘‘(B) PROPOSED SET OF MEASURES.—The
    11 Secretary shall publish in the Federal Register
    12 proposed quality measures on end of life care
    13 and advanced care planning that the Secretary
    14 determines are described in subparagraph (A)
    15 and would be appropriate for eligible profes16
    sionals to use to submit data to the Secretary.
    17 The Secretary shall provide for a period of pub18
    lic comment on such set of measures before fi19
    nalizing such proposed measures.’’.
    20 (c) INCLUSION OF INFORMATION IN MEDICARE &
    21 YOU HANDBOOK.—
    22 (1) MEDICARE & YOU HANDBOOK.—
    23 (A) IN GENERAL.—Not later than 1 year
    24 after the date of the enactment of this Act, the
    25 Secretary of Health and Human Services shall
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    1 update the online version of the Medicare &
    2 You Handbook to include the following:
    3 (i) An explanation of advance care
    4 planning and advance directives, includ5
    ing—
    6 (I) living wills;
    7 (II) durable power of attorney;
    8 (III) orders of life-sustaining
    9 treatment; and
    10 (IV) health care proxies.
    11 (ii) A description of Federal and State
    12 resources available to assist individuals
    13 and their families with advance care plan14
    ning and advance directives, including—
    15 (I) available State legal service
    16 organizations to assist individuals
    17 with advance care planning, including
    18 those organizations that receive fund19
    ing pursuant to the Older Americans
    20 Act of 1965 (42 U.S.C. 93001 et
    21 seq.);
    22 (II) website links or addresses for
    23 State-specific advance directive forms;
    24 and
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    1 (III) any additional information,
    2 as determined by the Secretary.
    3 (B) UPDATE OF PAPER AND SUBSEQUENT
    4 VERSIONS.—The Secretary shall include the in5
    formation described in subparagraph (A) in all
    6 paper and electronic versions of the Medicare &
    7 You Handbook that are published on or after
    8 the date that is 1 year after the date of the en9
    actment of this Act.

    Everybody got that? Good.

    And as noted here…

    Many observers now today write in the media that erroneous interpretations of Section 1233 of Health Care Reform Bill is (sic)very “egregious,” as it involves the lives of our senior citizens. The erroneous interpretation is that the government will counsel the senior citizens every five years on how to end their lives early. This is outrageous interpretation of end of life planning.

    What the Section 1233 of the Health Care Reform Bill really reads is that “Medicare will pay for an “advance care planning consultation” once every five years. Section 1233 is actually creating a new benefit for seniors that will be paid for by Medicare. It will only pay for one consultation every five years unless the patient’s health changes. If that happens, the provision then calls for Medicare to pay for a new consultation when the change in health occurs,” explains SV Herald.

    (More information is available here.)

    By the way, I actually visited J.D. Mullane’s blog yesterday (where common sense goes home to die) and found out that his column will, according to Mullane, now “run…in the Burlington County Times, our sister newspaper across the river, beginning September. I’m looking forward to covering the governor’s race, one of the highest profile matchup’s in the country. With the Courier, the Intel in Doylestown and the Burlington paper, the audience expands to more than 100,000 readers.”

    I just thought anyone out there who was thinking of renewing their subscription to the Courier Times (and who may be reading this) should know that Mullane’s publisher thinks rank propaganda should be rewarded instead of punished.

    And newspapers wonder why they’re losing circulation…


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