Tag Archives: Medicaid

Trump needs to fire some staff – especially Bannon

But first …

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By Steven R. Maher

In the wake of the disastrous end of his “repeal and replace” Obamacare legislation, President Donald J. Trump should fire some of his staff. It’s what a smart businessman usually does after such a debacle.

After he withdrew the legislation, Trump said he wanted to work with Democrats in the future on health care. He also clearly wants to work with the “Freedom Caucus,” the successor to the “Tea Party” – a group that thought throwing 24 million Americans off their health insurance didn’t go far enough.

The website “Business Insider” reported on Saturday March 25, 2017, that White House Chief Strategist Steven Bannon said to Freedom Caucus members: “Guys, look. This is not a discussion. This is not a debate. You have no choice but to vote for this bill.”

The New York Times reported Saturday that Bannon and Legislative Affairs Director Marc Short wanted a vote on Trump’s health care bill because they would be able to compile an “enemies list” of Republican Congressman to take revenge on.

“You know, the last time someone ordered me to do something, I was 18 years old,” one Freedom Caucus member was quoted as saying. “And it was my daddy. And I didn’t listen to him, either.”

Trump also supposedly said during one meeting that he was not going to negotiate further on his insurance program, and Trump wanted their votes.

Not private sector

This “take it or leave it” approach might work in the private sector where everyone works for the boss, but it can be fatal in ego driven Washington, where Trump needs the votes of independently elected representatives.

Trump has two choices: If Trump expects to win enough Republican votes to pass his legislation on every major issue, he will be turning veto power on his Presidency over to a group of conservative extremists who will not compromise on issues that cry out for bi-partisan support. If he wants to find common ground with the Democrats, Trump will be writing off the Freedom Caucus.

Either way, Trump should clean house. A first good step would be to fire Bannon and Short. Both have alienated the Freedom Caucus. The Democrats despise Bannon for his involvement in Breitbart and see him as the evil genius manipulating Trump for his own obscure goals. Getting rid of Bannon would demonstrate that Trump is serious about changing his approach and would make it easier for Trump to reach out to either the Freedom Caucus or the Democrats.

Bannon feuds with Ryan

The one to watch is White House Chief of Staff Rence Priebus. Priebus reportedly urged Trump to work on his health plan first. He is a close ally of House Speaker Paul Ryan, with whom Bannon has also been feuding. This is another reason for Trump to fire Bannon. Not only is Bannon alienating the Freedom Caucus, he is straining the relationship between Trump and Ryan. If Trump fires Priebus, Washington insiders would take this as a victory of Bannon over Ryan.

Trump will undoubtedly find many scapegoats for his defeat on health care. Whether he learns the harsh lessons Washington taught him on March 24, 2017, remains to be seen.

In the meantime, Trump faces two upcoming issues on which he is also likely to be opposed by the Freedom Caucus. As the New York Times reported Saturday: “Mr. Ryan repeatedly counseled the president to avoid seeking vengeance – at least until he has passed spending bills and a debt-ceiling increase needed to keep the government running. In the end, the president decided to back down.”

State Senator Chandler and cavities

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A beautiful smile costs $$$!

By Gordon Davis

Massachusetts State Senator Harriette Chandler has been busy in the State House. Senator Chandler has amended the State budget for 2017 to include a new level of dental care. Being proposed by Senate Majority Leader Chandler helped to ensure the approval of the amendment by a 39-0 vote.

The amendment will create an “Advanced Hygienist Practitioner” … “who is a graduate of a registered dental practitioner education program of not more than 18 months provided by an accredited post-secondary institution, who has been certified by the Board to practice as an advanced dental hygiene practitioner pursuant to section 51B; and who provides oral health care services, including preventive, oral evaluation and assessment, educational, palliative, therapeutic, and restorative services as authorized.”

There seems to be some overlap between what a dentist can do and what an advanced hygienist practitioner can do. The amendment is being opposed by the Dentists’ association. During a telephone survey I had to say “I do not know enough to have an opinion” for many of the questions posed on the issue. It is clear that Advanced Hygienist Practitioners do not have to go through a dentist to be paid. The amendment specifically establishes that government payments go directly to the advanced practitioners.

“Advanced dental hygiene practitioners shall be directly reimbursed for services covered by Medicaid or the commonwealth care health insurance program.”

However, the relationship with a dentist or hospital is required for the Advanced Practitioner. How that works is seeming left to the parties to figure out.

“An advanced dental hygiene practitioner shall not operate independently of a dentist, except for an advanced dental hygiene practitioner working for a local or state government agency or institution or practicing in a mobile or portable prevention program licensed or certified by the department of public health”

The amendment seems to imply that the writer of the amendment was not sure if the new Advanced Hygienist Practitioner is needed. There is no evidence that it would improve oral health in the so called poor “underserved” communities. So called “minority” and disabled communities have been mentioned several times in the media as targeted communities.

“The Board of Registration in Dentistry, in consultation with the Executive Office of Health and Human Services, shall develop an evaluation process that focuses on assessing the impact of advanced dental hygiene practitioners in terms of patient safety, cost-effectiveness, and access to dental services. The process shall focus on the following outcome measures: (1) number of new patients served; (2) reduction in waiting times for needed services; (3) decreased travel time for patients; (4) impact on emergency room usage for dental care; and (5) costs to the public health care system.”

I ran into my dental hygienist at a party for a friend. I found out that besides being a dental hygienist in a dentist office, she worked as a coordinator for families with children at Head Start. She said many of the children there did not get proper dental care and that she would follow up with the children after they went to the dentist. For these children there was access and affordability issues. She said bad teeth as a child usually means a mouthful of trouble as an adult. The children in Head Start all were required to have their oral health evaluated and cared for as a condition for attending the federal anti-poverty and education program.

It looks like the real issue is affordability for adults. Medicaid has restrictive benefits for adult oral care. MassHealth has limited dental insurance for adults. We bought the Dental Insurance from MassHealth several years ago. It did not cover anything. So, not wanting to throw good money after bad, we cancelled the MassHealth dental insurance.

Medicare does not have dental coverage.

Senator Chandler’s amendment seems to be a noble effort but details are consequences of it are a little fuzzy.

A program at community colleges will have to be developed. Then the courses have to be taken, which will take at least 18 months. So there will be no Advanced Practitioners for at least three years.

I think it would make as much sense to have Medicaid, Medicare and MassHealth increase their coverage of dental care.

An alternate purpose of the amendment might be to cut dentists out of the school care loop. Presently as my hygienist said all children in Head Start and on Medicare are referred to a dentist and their parents must provide a certificate of compliance. A visit to a UMASS clinic Advanced Hygienist Practitioner might do as well at a lower cost.

I am not certain about how this will turn out. I am certain that it will be difficult with our present economic challenges to provide the dental and health care that people need.

In debt vote, Senator Scott Brown has a choice: Medicaid or the super wealthy

By Jason A. Stephany

Tuesday, August 2, marks a critical deadline for the United States economy: for the first time in our nation’s history, the government may default on its debts. And should that happen, the ripple effects will be felt by every American consumer and taxpayer. A downgrade of the United States’ credit rating, higher interest rates on our credit cards, mortgages and car loans, and investor uncertainty that will leave already-fragile markets reeling. Our slow-but-sureeconomic recovery could revert to a full-on recession in a matter of days.

The clock is running out on the debt debate, and responsible lawmakers agree that default is not an option. So why are some in congress – including US Senator Scott Brown – refusing to state a position on key aspects of the debt proposals before them? One would think big ticket items like $500 billion in proposed health care cuts would call for an immediate rebuke from the commonwealth’s junior senator. Yet questions from constituents and journalists on debt-related health care cuts have gone unanswered for weeks, as Brown and his staff continue to avoid taking a position on a host of programs, including Medicaid.

Over the last week, large coalitions of healthcare providers, patients, consumer advocates – even insurance company representatives – have gathered to call on Brown and his fellow lawmakers to do the right thing and take a stand in support of Medicare, Medicaid and other critical health care programs that are now on the chopping block. At one gathering, many pointed to the key decision that remains at the crux of the debt negotiations: protecting tax breaks for major corporations and our wealthiest citizens or preserving funding for federal health care programs.

Among them was David Sandison, a disabled Medicaid recipient who relies on in-home assistance, who addressed the issue head-on.“Because of my disability, I depend on Medicaid funds to live and work independently,” said Sandison. “So I have a question for Scott Brown: will you vote to save Medicaid, or will you support tax breaks for oil companies and billionaires?”

Stacy Hart, a consumer advocate with the Boston Center for Independent Living, explained that for many families – including her own – the funding of Medicaid programs is a matter of life and death. “Medicaid saved my husband’s life. He was in a coma for several months until the doctors could address a very serious medical condition,” said Hart. “Without Medicaid, my husband never would have woken up, rejoined his family, or come back to work as a member of the community. We need to know where Scott Brown stands on these cuts.”

The cuts Sandison and Hart describe aren’t just abstract numbers orhypotheticals. Health care providers estimate the cuts being contemplated could anywhere from $1 billion to $3 billion from state coffers – a full tenth of the overall Massachusetts budget. A recent report by Families USA, the non-partisan health care consumer organization, shows the funding shortfall would not only slash assistance for the poor, elderly and disabled; it would also jeopardize as many as 50,180 jobs and $6.8 billion in economic activity in the Bay State.

With so much at risk for Massachusetts citizens, the choice for any representative of the people should be clear. Yet Senator Brown continues his silence, reinforcing a “no position” position on what would certainly be disastrous cuts to health care. The question remains: why? What is keeping Brown from doing what’s right for Massachusetts? Amy Whitcomb Slemmer, Executive Director of Health Care for All, put the decision before Brown in the starkest of terms. “I know it’s tough for Senator Brown to balance serving his party and serving the people of Massachusetts – but there should be no choice between maintaining the health of our state’s elderly and disabled residents and cutting taxes for the most wealthy among us,” said Whitcomb Slemmer. “Hundreds of billions of dollars in health care cuts, and millions of lives, are at stake. We call on Senator Brown to show leadership by supporting health care for our state’s most vulnerable populations.”

Whitcomb Slemmer’s pointed analysis lays the terms out plain. But at the end of the day, will Scott Brown do the right thing for Massachusetts? Will our Senator choose Medicaid or millionaires in the fight to address the national debt? Only time will tell – but withan August 2 deadline rapidly approaching, the clock is ticking.

Constituents may reach US Senator Scott Brown on this or any other issue of interest by calling (617) 565-3170.

Jason Stephany is the spokesman for MASSUNITING – a non-partisan coalition of neighbors, community groups, faith organizations and labor united in the fight for good jobs, corporate accountability and stronger communities.

Dozens of Medicaid recipients, providers and advocates demand answers from Senator Scott Brown

editor’s note: Scott Brown needs to be dumped by the voters this fall. Brown is nothing more than a smooth-talking opportunist. He puts his finger in the wind and decides how to vote based on: WILL THIS GET ME RE-ELECTED? No character. No moral code. No beliefs worth fighting for – so unlike our late, great Teddy Kennedy. Brown is just an empty vessel wearing a barn jacket.

We miss Kennedy now more than ever. He would be the voice of reason, the voice of compassion, the wind beneath our wings.

– R. Tirella

Dozens of Medicaid recipients, providers and advocates demand answers from the commonwealth’s junior senator as national debt deadline looms!

BOSTON – As politicians continued their high-stakes horse trading over the national debt in Washington, dozens of Massachusetts residents directly affected by the negotiations rallied Thursday to demand answers from their own US Senator, Scott Brown. The broad coalition of local Medicaid recipients, service providers and independent living advocates gathered to ask Brown: “Will you choose Medicaid or Millionaires?”

“Because of my disability, I depend on Medicaid funds to live and work independently,” said David Sandison, a local Medicaid recipient who relies on in-home assistance. “So I have a question for Scott Brown: will you vote to save Medicaid, or will you support tax breaks for oil companies and billionaires?”

Questions from constituents and journalists on debt-related Medicaid cuts have gone unanswered for weeks, as Brown and his staff continue to avoid taking a position on more than $500 billion in proposed cuts to federal health care programs.

Stacy Hart, a consumer advocate with the Boston Center for Independent Living, explained that for many families – including her own – the funding of Medicaid programs is a matter of life and death. “Medicaid saved my husband’s life. He was in a coma for several months until the doctors could address a very serious medical condition,” said Hart. “Without Medicaid, my husband never would have woken up, rejoined his family, or come back to work as a member of the community. We need to know where Scott Brown stands on these cuts.”

Joseph Rotella, a successful business owner from Waltham, called on Brown to do the right thing for the most vulnerable in Massachusetts – even if that means raising taxes.

“I’m a beneficiary of the Bush-era tax cuts. But as someone fortunate enough to be in the top income bracket, I’m fully able and willing to make my contribution to society,” said Rotella. “So I have to ask Scott Brown to take a hard look at where his priorities lie. Will he stand up and protect Medicaid funding for those who need it most? Or will he cut those funds to protect tax breaks that aren’t really necessary?”

Amy Whitcomb Slemmer, Executive Director of Health Care for All, put the decision before Brown in the starkest of terms, calling on the senator to set partisanship aside and take a stand in support of his constituents.

“I know it’s tough for Senator Brown to balance serving his party and serving the people of Massachusetts – but there should be no choice between maintaining the health of our state’s elderly and disabled residents and cutting taxes for the most wealthy among us,” said Whitcomb Slemmer. “Hundreds of billions of dollars in health care cuts, and millions of lives, are at stake. We call on Senator Brown to show leadership by supporting health care for our state’s most vulnerable populations.”

As of press time, Brown has offered no additional clarity on his potential support of the $500 billion health care cut – or tax breaks for the wealthiest of Americans – that remain at the center of ongoing debt negotiations.

Union calls for action on Medicaid rates, workforce training and job protection within payment reform legislation

BOSTON – The largest healthcare union in Massachusetts is about to take the issue of healthcare payment reform public with a series of mobilizations, community forums, a massive advertising blitz, caregiver workshops, and other actions in a new statewide campaign slated to launch on Wednesday, April 6. The campaign aims to elevate the voices of all healthcare workers in the ongoing debate around quality and cost control reforms, while also raising awareness of the key role hospital service workers play in overall healthcare delivery. 1199SEIU members are calling it the “Voices of Quality Care” campaign.

The campaign kicks off Wednesday with a TV ad featuring the kind of service and technical workers who union members say are often overlooked as part of the care delivery team. The ad promotes a new website that both explains 1199SEIU’s take on payment reform, and encourages caregivers to join the union.

“Our basic message is that patients and caregivers need more than a voice in these upcoming reforms – they need a strong voice,” said John Herr, a respiratory therapist at St. Elizabeth’s Medical Center in Brighton. “We can’t let the conversation be dominated by insurance executives and regulators, so we’re bringing our perspective as frontline caregivers straight to the public.” Continue reading Union calls for action on Medicaid rates, workforce training and job protection within payment reform legislation