There has been much made of the latest health insurance reform package, both pro and con. One of the biggest arguments against the package is that we need to keep government out of health care. I know that the reform package is related to health insurance, and it’s not quite the same as health care. I also know that there won’t be a nickel’s worth of difference between the two when it comes to government having its finger in health care/insurance.
The fact is that government is already pervasive in health care/insurance. But don’t take my word for it. Tom Scully, CMS (Centers for Medicare and Medicaid Services, the agency that administers the Medicare program) Administrator in the Bush era from 2001 to 2003, said in a news clip regarding the role of CMS in health care/insurance, “You (CMS) get into every little nook and cranny of every part of the health care field.” This is from a man who was there well before any reform was passed by this congress.
Think about that amazing statement. “Every nook and cranny of every part” of the health care field (which includes health insurance, by the way). The government, friend, is already there and has been there for decades. Both parties are responsible. Neither will own up to it.
Let me tell you a true story. I know of a nursing home that had an annual fire inspection not long ago. It used to be that, since the State of Kansas was conducting the inspection, state regulations were used as the standard. Not so now. The inspector was working for the State of Kansas (Fire Marshal’s office), but was conducting an inspection according to CMS standards. CMS contracts with state agencies to conduct these kinds of inspections at facilities that participate in Medicare or Medicaid.
The inspector cited a deficiency in a linen storage closet, saying that fire sprinklers needed to be installed in the closet. This closet was built into the wall and was about three feet wide and sixteen inches deep. It had doors on the front and shelves in the closet to hold linens.
The building is relatively new (two years old). It has passed multiple fire inspections on both the local (Wichita Fire Department) and State (Fire Marshal) levels. The architect (well-versed in regulations of this kind) didn’t spec sprinklers in the closet when he drew the plans. The sprinkler sub-contractor, who is also well-versed in sprinkler regulations, didn’t see the need for sprinklers in the closet. An independent fire safety engineer reviewed the area and said in a formal opinion that the NFPA (National Fire Protection Association) Code, the gold standard for fire safety, specifically stated that sprinklers were not necessary.
CMS, however, wouldn’t budge. Regardless of the opinions of multiple professionals, and the explicit statement of the gold standard of fire safety, it threatened to withhold all payments to the facility until the problem was corrected. The State of Kansas threatened to not issue a license to operate the facility. The facility was faced with the real possibility (these guys don’t fool around with you) of having to transfer over 60 residents to other facilities and close its doors if it didn’t comply.
The facility reached an agreement with CMS that was satisfactory to CMS by cutting a 4 inch by 12 inch opening at the top of each of the closet doors. Think about that for a minute, then mumble under your breath in hapless wonder.
Let’s see. CMS is already into health care so deeply that it can mandate that a facility cut a 4 inch by 12 inch hole in a closet door, under penalty of non-payment of about $20,000 a day due from Medicare for treatment of Medicare residents. And you have the nerve to tell me that government is not into health care, and that the new reform package will ruin all of that and put government into the equation?
Oh, you say that government may be into health care, but the new package will make things worse. How can it be any worse than the federal government using the power of the State of Kansas (to withhold a license to operate a facility) and the power of the federal purse to mandate a hole in a closet door that doesn't, by all professional accounts, have to be there?
Would someone honestly answer that question for me without partisanship, without stump speech phrases, and without rancor?
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