[eggplant43]

http://www.emergingdemocraticmajorit...s/000387.shtml

[eggplant43]

GI Denied Health Care After Speaking Out
By Mark Benjamin
United Press International

Tuesday 02 March 2004

Congress, veterans groups, and the press should immediately launch a full investigation into this Operation Iraqi Freedom veteran's allegation he suffered retaliation from the military for speaking with reporters about substandard military healthcare. A series of three UPI articles about this major scandal are posted here. They describe the "squalor" more than 1,000 wounded, ill, or injured service members were forced to endure while on "medical hold." -- Veterans for Common Sense
WASHINGTON -- An Operation Iraqi Freedom veteran says Army officials at Fort Knox, Ky., refused him medical treatment after he talked publicly about poor care at the base, which helped spark hearings in Congress.

Fort Knox officials charged that soldier, Lt. Jullian Goodrum, with being absent without leave and cut off his pay after he then went to a private doctor who hospitalized him for serious mental stress from Iraq, Goodrum said.

"They are coming after me pretty bad," said Goodrum, 33, a veteran who has served the military for more than 14 years, including the first Gulf War and Operation Iraqi Freedom.

He showed United Press International a form from Fort Knox that states that Fort Knox officials "do not want him in medical hold." Some soldiers are kept on medical hold during treatment while the Army determines their status.

Goodrum has now been hospitalized in a locked mental ward at the Walter Reed Army Medical Center in Washington, D.C. after turning himself in there Feb. 9. Doctors there say he has post-traumatic stress disorder from Iraq and major depression, and they worry he could hurt himself. He is not allowed to go down the hall from the inpatient psychiatric clinic for a Coke without an escort.

Goodrum said stress from Iraq, and the way he has been treated by the military since he returned, has made him so depressed he is lucky to be alive. He also has injuries to both wrists, in part from loading 65-pound shells on the USS Missouri when he was in the Navy in the first Gulf War. The ship pounded Iraqi troops in Kuwait and took fire from Iraqi tanks. An Iraqi Silkworm missile missed her bow by 30 yards.

Goodrum appeared in an Oct. 29 UPI (see full article below) about more than 400 soldiers on medical hold at Fort Knox who were waiting weeks and sometimes months for medical treatment.

That article, and an article on a similar situation at Fort Stewart, Ga., sparked a series of hearings in Congress -- including a Jan. 21 appearance by Col. Keith Armstrong, garrison commander at Fort Knox, before a panel of the House Armed Services Committee.

Fort Knox spokeswoman Connie Shaffery said privacy rules prohibit her from commenting on Goodrum's case, unless he signed a waiver saying otherwise. He declined. Shaffery said a soldier who does not show up for duty is absent without leave.

"If a soldier is not at his or her duty station and is not in an authorized leave or pass status, he is absent without leave," Shaffery said. "When a soldier is listed as AWOL, it stops all pay and benefits. When instructed to return and they do not comply, that is a violation."

After appearing in the UPI article on Oct. 29, Goodrum asked for medical care on or about Nov. 7. He said he told Fort Knox officials that he was having a breakdown.

"I said I was having problems. I told them I felt like I was having a breakdown right there," Goodrum said. Goodrum said Fort Knox told him to go away. A handwritten note in Goodrum's records from Nov. 7 says, "Colonel Stevens do (sic) not want this patient to be in medical hold."

Goodrum said he then drove down an interstate highway at 5 miles an hour through rushing traffic. He said he was completely dysfunctional because of a combination of PTSD and what he says was retribution from his chain of command for speaking up about poor medical care at the base. He said he could have wound up dead.

"A truck could have run right over me," Goodrum said about that day. "It was a complete nervous breakdown."

Goodrum, a member of the Army Reserve, was named the 176th Maintenance Battalion's "Soldier of the Year" in 2001. He has received a host of awards, including the combat action ribbon, and positive reviews from superior officers.

"Lt. Goodrum is a truly outstanding junior officer," reads one performance evaluation from 2002. "In addition to his technical competence, he demonstrates great leadership potential. ... Promote to captain and select for advance military schooling."

Goodrum said his problems began in Iraq, working under combat conditions in a transportation company. There, he said, safety violations -- including the use of "deadlined" or broken vehicles -- resulted in the death of a 22-year old soldier. Goodrum appealed to the Army's Inspector General and Congress when he returned home.

After Goodrum sought medical help at Fort Knox on Nov. 7 and was denied, Goodrum's civilian doctor hospitalized him for PTSD and alerted Fort Knox.

Dr. Vijay Jethanandani wrote Fort Knox Nov. 15 that Goodrum needed medical leave until Dec. 7. The doctor kept officials there up to date on Goodrum's condition in a series of five letters.

"Unfortunately, recent intimidation, threats of being arrested for staying on medical leave from his superiors has resulted in recurrent psychiatric symptoms," Jethanandani wrote Dec. 3. "Until 11/26/03, Mr. Jullian Goodrum was progressing fairly well."

"It does not help that Mr. Goodrum was in combat with a unit in Iraq, where a superior officer ignored safety protocol jeopardizing the safety of soldiers and resulting in the death of one man," Jethanandani wrote. "Instead of following up on his complaints, it appears that some of his superiors on stateside may be penalizing him for reporting his superior officer in Iraq."

In the wake of the Fort Stewart and Fort Knox stories, last fall Undersecretary of Defense David S.C. Chu ordered that if medical care is not available on base, "medical commanders shall promptly refer patients to other military, Veteran Affairs, or civilian sources of care."

Goodrum said he showed Chu's memo to Fort Knox officials, but it did not help. "I told them they were ignoring an order from the undersecretary of Defense," Goodrum said.

Goodrum's medical files shows that Walter Reed medical staff also have been unable to get Fort Knox medical officials to discuss his case. "Patient is currently assigned to the medical hold company in Fort Knox, Ky., and to a Capt. Savage. Capt. Savage has NOT returned any phone calls from this office," his record states.

Soldiers at Fort Knox contacted UPI about another situation they consider a sign of poor care.

On Feb. 11, a soldier on medical hold at Fort Knox who served in Iraq apparently attempted suicide in the barracks. He was attached to a Special Forces unit in Iraq.

Soldiers there said he deeply slashed both of his wrists, spraying blood in the barracks hallway and around his room before being rushed to the hospital.

"If it was not for about three guys, if they had not applied direct pressure and immediate pressure, he would have died," said a soldier at Fort Knox who knows him.

Soldiers said they worry that Army officials did not act aggressively to address his problems, including heavy drinking, that appear to have surfaced since Iraq.

Shaffery said she could not comment on that case, either. "We are sensitive to psychiatric or suicide issues with all of our population," she said.


--------------------------------------------------------------------------------

Go to Original

Sick Soldiers Wait for Treatment
By United Press International

Wednesday 29 October 2003

FORT KNOX, Ky. -- More than 400 sick and injured soldiers, including some who served in Operation Iraqi Freedom, are stuck at Fort Knox, waiting weeks and sometimes months for medical treatment, a score of soldiers said in interviews.

The delays appear to have demolished morale -- many said they had lost faith in the Army and would not serve again -- and could jeopardize some soldiers' health, the soldiers said.

The Army Reserve and National Guard soldiers are in what the Army calls "medical hold," like roughly 600 soldiers under similar circumstances (see full article below) waiting for doctors at Fort Stewart, Ga.

The apparent lack of care at both locations raises the specter that Reserve and Guard soldiers, including many who returned from Iraq, could be languishing at locations across the country, according to Senate investigators.

Representatives from the office of Sen. Kit Bond, R-Mo., were at Fort Knox Wednesday looking into conditions at the post.

Following reports from Fort Stewart, Senate investigators said that the medical system at that post was overwhelmed and they were looking into whether the situation was Army-wide.

Army officials at the Pentagon said they are investigating that possibility. "We are absolutely taking a look at this across the Army and not just at Fort Stewart," Army spokesman Joe Burlas said Wednesday.

"I joined to serve my country," said Cpl. Waymond Boyd, 34. He served in Iraq with the National Guard's 1175 Transportation Company. He has been in medical hold since the end of July.

"It doesn't make any sense to go over there and risk your life and come back to this," Boyd said. "It ain't fair and it ain't right. I used to be patriotic." He has served the military for 15 years.

Boyd's knee and wrist injuries were severe enough that he was evacuated to Germany at the end of July and then sent to Fort Knox. His medical records show doctor appointments around four weeks apart. He said it took him almost two months to get a cast for his wrist, which is so weak he can't lift 5 pounds or play with his two children. He is taking painkilling drugs and walks with a cane with some difficulty.

Many soldiers at Fort Knox said their injuries and illnesses occurred in Iraq. Some said the rigors of war exacerbated health problems that probably should have prevented them from going in the first place.

Boyd's X-rays appear to show the damage to his wrist but also bone spurs in his feet that are noted in his medical record before being deployed, but the records say "no health problems noted" before he left.

"I don't think I was medically fit to go. But they said 'go.' That is my job," Boyd said.

Fort Knox Public Affairs Officer Connie Shaffery said, "Taking care of patients is our priority." Soldiers see specialists within 28 days, Shaffery said and Fort Knox officials hope to cut that time lag.

"I think that we would like for all the soldiers to get care as soon as possible," Shaffery said.

Shaffery said of the 422 soldiers on medical hold at Fort Knox, 369 did not deploy to Operation Iraqi Freedom because of their illnesses. Around two-thirds of the soldiers at Fort Stewart did serve in Operation Iraqi Freedom.

Soldiers at Fort Knox describe strange clusters of heart problems and breathing problems, as did soldiers at Fort Stewart and other locations.

Command Sgt. Major Glen Talley, 57, is in the hospital at Fort Knox for heart problems, clotting blood and Graves' disease, a thyroid disorder. All of the problems became apparent after he went to war in April, he says. He is a reservist.

Talley said he was moved to Fort Knox on Oct. 16 and had not seen a doctor yet, only a physician's assistant. His next appointment with an endocrinologist was scheduled for Dec. 30.

"I don't mind serving my country," Talley said. "I just hate what they are doing to me now." Talley has served for 30 years. He was awarded two Purple Hearts in Vietnam.

Sgt. Buena Montgomery has breathing problems since serving in Operation Iraqi Freedom. She said she has been able to get to doctors but worries about many others who have not.

"The Army did not prepare for the proper medical care for the soldiers that they knew were going to come back from this war," Montgomery said. "Now the Army needs to step up to the plate and fix this problem."

In nearly two dozen interviews conducted over three days, soldiers also described substandard living conditions -- though they said conditions had improved recently.

A UPI photographer working on this story without first having cleared his presence with base public affairs officials was detained for several hours for questioning Tuesday and then released. He was told he would need an Army escort for any further visits to the base. He returned to the base accompanied by an Army escort on Wednesday.

This reporter also was admonished that he had to be accompanied by an Army public affairs escort when on base. The interviews had been conducted without the presence of an escort.

After returning from Iraq, some soldiers spent about eight weeks in Spartan, dilapidated World War II-era barracks with leaking roofs, animal infestations and no air conditioning in the Kentucky heat.

"I arrived here and was placed in the World War II barracks," one soldier wrote in an internal Fort Knox survey of the conditions. "On the 28th of August we moved out. On 30 Aug. the roof collapsed. Had we not moved, someone would be dead," that soldier wrote.

Shaffery said all of the soldiers have moved out of those barracks. "As soon as we were able to, we moved them out," Shaffery said. The barracks now stand empty and have been condemned.

Also like Fort Stewart, soldiers at Fort Knox claimed they are getting substandard treatment because they are in the National Guard or Army Reserve as opposed to regular Army. The Army has denied any discrepancies in treatment or housing.

"We have provided, are providing, and will continue to provide our soldiers -- active and Reserve component -- the best health care available," Army spokesman Maj. Steve Stover said Oct. 20. He said Army policy provides health care priority based on a "most critically ill" basis, without differentiation between active and our Reserve soldiers.

"Medical hold issues are not new and the Army has been working diligently to address them across the Army," Stover said.

"They are treating us like second-class citizens," said Spc. Brian Smith, who served in Operation Iraqi Freedom until Aug. 16 and said he is having trouble seeing doctors at Fort Knox. The Army evacuated him through Germany for stomach problems, among other things. "My brother wants to get in (the military). I am now discouraging him from doing it," Smith said.

"I have never been so disrespected in my military career," said Lt. Jullian Goodrum, who has been in the Army Reserve for 16 years. His health problems do not appear to be severe -- injured wrists -- but he said the medical situation at Fort Knox is bad. He said he waited a month for therapy. "I have never been so treated like dirt."


--------------------------------------------------------------------------------

Go to Original

Sick, Wounded U.S. Troops Held in Squalor
By United Press International

Friday 17 October 2003

FORT STEWART, Ga. -- Hundreds of sick and wounded U.S. soldiers including many who served in the Iraq war are languishing in hot cement barracks here while they wait -- sometimes for months -- to see doctors.

The National Guard and Army Reserve soldiers' living conditions are so substandard, and the medical care so poor, that many of them believe the Army is trying push them out with reduced benefits for their ailments. One document shown to UPI states that no more doctor appointments are available from Oct. 14 through Nov. 11 -- Veterans Day.

"I have loved the Army. I have served the Army faithfully and I have done everything the Army has asked me to do," said Sgt. 1st Class Willie Buckels, a truck master with the 296th Transportation Company. Buckels served in the Army Reserves for 27 years, including Operation Iraqi Freedom and the first Gulf War. "Now my whole idea about the U.S. Army has changed. I am treated like a third-class citizen."

Since getting back from Iraq in May, Buckels, 52, has been trying to get doctors to find out why he has intense pain in the side of his abdomen since doubling over in pain there.

After waiting since May for a diagnosis, Buckels has accepted 20 percent of his benefits for bad knees and is going home to his family in Mississippi. "They have not found out what my side is doing yet, but they are still trying," Buckels said.

One month after President Bush greeted soldiers at Fort Stewart -- home of the famed Third Infantry Division -- as heroes on their return from Iraq, approximately 600 sick or injured members of the Army Reserves and National Guard are warehoused in rows of spare, steamy and dark cement barracks in a sandy field, waiting for doctors to treat their wounds or illnesses.

The Reserve and National Guard soldiers are on what the Army calls "medical hold," while the Army decides how sick or disabled they are and what benefits -- if any -- they should get as a result.

Some of the soldiers said they have waited six hours a day for an appointment without seeing a doctor. Others described waiting weeks or months without getting a diagnosis or proper treatment.

The soldiers said professional active duty personnel are getting better treatment while troops who serve in the National Guard or Army Reserve are left to wallow in medical hold.

"It is not an Army of One. It is the Army of two -- Army and Reserves," said one soldier who served in Operation Iraqi Freedom, during which she developed a serious heart condition and strange skin ailment.

A half-dozen calls by UPI seeking comment from Fort Stewart public affairs officials and U.S. Forces Command in Atlanta were not returned.

Soldiers here estimate that nearly 40 percent of the personnel now in medical hold were deployed to Iraq. Of those who went, many described clusters of strange ailments, like heart and lung problems, among previously healthy troops. They said the Army has tried to refuse them benefits, claiming the injuries and illnesses were due to a "pre-existing condition," prior to military service.

Most soldiers in medical hold at Fort Stewart stay in rows of rectangular, gray, single-story cinder block barracks without bathrooms or air conditioning. They are dark and sweltering in the southern Georgia heat and humidity. Around 60 soldiers cram in the bunk beds in each barrack.

Soldiers make their way by walking or using crutches through the sandy dirt to a communal bathroom, where they have propped office partitions between otherwise open toilets for privacy. A row of leaky sinks sits on an opposite wall. The latrine smells of urine and is full of bugs, because many windows have no screens. Showering is in a communal, cinder block room. Soldiers say they have to buy their own toilet paper.

They said the conditions are fine for training, but not for sick people.

"I think it is disgusting," said one Army Reserve member who went to Iraq and asked that his name not be used.

That soldier said that after being deployed in March he suffered a sudden onset of neurological symptoms in Baghdad that has gotten steadily worse. He shakes uncontrollably.

He said the Army has told him he has Parkinson's Disease and it was a pre-existing condition, but he thinks it was something in the anthrax shots the Army gave him.

"They say I have Parkinson's, but it is developing too rapidly," he said. "I did not have a problem until I got those shots."

First Sgt. Gerry Mosley crossed into Iraq from Kuwait on March 19 with the 296th Transportation Company, hauling fuel while under fire from the Iraqis as they traveled north alongside combat vehicles. Mosley said he was healthy before the war; he could run two miles in 17 minutes at 48 years old.

But he developed a series of symptoms: lung problems and shortness of breath; vertigo; migraines; and tinnitus. He also thinks the anthrax vaccine may have hurt him. Mosley also has a torn shoulder from an injury there.

Mosley says he has never been depressed before, but found himself looking at shotguns recently and thought about suicide.

Mosley is paying $300 a month to get better housing than the cinder block barracks. He has a notice from the base that appears to show that no more doctor appointments are available for reservists from Oct. 14 until Nov. 11. He said he has never been treated like this in his 30 years in the Army Reserves.

"Now, I would not go back to war for the Army," Mosley said.

Many soldiers in the hot barracks said regular Army soldiers get to see doctors, while National Guard and Army Reserve troops wait.

"The active duty guys that are coming in, they get treated first and they put us on hold," said another soldier who returned from Iraq six weeks ago with a serious back injury. He has gotten to see a doctor only two times since he got back, he said.

Another Army Reservist with the 149th Infantry Battalion said he has had real trouble seeing doctors about his crushed foot he suffered in Iraq. "There are not enough doctors. They are overcrowded and they can't perform the surgeries that have to be done," that soldier said. "Look at these mattresses. It hurts just to sit on them," he said, gesturing to the bunks. "There are people here who got back in April but did not get their surgeries until July. It is putting a lot on these families."

The Pentagon is reportedly drawing up plans to call up more reserves.

In an Oct. 9 speech to National Guard and reserve troops in Portsmouth, New Hampshire, Bush said the soldiers had become part of the backbone of the military.

"Citizen-soldiers are serving in every front on the war on terror," Bush said. "And you're making your state and your country proud."

-------

[eggplant43]

Bush administration ordered Medicare plan cost estimates withheld

By Tony Pugh

Knight Ridder Newspapers


WASHINGTON - The government's top expert on Medicare costs was warned that he would be fired if he told key lawmakers about a series of Bush administration cost estimates that could have torpedoed congressional passage of the White House-backed Medicare prescription-drug plan.


When the House of Representatives passed the controversial benefit by five votes last November, the White House was embracing an estimate by the Congressional Budget Office that it would cost $395 billion in the first 10 years. But for months the administration's own analysts in the Centers for Medicare and Medicaid Services had concluded repeatedly that the drug benefit could cost upward of $100 billion more than that.


Withholding the higher cost projections was important because the White House was facing a revolt from 13 conservative House Republicans who'd vowed to vote against the Medicare drug bill if it cost more than $400 billion.


Rep. Sue Myrick of North Carolina, one of the 13 Republicans, said she was "very upset" when she learned of the higher estimate.


"I think a lot of people probably would have reconsidered (voting for the bill) because we said that $400 billion was our top of the line," Myrick said.


Five months before the November House vote, the government's chief Medicare actuary had estimated that a similar plan the Senate was considering would cost $551 billion over 10 years. Two months after Congress approved the new benefit, White House Budget Director Joshua Bolten disclosed that he expected it to cost $534 billion.


Richard S. Foster, the chief actuary for the Centers for Medicare and Medicaid Services, which produced the $551 billion estimate, told colleagues last June that he would be fired if he revealed numbers relating to the higher estimate to lawmakers.


"This whole episode which has now gone on for three weeks has been pretty nightmarish," Foster wrote in an e-mail to some of his colleagues June 26, just before the first congressional vote on the drug bill. "I'm perhaps no longer in grave danger of being fired, but there remains a strong likelihood that I will have to resign in protest of the withholding of important technical information from key policy makers for political reasons."


Knight Ridder obtained a copy of the e-mail.


Foster didn't quit, but congressional staffers and lawmakers who worked on the bill said he no longer was permitted to answer important questions about the bill's cost.


Cybele Bjorklund, the Democratic staff director for the House Ways and Means health subcommittee, which worked on the drug benefit, said Thomas A. Scully - then the director of the Medicare office - told her he ordered Foster to withhold information and that Foster would be fired for insubordination if he disobeyed.


Health and Human Services Department officials turned down repeated requests to interview Foster. The Medicare office falls under the control of HHS.


In an interview with Knight Ridder, Scully, a former health-industry lobbyist deeply involved in the administration's campaign to pass the drug benefit, denied Bjorklund's assertion that he'd threatened to fire Foster. He said he curbed Foster on only one specific request, made by Democrats on the eve of the first House vote in June, because he felt they'd use the cost estimates to disrupt the debate.


"They were trying to be politically cute and get (Foster) to score (estimate the cost of the bill) and put something out publicly so they can walk out on the House floor and cause a political crisis, which is bogus," Scully said.


"I just said, `Look, (Foster) works for the executive branch; he's not going to do it, period,'" he said.


Otherwise, Scully said, Foster was available to lawmakers and their staffs.


" ... I don't think he ever felt - I don't think anybody (in the actuary's office) ever felt - that I restricted access. ... I think it's a very nice tradition that (the actuary) is perceived to be very nonpartisan and very accessible, and I continued that tradition."


Scully said Liz Fowler, the chief health lawyer for the Democrats on the Senate Finance Committee, could confirm the actuary's independence. Fowler didn't.


"He's a liar," she said of Scully.


At a Ways and Means Committee hearing last month, HHS Secretary Tommy Thompson all but repudiated Scully's tactics.


"I may have been derelict in allowing my administrator, Tom Scully, to have more control over it than I should have. ... And maybe he micromanaged the actuary and the actuary services too much. ... I can assure you that from now (on), the remaining days that I am secretary you will have as much access as you want to anybody or anything in the department. All you have to do is call me."


Democrats asked Thompson on Feb. 3 and March 3 for a complete record of Foster's estimates. They've yet to get it.


Said HHS spokesman Bill Pierce: "We respond to all inquiries in time and we will do the same" with these.





Scully left the administration and in January took a job with Alston & Bird, an Atlanta-based law firm that represents numerous hospitals and health insurers. He was exploring jobs in the private sector while he was pushing for passage of the prescription drug bill, thanks to a waiver from Thompson that allowed him to conduct job interviews while he was still a federal employee.


In February, the White House announced that President Bush's appointees no longer would be permitted to job-hunt while on the federal payroll.




Members of Congress and congressional staffers complained that Scully's handling of Foster has deepened congressional mistrust of the Bush administration and that withholding information makes it harder for Congress to draft good legislation.


Myrick didn't think the episode was an effort to "pull the wool over our eyes."


But Democratic Rep. Pete Stark of California felt otherwise. "This `need to know, our eyes only' stuff is getting too restrictive for us to do a decent job," said Stark, the ranking Democrat on the House Ways and Means health subcommittee.


For years before Scully's arrival in 2001, key lawmakers had direct access to Medicare actuaries.


In 1997, when Republicans were having trouble getting health-care cost information out of the Clinton administration, Rep. Bill Thomas, R-Calif., who's now the chairman of the House Ways and Means Committee, added language to the Balanced Budget Act conference report to emphasize the importance of free access to Foster.


"The process of monitoring, updating and reforming the Medicare and Medicaid programs is greatly enhanced by the free flow of actuarial information from the Office of the Actuary to the committees of jurisdiction in the Congress," the report says.


"When information is delayed or circumscribed by the operation of an internal Administration clearance process or the inadequacy of actuarial resources, the Committees' ability to make informed decisions based on the best available information is compromised."

[eggplant43]

March 16, 2004
The Actuary and the Actor

An Orwellian taint is emerging in the Bush administration's big victory last year in wringing the Medicare prescription drug subsidy from a balky Congress. The plan is being sold to the public through propagandistic ads disguised as TV news reports, and it turns out the government's top Medicare actuary was muzzled by superiors during the debate about the program's price tag.

Richard Foster, one of the government's foremost Medicare experts, says he was ordered not to provide requested information to Congress last fall when doubts were being raised about the drug benefit's cost. The administration denies this, but a ranking former official has confirmed Mr. Foster's story. As the bill was being considered, Mr. Foster privately cautioned that its cost could amount to as much as $600 billion, while the White House publicly stuck to the Congressional Budget Office figure of $400 billion over 10 years. The administration eventually conceded a cost of $534 billion, but only after the bill was safely signed into law.

With program in hand, the administration then attempted to rally support — and take political credit — with government-produced TV ads masquerading as news reports. Actors were hired by the Department of Health and Human Services to pose as television journalists purveying faux upbeat "news" segments about the expanded Medicare coverage. The hope is that TV stations will air them as their own. In one version, anchors are offered a script in which they promise that "reporter Karen Ryan" — an actress — will explain the details of the new drug plan.

This sleight of hand only deepens doubts about White House credibility on a complex issue. The public deserves straightforward information about the changes in Medicare, and federal agencies should not be engaging in political spin. This is no way to run a democracy nourished by information and taxpayers' money.

[bassetman]

Corporate greed and your health!

Her father was dying, and the drug company wanted $47,000 for his medication. So she did what any daughter would do: She became a liar and a fraud.

By Julia Whitty

March/April 2004 Issue

Rest of the story here:
http://www.motherjones.com/news/feat...03/02_403.html

[eggplant43]

March 20, 2004

Medicare Actuary Gives Wanted Data to Congress

By ROBERT PEAR

WASHINGTON, March 19 — Richard S. Foster, the chief actuary of Medicare, provided Congress with documents on Friday showing that federal payments to private health insurance plans under a new Medicare law could far exceed what Congress assumed when it passed the measure last fall.

For months, lawmakers had been seeking the data, but Mr. Foster said in an interview that he had withheld it under instructions from Bush administration officials.

He turned over documents outlining the information at a meeting on Friday with Congressional aides of both parties who work on health legislation.

The documents estimate that the new law will increase Medicare payments to private health plans by a total of $46 billion over the next 10 years, not the $14 billion assumed by lawmakers when they voted on the legislation. Mr. Foster had cited the discrepancy in an interview earlier this week, but the documents he turned over on Friday, Mr. Foster said, show that the Bush administration was aware of the gap well before Congress approved the new law.

Moreover, the documents show that the administration expects a huge increase in the number of Medicare beneficiaries enrolled in various types of managed care. About 12 percent of the 41 million current Medicare beneficiaries are in such private health plans today. By 2009, Mr. Foster says, the proportion will reach 32 percent, equally divided between health maintenance organizations and preferred provider organizations.

By contrast, the actuary estimates that enrollment in the traditional government-run Medicare program will decline from 2006 to 2009, along with payments to many health care providers.

For example, the documents show that payments to doctors under Medicare's fee schedule will decline each year from 2006 to 2012, while spending for inpatient hospital services and skilled nursing homes under the traditional government-run program will decline in 2006 and 2007.

Doctors and hospitals have lobbied vigorously against such cuts in recent years. The actuary's report suggests they will need to mobilize their lobbyists again if they want to preserve the gains they won last year.

Many Republicans wanted to encourage the growth of private health plans because they believe such insurers coordinate care better than the traditional Medicare program.

But if the estimates of higher costs had been known last year, they would have given ammunition to Democrats and other critics who said the bill was lavishing money on insurance companies at the expense of the traditional Medicare programs.

Mr. Foster said he withheld the cost estimates and other information from Congress last year on instructions from Thomas A. Scully, who was then administrator of the Medicare program.

Mr. Foster, who has been a government actuary for more than 30 years, said Mr. Scully had threatened to fire him if he gave the data to Congress.

Mr. Scully, who left the government in December, confirms that he told Mr. Foster to withhold certain information, but denies threatening to fire him.

A federal law stipulates that officials must not try to prevent federal employees from having "oral or written communication or contact" with any member of Congress on matters relating to the employees' duties.

On Thursday, a group of 18 Democratic senators led by Frank R. Lautenberg of New Jersey asked the comptroller general to investigate whether Mr. Foster had been muzzled in violation of this law.

Trent D. Duffy, a White House spokesman, said no White House official had instructed Mr. Foster or Mr. Scully to withhold information from Congress. But Mr. Duffy acknowledged that the actuary's cost estimates had been sent to White House officials, including Doug Badger, a special assistant to President Bush who negotiated with Congress on the Medicare bill.

Some Republicans, especially conservatives concerned about the cost of the new law, have criticized the administration for withholding information.

An earlier Medicare law, adopted in 1997 at the behest of Republicans, explicitly protects the actuary's independence.

A spokeswoman for Representative Bill Thomas, Republican of California, who helped write that provision, said Mr. Thomas believed "that members of Congress should have access to differing assumptions and estimates and that any administration should provide requested information."

Representative Jeb Hensarling, Republican of Texas, who voted reluctantly for the Medicare bill, said the costs of benefit programs often soared beyond expectations.

"I never believed anybody's cost estimates for the Medicare bill," Mr. Hensarling said. "I didn't believe the Congressional Budget Office or the administration."

Consumer advocates told the administration on Friday that one way to hold down costs would be to allow Americans to import drugs from Canada and other countries.

They said the government could guarantee the safety of such imports by inspecting foreign production plants, licensing wholesale importers and tracking shipments from factory to pharmacy, with the help of new technology.

The administration has strenuously opposed drug imports, saying they pose an unacceptable risk to consumers. But under a requirement in the new Medicare law, a panel of 13 administration officials is studying ways to ensure the safety of imported drugs.

David M. Certner, director of federal affairs at AARP, told the panel: "Individuals are already doing this on their own. It would be far better to establish a safe regime for imports."

Mr. Certner said the Food and Drug Administration should, on its Web site, provide a list of "approved pharmacies" that could supply safe medicines from abroad.

Dr. Georges C. Benjamin, executive director of the American Public Health Association, said federal officials should be able to guarantee the safety of imported drugs because doctors, pharmacists, wholesalers and manufacturers were all "trusted agents," subject to federal or state regulation.

[bassetman]

Good work Eggy!

[Rep]

So, the Bush administation sets up what looks like a newscasts and sends them to TV news stations touting the prescription drug program. That, and along with a whole bunch of other spending trying to convince us the program is good for us adds up to $80 million.

What could $80 million buy?

see here: http://www.americanprogress.org/site...RJ8OVF&b=38005

[bassetman]

The best thing Bush did for us is to take away our Governor! Thank God is is messing with the national system!
I speak of course of Tommy Thompson! The man who helps to prevent you from getting affordable drugs from Canada!

Please, keep him!

[eggplant43]

March 23, 2004

Medicare to Go Broke by 2019, Trustees Predict

By ROBERT PEAR

WASHINGTON, March 23 — Medicare's financial condition has significantly deteriorated, partly because of exploding health costs and partly because of the new Medicare law, the government reported today.

In their annual report to Congress, the Medicare board of trustees said the program's hospital insurance trust fund could run out of money before the end of the next decade.

The trustees have made such projections in the past, but this one was much bleaker than the outlook reported just last year.

By contrast, the financial outlook for Social Security, though shaky in the long run, changed little from last year.

John L. Palmer, a public representative on the six-member board, who is also a former dean of the Maxwell School at Syracuse University, said: "The magnitude of the problems is much greater in Medicare. They start sooner, get bigger and will be much more difficult to deal with. The problems of Social Security are manageable, compared with those of Medicare."

In their report, the trustees lobbed a political bombshell into this year's elections, saying Medicare appeared unsustainable in its current form. They made three blunt statements that highlighted the problems:

Under current law, Medicare's hospital insurance trust fund, which pays for inpatient hospital care, will be exhausted in 2019, seven years earlier than forecast last year.

Medicare will grow much faster than the economy as a whole, increasing from 2.6 percent of the gross domestic product last year to 3.7 percent in 2010, 7.7 percent in 2035 and nearly 14 percent at the end of the 75-year period commonly used for long-range projections.

"Projected Medicare costs would exceed those for Social Security in 2024. By 2078, the level of Medicare expenditures would represent nearly twice the cost of Social Security."

The new figures touched off a political brawl between Democrats and the White House.

"In just one year, George Bush's reckless policies have sped Medicare seven years closer to bankruptcy," said Senator John Kerry, the likely Democratic presidential nominee.

Bush administration officials said Medicare's financial problems would be far worse if Democrats had prevailed in the effort to pass drug legislation costing twice as much as the new law.

The board of trustees consists of four administration officials and two public representatives, Mr. Palmer and Thomas R. Saving, an economist at Texas A&M University.

In a joint statement, the two public trustees said that surging Medicare costs, combined with the new drug benefit, "raise serious doubt about the sustainability of Medicare under current financing arrangements."

Moreover, the full board said, the fiscal outlook may be worse than the official projections indicate, because the estimates are based on the unrealistic assumption that the average Medicare fee for doctors' services will be cut about 5 percent each year from 2006 to 2012, as required under current rules. Doctors will almost surely persuade Congress to reverse those cuts, lawmakers say.

Though issued by the Bush administration, the Medicare report was prepared mainly by the office of the actuary, Richard S. Foster, a longtime civil servant who recently stirred up a political row when he said he was ordered to withhold some of his cost estimates for the prescription drug legislation from Congress. In the last year, he wrote, "the financial status of the hospital insurance trust fund has deteriorated significantly."

For example, the report says, tax revenues earmarked for the hospital trust fund will fall short of outlays beginning this year, not in 2013, as the trustees predicted last March. Similar shortfalls have occurred in the past.

Democrats found themselves in a delicate position. They insisted today that Medicare was not facing a fiscal crisis, and they said they saw no reason for alarm. But at the same time, Democrats blamed President Bush for Medicare's problems.

Senator Kerry said Mr. Bush had had an opportunity to shore up Medicare's finances, but had squandered it by providing "tax breaks for the wealthy and a giveaway to prescription drug companies."

Trent D. Duffy, a White House spokesman, fired back, saying: "John Kerry would like to steal the drug benefit away from seniors before they even get it. This president won't allow him to do that. This president has delivered; Democrats have made empty promises for more than a decade."

Moreover, Mr. Duffy said that Medicare's financial problems resulted more from rising health costs in general than from the drug benefit proposed by Mr. Bush and approved by Congress last year.

But the trustees said the drug benefit would indeed be a major factor adding to Medicare's fiscal problems.

Medicare spending on the drug benefit will start at $85 billion a year in 2006 and will grow an average of 9.6 percent a year, to $161.8 billion in 2013, the trustees said.

In a separate analysis, the trustees said that the Social Security trust fund would be exhausted in 2042, but that annual costs would exceed tax revenues starting in 2018. Those dates are the same as in last year's report.

Social Security officials emphasized that the program would not stop paying benefits even under those assumptions. While the assets of the trust fund would be depleted in 2042, they said, tax income would still cover 73 percent of benefit costs.

Medicare's hospital insurance trust fund, which now accounts for 55 percent of Medicare spending, has been a widely used gauge of the program's financial condition. It fluctuates from year to year.

Robert D. Reischauer, president of the Urban Institute and a former director of the Congressional Budget Office, said: "The date of insolvency moved forward seven years. By my way of calculating, that's the largest deterioration since we began doing these projections in 1970."

Trustees listed several reasons for the worsening condition of the hospital trust fund. Spending was a little higher than expected last year, and payroll tax collections were lower than expected, because of "very slow growth in wages in 2003," the report said.

In addition, it said, the new Medicare law will significantly increase costs for the trust fund, "primarily through increased payments to rural hospitals and private health plans."

The report is full of complex statistics, but the two public trustees explained their significance for ordinary Americans.

In 2003, they observed, premiums and co-payments for a typical Medicare beneficiary amounted to 15 percent of the average Social Security benefit. By contrast, they said, premiums and co-payments for doctors' services and the new drug benefit will exceed 35 percent of the average Social Security benefit in 2010 and 50 percent by 2030.

[eggplant43]

--------------------------------------------------------------------------------

March 26, 2004

Entitlements 'Crisis'

The latest projected shortfalls in financing Medicare and Social Security have brought the usual sober warnings that neither program is sustainable over the long run. The Social Security trustees reported this week that the fund would be exhausted in 2042, the same date projected last year, while Medicare trustees projected that their hospital insurance trust fund would be empty in 2019, seven years earlier than forecast last year. But don't jump off a bridge just yet. The financing problems are clearly manageable if political leaders will only address them, the sooner the better.

Although the challenges facing Social Security as the baby boomers reach retirement age are routinely described as a crisis, that characterization seems overblown. The 75-year projections give Social Security another 38 years during which the full promised benefits can be paid; even after the trust fund disappears, the annual Social Security tax revenue would be enough to finance some 70 percent of the benefits until 2078. Those worried that Social Security will not be there for them when they retire are simply mistaken.

No one should be complacent with a long-term projection that winds up with Social Security falling 30 percent short of the money it needs to pay for promised benefits. Fortunately, there is time to cope with this problem. The fixes that are needed appear modest, and they can be kept modest by making the changes sooner rather than later so the savings have time to accumulate.

The prognosis for Medicare is far more worrisome. Its hospital insurance trust fund is now projected to run dry by 2019, and the parts of Medicare that pay for doctors' services and the new prescription drug coverage, which are financed mostly by general revenues rather than by the trust fund, are also expected to increase rapidly in cost.

What makes Medicare a tougher problem than Social Security is the inexorable rise in health care costs. The very long-term projections are stunning. The study estimated that Medicare expenditures would rise from 2.6 percent of gross domestic product today to 13.8 percent in 2078, roughly the percentage of G.N.P. that has historically been paid in federal income taxes. Such long-term projections must be taken with a huge dose of salt. Who really thinks that a prognosticator consulting a crystal ball 75 years ago, on the eve of the Depression, could have foreseen today's high-tech medicine?

Nevertheless, there's a big problem here, and it reaches far beyond Medicare. There are few domestic policy issues more urgent than the need to get some kind of handle on the rising cost of medical care. Unless that underlying problem is solved, Medicare will inevitably require higher taxes or be forced to reduce benefits.

Congress can certainly take a first step in dealing with the looming entitlement shortfalls by rebuffing the administration's efforts to extend its tax cuts for wealthy Americans. The Center on Budget and Policy Priorities, a liberal analytical group, estimates that if most of the 2001 and 2003 tax cuts are made permanent, the revenue lost to the federal government in the next 75 years would roughly equal the combined Social Security and Medicare trust fund shortfalls over that period. It would be irresponsible for lawmakers to wring their hands over entitlements and yet deny the government the revenue that could ease the problem.



Copyright 2004 The New York Times Company

[eggplant43]

Posted on Wed, Mar. 31, 2004



White House refuses to let adviser testify on Medicare drug costs

By Tony Pugh

Knight Ridder Newspapers


WASHINGTON - Citing executive privilege, the White House refused to allow President Bush's chief health-policy adviser, Douglas Badger, to testify Thursday before the House Ways and Means Committee about early administration estimates that the new Medicare prescription-drug benefit would be far more costly than many lawmakers believed when they voted for it.


White House spokesman Trent Duffy said the decision not to let Badger testify was justified by the longstanding principle that exempts assistants to the president from testifying before Congress.


Executive privilege, while not mentioned specifically in the Constitution, has been recognized by the Supreme Court as necessary to, as Duffy put it, "preserve the White House's ability to get the best information possible and to speak candidly."


Until Bush yielded on Tuesday, his administration used the same argument to keep National Security Adviser Condoleezza Rice from testifying publicly before the commission investigating the terrorist attacks of Sept. 11, 2001.


Several Ways and Means Committee members wanted to know whether Badger suppressed or passed on to senior Bush administration officials figures he obtained in early June indicating that the drug benefit might cost more than $500 billion in its first 10 years. When lawmakers narrowly passed the measure in November, many relied on a $395 billion Congressional Budget Office estimate.


Knight Ridder reported on March 11 that former Medicare administrator Thomas Scully threatened to fire his chief actuary, Richard Foster, if Foster shared the far higher estimate with members of Congress. The alleged firing threat, which Scully contends was not serious, sparked sharp bipartisan criticism from lawmakers, editorial writers and interest groups, as did the administration's effort to keep the higher cost figure out of the congressional debate. Lawmakers in prior years had free access to Foster's estimates.


In testimony last week before the Ways and Means Committee, Foster said that Badger, Scully and other members of the Bush administration received his June estimate that the program might cost $511 billion. But Foster said he didn't know whether those estimates were shared with higher-ups in the White House - perhaps even with Bush, who lobbied hard for the bill.

[oldie]

Health care is a human right rather than a product for economic profit. Therefore, all have equal access to health services, and all services are free.

Oldie

[eggplant43]

That's what I believe. Just have a few corporate contributors, and about half of my fellow citizens to convince.

[oldie]

Country ranking

1: Oman
2: Malta
3: Italy
4: France
5: San Marino
6: Spain
24: UK
72: US
189: Namibia
190: Zambia
191: Zimbabwe

Source: WHO

Regards - Oldie

Addendum

Several European countries did well, among them Italy, France and Spain, and much smaller states such as Malta, Andorra and San Marino also made the top 10.