Wednesday, October 30, 2013

LWV FORUM



The LWV’s Candidates Forum Wednesday night was a well-attended event.  I can only report impressions not facts.
Unfortunately the 4th Ward candidates section was cancelled due to one of the candidate’s illness. However incumbent Rivers was permitted to make a brief statement.

The first hour was devoted to the 6 candidates seeking election to the Board of Education. Although this is supposed to be a non-partisan election there are actually two political slates; one allegedly sponsored by John Campbell and led by Board President Wilma Campbell; the other which has had City Democrat Chairman Green’s benevolence.

The less said about that hour the better. The usual first comment from most of the candidates was “please repeat the question”. With the exception of  Richard Lear of the, as Wilma Campbell pointedly and frequently referred to as the “Green Team”, either passed on general questions  or made only generic answers.

On the other hand Mr. Lear was most impressive.

Campbell continually defended the record of the so-called Slam Team which had been elected on a platform of transparency which has become opaque. Her running mates include incumbent Moore who has only been on the board for a year as a replacement, and David Rutherford.

Both were more eloquent than their opposition and worldlier.

This forum did little to give me confidence in voting next Tuesday. The Slam has done little to justify reelection and there has been severe criticism from the state in the manner of choosing attorneys. 

Moreover the Board is responsible for policy and selecting administrators. There has been little indication that there has been any improvement in the district these past three years.

On the other hand I do not feel that two of the other slate has the expertise or understanding of the role of the BOE to merit election.

Once again I would opt for an appointed Board.

The four candidates for the Mayor’s office were all impressive. Without naming names; I would not be unhappy with three of them. 

However I cannot escape the feeling after the past four years, that Mapp who has experience and contacts is the best person for the position at the present time.

His knowledge of the laws and regulations which he will follow is important. We need an ASAP professional structuring of our administration and Mapp will do that.

Sometime a career politician is the best choice. Plainfield has no time for “learning on the job”.

NOVEMBER COUNCIL MEETINGS



Because Election Day is on Tuesday the Council Agenda Setting Meeting which would have been on Monday has been rescheduled for the 12th. This is a customary procedure with the business meeting taking place the following week.
However this year both sessions are scheduled for the 12th I presume the business meeting will follow the agenda session but for all practical purposes it could precede it.

How can any reasonable interested citizen have a chance to study and or remark on matters on the agenda? A few dedicated ones will preview the agenda for the agenda setting session but they according to format will have no chance to comment or call attention to others about the subject matter prior and perhaps cause the Councilors to reflect on what they are voting about.

There is no excuse for the Councilors not accepting their fiduciary responsibilities and finding two separate dates for the meetings.

One final note; how will Bill get home by 10?

A FOLLOW UP TO YESTERDAY



In my previous blog I wrote about some of the fallout that was occurring in the Insurance field as a result of the mandatory requirement for individual health insurance. I was focusing on the carriers constricting their panels of providers and also culling risk oriented individuals from their policies.
As an example here are two Facebook commentaries from the same author not solicited by myself but found at random.
“Like many, my health plan is being phased out at year-end and eventually Anthem will send me info on a recommended replacement. I have asked three Anthem agents about how to accept if I want it. One said it would convert automatically if I do nothing. One said I will receive a number to call and verbally accept. One said it is just a recommendation and I will have to formally apply. I need one of those emoticons for: bangs head against wall:”
Given how much incorrect info Anthem is putting out, I think I am going to look into Connecticare, also. I just don't feel like I will really know what I am committing to buy from Anthem right now. There are different plan details on the Exchange and Anthem sites right now for the same plan and the agents can't explain it.”
Thank you HR
These are excerpts from and article in Medscape; a cardiologist in RI received this letter
United Healthcare (UHC) is amending your Agreement . . . to discontinue your participation in the Medicare Advantage network effective on February 1, 2014," The October 2, 2013 letter went on to say his termination is "without cause," his contract permits the company to take this action, and his affected patients would be contacted about the change separately. “

An interventionalist in Connecticut, received a similar letter from UHC more than a week ago, along with the 16 other cardiovascular specialists in his practice. About 3000 of their patients are affected, including >500 of his own patients, "people that I've cared for for over 20 years. I'd say that represents 10% to 15% of my practice," he said.

"These are relationships that have been established, and all of a sudden they are terminated in this absolutely irrational way by United Healthcare," he said.

A spokesperson for the Yale Medical Group (New Haven, CT), with >1000 physicians who are Yale University School of Medicine faculty has said that UHC has dropped it from its Medicare Advantage plans.
The cuts' impact could be especially hard on patients in remote areas. 

In an October 22 letter published in the Providence Journal, the director of health services on Block Island, 13 miles off the coast of Rhode Island, reports that all of the tiny island's physicians received one of UHC's termination letters.

The island of about 10 square miles with a year-round population of about 1000 is a popular summer destination for tourists. To avoid out-of-network rates, the according to the letter to the editor, "patients in need of care who have Medicare Advantage would need to travel to the mainland by ferry or plane, no easy task in bad weather."

UHC has sent such a letter to thousands of physicians in the US, specifying that the cuts apply only to their Medicare Advantage contract, not to any other UHC plans they may take. The company sells such plans nationally through AARP, which calls them AARP MedicareComplete.

The intriguing part is that many of these physicians have received high efficiency ratings from the company and have not been dropped from their other plans; only Medicare and exchange plans.

A UHC spokesperson wrote "Our decisions are based on providing a network of physicians whom we can collaborate with to help enhance health plan quality, improve healthcare outcomes, and curb the growth in healthcare costs. Factors include geography and ensuring ready access to care, the relative performance of providers on a range of industry quality metrics, and a provider's ability to deliver high-quality care for the most members in the most cost-efficient manner."

I have copied this document to illustrate one of the greatest changes that will happen. Like England and other European countries we are going to develop a two tier system; an expensive because it will be tax supported government controlled healthcare system in which convenience, and I believe  quality will be compromised, serviced by Insurance companies that are profit oriented. The other system will be a private independent system including not only physicians but also hospitals catering to those who can afford to pay for their care.

Tuesday night's NBC 7:30 pm world news segment had a report about those self insured individuals not having their policies renewed. In many cases they are told that the policy which was low cost did not meet the new specifications required by the ACA. If and when they can get new policies the premium is often several 100% higher than the old one. But then again a 60 year old woman may need maternity or abortion coverage.

There are other repercussions that I have not discussed, such as programs to cut the Medical School training to three years and the postgraduate residencies to at the most two years to counteract the deficiency in primary care physicians, which is being met by increased use of Nurse Practioners, as well as Physicians Assistants, all with different degrees of expertise. I could add to the list the growing tendency for chain pharmacies to have in store care centers. 

Nowadays it takes many physicians up to five years after Medical School to refine the skills of their trade.

One bright spot away from this subject that I will get back to from time to time; tonight is the final local candidates forum. With the election next week; politics will be on the front burner.