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Seriously, Florida, WTF?

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no stress
Floridatexan
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1Seriously, Florida, WTF? Empty Seriously, Florida, WTF? 3/8/2014, 1:23 pm

Floridatexan

Floridatexan


http://www.dailykos.com/story/2014/03/03/1281865/-Seriously-Florida-WTF?detail=email

"The fact that Florida's Republican governor and legislature refused to expand Medicaid under Obamacare was bad enough. Florida has the second highest number of uninsured people among all the states. About one quarter of Florida's population was uninsured before the health exchange opened in January. That's 3.8 million people. If the state were to expand Medicaid, one million of them would get Medicaid coverage. But it gets worse. Florida isn't just turning away Medicaid expansion money, they've jeopardized existing funding by refusing to comply with federal Medicaid law. The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. The feds say Florida can't do that, Florida says, sure we can. And now they're losing funding.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan. [...]
It’s unclear yet how much the state could be penalized. CMS says it will initially withhold 10 percent of whatever the state claims for certain administrative costs. That amount will go up 5 percent each quarter while the state remains out of compliance.

The state knew it was out of compliance imposing these limits because when they asked the feds for a waiver to do it, they were turned down. They knew that they could lose funding, and did it anyway. But that, as well as expansion refusal, are just part of the major Medicaid fiasco for Florida. The state has also passed a law back in 2011 that will be implemented in July, and could cost some hospitals in the state hundreds of millions of dollars. The law set up a new distribution system for funding, redistributing federal Medicaid dollars around the state..."

2Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 4:37 pm

no stress

no stress

The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. I've been to the emergency room 3 time total in my life. How is 6 visits per year a hardship?

3Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 4:54 pm

dumpcare



Florida I believe has quietly privatized medicaid and has something like 8 regions and private insurance company's (HMO's) are insuring medicaid patients with the federal government approval. This was past last month, if it has not taken effect yet it will soon.

Gunz that't great you haven't had to use an er, but get a chronic condition and let it flare up on a weekend. I never used them either and have been twice in the past two months. There are some things you just cannot help. A close relative of mine that had never in her life been to one in her last 4 months of life had about 8 trips to er in the middle of the night.

4Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 5:10 pm

no stress

no stress

ppaca wrote:Florida I believe has quietly privatized medicaid and has something like 8 regions and private insurance company's (HMO's) are insuring medicaid patients with the federal government approval. This was past last month, if it has not taken effect yet it will soon.

Gunz that't great you haven't had to use an er, but get a chronic condition and let it flare up on a weekend. I never used them either and have been twice in the past two months. There are some things you just cannot help. A close relative of mine that had never in her life been to one in her last 4 months of life had about 8 trips to er in the middle of the night.
Didn't think about the elderly poor. I guess 6 trips would be possible in that case. I have been lucky in my health. Fixing to turn 50...no maintenance drugs, no glasses and no aches and pains so far.

5Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 5:17 pm

dumpcare



50 is young and stay away from maintenance drugs, I believe they alone screw you up. One prescription always leads to another it seems.

6Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 5:20 pm

no stress

no stress

ppaca wrote:50 is young and stay away from maintenance drugs, I believe they alone screw you up. One prescription always leads to another it seems.
Thanks, if I could only stay away from the looming colonoscopy that I am coming due for...first time.

7Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 5:22 pm

dumpcare



Don't want to scare you, but that is exactly why I ended up on a Saturday night two weeks ago in the er.

8Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 5:37 pm

knothead

knothead

Comment to support ppaca's admonition regarding the ER, my wife is very very healthy . . . . we are very close friends with our personal doc who is only a phone call away night or day . . . . she became violently ill nausea and stayed that way for a couple days . . . she thought it was a bug . . . . finally I called and talked to doc and he said go straight to ER as there was nothing he could do at his office . . . . we did and she had an obstructed lower bowel . . . . . nine days in hospital ending with a surgical procedure . . . . $3600 for ER alone but she and I are happy we took the advice . . . you just never know.

9Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 6:59 pm

dumpcare



Glad everything came out alright Knothead. Usually when you call your doctor after hours they tell you to go to er.

10Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 7:11 pm

Guest


Guest

by Gunz Today at 3:37 pm
The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. I've been to the emergency room 3 time total in my life. How is 6 visits per year a hardship?
------
Exactly

11Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/8/2014, 11:22 pm

Markle

Markle

Floridatexan wrote:
http://www.dailykos.com/story/2014/03/03/1281865/-Seriously-Florida-WTF?detail=email

"The fact that Florida's Republican governor and legislature refused to expand Medicaid under Obamacare was bad enough. Florida has the second highest number of uninsured people among all the states. About one quarter of Florida's population was uninsured before the health exchange opened in January. That's 3.8 million people. If the state were to expand Medicaid, one million of them would get Medicaid coverage. But it gets worse. Florida isn't just turning away Medicaid expansion money, they've jeopardized existing funding by refusing to comply with federal Medicaid law. The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. The feds say Florida can't do that, Florida says, sure we can. And now they're losing funding.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan. [...]
It’s unclear yet how much the state could be penalized. CMS says it will initially withhold 10 percent of whatever the state claims for certain administrative costs. That amount will go up 5 percent each quarter while the state remains out of compliance.

The state knew it was out of compliance imposing these limits because when they asked the feds for a waiver to do it, they were turned down. They knew that they could lose funding, and did it anyway. But that, as well as expansion refusal, are just part of the major Medicaid fiasco for Florida. The state has also passed a law back in 2011 that will be implemented in July, and could cost some hospitals in the state hundreds of millions of dollars. The law set up a new distribution system for funding, redistributing federal Medicaid dollars around the state..."

DEPENDABLE DailyKOS.  What fun!

Seriously, Florida, WTF? DailyKosFetusParasite

Seriously, Florida, WTF? DailyKOSWeinerPresseraFake-1

The "truth" from the DailyKOS.



Last edited by Markle on 3/9/2014, 7:38 pm; edited 1 time in total

12Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 12:36 am

knothead

knothead

Markle wrote:
Floridatexan wrote:
http://www.dailykos.com/story/2014/03/03/1281865/-Seriously-Florida-WTF?detail=email

"The fact that Florida's Republican governor and legislature refused to expand Medicaid under Obamacare was bad enough. Florida has the second highest number of uninsured people among all the states. About one quarter of Florida's population was uninsured before the health exchange opened in January. That's 3.8 million people. If the state were to expand Medicaid, one million of them would get Medicaid coverage. But it gets worse. Florida isn't just turning away Medicaid expansion money, they've jeopardized existing funding by refusing to comply with federal Medicaid law. The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. The feds say Florida can't do that, Florida says, sure we can. And now they're losing funding.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan. [...]
It’s unclear yet how much the state could be penalized. CMS says it will initially withhold 10 percent of whatever the state claims for certain administrative costs. That amount will go up 5 percent each quarter while the state remains out of compliance.

The state knew it was out of compliance imposing these limits because when they asked the feds for a waiver to do it, they were turned down. They knew that they could lose funding, and did it anyway. But that, as well as expansion refusal, are just part of the major Medicaid fiasco for Florida. The state has also passed a law back in 2011 that will be implemented in July, and could cost some hospitals in the state hundreds of millions of dollars. The law set up a new distribution system for funding, redistributing federal Medicaid dollars around the state..."

DEPENDABLE DailyKOS.  What fun!

Seriously, Florida, WTF? DailyKosFetusParasite

Seriously, Florida, WTF? DailyKOSWeinerPresseraFake-1

The truth from the DailyKOS.

I guess you would need to stick to The Blaze for your pure version of the 'the truth' . . . .

13Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 1:46 am

Guest


Guest

This nation is pretty much beyond repair minus divine intervention. We are as split as the union pre Civil War and forums like this prove that.

14Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 3:16 am

Markle

Markle

knothead wrote:
Markle wrote:
Floridatexan wrote:
http://www.dailykos.com/story/2014/03/03/1281865/-Seriously-Florida-WTF?detail=email

"The fact that Florida's Republican governor and legislature refused to expand Medicaid under Obamacare was bad enough. Florida has the second highest number of uninsured people among all the states. About one quarter of Florida's population was uninsured before the health exchange opened in January. That's 3.8 million people. If the state were to expand Medicaid, one million of them would get Medicaid coverage. But it gets worse. Florida isn't just turning away Medicaid expansion money, they've jeopardized existing funding by refusing to comply with federal Medicaid law. The state has decided to impose a limit of six emergency room visits per year to Medicaid patients. The feds say Florida can't do that, Florida says, sure we can. And now they're losing funding.
The Florida Agency for Health Care Administration is in the midst of an appeal of the federal government’s rejection of the six-visit limit. A September hearing is scheduled.
But while the fight has been pending, the state agency went ahead with its plan. [...]
It’s unclear yet how much the state could be penalized. CMS says it will initially withhold 10 percent of whatever the state claims for certain administrative costs. That amount will go up 5 percent each quarter while the state remains out of compliance.

The state knew it was out of compliance imposing these limits because when they asked the feds for a waiver to do it, they were turned down. They knew that they could lose funding, and did it anyway. But that, as well as expansion refusal, are just part of the major Medicaid fiasco for Florida. The state has also passed a law back in 2011 that will be implemented in July, and could cost some hospitals in the state hundreds of millions of dollars. The law set up a new distribution system for funding, redistributing federal Medicaid dollars around the state..."

DEPENDABLE DailyKOS.  What fun!

Seriously, Florida, WTF? DailyKosFetusParasite

Seriously, Florida, WTF? DailyKOSWeinerPresseraFake-1

The truth from the DailyKOS.

I guess you would need to stick to The Blaze for your pure version of the 'the truth' . . . .

Next time I post something from the Blaze, show me what is false. I don't post opinion pieces. Your source calls a fetus a "parasite" and said that the Weiner Press Conference, where he announced his resignation after all his selfies came out, was fake and he did not resign.

Here is another lie from the same source. The Spanish Study referred to is a valid, unbiased study.

Seriously, Florida, WTF? DailyKOSLogoSpanish-1

15Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 9:43 am

Guest


Guest

PACEDOG#1 wrote:This nation is pretty much beyond repair minus divine intervention. We are as split as the union pre Civil War and forums like this prove that.

so funny to see you say that. there are other posters who also believe the nation is in decline.  Wink 

16Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 10:06 am

Joanimaroni

Joanimaroni

Gunz wrote:The state has decided to impose a limit of six emergency room visits per year to Medicaid patients.         I've been to the emergency room 3 time total in my life.    How is 6 visits per year a hardship?

A friend of mine was trying get insurance for his 2 grandchildren. He got coverge for the 6 year old but the 2 year old was deemed uninsurable. Further checking revealed the mother, while on medicaid, took him to the ER for any and everything......he was uninsurable because he had too many ER visits.

17Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 10:07 am

dumpcare



Since the thread is WTF Florida thought this article may be appropriate:

Anesthesia proposal in state House goes too far
Here’s a statement that should con­cern anyone who is serious about patient safety in our state: “Florida House of Rep­resentatives proposal PCB 14-01 would allow nurse anesthetists to administer anesthesia – in all cases – indepen­dently and without any supervision of a physi­cian.”

This proposed legisla­tion would fundamental­ly alter the safest clin­ically proven model of anesthesia care in America and one that Floridians have the most confidence in. The bill represents a sharp de­parture from a well­recognized nationwide standard of physician­led anesthesia that would not just make Florida a national out­lier, it would signifi­cantly decrease the level of safety for Flori­da’s patients while doing nothing to control costs.

To be unmistakably clear, the bill would allow nurse anesthetists to do in Florida what they can currently do in only three other states (Utah, New Hampshire and Montana): conduct or administer an an­esthetic independently and with zero physician involvement or over­sight.

Ironically, this dra­matic move flies in the face of the study pre­sented and paid for by the nurse anesthetist lobby, one that shows the safest way to clin­ically put someone to sleep is with a team led by a physician. Nurses, educated with half the classroom education and one-seventh the clinical training of physician anesthesiologists, would be given complete and full autonomy in all areas of providing an­esthesia services.

Advocates claim that this is an access to care issue. While Florida does indeed have a pending shortage of some types of physi­cians, it is vital to note that this shortfall is mostly in the area of primary care. Coinci­dentally, we are also projected to have a very serious shortage of nurses. According to the Florida Center for Nurs­ing, Florida in 2025 will need 50,000 more nurses than it will have on hand. No such deficit exists in the area of anesthesiology, and Florida law has this well covered by already per­mitting nurse anesthe­tists to practice to the full scope of their train­ing under nonanesthesi­ologist physicians.

Nurse anesthetists are respected members of the anesthesia care team and I work with them daily in my prac­tice. They are extremely competent and highly skilled individuals who can handle many situa­tions and circumstances related to anesthesia care. But when it comes to complex medical decision-making re­quired in certain types of surgical procedures or unexpected emergen­cies that may arise dur­ing even simple cases, physicians leading the anesthesia care team can make all of the dif­ference in achieving better outcomes. Addi­tionally, there are spe­cialized areas of an­esthesia where the ad­vanced training of med­ical doctors is crucial.

Finally, it is impor­tant to note that in an era of health care cost consciousness, physi­cian- led anesthesia teams cost no more than if a single person were providing that care – regardless of that per­son’s training. When it comes to anesthesia, the vast majority of insur­ers, including Medicare, pay for the anesthesia service provided and not based on who pro­vides it. Anesthesiolo­gists save additional dollars by effectively making patient triage decisions, preventing complications, increas­ing patient rescue rates, and limiting the need for additional doctors to be involved. The physician, therefore, adds a tre­mendous amount of value to the safety of anesthesia without cost­ing the system any addi­tional expense.

Florida has a time­tested, efficient, cost­aware, accessible sys­tem for providing safe anesthesia care to our families and friends. Lacking a demonstrable and compelling reason to change this success­ful formula, the Florida Legislature ought to err on the side of safety and caution and retain the physician supervision requirement over anes­thetists.

Dr. Jay Epstein is president of the Florida Society of Anesthesiolo­gists.


18Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 10:10 am

dumpcare



Joanimaroni wrote:
Gunz wrote:The state has decided to impose a limit of six emergency room visits per year to Medicaid patients.         I've been to the emergency room 3 time total in my life.    How is 6 visits per year a hardship?

A friend of mine was trying get insurance for his 2 grandchildren. He got coverge for the 6 year old but the 2 year old  was deemed uninsurable.  Further checking revealed the mother, while on medicaid,  took him to the ER for any and everything......he was uninsurable because he had too many ER visits.

The problem may have not been all the trips (of course that didn't help) many were declined because of no definitive diagnosis and never completed recommended tests.

19Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 10:20 am

Joanimaroni

Joanimaroni

ppaca wrote:
Joanimaroni wrote:
Gunz wrote:The state has decided to impose a limit of six emergency room visits per year to Medicaid patients.         I've been to the emergency room 3 time total in my life.    How is 6 visits per year a hardship?

A friend of mine was trying get insurance for his 2 grandchildren. He got coverge for the 6 year old but the 2 year old  was deemed uninsurable.  Further checking revealed the mother, while on medicaid,  took him to the ER for any and everything......he was uninsurable because he had too many ER visits.

The problem may have not been all the trips (of course that didn't help) many were declined because of no definitive diagnosis and never completed recommended tests.

All I know is what he said about the visits.....diaper rash, colds/ cough. Routine office visit stuff. The kid had been treated mostly by pediatric interns and was put on multiple antibiotics by the interns. He said the director of pediatrics made a note the kid could not be prescribed any more antibiotics unless he or another attending ok'd the Rx. I don't know how many ER visits but it was a lot...and the mother used all the local ER's.

20Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 10:57 am

dumpcare



He's obtained insurance now for the kid, hasn't he?

He probably is right, it was all the trips and different diagnosis. The mother sounds like she had a problem.

21Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 11:06 am

Joanimaroni

Joanimaroni

ppaca wrote:He's obtained insurance now for the kid, hasn't he?

He probably is right, it was all the trips and different diagnosis. The mother sounds like she had a problem.

Yes he is covered. Mom was a problem.

22Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 11:19 am

knothead

knothead

ppaca wrote:Since the thread is WTF Florida thought this article may be appropriate:

Anesthesia proposal in state House goes too far
Here’s a statement that should con­cern anyone who is serious about patient safety in our state: “Florida House of Rep­resentatives proposal PCB 14-01 would allow nurse anesthetists to administer anesthesia – in all cases – indepen­dently and without any supervision of a physi­cian.”

This proposed legisla­tion would fundamental­ly alter the safest clin­ically proven model of anesthesia care in America and one that Floridians have the most confidence in. The bill represents a sharp de­parture from a well­recognized nationwide standard of physician­led anesthesia that would not just make Florida a national out­lier, it would signifi­cantly decrease the level of safety for Flori­da’s patients while doing nothing to control costs.

To be unmistakably clear, the bill would allow nurse anesthetists to do in Florida what they can currently do in only three other states (Utah, New Hampshire and Montana): conduct or administer an an­esthetic independently and with zero physician involvement or over­sight.

Ironically, this dra­matic move flies in the face of the study pre­sented and paid for by the nurse anesthetist lobby, one that shows the safest way to clin­ically put someone to sleep is with a team led by a physician. Nurses, educated with half the classroom education and one-seventh the clinical training of physician anesthesiologists, would be given complete and full autonomy in all areas of providing an­esthesia services.

Advocates claim that this is an access to care issue. While Florida does indeed have a pending shortage of some types of physi­cians, it is vital to note that this shortfall is mostly in the area of primary care. Coinci­dentally, we are also projected to have a very serious shortage of nurses. According to the Florida Center for Nurs­ing, Florida in 2025 will need 50,000 more nurses than it will have on hand. No such deficit exists in the area of anesthesiology, and Florida law has this well covered by already per­mitting nurse anesthe­tists to practice to the full scope of their train­ing under nonanesthesi­ologist physicians.

Nurse anesthetists are respected members of the anesthesia care team and I work with them daily in my prac­tice. They are extremely competent and highly skilled individuals who can handle many situa­tions and circumstances related to anesthesia care. But when it comes to complex medical decision-making re­quired in certain types of surgical procedures or unexpected emergen­cies that may arise dur­ing even simple cases, physicians leading the anesthesia care team can make all of the dif­ference in achieving better outcomes. Addi­tionally, there are spe­cialized areas of an­esthesia where the ad­vanced training of med­ical doctors is crucial.

Finally, it is impor­tant to note that in an era of health care cost consciousness, physi­cian- led anesthesia teams cost no more than if a single person were providing that care – regardless of that per­son’s training. When it comes to anesthesia, the vast majority of insur­ers, including Medicare, pay for the anesthesia service provided and not based on who pro­vides it. Anesthesiolo­gists save additional dollars by effectively making patient triage decisions, preventing complications, increas­ing patient rescue rates, and limiting the need for additional doctors to be involved. The physician, therefore, adds a tre­mendous amount of value to the safety of anesthesia without cost­ing the system any addi­tional expense.

Florida has a time­tested, efficient, cost­aware, accessible sys­tem for providing safe anesthesia care to our families and friends. Lacking a demonstrable and compelling reason to change this success­ful formula, the Florida Legislature ought to err on the side of safety and caution and retain the physician supervision requirement over anes­thetists.

Dr. Jay Epstein is president of the Florida Society of Anesthesiolo­gists.

**********************************************

Just a couple days ago I read another related article, not addressing the advocacy for a change of giving more latitude to N.A. in Florida but rather one given the authority to meet much more common medical needs that Nurse Practitioners could effectively address to begin to provide care to many yet limited in scope with MD oversight in more complex issues requiring their input. It seems to be a common sense approach and would unleash the potential without creating a safety issue. Most Doctors would probably be resentful that a less trained individual would be permitted to treat most ailments at the onset but would necessarily refer more complex conditions to the MDs.


23Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 11:49 am

Joanimaroni

Joanimaroni

There are many Nurse Practitioner clinics around the country. There are also many physicians that hire Nurse Practitioners as well as PA's.

I'm sure you can always find physicians tthat are resentful of PA's and NP but for the most part they work well together. In fact, most offices I have been to employ either a PA or NP.

24Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 11:56 am

Floridatexan

Floridatexan

http://money.cnn.com/2013/07/01/news/economy/medicaid-expansion-states/

"...Nearly half the nation's states are opting not to expand Medicaid to all of their low-income residents, leaving billions of federal dollars on the table and millions of poor Americans uninsured.
At least 21 states are opting out of Medicaid expansion for next year. In another six states, legislators are still weighing their options, according to the Kaiser Family Foundation, which is tracking the states' plans.

The Supreme Court changed the Obamacare rules last June when it decided that governors and lawmakers could opt out of widening their Medicaid rosters. Under the original health-care reform law, all those earning less than 138% of the federal poverty line, or roughly $31,800 for a family of four, would have been eligible for Medicaid. Medicaid rules currently vary from state to state, but many states provide little to no coverage of childless, non-disabled and non-elderly adults..."

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

25Seriously, Florida, WTF? Empty Re: Seriously, Florida, WTF? 3/9/2014, 12:11 pm

Guest


Guest

Medicaid for all..!! (Except the ruling elite and unions of course) Yea collectivism..!! It'll definitely work this time.

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