Open Letter to #Virginia #FOIA_Council in Support of More #OpenGovernment Laws

Dear Honorable Members of the Virginia FOIA Council:

In your role as a Virginia FOIA Council member, you have a responsibility to serve us citizens of Virginia in a way that TRULY protects our rights to be able easily monitor and know how our government is working.  Take action now to remove most if not all of the 48 permitted existing barriers to open government in Virginia.  It is unconscionable that one of (if not) the most historic states in our country relative to our nation’s founding has so many obstructions to citizens’ ability to be assured that government is operating as we intend it.  Fix this problem now.

Please read the Daily Press editorial below.  It is spot on as to the problem and how you can fix it.  My family, friends, and I here in Yorktown (where the British conceded defeat and we won independence) share these views an expect you to help us move our cause in the right direction.

Thank you for your service on behalf of your fellow citizens.

Sincerely,

Robert E. Lehman
Yorktown, VA

http://www.dailypress.com/news/opinion/editorials/dp-edt-foia-meeting-20150721-20150720-story.html#page=1

“In Virginia, if you want to know what the State Police found investigating the worst mass murder in U.S. history, or what the consultants Hampton taxpayers hired to look into a proposed aquatics center, or what Newport News council members had to say about the city manager’s performance last year, you’re out of luck.

If you were a parent up in Staunton wondering about the financial management that allowed a school bookkeeper to embezzle thousands from an account holding student-raised funds for extracurricular activities, too bad.

Wondering what happened when that Winchester council member was charged with illegally shooting a gun, or the costs Richmond thinks it needs to cover with higher water and sewer bills? Well, you get the picture.

The commonwealth is at a crossroads when it comes to the relationship between citizens and their government.

In 2014, the General Assembly ordered the Freedom of Information Advisory Council to conduct a three-year review of the Freedom of Information Act, the open government statute which defines the critical relationship between citizens and their government.

The council has since seemed reluctant to consider any significant changes. And there is now reason to fear that this once-in-a-generation opportunity to recast the commonwealth’s approach to government transparency could be squandered without citizen intervention.

Consider the following:

It is still mulling how to handle records that businesses give governments when they seek favors. In just one case, it acted to make clear that an exemption should not be used, as it has been, to keep secret records that officials are required to release.

Of the 24 reasons public officials can cite for their overused option of meeting behind closed doors, the working group recommends letting stand 18. It is eliminating an exemption for an entity that never existed. It is studying the rest.

And when asked to consider a mechanism for punishing those who willfully violate the law, the council dismissed the proposal out-of-hand. Our experience tells us that there must be criminal penalty to enforce compliance, as many other states use in their open government laws.

The FOIA council is a state agency that effectively serves as the point of contact for inquires about the commonwealth’s open government laws. It answers questions, issues advisory opinions and, since last year, has been conducting a thorough review of the law.

But we are concerned that the 12-member board leans too heavily toward public officials and lacks strong advocates for openness. We worry that its members, though well-intentioned public servants, are informed by their experience in government.

They do not know the frustration of seeing officials in Isle of Wight County, York County and Poquoson give vague reasons for closing the door on the public time and time again. They have never tried to pry documents out of city halls in Newport News or Hampton, or hit a series of dead ends in trying to determine how one construction bid was selected over others.

Virginia’s FOIA needs to be broader. It should be easier for citizens to use and harder for officials to violate. And it must live up to the expectation in its preamble that “the affairs of government are not intended to be conducted in an atmosphere of secrecy.”

But to achieve that, we need your help.

The council will gather this week in Richmond, its first meeting since May and its only one until September. It will review minutes from its subcommittees for records and meetings, which are hashing through the minutia of the law’s exemptions.

If you believe that a transparent government is one that best serves the people, and that Virginia would better for having open government laws that honor the people’s right to know, then we urge you to contact the council, as well as its members, and say precisely that.

Here is that information:

Sen. Richard H. Stuart, a Republican representing District 28, can be reached at 804-698-7528 and district28@senate.virginia.gov.

Del. James M. LeMunyon, a Republican representing District 67, can be reached at 804-698-1067 and DelJLeMunyon@house.virginia.gov.

Christopher Ashby is a lawyer in Alexandria. He can be reached at 202-281-5463 and Chris@Ashby-Law.com.

John G. Selph is a lawyer in Richmond who can be reached at 804-270-0791.

1. Timothy Oksman formerly served as city attorney in Portsmouth and now serves as opinions counsel in the Office of the Attorney General. He can be reached at 804-786-1861 and toksman@oag.state.va.us.

Stephanie Hamlett is the executive director of the Virginia Resources Authority, the agency which oversees bond and loans to municipal governments through the state. She can be reached at 804-616-3448.

Edward Jones is a former editor of The Free Lance-Star in Fredericksburg. He now serves as secretary and chief of staff for the Episcopal Diocese of Virginia. He can be reached at 800-346-2373 ext. 1030 and at ejones@thediocese.net.

Sandra G. Treadway serves as the librarian of Virginia, leading the state repository for the commonwealth’s extensive collection of books, manuscripts and official records. She can be reached at 804-692-3535 and sandra.treadway@lva.virginia.gov.

Forrest M. “Frosty” Landon was executive editor of the Roanoke Times and a driving force in the creation of the Virginia Coalition for Open Government. He can be contacted at 540-354-8918.

Robert L. Tavenner is the director of the Division of Legislative Services, the state entity which assists lawmakers in the drafting of legislation, among other duties. He can be reached at 804-786-3591 ext. 233 and rtavenner@dls.virginia.gov.

Kathleen Dooley serves as the Fredericksburg city attorney. She can be reached at 540-372-1020 and kdooley@fredericksburgva.gov.

Marisa J. Porto is the vice president for content at the Daily Press Media Group and a member of this editorial board. She can be reached at 757-247-4660 and mporto@dailypress.com.

Finally the FOIA Council can be contacted at 804-225-3056 and foiacouncil@dls.virginia.gov. The executive director is Maria J.K. Everett, who can be reached at foiacouncil@dls.virginia.gov.

Copyright © 2015, Daily Press“

Health Plan Policy Coverage Guidelines Challenged

Background story: Keller family sues U.S. Department of Defense after TRICARE refuses to cover equine physical therapy.

This is an interesting case from a policy setting perspective. It highlights the struggles that providers must learn to more effectively overcome in working with health plans when confronted with the issue of advocating for their patients when coverage guidelines on the payer side are not met for treatments/services that the physician believes necessary for her/his patients.

The final outcome may very well hinge on the argument of whether or not a horse is a tool to aid in the provision of already proven physical therapy vs. a separate modality that is unproven which is the prevalent status of hippotherapy aka equine therapy.  That would appear to be a decision that transcends but is nonetheless foundational to CHAMPUS regulations that seem to be guiding TRICARE’s decision to withhold coverage in spite of the ALJ decision.

The report and the complaint filed with the court for relief from TRICARE’s maintaining its decision to not cover the horse related physical therapy did not appear to address one of the likely primary considerations contributing to TRICARE’s decision. There is an additional federal regulation that requires all covered care to be proven.  If the larger issue of whether or not horses are mere tools in the provision of physical therapy as opposed to being a completely stand alone treatment modality then the issue of it being considered a proven treatment is hanging as a larger looming issue.

Here is the regulation not cited in the complaint:

32 CFR Section 199.4 – Basic program benefits:  (15) Unproven drugs, devices, and medical treatments or procedures. By law, CHAMPUS can only cost-share medically necessary supplies and services. Any drug, device, or medical treatment or procedure, the safety and efficacy of which have not been established, as described in this paragraph (g)(15), is unproved and cannot be cost-shared by CHAMPUS except as authorized under paragraph 199.4(e)(26) of this part.

It appears to be a primary issue of semantics – whether or not Kaitlyn is benefiting from physical therapy that uses a horse as a therapy tool or whether she is benefiting from hippotherapy aka equine therapy.  Here is an article written by a PT who attempts to address the semantics issue.  It’s a compelling argument.

What’s troubling however, is that as a group of health professionals, PT’s and other healthcare professionals who advocate use horses as tools in PT and OT apparently have failed as of yet to generate the credible evidence that meets the rigid requirements of health payers to accept use of horses as tools in therapy as safe and effective and / or they have failed to differentiate the use of horses as tools from the generally unaccepted modality that is hippotherapy.  Regardless, they have failed to get use of horses to be an acceptable component of reimbursable healthcare under prevailing health insurance practices.

Interestingly, TRICARE does have a hippotherapy benefit under the ECHO program but for diagnoses that Kaitlyn appears not to have. Hippotherapy is not covered under TRICARE basic benefits. Hippotherapy is usually not covered under TRICARE due to the above referenced regulation that excludes non-proven / investigational care outside of TRICARE approved pilot or demonstration projects.

Other insurance payers seem to consider both physical therapy using horses and hipportherapy /equine therapy to be one and the same but stand firm on the side of it being a modality that is unproven.  There appears to be mixed policies with respect to coverage across various health plans, though the vast majority cite it as unproven.  Most look at it from perspective whether it is proven as effective treatment of spastic CP.

Here is a short list of health plans that deem equine therapy as not covered / investigational, though most here do not specifically address it as modality to treat scoliosis:

http://www.aetna.com/cpb/medical/data/100_199/0151.html

Click to access rehabilitative_therapies.pdf

http://www.anthem.com/medicalpolicies/anthem/va/policies/mp_pw_a050176.htm

Here is a plan where it is covered in only very limited / minimal instances  – somewhat similar to TRICARE ECHO program allowance, though I think maybe less generous:

https://www.wellcare.com/WCAssets/corporate/assets/ccg/hs_ccg_hip

A decision by TRICARE to permit coverage of the CPT billing codes as reported about Kaitlyn’s care in the Dallas News blog article linked above seems at face value to be an innocuous decision in light of the fact that Katilyn’s treating healthcare providers report that the therapy using a horse is maintaining her spinal alignment and that the costs to doing so is neutral to therapy provided using other tools that are less effective.

Risk of setting a precedent for allowing arguably unproven treatment tools or modalities is a likely overriding concern that is compelling the decision not to approve coverage. It is a completely legitimate concern as it drives to the ability of health plans to assure that covered care guidelines assure safe, proven, and effective care under the benefits. It is all the more prudent in light of the ever present need to minimize the tax burden to publicly funded plans and assure valuable returns on the investment.  DoD healthcare dollars are not in abundance as policy makers continue to wrestle with sequestration  It is unfortunate that such considerations affect individual patients from getting treatments or services that their treating providers believe are necessary to meeting their individual healthcare needs.  Such fall out is a byproduct of trying to balance the goals of operating effective health plans at a population based level while maintaining a responsibility to meeting the person centered needs of individualized care planning.

It would be ideal and most prudent if the physical and occupational therapy professional community could work to generate the evidence needed to legitimize the use of horses as a reimbursable component of their craft in whatever way the health insurance industry requires.  The bottom line is that if use of horses as a tool for administering physical or occupational therapy is indeed an effective treatment to a generalizable group of patients with similar health conditions such as scoliosis and other musculoskeletal conditions, then it should be provable in commiserate methods and fashion just as other established medical standards of care are.

In the mean time, in light of the cost neutrality and apparent effectiveness of the use of horses as tools in the provision of the actual therapy treatments rendered to Kaitlyn, perhaps some authorized type of waiver can be granted or the DoD Undersecretary of Health Affairs can reverse course and abide by the ALJ ruling to let Kaitlyn resume getting the therapy using a horse so as to prevent further misalignment of her spine that her physicians fear will lead to a worsening of her health – requiring even more healthcare expenditures and hardship to Kaitlyn and her family.  That can assuredly be done with minimal if any damage to the TRICARE program while the issue is worked out of whether or not the use of horses in the provision of PT and OT is proven or not regardless of the semantics of it being a tool used in generalized PT/OT or completely separate modality.

Patient Protection and Affordable Care Act and Morals

October 1, 2013 came and went as the first day open enrollment began for the Patient Protection and Affordable Care Act, or more commonly known as Obamacare.  Problems with accessing the enrollment website at http://www.healthcare.gov have been widely reported and commented by pundits pro and con.

I read today that the health insurance industry giants have partnered up (yet again) to offer aid to the embattled Obama administration to see if they can lend their expertise in getting the http://www.healthcare.gov website off the ground as bipartisan calls are starting to be made to hold senior government leaders accountable to the debacle.  Besides power lusting progressive politicians, the health insurance industry stands to lose the most with the government’s prolonged inability to corral the “sheeple” into its health insurance holding pen.

Mine is a moral and ethical objection that an industry(in this case mine) has partnered with the government to enact a tax penalty against all citizens simply for being alive and not wanting to purchase health insurance.  Who could have ever imagined that America would ever see a tax on the living imposed on its people?  The government does not care if there are segments of citizens who opt to live healthy and practice wellness in their daily living outside the prevailing healthcare system – making a conscience decision to not purchase something that they do not want nor need.  Instead, masking as a parent, it coerces them to buy something that they otherwise might not want to buy simply because the it has the might of the IRS to enforce penalties.  Might is not always right.  Countless polls show vast numbers of Americans (tens if not hundreds of millions) do not want this healthcare mandate to purchase insurance.  While the PPACA may be the law of the land, ushered in by a political party majority that obtained power via elections, it still does not make it a just law – even if the Supreme Court upheld it as some bullshit taxing power interpretation.

From Chief John Robert’s Ruling:.

“The Affordable Care Act is constitutional in part and unconstitutional in part. The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it. In this case, however, it is reasonable to con­strue what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Con­gress’s power to tax.”

“The Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today. But the Court does not express any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people.”

Mr. Chief Justice, let my judgement be known that I deny my consent to this government requirement/tax shakedown on the grounds that it is morally and ethically wrong to coerce a person to purchase something simply because they are alive, regardless of their income or wealth status or lack thereof.

Something Just Doesn’t Feel Right

Many people have the same feeling that things just are not right with the overall condition of our country.

It has been a while since my last post.  I have just been observing and reading and thinking and mainly enjoying life.

I found it becoming increasingly difficult to enjoy my time with me staying connected to the condition of our country.  Maybe it is all current events that rob me of my joy.

It’s hard to make a difference nowadays as the political machines grind away at moving the military industrial media complex forward.

So I quit worrying & wondering about it and instead just try to remain true to my values and principles and just enjoy life.

But I can’t shake that feeling that something just isn’t right in our USA.

Daily Press Editorial: Dear Mr. President Sequestration alarms are false attempts to justify a spendthrift government

dailypress.com/news/opinion/dp-edt-sequester-0226-20130225,0,4423054.story

dailypress.com

Editorial: Dear Mr. President

Sequestration alarms are false attempts to justify a spendthrift government

5:58 PM EST, February 25, 2013

 

Welcome to Newport News, Mr. Obama.

Folks on the Peninsula tend to be straight shooters, so when you visit Newport News Shipbuilding today we sure wish you’d stop your campaigning (you’ve already won re-election, remember?) and honestly answer some questions about the hysteria you’ve fanned over sequestration.

If Sunday’s Daily Press accounts are accurate, the beginning of sequestration at week’s end will be even more catastrophic than if that recent fly-by asteroid had actually hit us.

The Pentagon will be left unarmed, schools will be left without services, air travel will come to a standstill, libraries will be shuttered, seniors will be left without meals, and preschool classes slashed. The average American voter, whose knowledge of either economics or government is based on 30-second TV narratives by well-coiffed anchors, is no doubt scared stiff.

We think you could do us a great service, then, Mr. President, if you explained how all this carnage to our nation could result from cutting a measly 2.3 percent from the budget. That’s right; we’re talking about $85 billion in cuts from a national budget of $3.6 trillion this year.

If such a comparatively insignificant amount will bring our country to a screeching halt, it makes us wonder what our government is doing with the other $3.59 trillion.

For example, it’s hard to imagine the U.S. Navy couldn’t find other ways to cut expenses besides delaying the deployment of the USS Harry S Truman — a decision it has attributed to sequestration cuts. And does anyone seriously think the FAA would cripple the nation by closing down air traffic control towers?

If these sequestration cuts are so dastardly, why did the original proposal emerge from your own White House during 2011’s debt ceiling negotiations? According to news accounts at the time, the main proponent for the idea of sequestration was Jacob J. Lew, then your budget director and now your nominee for Treasury secretary.

And can you please explain why, just a month after reaching an agreement on the debt ceiling that raised income taxes on high earners by another $600 billion, you and your supporters — including Virginia’s own Sen. Tim Kaine — are saying we need to raise taxes again?

Raising taxes is the whole idea, isn’t it?

Your goal in your second administration is to enact your vision of a fairer America by equalizing income levels, which is on its face not an ignoble aim. Where we must disagree is the blunt tool you’ve chosen to implement that goal: a bigger and more intrusive government, funded by increasing taxes on the incomes of those whose investments and risks keep our economy moving.

The problem with that approach, Mr. President, is that eventually you run out of rich people to tax. So you start defining the “rich” downward, and eventually hit the middle class. (For those of you who rely on TV news for your information, just take a look at your paycheck since the payroll taxes came back to their normal levels. This single step, which was overdue, was blamed by national retailers with setting back their business last month).

We suppose that equalizing income levels by making everyone poor and miserable is one way of achieving your aims, Mr. President. But we think our neighbors, like most Americans including you, would prefer to grow our economy so that all could do better.

As President John F. Kennedy famously reminded us in a 1963 speech, “a rising tide lifts all the boats.” He was alluding to the sweeping tax reform and reduction legislation that the U.S. House Ways and Means Committee had recently passed. Mr. Kennedy recognized the role such policy would play in maintaining the nation’s expanding economy and prosperous foreign trade.

Election season is over, but your administration and many in Congress still won’t talk about the sacrifices our federal government must make by reining in spending and taxing more fairly. American families are used to these sacrifices, as are localities and states like Virginia that are trying to make their governments leaner and more efficient.

Like the cuts threatened by some localities who paint a gloomy picture of service cutbacks in order to convince citizens to pay more taxes, sequestration cuts are strategically designed to scare Americans into paying more taxes. We aren’t buying it.

Copyright © 2013, Newport News, Va., Daily Press

Only in America – Author is an Unknown Canadian

TOP-10 “ONLY IN AMERICA” OBSERVATIONS – BY A CANADIAN*

1) Only in America could the rich people – who pay 86% of all income taxes – be accused of not paying their “fair share” by people who don’t pay any income taxes at all.

2) Only in America could people claim that the government still discriminates against black Americans when they have a black President, a black Attorney General, and roughly 18% of the federal work-force is black while only 12% of the population is black.

3) Only in America could they have had the two people most responsible for our tax code, Timothy Geithner, the head of the Treasury Department and Charles Rangel who once ran the Ways and Means Committee, BOTH turn out to be tax cheats who are in favor of higher taxes.

4) Only in America can they have terrorists kill people in the name of Allah and have the media primarily react by fretting that Muslims might be harmed by the backlash.

5) Only in America would they make people who want to legally become American citizens wait for years in their home countries and pay tens of thousands of dollars for the privilege while we discuss letting anyone who sneaks into the country illegally just ‘magically’ become American citizens.

6) Only in America could the people who believe in balancing the budget and sticking by the country’s Constitution be thought of as “extremists.”

7) Only in America could you need to present a driver’s license to cash a check or buy alcohol, but not to vote.

8) Only in America could people demand the government investigate whether oil companies are gouging the public because the price of gas went up when the return on equity invested in a major U.S. oil company (Marathon Oil) is less than half of a company making tennis shoes (Nike).

9) Only in America could the government collect more tax dollars from the people than any nation in recorded history, still spend a Trillion dollars more than it has per year – for total spending of $7-Million PER MINUTE, and complain that it doesn’t have nearly enough money.

10) Only in America could politicians talk about the greed of the rich at a $35,000.00 a plate campaign fund-raising event.

President Obama Takes Oath of Office for Second Term

Will he uphold and defend the Constitution?

The “I Just Want to Be Left Alone to Be Free” Sound-Off Blog

After a while, it gets fairly redundant trying to think of things to write about.  Clearly, the pros are very talented. Walter Williams, Krauthammer, George Will, Perry Willis, Jim Babka, and J. Hornberger – those are all brilliant thinkers and writers.

That being written, on the cusp of the 2012 election, what is that you need to get off your chest?  Please feel free to write it here. No matter how seemingly trivial or insignificant that you think it is, post it here.

Is Shrinking the US Federal Government a Real Possibility?

It is always good when you see or hear bureaucrats communicating that they want to shrink government and make things efficient and useful.  Only doing that which adds value is a way of life in the real business world.

So I was happy (but skeptical) when I saw the White House website “21st Century Government – Campaign to Cut Waste” which stems from Executive Order # 13576 on Government Efficiency, Effectiveness, and Accountability from June 13, 2011. 

Here is a brief excerpt of the order:

“The American people must be able to trust that their Government is doing everything in its power to stop wasteful practices and earn a high return on every tax dollar that is spent.  To strengthen that trust and deliver a smarter and leaner Government, my Administration will reinforce the performance and management reform gains achieved thus far; systematically identify additional reforms necessary to eliminate wasteful, duplicative, or otherwise inefficient programs; and publicize these reforms so that they may serve as a model across the Federal Government.”

At the same website, I found the following post: “Building a 21st Century Government by Cutting Duplication, Fragmentation, and Waste”:

“Yet, the Administration will not wait for congressional action. Where we can, we are taking aggressive action to eliminate overlap and reduce fragmentation administratively across government (emphasis added).

You get the gist of what they are trying to sell.  Here is my favorite: Regulatory Reform.

Anyway, I came across something that I think was missed and I just need to get it off my chest.  In the grand scheme of all the hundreds of millions if not billions of dollars wasted each year due to government inefficiency and regulatory mismatches and red tape, I am sure this is a small drop in the bucket.  But a bigger concern than the wasted tax dollars, is the potential lack of access to clearly proven laboratory health services for millions of beneficiaries.

Here is the head scratcher.  The federal government funds health plans.  You know them as Medicare and Medicaid under the regulatory agency known as the CMS under the Department of Health and Human Services.  The Secretary, Kathleen Sebelius reports to the President. There are also Federal Employee Health Benefits Plans and I think they are regulated under the office of Personnel Management which I believe to be an independent federal government agency.

Lastly there is TRICARE, a Military Health System benefits entitlement program administered by the Department of Defense. It has its own Secretary, Leon Pannetta, who reports to the President.

TRICARE Management Activity or TMA recently released word of a new Demonstration Project for something called Lab Developed Tests or LDTs.  Below are pulled sections of a published  justification and mission statement derived from the Office of the Secretary of Defense pulled from the Federal Register: that is announcing the need for doing the whole demonstration project.  You may just want to read the whole thing to see the flow of TMAs thinking and justification.

An LDT is a test developed by a single clinical laboratory that
provides testing to the public but does not sell the lab kit to other
labs. In the past, these tests were relatively simple tests used to
diagnose or monitor diseases and other conditions within a single
laboratory usually at a local large hospital or academic medical
center. As a result the FDA has utilized enforcement discretion (where
the FDA does not enforce some or all applicable laws and regulations on
certain categories of products) of LDTs and has taken no action to
remove them from the marketplace.

In contrast to TMA, CMS regulations do not have a specific
requirement that devices be FDA approved. As a result CMS policy
provides a mechanism for the review and payment of non-FDA approved
LDTs (Section 522 of the Benefits Improvement and Protection Act). Non-
FDA approved LDTs which meet CMS’s standards are approved through its
National Coverage Determination (NCD) or Local Coverage Determination
(LCD) process. Once a LDT receives a LCD, it is considered a nationwide
Medicare covered benefit.

A demonstration project will be initiated by the TMA to test
whether CMS approved LDTs which have not received FDA medical device
510(k) clearance or premarket approval (therefore considered non-FDA
approved) are safe and effective for cost-sharing for TRICARE
beneficiaries. The LDTs for this demonstration would be limited to only
those that significantly inform clinical decision-making for
surveillance, surgical intervention, chemotherapy, or radiation therapy
for cancer.

What irks me as a taxpayer is that the DoD feels it has to expend however many hundreds of thousands or maybe even millions of dollars doing a complicated 3 year demonstration project to see if BRCA 1 and BRCA 2 tests and Oncotype gene tests (all are LDTs) can yield safe and helpful results to improve the health of TRICARE beneficiaries.

Why does TMA think it has to do all of this to prove something that likely is already proven by CMS?  What does TMA think makes a CMS patient different than a TRICARE patient?  If these lab tests are helping save Medicare or Medicaid lives under CMS, does TRICARE not think they can do the same for TRICARE lives, as if the payor source of the tests changes the outcomes?  It it ludicrous.

The only reason TRICARE is doing this is because the Code of Federal Regulations has divergent rules that permit the same federal government from paying or not paying for the same exact tests under different health benefit programs!  It is just a government red tape issue and not anything to do with proven and effective health care!

Why couldn’t the Department of Defense and TMA just ask for an executive order to cut through the red tape of the regulatory mismatching that makes the same exact tests being able to be covered under Medicare but not TRICARE go away?

Think about it.   A TRICARE beneficiary becomes Medicare eligible at 65.  So what is so magic about a lab test all of a sudden being proven as safe and reliable for good health outcomes when the person’s benefit plan eligibility changes from TRICARE as primary payor to Medicare?  It is all red tape driven.  Cut the red tape and save patients time and save taxpayers money.
If it is good for the federal government to fund payment under Medicare, why not make it good for the federal government to fund payment under TRICARE and vice versa?  Fixing this issue now rather than doing a costly and wasteful demonstration project will certainly go a long way towards removing any skepticism that I have regarding the White House’s boasting on making government more efficient in the 21st century.

Seeking Many Opinions About Money

As a libertarian, government monetary policy is of interest to me.  I posted here on the Wake Up blog before about how my money is my life.  In fact money issues flow through many of my posted thoughts here in this blog site.

During the current election cycle, at front and center of the debate of who should be elected is the important topic of our country’s debt and the plan of how best to fix the economy.  For the presidential election, neither candidate seems to be presenting a plan that really cuts to the heart of what ails our economy.  Similarly missing in congressional races is any plan that really offers any true promise of effectively fixing the problems.

The crux of the problem is rooted in our monetary policy.  Decades of creating cheap money (debt based currency where money is literally printed out of thin air) permits The State, er um I mean our “government” to mortgage our children’s and grand-children’s futures to fund our current lust for spending and “government ” expansion and growth which further stifles our freedom.

Why don’t people understand this?  Supporters of Obama and Romney (Democratic or Republican Parties) refuse or are unable to grasp the gravity of our country’s and the world’s economic problems.

Please take a moment and consider candidly sharing what you know about money.  If you are a liberal or a conservative or have any other political persuasion, you have to have an opinion on what money means to you.  I and others would surely be interested in it.

Just click on the quotations bubble to the right of the post title above, or click on the “Leave a reply” link just below. Please share your thoughts on money and try your best to answer the following questions:

• Where do you think money comes from?
• Why do humans use money?
• What does money mean to you?
• How is money important to an economy?
• What is the best thing The State, oops, I mean the “government” can do to fix our economy?