The Sequestration Comes Home

The Sequestration Comes Home
One Woman’s Opinion
By – Sheri de Grom

I believe every man, woman and child will be affected by the failure of Congress and US CONGRESSPresident Obama to pass a national budget as required by law.

We saw what happened when air traffic controllers were furloughed. Because the resulting upheaval was so public and Congress wanted to travel immediately, Congress acted and the air traffic controllers went back to work.

I’m concerned about the portion of set-aside monies Congress instructed the Federal Aviation Administration to now ear-mark for salaries. The ear-marking of previously set-aside funds means something potentially vital to aviation safety will not happen because the monies have gone to salary and not its ear-marked purpose.

Of further concern, Congress has set a precedent for its own selfish interests ahead of the average citizen’s needs.

What about the Medicare patient with cancer now being turned away from his usual place of treatment? Congress hasn’t made an exception for this person.

It doesn’t sound like much when you read that Medicare providers (hospitals, doctors, stand-alone clinics, etc.) are now receiving reimbursements of ninety-eight cents on the dollar. That’s only a cut of two percent, but when you add up the total number of patients and the total cost of care and see what is actually reimbursed, the cost differential is staggering.

It’s important for everyone of Medicare age seeking treatment to call a facility or doctor first and determine if they are accepting Medicare as payment. Many providers will treat a person but in the fine print it will state it’s the patient’s responsibility to ensure their insurance company is a payer to the provider of care.

Many health facilities are no longer accepting new patients with Medicare and Tricare (the insurance for active duty and retired military personnel). If a facility has never accepted Medicare or Tricare patients, they don’t have to accept them now. Furthermore, providers of Tricare may opt-out when it’s time to renew their contract and many are.

If you’re headed to a national park this summer, expect visiting hours shortened at all three hundred ninety-eight parks. Thousands of seasonal workers will not be hired due to the sequester. According to National Park Service director, Jon Jarvis, visitors will encounter locked restrooms, fewer rangers and trash cans will be emptied less frequently.

The Department of Education is warning the parents of some seventy thousand students enrolled in pre-kindergarten that Head Start will be cut and fourteen thousand teachers will lose their jobs. For students with special needs, the cuts will eliminate an additional seven thousand teachers and aids. The Education Department is also warning that twenty-nine million student loans could be at risk.

I haven’t mentioned Homeland Security, the Food and Drug Administration, nuclear security, the Internal Revenue Service, the Department of Labor, the Department of Agriculture, and the Department of Defense in the above risks taken by Congress and President Obama. Each agency is vital to the welfare of our country. Our nation will eventually come to an operational stand-still without the freedoms set forth in the Constitution of the United States.

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About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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28 Responses to The Sequestration Comes Home

  1. Rachie – As long as we have citizens with minds knowing our government is wrong and willing to speak out, we will be on the winning side. It is when the people are silenced that real problems fester and take over the hearts and souls of mankind. Our leaders no longer have to be great speakers as they have speech writers and staffers that tell them what to think and what to say. Is it any wonder they don’t have an opinion of their own?

  2. I really don’t understand politics very well. Most political behavior seems so atrocious to me that I often can’t stomach it – maybe this happens to other people as well and we ignore it instead of taking action. How can the average person take action nowadays? I mean… I just can’t understand why it’s so hard for politicians to behave ethically in the best interest of the people instead of themselves. Are we all so blind that we elect them to higher and higher positions until they calmly flush us down the toilet? I wish I understood how the whole process actually works. Maybe you could blog on that? I’d like to hear it from someone I respect, ya know? Like “Legislation For Dummies” or something like that. I feel like if I understood things better I could problem solve ways to take action for positive change (at least in my head) better than just feeling like I have to sit back and watch the train wreck.

    • Rachie – Thank you for weighing in on this subject. The political agenda we are seeing played our for our conuntry is not what our founding fathers had in mind when they wrote the constitution. I believe they wrote the constitution based on equality for all, for honesty and integrity. We have none of that in our present legislative system. Our present congress is more concerned about what they are going to get out of something instead of how they can improve the lives of the people they represent.
      I honestly believe the media is at fault for many individuals not running for elected office. Many individuals who are more capable of holding the highest offices in the land won’t run for public office becuse they refuse to have their lives and the lives of their families drawn through the mud the media loves to sling. We’ve lost all hope of ever having anyone with true moral integrity being in office to represent the citizens of the United States.

      • All of that makes sense. I’m not a huge history buff, but I do like “founding father” history. I should probably read more about other time periods as well, but I find the early colonial period particularly interesting. THAT I can understand. I like to read the old documents, and it’s sad to me that a lot of people will probably go their whole lives without actually reading the Declaration of Independence or the U.S. Constitution. There’s a lot of really powerful concepts in those works that have been blurred out by all the crud politicians come up with these days. I also agree that the media is a huge factor in deterring potential candidates. I’ll admit I have secret daydreams of turning things around and inspiring people to grow as individuals and a nation. I know I would need to learn a lot, and grow a much thicker skin before anything like that. When was the last time we had a good orator? It seems like we lost the great speakers along the way. Their voices just grate on me with the lies they spew. Anyways, we can’t ever give up hope. If we give up hope then they’ve won. We can’t have that! 😛

  3. Jane Sadek says:

    I’ve been missing you blog! My mom fell and I’ve sort of been out of my normal schedule. Perhaps the first thing to be sequestered should be the legislative salaries and benefits. That might solve the problem once and for all!

    • Jane – I hope your mother is doing better. I’m not on Facebook much but I happened to catch your post about the time you were just getting settled at the hospital. My DH has also had additional medical problems and I’m somewhat behind on catching up with my blogging responsibilities. That’s the great thing about wordpress – our friends understand life goes on – and we’ll catch up with them because everyone knows that life does indeed go on. And yes, I so agree – let’s take the salaries and benefits from ‘The Hill.’ Let them feel the pinch for a change.

  4. Denise Hisey says:

    Sheri, as someone who works in the healthcare field I can attest to many doctors/providers dropping out of Medicare because of 1: red tape, 2: reduced reimbursements, 3: increased demands on the office including access to patient records ETC.
    I shudder to think of the upcoming shortage of providers for Medicare covered patients.

    • Denise – Thanks for bringing real world experience to the table. I’ve been a part of health care strategy sessions for both large hospitals and small 2 man offices. You are so right about Medicare being the most difficult to bill and receive payment from. Heaven help the facility that has to fight for an appeal. One of the trends I’m noticing is that many doctor offices in the area where I live are allowing major hospitals to buy them out. At that point they fall under the umberella of being a hospital out-patient clinic and are able to charge higher rates (the same a if the patient was still in the hospital). I can’t say as I blame them for doing this. They do have to earn a living. What I have a problem with is that hospitals that own these clinics are pushing patients out of the hospital before they are ready and then it’s up to the patient and/or their caregiver to get them to their respective appointments.

      • Denise Hisey says:

        Yes, it’s a real problem that is definitely not being addressed properly. The baby boomer generation is either going to have to revolt or start socking away money for medical bills.

  5. Well, we are certainly racing our way to “3rd world country” status just as fast as our little feet will carry us. I too write letters, make phone calls and send emails. I’ve even been known to walk in a protest and stand on a street corner holding a sign. It’s about as effective as screaming into the wind. But I do agree, we can’t give up. I really don’t think any citizen, Liberal or Conservative, is pleased, with the direction, this country is headed.

  6. This Congress is the least effective in history and the least respected. They seem to constantly be jockeying for future political appointments or elections instead of focusing on the job at hand. I’m thinking it would be more effective to choose random tax payers and have them spend six months in Washington replacing the current members of Congress – like jury duty. Then they could return home and another selection take their place. It couldn’t be any worse.

    • Renee – I like the way you think. I don’t think we could be any worse off and at least the citizens would know what it’s like to live in the real world!

  7. The politicians do the work for the big corporations, big banks, big pharma, when there supposed to be working for the common people who put them in office. I say sequester their pay, or dock them severely, as these shit heads don’t deserve the pay they get…

  8. Oh Sheri my friend, what a mess this is and has been for sometime. I believe we will see the citizens rise up and a civil war within our borders before this is over with (if it ever will be). It is because as you said our elected officials are willing to sell out for a meal of prime rib and a few cocktails, they could care less about the citizens that voted for them. I believe they get to Washington and classes are held to teach those that go in with good intentions (can a politician have those?) how to be more power hungry and and how to stick it to the voters. Thank you fir keeping us informed.

    • Hello Lynn – Thanks for reading with me. Yes, our government has never been in a bigger mess and I’m beginning to wonder if it will ever be fixed. I’ve come to believe one group of well-meaning citizens will never be able to put Congress back on track. As long as we have such a severe power struggle acting on our behalf, we’ll never see compromise in any form. My father, my very own John Wayne, has predicted civil war in this country for well over a decade. Dad is gone now but I remember his words as I watch what’s happening to each of us. How much longer can we maintain our status quo. My concern is that if we do reach civil war, we won’t know who our own enemies are. Our country has become so divided into factions. I’m not sure we can think for the common good.

  9. Oh boy, Sheri … you’ve hit a vital nerve that gives me the sensation of electricity buzzing through my brain. I wish I could believe that because there are still a few who are willing to call Congress out on their continuing practices to negate the public’s welfare that change is still possible.

    Not that I want to be a major downer nor do I want to see folks like you throw in the towel … it’s just that we seem to be blowing in the wind. Because Congress and our governent has already worked out (like corporations with acceptable risks) that if a few thousand are hurt they can be chalked up to acceptable loss.

    You wonder how much more can be cut and still have a healthy nation? I don’t think we’ve been a healthy nation for decades but because the changes came so slowly at first, almost invisibly, we have lost control of our government and lost the vital resources needed to bring it back to full health. And that’s my Monday take on the state of the nation 🙂

    • Florence – You are correct in that we haven’t been a healthy nation in decades. We’ve entered wars that IMO we should have stayed far away from. We’re still calling Viet Nam a conflict and we fought it to stop the rise of communisim and you know that didn’t work. Then before that we fought the Korean war based on the same principle. We had to stop the rise of communisim. I don’t believe we made even a ‘drop in the bucket’ as my grandmother used to say. We went to Panama, the Gulf, and then led blindly into Iraq by the Bush Dynasty. It was further perpetuated as we moved into Afghanistan and I ask you for what. The Afghanistan forces we are training are killing our service members. I think about the multiple billions of dollars we would have had to spend on education, rebuilding our own infrastructure, health care, feeding the poor, and the list goes on. I sincerely believe our country is more at risk than it has ever been – but that’s just my 2 cents worth.

  10. Robyn Lee says:

    So disconserting Sheri ~ these are all very important issues… Medicare especially — I fear this real possibility that doctors and hospitals will loose incentive to treat… frankly it is appalling. Thank you for for being a voice to defend and educate others — our constitutional freedoms are worth fighting for!! Love to you dear friend ~ RL

    • Robyn – Along with you, I see the erosion of medical care on a daily basis. It is a scarry proposition indeed. I wonder, how much more can be cut and still have a healthy nation. Sometimes I want to go back to writing pieces of lightness and leave this discouraging arena of government we find ourselves in. Thank you for reading with me.

  11. Don’t know where they come up with the 98% figure on medicare reimbursements. In real life, it’s more like 50%, which discourages doctors & hospitals from wanting to treat us.

    • David – You may be seeing the amount the physician/hospital billed for a service and then the negotiated rate the physician/hospital said they would accept for the service. This is always about 50% of what the actual amount billed is. Medicare knows they have the negotiated rate locked in and the 2% less they are paying is on the previously negotiated rate. The medical profession negotiated their original rates based on what they thought they could survive at and now they have another 2% reduction placed on top of that. Presently, physicians who currently treat patients with Medicare cannot discontinue doing so. However, they do not have to accept new patients. One of the problems healthy seniors run into is that when the time for a specialist arrives, they are unable to find one that accepts Medicare and they are locked out because that particular physician did not treat them before they reached Medicare age.

      My advise to anyone within five to ten years of reaching Medicare age is to start lining up speciality doctors even if you don’t think you actually need them now. At a minimum, have on board the following specialist: heart, gastro, neuro, urologist, endocronoligist, and if you have joint and muscle issues you’ll want someone in that speciality also. It’s never to early to begin your long range planning.

  12. AACK! Sheri, I read this and want to cry. What in the hell can the average citizen DO? I vote for my liberal senators and house reps and I voted for Obama and yet reading this post makes me wonder if I should have bothered at all, since everything’s so messed up anyway.
    When petitions come through on the internet I sign them and yet it SEEMS that our reps are ignoring the people. What do they expect us to do? Take this lying down? I think not. But do protesting and writing letters do a damn thing anyway? Must the American people unite in another fashion? If so, what IS that fashion? Ah, such a quagmire.
    Patti

    • Patti – I hate to keep dishing up discouraging dirt on Monday morning. Perhaps that’s the reason my Morti and Me is my all time high for hits of all blogs I’ve published. He was the sweetest most loving creature and all he ever asked for was his saucer of cream and a warm body to curl up with. In the fine reality of life, isn’t that what most of us want. I for one can relate to the need of knowing where my next meal is coming from and having the tight arms of unconditional love wrapped around me at night. I like to subscribe, from time to time at least, that the combination of the two will keep the boogie man away.
      In days gone by, make that many days gone by, when I worked the hill for the Deartment of Defense, I felt I made a difference. I was able to see legislation slowly inch its way forward until something good happened for our military men and women. Now, we have committees made up of weak legislators that are willing to sell their souls for a double scotch at a Georgetown bar on any weeknight. (Excuse me while I get a little wild with my frustration here). Like you, I’ve pretty much given up on signing petitions. I do make phone calls on matters I feel strongly about and follow those phone calls up with a letter stating what we talked about. I’m still not convinced that help any longer either. On a final note, we can’t give up. This is our country.

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