Thursday, June 17, 2010

Mike Cady to run for Orphans’ Court for Frederick County, Maryland

The following was received via e-mail and hand delivery from Mike Cady:

Please be advised of my [Mike Cady photo right with Kent Courtney] announcement to register as a candidate for the Orphans’ Court for Frederick County, Maryland. Some may be confused as to the purpose and duties of the Orphans’ Court.

The Orphans’ Court consists of three elected judges who are responsible for the supervision of estates that must go through probate. They may also appoint guardians for the person and property of minors (under age of eighteen). The Orphan’s Court convenes several times a week to conduct formal hearings involving estate and guardianship disputes and rule on petitions regarding them.

Having served as Vice President of the Frederick County Board of County Commissioners from 2002 to 2006, I feel both qualified and prepared to serve the county in this capacity. As a Commissioner, I was involved in numerous administrative and quasi-judicial hearings, and presided over many of them. In addition to my duties as a Commissioner, I also actively served as Commissioner Liaison to the:

Adult Public Guardianship Board
Child Advocacy Center
Substance Abuse Council
Commission on Disabilities
Coalition for the Homeless
Board of Education
Planning Commission
Tourism Council
Parks & Recreation Commission
Weinberg Center for the Arts

For more information, please contact Mike Cady.


SAY WHAT! By Mike Cady

We are one step closer to Socialized Medicine!

Yes, it is true; with the enactment of the Patient Protection and Affordable Care Act (otherwise known as ObamaCare) our country moved one monster step closer to having socialized medicine. However, the socialization of our health care delivery and finance system did not start with President Obama. In fact, for the past sixty-four years, our government (at every level) steadily worked toward the elimination of the “fee for service” payment system and doctor / patient relationship we once knew and valued.

To better understand how we got to where we are today, a brief review of key legislation may be helpful.

Hill-Burton Act (The Hospital Survey & Construction Act of 1946) - The Act provided federal grants and guaranteed loans to improve the physical plant of the nation’s hospital system. Money was designated to the states to achieve 4.5 beds per 1,000 people. Facilities that received Hill-Burton funding had to adhere to several requirements that included the provision of free care. The cost of such services was then built into hospital rates for others to pay.

Social Security Act (Title XVIII and XIX) in 1967, Medicare was implemented. It provides comprehensive health care services to disabled citizens and those 65 and older provided they are otherwise eligible for Social Security benefits. While providing needed coverage to a huge population, Medicare also controls participating physicians’ fees, length of hospital stays and what treatment may be rendered. Starting the following year, Medicaid was initiated in many states (including Maryland). It provides limited services to indigent families with greater government imposed restrictions on health care providers than Medicare.

Health Services Cost Review Commission In 1974, Maryland was one of the first states to enact a cost review commission. The Commission sets the rates that hospitals charge.

Health System Agency(HAS) In 1975, a HSA that served a specific geographic region was delegated a role in determining whether the state will approve an application for a new or converted, expanded, or otherwise significantly modified health facility. In other words, the state government controlled if a hospital could expand or modernize, and what services it may offer its community.

With these legislative initiatives came an abundance of allied groups that added layers of bureaucracy to the delivery of health care services and further imposed upon the doctor / patient relationship. They included: Utilization Review Committees, Medical Care Foundations, Peer Review Committees, Quality Assurance Programs, etc. However, for the past twenty-five years, the health care system was void of any additional major government intrusion into our health care. In fact, with the passage of HIPAA (Health Information Privacy Act), the government guaranteed that our medical history would be protected and shared only with entities we expressly approved. In this electronic era, this legislation was sorely needed.

Then came ObamaCare. On March 23 of this year, President Obama signed into law the Patient Protection and Affordable Care Act. Beware, the more endearing the title of legislation, the more suspect it is. The question asked and not yet answered is, affordable for whom – probably not the taxpayers or employers. In the words of Kathleen Sebelius (Secretary of Health & Human Services), ObamaCare “will provide you and your family greater savings and increased quality health care”. If this turns out to be true, to my knowledge it will be the first federal entitlement program to achieve such lofty goals. Certainly, Medicare and Medicaid missed this mark since health care costs have escalated faster than any other industry since their inception.
It is very difficult to wrap your arms around the ObamaCare Program and succinctly define its components. Core concepts include:

All individuals will be required to obtain health care coverage or pay penalties. Empolyer provided coverage will generally meet this requirement.

Lower income will receive a credit or voucher to help pay for health insurance.

Employers currently offering health insurance can elect to continue offering coverage as long as their plans meet certain minimum requirements.

Employers electing to not offer qualifying coverage will be subject to additional taxes. Exceptions will be made for small businesses.

As we all know, the devil is in the detail. Here are just a few concerns that you may wish to monitor to ensure that you do not end up with less coverage for more money.

Lose your current insurance and doctor - CNN reported that some large employers may drop their current health care plans they now offer their respective employees because ObamaCare makes it much cheaper for these employers to convert their employees into the government controlled health exchanges and pay a penalty for not insuring them.

Children covered up to age 26 – Most insurance coverage covers children up to the age of 19 or up to 25 if they are a full-time student or disabled. However, ObamaCare extends coverage of children up to age 26, regardless of student status. As a result, just from this provision, insurance rates will increase a minimum of one percent. Associated Press reported that it will cost $3,380 for each adult dependent in 2011.

Physician owned hospitals will suffer – Frederick County is blessed with a single outstanding hospital (Frederick Memorial) and its complete system that provides outpatient laboratory, radiology, surgical, physical therapy, home health and other services. This is very unique as most communities rely on a variety of facilities, including physician owned hospitals. Under ObamaCare, physician owned hospitals are subjected to restrictive regulations that include a ban on expansion, limitations on new investments, additional reporting requirements and fines for failure to comply with new transparency rules that apply only to them.

Shortage of physicians, especially general practitioners – Obamacare does absolutely nothing to address doctors’ ever growing and legitimate concerns about the cost of malpractice insurance, substantially low reimbursement rates for government sponsored programs, and the never ending paper-work required of them. The results of which may drive more general doctors out of their offices like we have already witnessed in some specialties (e.g., OB / Gyn).

Employers may be fined for providing current coverage – Under ObamaCare, employers may be fined for not providing their employees with what the government defines as an appropriate level of coverage. According to Mercer (a human resource consultancy) “38% of the nation’s employers have at least some employees for whom coverage would be considered unaffordable under the newly enacted Patient Protection and Affordable Care Act”. So, what do they do to avoid penalties? One option is to cancel their current high-end coverage and go with the ObamaCare option with fewer benefits. However, because all of the regulations are not yet promulgated, many details are not yet know.

Thus, the debate about the delivery and financing of our national health care system is not over. The enactment of ObamaCare was Phase one and two phases remain to be formed. The next two phases are how the state and local governments will reform health care in their jurisdictions. These debates will provide all of us with an opportunity to let our thoughts be known and impact the outcome.

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