Tuesday PM ~ thefrontpagecover

TheFrontPageCover
~ Featuring ~ 
Distorting the Doctor-Patient Relationship
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Arnold Ahlert   
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ICE Spotlights Releases of Criminal Aliens 
as Governor Defends Sanctuary Policies
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by Fred Lucas 
dailysignal.com } ~ An illegal immigrant from Honduras returned to the U.S. sometime after being deported in 2006. The Charlotte-Mecklenburg Police Department in North Carolina arrested the man in June on a charge of first-degree rape and two counts of taking indecent liberties with a child... One day after the arrest of Oscar Pacheco-Leonardo, 33, U.S. Immigration and Customs Enforcement issued a detainer asking the Mecklenburg County Sheriff’s Office to hold the illegal immigrant. The sheriff’s office not only refused to honor the detainer, it released Pacheco-Leonardo from custody without notifying ICE, the federal agency says. The incident marked one of numerous times that the sheriff’s office opted to release a dangerous criminal rather than cooperate with ICE, according to the immigration agency, which released a lengthy list of examples this month. The case of the Honduran man was the most recent of several that prompted North Carolina’s Republican-controlled state Legislature to pass a bill requiring local sheriffs to honor ICE detainers. Gov. Roy Cooper, a Democrat, vetoed the bill last week, days after ICE agents captured Pacheco-Leonardo on their own. “North Carolina Governor Cooper Vetoed a Bill that would have required Sheriffs to cooperate with Ice [sic],” Trump tweeted. “This is a terrible decision for the great people of North Carolina. He should reverse his decision and get back to the basics of fighting crime!” Cooper said the legislation, House Bill 370, would drain resources from local law enforcement. However, that’s not the view of most of the state’s sheriffs... NC made a big mistake in electing Cooper, will they correct their mistake.
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Backgrounder: The Islamic 
Revolutionary Guard Corps (IRGC)
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by Gary C. Gambill
meforum.org } ~ Nearly all of Iran's headline-grabbing provocations in the last few months, from sabotaging and seizing oil tankers to drone attacks on Saudi pipelines... are the work not of its traditional military service branches, but of the Islamic Revolutionary Guard Corps (IRGC). This shadowy paramilitary institution was established by the late Ayatollah Ruhollah Khomeini with the constitutional mandate of "guarding" the 1979 revolution that gave rise to Iran's Islamic Republic from enemies at home and abroad. It has been extraordinarily effective in both stamping out internal dissent and battling external adversaries. The roughly 125,000-strong IRGC grew out of the protection forces that guarded Khomeini and other senior clerics who distrusted military and police bodies inherited from the Shah in the early days of the revolution. It soon moved on to assassinating opponents of the nascent Islamic republic, violently enforcing its strict social codes, and muscling its way into every corner of Iranian society. Its volunteer paramilitary militia, the Basij (Nirou-ye Moqavemat-e Basij, Mobilization Resistance Force), infamous in the West for organizing human wave attacks during the 1980-1988 Iran-Iraq war, has millions of members. The university branch of the Basij, the Student Basij Organization (SBO), has played a critical role in monitoring and suppressing anti-government dissent among students, as shown by Middle East Quarterly author Saeid Golkar, an assistant professor of political science at the University of Tennessee-Chattanooga. It was instrumental in suppressing the massive nation-wide protests that erupted following Iran's 2009 presidential election. Unlike Iran's traditional military and police, the IRGC does not answer to elected Iranian leaders and has frequently stirred opposition to their policies. But the wishful assumption of many Westerners that the IRGC is a "rogue" institution the antidote to which is invariably engagement with elected "moderates" is false. "The group has seldom engaged in activities not sanctioned by the Iranian leadership," concludes Middle East Quarterly author  Michael Rubin, a resident scholar of the American Enterprise Institute. Answering directly, without intermediaries, to Supreme Leader Ayatollah Ali Khamenei, it is the purest expression of the Islamic Republic's authority...
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High Alert in Northern Israel
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by israeltoday.co.il ~ The Israel Defense Force’s Northern Command has mobilized in preparation for an expected attack by the Lebanese terrorist militia Hezbollah after the group’s leader, Sheikh Hassan Nasrallah... publicly accused Israel of carrying out a drone strike in Beirut on Sunday. Nasrallah threatened retaliation, and warned that no Israeli should feel safe, even those living in the densely-populated central regions of the Jewish state. According to Hezbollah, two drones that crashed in the Lebanese capital of Beirut earlier this week were sent by Israel, and were loaded with explosives. In Israel, the threat is being taken very seriously. Additional Iron Dome batteries are being deployed to the area, and patrols of the border are being beefed up to prevent a successful terrorist ambush. Nasrallah has followed through on such threats in the past, such as in January of 2015, when Hezbollah ambushed a military patrol on the border and killed two Israeli soldiers in response to an IDF air strike on a Hezbollah convoy in Syria. IDF officials issued a counter-warning that any Hezbollah attack would be met with a “disproportionate” Israeli response.
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How The Media Enables Destructive 
Climate Change Hysteria 
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By David Harsanyi
thefederalist.com } ~ Last weekend, the former chairman of psychiatry at Duke University, Dr. Allen Frances, claimed that Donald Trump “may be responsible for many more million deaths” than Adolf Hitler, Joseph Stalin, and Mao Zedong combined... Frances, author of the fittingly titled “Twilight of American Sanity,” would later clarify by tweeting that he was talking about the “terrible damage Trump is doing to world climate at this global warming tipping point may be irreversable/ could kill hundreds of millions of people in the coming decades.” That’s quite the bold statement, considering the hefty death toll the Big Three extracted. But, really, it isn’t that shocking to hear. Frances’ pseudohistoric twaddle comports well with the pseudoscientific twaddle that’s been normalized in political discourse. Every year Democrats ratchet up the doomsday scenarios, so we should expect related political rhetoric to become correspondingly unhinged. All of this is a manifestation of 50 years of scaremongering on climate change. Paul Ehrlich  famously promised that “hundreds of millions of people” would “starve to death,” while in the real world we saw hunger precipitously drop, and the world become increasingly cleaner. Yet, neo-Malthusians keep coming back with fresh iterations of the same hysteria, ignoring mankind’s ability to adapt. At a 2005 London conference of “concerned climate scientists and politicians” that helped launch contemporary climate rhetoric, attendees warned that the world had as little as 10 years before the Earth reached “the point of no return on global warming.” Humans, they claimed, would soon be grappling with “widespread agricultural failure,” “major droughts,” “increased disease,” “the death of forests,” and the “switching-off of the North Atlantic Gulf Stream,” among many other calamities. Since then, the Earth has gotten greener. This year, for the first time since we began logging data in 2000, there were no “extreme” or “exceptional” droughts across the contiguous United States—although we’ve come close to zero on numerous occasions over the past decade. Every time there’s a drought anywhere in the world, climate change will be blamed. But world crop yields continue to ensure that fewer people are hungry than ever. I’m not a scientist, but I assume the North Atlantic Gulf Stream is still with us...
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Democrats Brace for War over Supreme Court
By Fletch Daniels
americanthinker.com } ~ The news that Ruth Bader Ginsburg was treated for pancreatic cancer raised the possibility of a Supreme Court opening within the next year... The 86-year-old Ginsburg's health has been declining for years, to where the last year has felt like a bad remake of the 1989 Weekend at Bernie's movie. Instead of enjoying her golden years in retirement, Ginsburg has been propped up and hidden in the hopes of holding the seat until a Democrat is elected. The always elegant Michael Moore, who previously placed a Ginsburg doll atop a Christmas tree, summed up the Democrat zeitgeist when he tweeted, "HOLYMOTHEROFRBG!! EVERYBODY, RIGHT THIS SECOND, JOIN A MOVEMENT, CAMPAIGN, GRASS ROOTS GROUP -WHATEVER - AND WORK NONSTOP BTWN RIGHT NOW & NOV 2020!" The Left is already manning the barricades. The resulting hearing will make the Brett Kavanaugh fiasco, a dark moment in U.S. history, look like a charming affair. In the event that President Donald Trump nominates Amy Coney Barrett, as many conservatives hope, this hearing will be a preview of the Apocalypse.  The  rise of hatred on the Left, aided by years of persistent media bias and leftist propaganda, has created a rolling tidal wave of hate ready to crash on shore in violence. The two most likely triggering events that would cause that crash are the re-election of President Trump and the next opening on the Supreme Court, particularly to fill Ginsburg's seat. It's an increasingly good bet that the latter will come first...   https://www.americanthinker.com/articles/2019/08/democrats_brace_for_war_over_supreme_court.html  
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Distorting the Doctor-Patient Relationship
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Arnold Ahlert:  Imagine an American going to the supermarket to buy a loaf of bread and, when discovering that it has no price marked on it, inquiring how much it cost — only to be asked a question in return: What type of food insurance do you have? Most people would consider such a scenario bizarre. Unfortunately, if one changes “loaf of bread” to “knee operation,” the rest of the story becomes quite familiar.

Why familiar? Because the same Americans who would be infuriated by such a scenario at the supermarket have long grown accustomed — or is that resigned — to the idea that price transparency for healthcare services is as elusive as the White Rabbit in Alice in Wonderland. This is no accident. Contrary to food pricing, there are a host of middlemen between the consumer and the provider whose own interests depend on obscuring those prices. Self-remunerating interests that often inflate the cost of healthcare. And because true transparency is anathema to those interests, the Trump administration’s effort to provide it is meeting stiff resistance.

In 2018, the administration released a rule requiring hospitals to post their “chargemaster” rates, or list the prices for their services online. For those unfamiliar with medical lingo, a chargemaster is “a list of all the billable services and items to a patient or a patient’s health insurance provider,” explains columnist Jacqueline LaPointe. “The chargemaster captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges.”

All of those charges require billing codes, and the costs they generate are the result of negotiations between hospitals and insurance providers. Right now both entities consider those negations to be proprietary and confidential — meaning the cost of something depends on the secret deal one’s particular insurance provider has made with the hospital.

The Trump administration wants to change that equation as well. If a new proposal is finalized, that secrecy would be eliminated and hospitals would be required to disclose those negotiated rates.

The reaction? Hospitals are insisting “the burden is excessive and will undermine the ability of insurers to secure discounts for their customers,” writes American Enterprise Institute fellow James C. Capretta. “Lawsuits aimed at blocking the rule might be coming soon.”

The players themselves? The American Hospital Association (AHA), the Federation of American Hospitals (FAH), America’s Essential Hospitals, the Association of American Medical Colleges, and the Children’s Hospital Association issued a joint statement asserting that the proposed rule “is a misguided attempt to improve price transparency for patients because it fails to give them the information they need. Disclosing the negotiated rate between insurers and hospitals will not help patients make decisions about their care. Instead, this disclosure could harm patients by reducing patient access to care. This is the wrong approach to price transparency, and the administration should reverse course on this provision.”

The Federal Trade Commission’s Office of Policy Planning agrees. “Too much transparency can harm competition in any industry, including health care,” its “experts” insist.

This is ostensibly due to the fact that healthcare providers compete to be on an insurance company’s list of providers, and when those networks are selective, providers offer lower prices to be included on the list. “But when providers know who the other bidders are and what they have bid in the past, they may bid less aggressively, leading to higher overall prices,” the OPP adds.

That’s only half the gamesmanship. As Capretta  explains in a separate column, hospital billing codes are hardly layman-friendly, “because the terminology used is not intended for a lay audience.” He further explains that while current regulations require hospitals to provide the prices of component parts of their charges, they are not required to post “all in prices” for procedures that involve several components, such as “fees for the surgery, the anesthesia, the operating room, the lab tests, imaging services, and follow-up care” — all of which “involve multiple billing codes.”

Perhaps the first salient question might be: Why does the relationship between the provider and the middleman consume virtually the entire discussion about effective healthcare, while the actual consumer seemingly remains an afterthought? Moreover — and more important — why should prices for the exact same services vary, sometimes substantially, for that same consumer?

If insurance is a necessary evil, it can only be because the amount of money necessary to maintain a viable system of healthcare providers exceeds the ability of consumers to pay for maintaining it as a whole. Does it?

The question brings to mind the spiraling costs of college. Since colleges know the taxpayer is the ultimate underwriter of all student-loan defaults, they can — and have — raised the costs of tuition with impunity, because there is no incentive for them to do otherwise. That’s bad enough, but at least the student themselves, strapped by loans that are seriously affecting their lives, are concerned. By contrast, many healthcare consumers who complain about the cost of insurance have little to no concern regarding the actual price of healthcare, especially if they have a low-deductible policy.

Thus, unlike the direct consumer-provider relationship of buying food, most people are forced to cope with current provider-middleman-consumer dynamic — and politicians in both parties have become equally accustomed to addressing the first two components of that dynamic, while healthcare costs for the actual consumer continue to skyrocket.

In other words, the moneyed interests talk, and the American public walks — or limps, or hobbles to the best of their coping abilities.

Capretta provides some viable solutions, such as the government requiring hospitals to provide all-in rates, and requiring insurers to provide reference-based insurance payments that would standardize reimbursement rates to various providers, incentivizing patients to choose lower-cost providers, especially if they could pocket the difference between the standardized rate and the actual price. He also notes that there are “small pockets” in the country (such as Amish and Mennonite communities) where the actual consumer-provider relationship exists, and cash payments for services are made directly to hospitals by these religious groups, who don’t buy insurance.

Yet one is left to wonder why this direct consumer-provider relationship is the exception, not the rule. Certainly there are some costs that are beyond the consumer’s ability to pay, such as long-term care for debilitating diseases like cancer, but if there’s a role for both government and insurance providers, it would seem logical to work downwards, from the catastrophic to the ordinary, rather than lumping everything together — and negotiating rates in secret.

Unfortunately, the term “vested interests” didn’t arise out of thin air. Public comments on the administration’s latest proposal are due by Sept. 27, and the AHA has alluded to the possibility it will litigate, insisting the rule “misses the mark, exceeds the administration’s legal authority and should be abandoned.”

Nonsense. Genuine price transparency — and the elimination of discounts for the same services — are critical first steps in rebuilding a consumer-provider relationship that has been distorted for far too long. Some call it patient-centered healthcare.

Common sense is more like it.  ~The Patriot Post

https://patriotpost.us/articles/65049?mailing_id=4492&utm_medium=email&utm_source=pp.email.4492&utm_campaign=snapshot&utm_content=body

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