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March Madness!

By Big Tent Democrat, Section Blog Related
Posted on Thu Mar 20, 2014 at 07:52:03 AM EST
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Main draw begins play today.

My picks today: Michigan -16 over Wofford, Cincinnati -3 over Harvard, Connecticut -4½ over St. Joseph's, Michigan State -14 over Delaware, Pittsburgh -6½ over Colorado, BYU +5½* over Oregon, Ohio State -6 over Dayton, Wisconsin -13½ over American, Syracuse -13 over Western Michigan, Albany NY +21 over Florida, Arizona State +2* over Texas, Wisc-Milwaukee +16½ over Villanova, Oklahoma -3 over North Dakota State, Louisville -16½ over Manhattan, San Diego State -7 over New Mexico State, and NCState +3* over St Louis. (Asterisk indicates lower seed outright winners.)

Go Gators!

Open thread.

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    March Madness! | 128 comments (128 topical)

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    I like Wisc-Milwaukee (5.00 / 1) (#5)
    by Dadler on Thu Mar 20, 2014 at 11:04:21 AM EST
    That spread seems way too high. But if Villanova can hit their open jumpers it won't be.

    Thanks to you and BTD (5.00 / 2) (#7)
    by Towanda on Thu Mar 20, 2014 at 12:15:54 PM EST
    on behalf of my favorite tonight, too.

    Fyi, the game is on TBS, and for those not near a tv tonight or not with cable, I'm betting that jsonline.com will be live-blogging it.

    (jsonline.com is live-blogging the Badger game now, for any other Badger fans. C'mon, Bo, get the guys settled down, after missing 9 of 10 shots in a row.  Time to play like the team favored by double digits.  Time to finally go to the Final Four.)

    Parent

    p.s. I do have to agree, too (5.00 / 2) (#8)
    by Towanda on Thu Mar 20, 2014 at 12:19:38 PM EST
    that the spread is too high -- because of the average heights of the teams, alone.  The tallest for UWM is Tiby, but is a transfer this year and a sophomore.  The leading scorer for UWM, Aaron, is a different sort of player for the team, coming from NYC, and brings a lot to it -- but he is only 5-10.

    What works for them is their "swarm."  The first few minutes may tell us if that works against Vnova.

    Parent

    Towanda! (5.00 / 1) (#15)
    by Zorba on Thu Mar 20, 2014 at 03:47:09 PM EST
    Good to hear from you.  It has been awhile.  Take care!

    Parent
    Also glad to see she's around (5.00 / 5) (#16)
    by jbindc on Thu Mar 20, 2014 at 03:50:53 PM EST
    Even if her name has been taken in vain elsewhere.

    Parent
    Go Phoenix!! (none / 0) (#11)
    by Dadler on Thu Mar 20, 2014 at 02:34:38 PM EST
    Burn 'em.

    Parent
    Ah, wel.. 'Nova held Jordan Aaron (none / 0) (#55)
    by Towanda on Thu Mar 20, 2014 at 11:23:15 PM EST
    -- UWM's leading scorer -- to 0 of 10 from the start, until he finally scored at the free-throw line.  But that was the game, right there, because of 'Nova's height. as Aaron is only 5'10.  At least his family in NYC, which couldn't afford to come see him play at home, finally got to see him there.

    Parent
    Regarding eliminating top cancer centers (5.00 / 2) (#17)
    by MO Blue on Thu Mar 20, 2014 at 03:55:06 PM EST
    from exchange networks.

    It is a false claim that the same cancer treatments are available at all hospitals.

    There is a very definite reason that doctors from inside and outside the St. Louis area (often from out of state) have sent their patients to Siteman Cancer Center. The reason is that Siteman provides treatment options that are not available in hospitals in their area.

    Just ask anyone who has traveled to Siteman (or other top centers) for their treatment or for treatment of their loved one. Decide if you want to believe the doctors and the patients sent for specialized treatment or if you want to believe the ramblings of a health insurance employee. To try and use the statement below as a justification of eliminating top cancer centers is one of the lamest rationalizations our insurance spokesperson has come up with yet.

    The unique role of cancer centers is recognized under Medicare. Several are exempt from its hospital payment system, instituted to control costs.

    The pertinent facts regarding this exemption is 1) that it exists due to seriousness of the illness and Medicare recognizes that people must have the option to receive the best treatment possible and 2) this exemption is not part of Obama's insurance legislation.

    To depict the fact that this Medicare exemption does not include each and every cancer center as proof that eliminating them from networks on the exchange in MO and other states is just fine and dandy is not an honest argument. The unique role of cancer centers is not recognized in the exchanges.

    To state that people who have sufficient funds  can choose coverage that provides care at the facility they want as long as they are willing to pay a much higher premium ignores the fact that many of the sickest people cannot afford the higher premiums and the high deductibles that come with those PPO plans.  The options do NOT exist for people on the lower income scales.

    Insurance Spokesperson (5.00 / 1) (#18)
    by vicndabx on Thu Mar 20, 2014 at 04:36:47 PM EST
    I'm not, I just work there.

    Just like I'm sure you're not a spokesperson for Cancer Centers.  

    You have a perspective based on experience and information, as do I.

    I'll try not to put words in your mouth, won't you try affording me the same courtesy?

    This blog would go much better if everyone tried that.

    The fact remains that EXEMPTIONS, networks, etc., whatever you want to call them - are not a new problem and exist even w/in Medicare (which was my point) and yes, even for those services that are potentially life-saving.  I never said it wasn't an inconvenience and a cause of hardship.  That you inferred something I didn't state indicates the problem lies w/you.

    You made this assertion:

    Bottom line, it become a way to avoid covering costly preexisting conditions at no extra costs.

    Your implication that an insurer is scheming to not cover preexisting conditions - when treatment, however costly - will be covered at other facilities is what I took issue with - not specialized treatments available only at Siteman.


    Parent

    Doctors send their patients to Siteman and other (5.00 / 3) (#20)
    by MO Blue on Thu Mar 20, 2014 at 05:13:32 PM EST
    top treatment centers precisely because the specialized treatment is not available elsewhere.

    It is not just my implication that insurers want to discourage people with costly ailments from purchasing their policies as you would know had you read what has been written on the subject.

    By not including a top cancer center, an insurer can cut costs. It may also shield itself from risk, delivering an implicit message to cancer survivors or people with a strong family history of the disease that they should look elsewhere.

    For now, the issue seems to be limited to the new insurance exchanges. But it could become a concern for Americans with job-based coverage too if employers turn to narrow networks.

    These concerns are shared by doctors, hospitals and health care advocates.  

    Even the Obama administration has identified these narrow networks as a problems that needs to addressed.

    The Obama administration says it has notified insurers that their networks will get closer scrutiny for next year in the 36 states served by the federal exchange. Cancer care will be a priority, it says.

    As far as the Medicare exemption is concerned you turned the exemption around completely thereby distorting its intention. The exemption was to make sure that Medicare patients could access care at a large number of top cancer centers and not to restrict needed care.

    You never said it wasn't an inconvenience and a cause of hardship since you failed to address that subject at all. Not one word.

    Here is what you did say about someone getting the treatment that they need:

    ...people can choose coverage that provides care at the facility they want.  It may not be the lowest cost plan, or may not be w/the insurer they want, but the options do exist.

    So bottom line, if have enough money to pay the higher PPO premiums and deductibles they can choose coverage that provides care at the facility they want and with the doctors of their choice. If they cannot afford the higher costs, they are basically SOL.

     

    Parent

    Those with sufficient resources have (5.00 / 4) (#22)
    by Anne on Thu Mar 20, 2014 at 05:38:36 PM EST
    always been able to get the care they need where they want to get it, but what is happening now, with these narrow networks, is kind of a non-denial denial, in which the insurance company has not specifically said, no, we won't cover your care, they're saying, no, we won't cover it here, or here or here, but you can go there.

    For many people, it's the equivalent of "no," and it ends up working out really well for insurance companies if the subscriber chooses not to fight it, or not to get the care.

    It's why insurance companies routinely would say no - because a lot of people will just stop right there, won't take it to the next level.  All the better for the insurance company, and the narrow network thing is just the latest in that effort.

    I just don't understand why people didn't expect that, having been required to provide certain kinds of coverage, insurance companies would find other ways to mitigate the outlays for those coverages.

    Parent

    More news on this yesterday (none / 0) (#65)
    by jbindc on Fri Mar 21, 2014 at 08:55:17 AM EST
    Got Obamacare, can't find doctors

    (my bolding below)

    Limiting access to providers isn't new, but it is becoming more common as the Obamacare exchanges expand coverage to more people. So many people have complained that the Obama administration said last week it will require insurers in 2015 to maintain networks that provide enrollees with access to doctors "without unreasonable delay."

    McKinsey looked at how hospital access in 20 cities has changed over the past year for those buying individual policies. Last year, 33% of the offerings contained narrow networks. This year, the same carriers are offering more policies, but 68% of the options have limited networks.

    Narrow networks were defined in the study as those with fewer than 70% of the city's top 20 hospitals participating.

    Narrow networks, however, don't mean inferior care, said Jessica Ogden, associate partner in McKinsey's healthcare practice. The hospitals in the narrower networks scored similarly in the Centers for Medicare and Medicaid Services' quality and patient satisfaction metrics.

    Some Americans, particularly those who were uninsured before, may not care if they can only go to certain providers. But others are dismayed that their current doctors aren't in the plans or that they can't go to the ones they think are best for them. Still, others say there are local doctors listed in their networks, but they can't get appointments or the providers aren't accepting new patients.



    Parent
    We are talking about two different things (none / 0) (#29)
    by vicndabx on Thu Mar 20, 2014 at 06:57:41 PM EST
    the exemption I referred to was that even Medicare does not cover all services everywhere - even life saving cancer treatments.  Which was why I linked to info on clinical trials as an example.

    Be assured I understand what a PPS is and if a hospital is paid at a certain rate (or not) and thus is "par" or not.

    You misunderstood the meaning of the highlight.  My focus was on the word "several" as indicated by the words that followed the block quote.

    Several, not ALL.  How is that any different from a network

    So no, there was no distortion attempted and I don't ramble.  Again, just say you disagree and make your points.  Personal attacks questioning the meaning and credibility of what I post are unnecessary.  Better to ask for clarification.

    Parent

    All BJC hospitals (5.00 / 3) (#49)
    by MO Blue on Thu Mar 20, 2014 at 09:55:12 PM EST
    which include Siteman Cancer Center and the Center for Advanced Medicine are in the Medicare networks.

    People on Medicaid are able to go to Siteman, the Center for Advanced Medicine and their children are able to be treated by the St. Louis Hospital.

    The narrow networks on the exchange implemented by the private insurance industry  are the ones excluding the top cancer centers and the top children's hospitals.

    Parent

    True, at the request of consumers, not arbitrarily (5.00 / 1) (#63)
    by vicndabx on Fri Mar 21, 2014 at 08:19:28 AM EST
    and not with nefarious intent as you always imply.
    The Morning Consult - September 23 Tracking Poll: A majority of people (58 percent to 42 percent) prefer "less expensive plans with a limited network of doctors and hospitals" to "more expensive plans with a broader network of doctors and hospitals."

    Polling indicates Dems support is highest. Same holds true for all age groups except seniors.

    Link

    Look, I'm not saying these providers aren't great at what they do. I am saying that outcomes at these facilities when looked at on a macro level are likely not significantly different from outcomes at network providers.

    Parent

    Something tells me if you are one of those (5.00 / 1) (#67)
    by MO Blue on Fri Mar 21, 2014 at 09:21:56 AM EST
    at the micro level whose outcome depends on the specialized treatment they provide you will not be thrilled to know that your death is just part of the "big picture." After all lets look at things at the macro level and not at the health care needs of individuals.

    The health insurance companies have a track record of operating with nefarious intent and are still devising ways to get around the system. Just two of many examples:

    Anthem Blue Cross has reached a settlement with the California Department of Insurance and will pay a $1 million fine and reinstate 2,330 customers whose coverage was rescinded after submitting paperwork for bill payments, Insurance Commissioner Steve Poizner said Wednesday.
    ...
    "The settlement is a significant step towards ending illegal rescission practices that can devastate consumers already weakened in their battle against illness," Poizner said in a statement.

    The insurer has already settled with California's Department of Managed Health Care regarding the rescinded policies. That settlement brought a $10 million fine and the reinstatement of 1,770 policy holders.

    2013

    The lawsuits, filed Monday in Superior Court, may signal an emerging customer pushback against the approximately 900,000 cancellations in California alone of individual health insurance policies that will take effect Dec. 31.
    ...
    The two lawsuits allege that Anthem Blue Cross, California's largest insurer and a unit of insurance giant WellPoint Inc. (NYSE:WLP), deceptively enticed tens of thousands of Californians to switch out of their grandfathered plans, a practice known as "twisting," in violation of a state law and to cut its own costs.


    Parent
    It has always existed in Tricare too (none / 0) (#124)
    by Militarytracy on Sat Mar 22, 2014 at 11:33:41 AM EST
    And exclusions and new inclusions happen all the time.  I don't think Walgreens will take Tricare.  I don't know if they ever worked it out and I only use private pharmacies when on post is failing me, so I simply moved my business to CVS now.  And it works out great for me because CVS has pledged to quit selling cigarettes and other tobacco products.  For me, they are earning my business.  

    Parent
    It is not just the top cancer centers, (5.00 / 4) (#19)
    by Zorba on Thu Mar 20, 2014 at 04:44:01 PM EST
    MOBlue.
    It also includes patients who have any kind of difficult to treat problems.
    My father had all kinds of heart problems.  He got stellar, top-of-the-line care at Barnes-Jewish (BJC) in St. Louis.  (In fact, in his later life, when he went into the Veteran's Administration to get his heart drugs for a cheaper price, which he was able to, he asked the cardiologist at the VA if he should switch his heart care there, and the MD at the VA said, "Oh, no.  Keep going to Dr. X at BJC.  He was my mentor, and he is one of the very best in the country.")
    So my dad did.  BJC and its doctors gave him a much, much longer life, with an excellent quality of life, than he would have been able to get elsewhere.
    If he had not been able to access the care at BJC (which he was able to do because of Medicare and his decent supplemental plan), he would have died years before he did.
    And he could not have afforded that care otherwise.
    This was, of course, years ago, well before the current ACA kicked in.
    My siblings and I are just grateful for the excellent care, and extra years, that our dad had.  And thank you very much, BJC.  I only hope and pray that others in the area can access that same excellent health care.    

    Parent
    BJC's Center for Advanced Medicine (5.00 / 2) (#23)
    by MO Blue on Thu Mar 20, 2014 at 05:40:24 PM EST
    is superb. Another causality of the narrow networks is St. Louis Children's Hospital.

    Washington DC - June 5, 2012 - The U.S. News & World Report Honor Roll of Best Children's Hospitals will again include St. Louis Children's Hospital, which ranked in all ten specialties covered by the annual report.  Only 12 children's hospitals nationwide qualified for the honor roll distinction.

    "St. Louis Children's dedication and expertise reach across multiple pediatric specialties, as shown by its Honor Roll listing," said U.S. News Health Rankings Editor Avery Comarow. "Our goal at U.S. News is to identify and call attention to pediatric centers like St. Louis Children's that help the sickest kids."

    The report considered ten specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology.
    ...
    The hospital's success draws from its ability to provide more than today's best medicine. "We provide tomorrow's medicine," explains Dr. Alan Schwartz, Chairman of the Department of Pediatrics at Washington University School of Medicine and Pediatrician-in-Chief at St. Louis Children's Hospital. "St. Louis Children's Hospital provides an immediate application for some of the most promising scientific discoveries at Washington University School of Medicine, its academic partner."



    Parent
    More on not having access to St. Louis (5.00 / 2) (#25)
    by MO Blue on Thu Mar 20, 2014 at 06:01:09 PM EST
    Children's Hospital.

    St. Louis Children's Hospital is ranked as one of the top 10 best hospitals in the U.S. that treats critically ill children, according to a report, released Tuesday, by U.S. News & World Report.

    Gee, I wonder why Aetna Blue Cross/Blue Shield won't cover children getting treatment at St. Louis Children's Hospital.

    Critically ill children tend to be real expensive.  

    Parent

    Well (none / 0) (#31)
    by Ga6thDem on Thu Mar 20, 2014 at 07:11:18 PM EST
    we only have one here in GA and it's Emory. This is probably not going to be a problem in GA as long as you live in Metro Atlanta because it's probably on all the networks. I mean I believe Emory takes Medicaid, everything.

    The problem is going to be for the rural areas but in all honesty I'm willing to be Emory was out of network for most PPO's and HMO's here in GA outside of Atlanta already. I know that when I lived in Central GA Emory was not on my plan.

    I am wondering though if you could get a rider to get treatment at a cancer center if you could prove that you cannot get treatment locally.

    Parent

    I think it might be more of a state by state (none / 0) (#32)
    by CaptHowdy on Thu Mar 20, 2014 at 07:18:04 PM EST
    Problem.   I am rural and my plan includes virtually every doctor and med center we could think of.  We were going through the book and even the specialists my sister was going for treatment of breast cancer were included which is a specialized cancer center.

    Some problems are not with the law but surprise With the insurance companies.

    Parent

    Here in (none / 0) (#34)
    by Ga6thDem on Thu Mar 20, 2014 at 07:41:33 PM EST
    GA the rural areas are getting snockered because their premiums are higher and they have less choices. For example southwest GA has only on provider to choose from and it's more exepensive than what people pay in Metro Atlanta like twice as expensive. The insurers say this is because there is only one hospital which is true but surely those rural hospitals do not cost more than the ones in Atlanta? And it's not like Nathan Deal is going to do anything to help the people. He will end up closing the rural hospitals with what he is planning to do.

    Parent
    Unique among red states (5.00 / 1) (#38)
    by CaptHowdy on Thu Mar 20, 2014 at 07:49:08 PM EST
    And actually blue states AR is using the Medicaid money to allow people to buy private insurance.  It recently survived an attack from the right to survive another year.

    We have a dem governor

    Parent

    Yes, we are happy that one of our progeny (5.00 / 1) (#39)
    by Towanda on Thu Mar 20, 2014 at 08:11:14 PM EST
    moved to Arkansas, too, from a state with a Repub governor who is refusing federal funding and pushing many thousands of people off Medicaid and more.  

    My stepson, formerly a construction worker, broke his back and cannot work fulltime now.  The weather -- that is, being away from bitter-cold weather -- also is making it more possible for him to handle parttime work.  His call a week ago about finally getting health insurance coverage made our day, too.

    Parent

    Glad to hear it (5.00 / 1) (#40)
    by CaptHowdy on Thu Mar 20, 2014 at 08:17:45 PM EST
    It was a very bitter and prolonged fight in the state house.  They were actually threatening to refuse all Medicaid money and some one realized that the biggest recipient of Medicaid money in the state is old folks in nursing homes so it was rethought.  There has been mostly good healthcare news here recently.   At least compared to other red states.

    Parent
    Glad (none / 0) (#73)
    by Ga6thDem on Fri Mar 21, 2014 at 09:49:44 AM EST
    you at least have some fighting Dems there in AR. Of course, they are way outnumbered here with the nuts but there has been a lot of grassroots pushing for something to be done about the very large problems GA has. Apparently Deal is more worried about losing in the GOP primary than he is concerned about the general welfare of the residents of the state of GA. These people reside in the talk radio bubble.

    And he's an idiot if he thinks deny people care because they don't have insurance is going to keep rural hospitals in business. They are still going to go out of business because no one has health insurance in rural Georgia.

    Parent

    Follow the money... (none / 0) (#122)
    by Mr Natural on Sat Mar 22, 2014 at 10:54:06 AM EST
    the realization that the biggest recipient of Medicaid money in the state is old folks in nursing homes.

    In other words, the legislators "heard" from the nursing home lobbyists.

    Parent
    Was that in lieu of expanding (none / 0) (#42)
    by Anne on Thu Mar 20, 2014 at 08:24:22 PM EST
    Medicaid itself, do you know?

    Glad you were able to get good coverage, Captain; the last thing people need to be stressing over is what they're going to do if they need care, and how they're going to pay for it.  I would think people would be healthier just by not having that worry.

    Oh, and since I noticed you've been having some trouble with links, and because I know Jeralyn's going to say something, because the long-form links skew the site, here's a refresher on linking (although it may be a function of your trying to do it on an iPad?):

    1.  highlight the url you want to embed; click "copy."

    2.  go back to your comment and highlight the text where you want the link to be.

    3.  Click on the little "link" symbol above the comment text box.

    4.  Click into the box that appears, right click and select Paste.

    5.  Click OK.

    I usually preview the comment and make sure the link works before I post the comment.

    Parent
    Btw, on healthcare (5.00 / 1) (#45)
    by CaptHowdy on Thu Mar 20, 2014 at 08:54:34 PM EST
    You are so right.  I retired early, at 60, and have lived without coverage for the last two years.  A frightening thing for a senior citizen. It was a choice .  I could have worked and had employer insurance but I was ready to stop working so I rolled the dice.  It turned out well but could have easily been otherwise.  But having coverage, knowing that if I get sick I can actually go to a doctor is great and wonderful gift.  And I have lived my whole life with great employer based insurance.  I can't even imagine what it's like for people who have literally never been covered.
    During my pharmacy nightmare I got to know the people at the local pharmacy well and one of them told me a story.  And old lady came in with some problem and a new prescription card and the pharmacist said you know you should really go next door and have that looked at.  "How much do you think that would cost?" She asked.  20 bucks the pharmacist said you are covered.  The old lady started crying and headed off to see the doctor.

    Parent
    On Medicaid (none / 0) (#43)
    by CaptHowdy on Thu Mar 20, 2014 at 08:44:27 PM EST
    It is yes.  It was a compromise between the blue gov and red legislature.  Apparently it is something othe red states are looking at.  It seems to be working reasonably well.

    On links , sigh

    Thanks for the tips I will review them but the problem really is the iPad.  It's weird when I got it I was totally unprepared for how much I love it.  But it does make some things difficult.

    Parent

    The plight of rural hospitals in GA (none / 0) (#37)
    by CaptHowdy on Thu Mar 20, 2014 at 07:45:10 PM EST
    Is a national story.

    Parent
    It's what they bill and there's no competition (none / 0) (#44)
    by vicndabx on Thu Mar 20, 2014 at 08:49:47 PM EST
    But insurance brokers and health policy experts said that Phoebe's rates for private insurers are higher than they would otherwise be to make up for the money the system loses when it cares for the large uninsured population. Aside from MillerCoors and Procter & Gamble, there are not a lot of large employers that hospitals and doctors usually rely on for rich payments. "At the end of the day, if you're an institution this size and you've got a small commercial population, you've got to get that money from somewhere," said John Crew, a Savannah consultant to hospitals and physicians.

    WAPO Link

    Parent

    Well, (none / 0) (#85)
    by Ga6thDem on Fri Mar 21, 2014 at 11:07:36 AM EST
    yes but this is unlikely to change because GA refused the Medicaid expansion. So in other words people are still not going to have insurance because it is still unaffordable for them.

    Parent
    The BJC hospitals take Medicaid (none / 0) (#51)
    by MO Blue on Thu Mar 20, 2014 at 10:07:01 PM EST
    Medicaid is not the problem for those who are able to get it here in MO. If you are on Medicaid you can go to Siteman Cancer Center, the Center for Advanced Medicine or to Children's hospital and get the same great treatment as some one with great employer insurance or a high premium policy. Prior to implementing the exchange, the BJC system was part of all the networks for HMOs and PPOs etc. They were included in Aetna Blue Cross/Blue Shield networks as well.

    The problem is with the insurance policies offered on the exchange by the private insurance industry. We have only 2 providers offering policies on the exchange here in MO. Aetna Blue Cross/Blue Shield has excluded them from all of their policies offered on the exchange. The only other provider on the exchange only includes them on the network of their higher priced PPO policies.

    Parent

    If they (none / 0) (#74)
    by Ga6thDem on Fri Mar 21, 2014 at 09:53:13 AM EST
    are taking Medicaid then it makes no sense for them not to be on insurance plans. If they are willing to take low payments from Medicaid this really makes it very strange.

    Parent
    Strange or not (5.00 / 1) (#86)
    by MO Blue on Fri Mar 21, 2014 at 11:28:56 AM EST
    From an article published by Siteman promoting screening for breast cancer:

    If women are diagnosed with cancer, many are eligible for Medicaid, which pays for their treatment by Siteman breast oncologists and surgeons.

    If you google BJC and Medicaid, you will find that each BJC hospital, treatment center or physician group accepts Medicaid.

    According to nurses and patients I talked to while I was receiving treatment at Siteman, Medicaid patients made up a fairly large percent of their patient population. I've tried to locate the exact percentage but evidently I'm not using the correct criteria in my google search.

    Parent

    This sounds (none / 0) (#97)
    by Ga6thDem on Fri Mar 21, 2014 at 12:36:11 PM EST
    more like pay for play than anything else. If it was only money the insurance companies would be having them on the exchanges.

    Parent
    The BJC facilities treat (5.00 / 1) (#99)
    by MO Blue on Fri Mar 21, 2014 at 01:27:18 PM EST
    a high number of seriously ill people at the Siteman Center, the Center for Advanced Medicine and St. Louis Children's hospital with the most up to date treatment (i.e. more expensive). This on Children's:

    St. Louis Children's Hospital is ranked as one of the top 10 best hospitals in the U.S. that treats critically ill children.

    I really believe that this statement made about eliminating top centers is one of the main reasons for the exclusions:

    By not including a top cancer center, an insurer can cut costs. It may also shield itself from risk, delivering an implicit message to cancer survivors or people with a strong family history of the disease that they should look elsewhere.

    Insure more healthy people and eliminate as many people who will require on going expensive treatment as you can and you increase your profit margin. A subtle method of cherry picking IMO.

    Parent

    I realize (none / 0) (#107)
    by Ga6thDem on Fri Mar 21, 2014 at 03:02:29 PM EST
    what you are saying and I don't totally disagree but as a cancer survivor myself I understand that you don't have to go to a cancer center to get treatment. The problem with them being out of network is for those people WHO DO actually need a cancer center. But there is also a way to get around this for some people. I know someone with stage IV breast cancer. She went out to MD Anderson and got a treatment plan and the doctors here are administering the treatment directed by the doctors at MD Anderson. A lot of time it's not that people get better care at cancer centers so much as the fact that the doctors are more knowlegable and it's their expertise that can be very important in certain situations.

    Parent
    This kinda goes along with your (none / 0) (#115)
    by MO Blue on Fri Mar 21, 2014 at 09:54:52 PM EST
    statement that "the doctors are more knowledgeable and it's their expertise that can be very important in certain situations."

    IMO it also has to do with the fact that the top treatment centers often have the latest and most advanced treatment options and technical equipment.

    Also a top cancer center will have "cancer related" support that might not be available elsewhere. At Siteman, one of many the services they provide is free counseling with psychologists specially trained to help cancer patients deal with their disease and psychiatrists that are well versed in how to tailor anti-depressants etc. with the cancer drugs used in your particular treatment program.

     

    Parent

    It makes perfect sense (none / 0) (#100)
    by vicndabx on Fri Mar 21, 2014 at 01:39:37 PM EST
    if you understand how providers look to recoup monies from elsewhere.

    In October 2009, Dr. Tamim Antakli, a cardiothoracic surgeon from Indiana, was rushed to the hospital with a heart condition during a visit to St. Louis. The second shock came when he got the bill -- $41,308.80.

    The ambulance had taken Antakli to St. Joseph Health Center in St. Charles, which would not accept his insurance, telling him to seek reimbursement on his own. The hospital was "out of network," meaning it had no agreement with his insurance carrier on reimbursement rates.

    Antakli's insurer, meanwhile, had a different view of his care, pricing it at $19,425.81 -- and in effect sticking the patient with the balance.

    and

    A survey last year by a health industry trade group found that in 2008, out-of-network physicians in Missouri billed from 700 percent to 2,050 percent more than the Medicare fee for that service. For example, a Missouri physician charged $4,200 for a colonoscopy with biopsy -- a price that was 976 percent more than Medicare's reimbursement rate of $430.54.

    Common occurrence, and why, in most cases, insurers try to keep charges inline via negotiation and networks.


    Parent

    So.......and the lesson is (5.00 / 3) (#101)
    by Zorba on Fri Mar 21, 2014 at 01:47:34 PM EST
    Don't have a heart attack, a stroke, or any other emergency while you are traveling?  Or maybe, don't travel at all?
    Universal Health Care.  Single Payer.  Medicare for All.  Pick one, I don't give a rosy rat's @ss what you call it.
    Then, perhaps, we would not have to worry about "out of network" care.
    But then, I never have thought that relying on for-profit health insurance companies was any way to provide decent health care.

    Parent
    That is the big (5.00 / 2) (#108)
    by Ga6thDem on Fri Mar 21, 2014 at 03:03:19 PM EST
    advantage to single payer. You don't have to worry about being out of network ever unless you are in a foreign country.

    Parent
    So the insurance industry's response (5.00 / 1) (#102)
    by MO Blue on Fri Mar 21, 2014 at 02:06:08 PM EST
    is to intentionally create more out of network and balance billing situations by substantially narrowing network providers. Wow, what great corporate citizens.

    Insurance industry to consumers: Yes, there is a problem with out of network coverage. We are here to help you by creating a whole lot more out of network situations. You think it was bad before - wait until we are done. You think the networks are narrow now - Wait - You haven't seen nothing yet.

    Great job.

    Parent

    Miss the forest for the trees (2.00 / 1) (#103)
    by vicndabx on Fri Mar 21, 2014 at 02:24:13 PM EST
    but I understand, you've got your meme and you're sticking to it.

    Providers play no role here - all they want to do is provide care, they have no financial stake.  Got it.


    Parent

    Nope (5.00 / 3) (#104)
    by MO Blue on Fri Mar 21, 2014 at 02:36:35 PM EST
    I see the forest just fine. The insurance industry is by design making a bad situation worse.

    Single payer and standardized payments for care, negotiated prescription drugs prices and you eliminate out of network situations, balance billings and price gouging by providers and pharma.

    What you don't do is make the situation of out of network providers worse by reducing the number of providers in the network to the bare minimum required by law so that more and more people are finding themselves facing these problems.  

    Parent

    Look (5.00 / 3) (#109)
    by Ga6thDem on Fri Mar 21, 2014 at 03:16:34 PM EST
    if these people take medicaid the insurance companies should be able to work with them. For whatever reason they have chose not to and I spent one night in the hospital and they sent me a bill for 25K. If you're in insurance you should know that hospitals routinely do this kind of jacked up billing only to write the balance down to the negotiated rate. If this jacked up billing was the problem they wouldn't have any hospital on their insurance plan nor any doctor as doctors do the exact same thing. Endo sent me a bill for $200. The agreed rate with the insurance company was like $80. I have a $20 copay. So the doc was saying I owed them $180 until the claim was processed.

    Parent
    Exactly (5.00 / 2) (#110)
    by MO Blue on Fri Mar 21, 2014 at 03:48:57 PM EST
    ...hospitals routinely do this kind of jacked up billing only to write the balance down to the negotiated rate. If this jacked up billing was the problem they wouldn't have any hospital on their insurance plan nor any doctor as doctors do the exact same thing.

    This is just SOP and has been as long as I can remember. My providers (all in BJC) take Medicare. They send Medicare a bill for some ridiculous amount and Medicare pays them the Medicare approved amount which is always a very small fraction of the actual amount billed. The very same thing happened before I went onto Medicare.

    Parent

    Yes, when my dad finally died, (5.00 / 3) (#111)
    by Zorba on Fri Mar 21, 2014 at 04:14:57 PM EST
    after three months of extensive treatment at BJC, in and out of the hospital, although mostly in, the treatments he received must have cost thousands and thousands of dollars.
    My mom got a bill for exactly zip.  Nada.
    When she died, although her illness was much shorter but did involve intensive care, which is expensive, her bill was also exactly zip.  She was also in the BJC hospital system.
    My only wish is that everyone could access this level of quality care.  Without owing mega-bucks to the hospital and the doctors.
    BTW, did I say "Universal Health Care"?  Why yes, yes I did.

    Parent
    This article is about Christian Hospital (5.00 / 1) (#91)
    by MO Blue on Fri Mar 21, 2014 at 11:51:33 AM EST
    which is a BJCs facility.

    Christian, one of 13 hospitals in the BJC HealthCare system, logged 112,117 emergency department visits last year -- almost 14,000 more emergency visits and trauma cases as Barnes-Jewish Hospital. That figure includes Christian's 28-acre campus on Dunn Road (near the intersection of Interstate 270 and Highway 367) and its 24-hour emergency care facilities at Northwest HealthCare in Florissant.
    ...
    Christian officials said that 50 percent of their patients are on Medicare; 16 percent are on Medicaid; 23 percent are privately insured; and 11 percent are "self-pay" or uninsured. In addition, a substantial portion of patients' accounts are classified as "bad debt" because they do not pay their bills. In the emergency department, more than half the patients are uninsured or on Medicaid -- the highest proportion in the St. Louis area except for its two leading children's hospitals. link

    BJCs Children's Hospital is the leading children's hospital and as indicated they have one of the highest proportion of patients who are uninsured or on Medicaid.  

    Parent

    Each one of Josh's surgeries (none / 0) (#128)
    by Militarytracy on Sat Mar 22, 2014 at 06:27:42 PM EST
    We have to request an addition from Tricare for Emory.  His physician takes care of most of that so I am not certain what goes into requesting out of network, I only know we have had to do that for Joshua's surgeries for the past four years.

    Parent
    Yes (none / 0) (#129)
    by Ga6thDem on Sat Mar 22, 2014 at 06:51:16 PM EST
    this is why I am not wondering if there isn't a way around it. Like I said do you think that most parts of George have Emory in network? I am willing to bet they do not.

    I'm sure there are doctors in other parts of the state that literally cannot handle some of these cases nor can the local hospital.

    At one time I think Emory was the only facility in the state treating HIV cases.

    Parent

    Wanted to address something (5.00 / 2) (#30)
    by CaptHowdy on Thu Mar 20, 2014 at 07:04:24 PM EST
    Mentioned in the last open.

    Difficulty paying you bill associated with the ACA.  This happened to me.  I got signed up. Got my cards and went to the pharmacy.  They would not honor the card until I paid my first bill.  Ok.  I went home and tried to do that.  For days it seemed like the most absurd thing in the world.  All I wanted to do was pay my bill and no one could let me do it.  I literally spent days on the phone trying to pay the damn bill.  One day I had enough.  I called the aca number and I called the office of Mark Pryor and I told them both the same thing.  After relating the whole ridiculous story I said I was done.  The next call I was going to make was to the local tv station.  
    In less than an hour a very nice lady from Blue Cross called me and my spirits were filled an hour later.

    I do not blame the law or the law makers for this.  I don't even really blame Blue Cross.  Everyone I talked at BCBS seemed like very nice people who were completely overwhelmed.

    This is a gigantic change in the way these companies do business.  It will take a while.

    So, Fred Phelps (5.00 / 1) (#46)
    by Zorba on Thu Mar 20, 2014 at 09:09:30 PM EST
    did die today.
    I can only think of what Bette Davis supposedly said when Joan Crawford died:
    "I was taught to speak only good of the dead.  Joan Crawford is dead.  Good."
    I do not know if this quote is apocryphal or not, but substitute Fred Phelps for Joan Crawford in the above quote.
    That is all.
    I was reading about him today (none / 0) (#47)
    by CaptHowdy on Thu Mar 20, 2014 at 09:23:26 PM EST
     I knew he was excommunicated by him family/church members but I did not know why.  Apparently it was because he suggested that be kinder to each other.  There was even talk some of them would picket his funeral.
    I just thought it's somehow comforting to know there is a family somewhere who's thanksgiving is even more miserable than ours.

    Parent
    Gee Arkansas Blue Cross and Blue Shield. (5.00 / 1) (#52)
    by MO Blue on Thu Mar 20, 2014 at 10:23:55 PM EST
    is trying to game the system and sell customers insurance that DOES NOT meet the federal laws requirement that you have coverage or pay a penalty. You could buy these plans and still be considered non-compliant and forced to pay the federal penalty.

    Blue Cross and Blue Shield are marketing these plans telling customers that they are they're getting a better deal. What they are not telling them is that they're forgoing an opportunity to get premium tax credits and cost-sharing reductions through Arkansas' health insurance marketplace. And the plans sold on the marketplace will be more comprehensive and provide greater financial protection.

    Surely you jest. The private insurance industry is the greatest, most benevolent industry evah and they would never, ever try to take advantage of people needing health care.

    Soooo (5.00 / 1) (#53)
    by CaptHowdy on Thu Mar 20, 2014 at 10:38:35 PM EST
    You explain what was in the link I posted and then attemp snark - feebly - I am naive about it.

    One of us is confused.  

    Fwiw i wish i lived in Canada but I am glad I have insurance.  And it's actually pretty good insurance.  Sorry if that distresses you or messes with your meme.

    Parent

    I am glad you have insurance that (5.00 / 1) (#54)
    by MO Blue on Thu Mar 20, 2014 at 11:12:57 PM EST
    meets your health care needs.

    Yes one of use is definitely confused. What I am confused about is why you posted a link to an article that indicated that Blue Cross and Blue Shield was gaming the system and marketing products that would not allow people to use the credits that they were entitled to and that may result in the people still be considered non-compliant and forced to pay the federal penalty even after purchasing their product.

    I am confused. I am very interested in what you were trying to convey by posting that link.  Did you post that link because you thought that what Arkansas Blue Cross and Blue Shield was doing with those policies was a good thing or not? Did you think that Arkansas Blue Cross and Blue Shield were acting as an honest broker?

    Evidently the Georgetown University Health Policy Institute did not think it was a good thing. They thought the insurance company was gaming the system.

    The insurance company gets a tongue lashing in this article from the Georgetown University Health Policy Institute.


    Parent
    Georgetown University Health Policy Institute. (5.00 / 2) (#58)
    by MO Blue on Fri Mar 21, 2014 at 01:02:06 AM EST
    Health Plans Get Creative Skirting the ACA

    Details how Arkansas Blue Shield Essential Blue Freedom plan is gaming the system. Just one of the little details of the plan.

    ...consumers enrolled in these plans won't be able to meet the requirement in the ACA that they maintain health coverage. Short-term policies are not considered minimum essential coverage under the law. As a result, if consumers buy these plans, they will have to pay a tax penalty with their 2014 tax return


    Parent
    BTW, unless I am sadly mistaken you (5.00 / 3) (#56)
    by MO Blue on Thu Mar 20, 2014 at 11:36:50 PM EST
    did not purchase one of the Blue Cross/Blue Shield policies that were the subject of the article.

    Based on the information you provided you purchased a subsidized policy for $70.00 a month. That you were able to get an affordable policy does not distress me at all and does not mess with my meme at all.

    I admit that insurance companies who game the system and sell policies that do not meet the health care needs of consumers distresses me quite a bit. My meme, if you choose to call it that, is that it SOP for the private insurance companies to try and find ways around providing actual health care to increase their profits, that they are busy devising ways to get around the provisions of the legislation even now and the policies mentioned in your link IMO substantiates that opinion.

    Parent

    I post a comment (none / 0) (#61)
    by CaptHowdy on Fri Mar 21, 2014 at 08:15:56 AM EST
    Saying something like most problems are not with the law but with the insurance companies and provide a link illustrating the point.  If that is to nuanced for you I am afraid you are on your own. I do not intend to spend the day explaining it to you.

    Parent
    Evidently you don't like people to agree (none / 0) (#70)
    by MO Blue on Fri Mar 21, 2014 at 09:36:23 AM EST
    with you. Perhaps my response was too nuanced for you and you decided to take my comment as something personal.

    Can't help you with that either.

    Parent

    You know what (none / 0) (#77)
    by CaptHowdy on Fri Mar 21, 2014 at 10:02:00 AM EST
    I am confused. I am very interested in what you were trying to convey by posting that link.  Did you post that link because you thought that what Arkansas Blue Cross and Blue Shield was doing with those policies was a good thing or not? Did you think that Arkansas Blue Cross and Blue Shield were acting as an honest broker?

    I vowed when I started commenting here again that I would not get involved in the ridiculous flapping and squeaking that constantly goes on here.
    So
    I have said what I have to say.  Flap on.  I will be over here ignoring you.

    Parent

    You are sooooo funny (5.00 / 3) (#80)
    by MO Blue on Fri Mar 21, 2014 at 10:14:40 AM EST
    You choose to take offense to my original comment which agreed with you and now you are refusing to get in the "ridiculous flapping and squeaking" which BTW you started, by continuing to make another comment continuing your "ridiculous flapping and squeaking."

    Parent
    Btw (none / 0) (#79)
    by CaptHowdy on Fri Mar 21, 2014 at 10:09:44 AM EST
    For the record that was supposed to be squawking that was spell corrected to squeaking and was in no way a dig at squeaky.

    Parent
    This is the original comment try reading it (none / 0) (#64)
    by CaptHowdy on Fri Mar 21, 2014 at 08:25:39 AM EST
    I think it might be more of a state by state (none / 0) (#32)
    by CaptHowdy on Thu Mar 20, 2014 at 07:18:04 PM EST

    Some problems are not with the law but surprise With the insurance companies.

    Parent | Reply to This

    LINK

    Parent

    My comment agreed that the insurance (5.00 / 1) (#69)
    by MO Blue on Fri Mar 21, 2014 at 09:31:53 AM EST
    companies were the problem. It agreed with what was linked in the article - that the industry is currently devising creative ways to get around the system reforms.

    You acknowledged that my reference to the great benevolence of the health insurance industry was snark, so try reading my response with reference to your linked material and not as some type of personal attack on you or the policy you received through the exchange.

    Parent

    Time for another break from this place; (5.00 / 7) (#60)
    by Anne on Fri Mar 21, 2014 at 06:55:00 AM EST
    it didn't take long for me to reach the point I did a little while ago, and that's an indication to me that things aren't going to get better here, just increasingly worse.

    Thanks to all whose comments and conversation I've enjoyed; I've given Jeralyn a list of those whom she can give my e-mail to, in case you want to stay in touch.

    Be well.

    Take care, Anne. (5.00 / 1) (#87)
    by Donald from Hawaii on Fri Mar 21, 2014 at 11:42:13 AM EST
    Enjoy the spring (once it finally arrives on the eastern seaboard).

    We'll see ya when we see ya. Aloha.

    Parent

    I would (5.00 / 2) (#112)
    by lentinel on Fri Mar 21, 2014 at 05:19:39 PM EST
    try to dissuade you, but you have your mind made up.

    Have a good respite - and I'll look forward to your eventual return.


    Parent

    Sorry to hear that... (5.00 / 2) (#114)
    by unitron on Fri Mar 21, 2014 at 09:14:03 PM EST
    ...this place is lesser without you, even we aren't in total agreement on stuff.

    Parent
    to share your email address (none / 0) (#116)
    by Jeralyn on Fri Mar 21, 2014 at 11:17:34 PM EST
    If you'd like to exchange email addresses, I suggest you register for the Talkleft forums which allows you to send personal messages to each other.

    Parent
    Oh, my mistake for misremembering (none / 0) (#119)
    by Anne on Sat Mar 22, 2014 at 07:22:57 AM EST
    that you've accommodated many of us in the past by providing e-mail info with permission; I won't be registering for any TL forums for that purpose.

    Others here have my e-mail, and I'm sure we can figure out a way to communicate.

    Parent

    If anyone wishes (5.00 / 1) (#120)
    by Zorba on Sat Mar 22, 2014 at 09:01:51 AM EST
    to contact you, Anne, they can email me.  My email address is on my information page.  I can then pass along their email to you.

    Parent
    Thanks Zorba (none / 0) (#121)
    by MO Blue on Sat Mar 22, 2014 at 09:50:59 AM EST
    I sent you an email requesting Anne's info. I'm using a new account so let me know if you don't get my request.

    Thanks again.

    Parent

    Got it (5.00 / 1) (#126)
    by Zorba on Sat Mar 22, 2014 at 03:13:57 PM EST
    Sent you Anne's email.

    Parent
    Thanks (none / 0) (#127)
    by MO Blue on Sat Mar 22, 2014 at 05:53:55 PM EST
    Will contact her tomorrow. Have to get ready to go to a dance now.

    Parent
    Religious Freedom I can support (5.00 / 2) (#75)
    by MO Blue on Fri Mar 21, 2014 at 09:53:40 AM EST
    Religious Leaders Release Statement: Contraception Should Be Universally Accessible For The `Moral Good'

    This past Tuesday, several religious leaders released a statement in support of universal access to contraception coverage, calling it a "moral good." The statement below was signed by 47 leaders from a variety of religious institutions, including the United Church of Christ, Union Theological Institute, Network of Spiritual Progressives, Muslims for Progressive Values, National Institute of Jewish Women and United Methodist Church.

    As religious leaders, we support universal access to contraception. We believe that all persons should be free to make personal decisions about their reproductive lives, their health and the health of their families that are informed by their culture, faith tradition, religious beliefs, conscience, and community. . . . We support religious freedom. Religious freedom means that each individual has the right to exercise their own beliefs and the right not to have others' beliefs forced upon them.



    Paging Donald in Hawaii... (5.00 / 1) (#76)
    by kdog on Fri Mar 21, 2014 at 09:55:40 AM EST
    I'd love to hear your explanation for this sh*t.

    Sounds like a license to steal, at best. At worst, a license to rape.

     

    Wow (none / 0) (#81)
    by CaptHowdy on Fri Mar 21, 2014 at 10:15:40 AM EST
    "Authorities say they need the legal protection to catch lawbreakers"

    Accepting the money is not enough.  I guess next they will need to do the drugs to "make sure they are real"

    Nice work if you can get it

    Parent

    What I wanna know is... (5.00 / 1) (#82)
    by kdog on Fri Mar 21, 2014 at 10:29:02 AM EST
    are the undercovers posing as sex workers going all the way to?  

    I doubt it, and this is just an obscene perk for the undercover johns.  Though I guess in practice it's really no different than any other state (except Nevada)...cops are notorious for "freebie or jail".  I just can't believe Hawaii had the balls to codify it into law!

    Parent

    Do you (none / 0) (#84)
    by lentinel on Fri Mar 21, 2014 at 11:02:56 AM EST
    suppose that undercover sex workers will wind up s-rewing the undercover cops?

    And it's all tax-funded.

    Parent

    Actually, lentinel, that is ... (5.00 / 1) (#94)
    by Donald from Hawaii on Fri Mar 21, 2014 at 12:01:44 PM EST
    ... exactly what was happening. Cops were extorting sex workers for, among other things, sex.

    Parent
    That scenario... (none / 0) (#88)
    by kdog on Fri Mar 21, 2014 at 11:43:37 AM EST
    might run afoul of sexual harassment/hostile workplace rules;)

    Parent
    There's been tremendous public ... (none / 0) (#93)
    by Donald from Hawaii on Fri Mar 21, 2014 at 11:59:05 AM EST
    ... pushback on this, because prostitution has long been a fairly significant part of island society during western times. My late boss, who represented Waikiki and downtown in the State Senate, used to regularly introduce legislation to re-legalize prostitution, as it once was before 1946. I agree with her stance.

    The reason you're hearing about this controversy now is because literally, sex sells in media. Seriously, there's a bill presently working its way through the state legislature to close the loophole in the law, which police have heretofore interpreted as a license to engage in this sort of reprehensible conduct. The national networks just picked up on it only yesterday, even though it was first introduced last December.

    Had we not already known about the problem ourselves out here and sought to remedy it, doubtless you folks on the continent would have remained none the wiser.

    Aloha.

    Parent

    I don't think... (5.00 / 1) (#96)
    by kdog on Fri Mar 21, 2014 at 12:26:44 PM EST
    it's simply interpreted as a license...it is a clearly-stated license to abuse power and steal services, albeit illegal services.

    Parent
    Not necessarily "clearly stated." (5.00 / 1) (#113)
    by Donald from Hawaii on Fri Mar 21, 2014 at 05:30:07 PM EST
    Rather, it is the result of interpretation. The original law, Sec. 712-1200, Hawaii Revised Statutes, has been on the books out here for 42 years, ever since the late Gov. John Burns signed Act 9, Session Laws of Hawaii 1972. The law itself reads as follows:

    §712-1200 Prostitution. (1) A person commits the offense of prostitution if the person:
    (a) Engages in, or agrees or offers to engage in, sexual conduct with another person for a fee; or
    (b) Pays, agrees to pay, or offers to pay a fee to another to engage in sexual conduct.

    (2) As used in subsection (1), 'sexual conduct' means 'sexual penetration,' 'deviate sexual intercourse,' or 'sexual contact,' as those terms are defined in section 707-700.

    (3) Prostitution is a petty misdemeanor.

    (4) A person convicted of committing the offense of prostitution shall be sentenced as follows:
    (a) For the first offense, when the court has not deferred further proceedings pursuant to chapter 853, a fine of not less than $500 but not more than $1,000 and the person may be sentenced to a term of imprisonment of not more than thirty days or probation; provided that in the event the convicted person defaults in payment of the fine, and the default was not contumacious, the court may sentence the person to perform services for the community as authorized by section 706-605(1).
    (b) For any subsequent offense, a fine of not less than $500 but not more than $1,000 and a term of imprisonment of thirty days or probation, without possibility of deferral of further proceedings pursuant to chapter 853 and without possibility of suspension of sentence.
    (c) For the purpose of this subsection, if the court has deferred further proceedings pursuant to chapter 853, and notwithstanding any provision of chapter 853 to the contrary, the defendant shall not be eligible to apply for expungement pursuant to section 831-3.2 until four years following discharge.  A plea previously entered by a defendant under section 853-1 for a violation of this section shall be considered a prior offense.  When the court has ordered a sentence of probation, the court may impose as a condition of probation that the defendant complete a course of prostitution intervention classes; provided that the court may only impose such condition for one term of probation.

    (5) This section shall not apply to any member of a police department, a sheriff, or a law enforcement officer acting in the course and scope of duties. (Emphasis is mine.)

    The rationale for Subsection (5), highlighted in italics above, was ostensibly drafted at the time to preclude undercover law enforcement personnel from being charged under the act.

    Now, here is HB 1926 HD1, which is the measure I'm talking about. Please take note of Section 4 of the bill on page 7, which amends another section of the law defining solicitation of prostitution, and uses the exact same language as found in Sec. 712-1200(5), Hawaii Revised Statutes.

    The original measure as introduced in December did not include that language, and the House Judiciary Committee added it in HD1 last February at the request of Honolulu Police Dept. officials testifying in favor of the bill. And that proposed amendment is what triggered the resultant and furious public backlash against HPD, first in Hawaii and now nationally.

    As I read it, the enabling language found in Sec. 712-1200(5) actually places prostitutes at greater and not lesser risk for abuse by law enforcement personnel. And in fact, back when I was working in the legislature for the senator from Waikiki, we received repeated and regular reports of prostitutes being coerced by certain police officers into engaging in sexual acts in order to keep from being arrested or harassed. Further, mind you, this was 20 years ago!

    But by and large, it's been my professional experience as a legislative policy analyst that most of the general public doesn't like prostitution. We could never muster sufficient public backing to mitigate the many different problems caused by street prostitution in my senator's home district.

    And while people seem to believe that there are already programs in place to support prostitutes' efforts to get out of the business, as clerk of the House Judiciary Committee in 1998, I wrote the following findings of fact in House Stand. Com. Report No 155-98, which notes that the reverse is actually true:

    "The legislature found that prostitution was a multi-faceted problem which required efforts to encourage persons involved in the sex industry to seek alternative lifestyles and employment options. The legislature further found that persons involved in prostitution were often not capable of exploring those options, and thus, those persons needed assistance in finding educational and employment opportunities that would support their desire to leave prostitution. Unfortunately, such assistance has not only not been forthcoming, efforts to provide it have been actively opposed by certain active segments of the community."

    Prostitution law is a funny thing, kdog, in that it was often enacted initially not out of any real concern for anybody's safety specifically, but rather to coddle and indulge the peculiar sensibilities of those persons who are offended by the very notion that people would willingly pay for sex (if not offended by the entire notion of people having sex, period). Making prostitution a criminal offense is one method of controlling the scope of prostitution and thereby protecting those segments of society which are offended by its open existence.

    You can count me as one of the law's more vociferous detractors. But as much as I'd like to think that my advocacy of legalized prostitution exhibits foresight and practicality on my part, the pragmatic political animal in me also recognizes that a very large segment of society is not presently willing to accept such a liberal approach to the problem.

    The hypocrisy and injustice of it all finally struck home with me last year in May, when Ivanice "Ivy" Harris, a 29-year-old Las Vegas-based prostitute, was brutally killed by her john in Waikiki, and her body was later dumped out at Yokohama Beach on Oahu's remote leeward coast.

    Ivy's alleged killer turned out to be a rather prominent member of the U.S. military's POW / MIA Recovery Task Force, which is based at Joint Base Pearl Harbor-Hickam. He's presently facing a court martial at Pearl for her murder, which of course means that Ivy is also being tried posthumously because of the manner in which she sought to earn a living.

    Much like our various state and local laws regarding firearms, our nation's assorted prostitution statutes are little more than misguided notions of public morality based primarily upon emotion and wishful thinking, rather than anchored soundly in actual fact, reason and pragmatism.

    Aloha.

    Parent

    According to what I've read, Donald, (none / 0) (#123)
    by Mr Natural on Sat Mar 22, 2014 at 11:04:53 AM EST
    Hawaii's original Polynesian inhabitants were pretty open minded about sex.  It was the invaders and puritan missionaries who stunk the place up.

    I've been there.  Some places are still quite beautiful.  But if you look beyond the tourist attractions it's hard not to see an ugly back story.

    Parent

    Welcome back (none / 0) (#1)
    by CoralGables on Thu Mar 20, 2014 at 08:00:58 AM EST
    and Go Gators

    Investors Madness Begins... (none / 0) (#2)
    by kdog on Thu Mar 20, 2014 at 08:15:45 AM EST
    take Randolph & Mortimer to the cleaners Louis.

    If the NCAA ain't gonna pay their job creators, maybe we can get the bookies to throw the workhorses a percentage of the vig;)

    March Madness Question (none / 0) (#3)
    by CoralGables on Thu Mar 20, 2014 at 08:17:39 AM EST
    Why do they continue to refer to it as March Madness during the Final Four...in April.

    Because ... (none / 0) (#21)
    by Donald from Hawaii on Thu Mar 20, 2014 at 05:19:34 PM EST
    ... "Apoplectic April" didn't play as well in their public marketing surveys?

    ;-D

    Parent

    Another sports-related story (none / 0) (#4)
    by jbindc on Thu Mar 20, 2014 at 08:20:43 AM EST
    The Texas Motor Speedway has just installed what is claimed to be the world's largest HD screen.

    Positioned along the backstretch of the Texas Motor Speedway outside of Fort Worth, "The Big Hoss TV" is reportedly 12 stories tall and provides 20,633.34 square feet of HD broadcasting, according to ESPN.
    AN AXE LENGTH AWAY, vol. 308 (none / 0) (#6)
    by Dadler on Thu Mar 20, 2014 at 11:08:06 AM EST
    She reads palms and also greases them. (link)

    v. 307
    v. 306

    GO SAN DIEGO STATE!!!

    Dayton! (none / 0) (#9)
    by jbindc on Thu Mar 20, 2014 at 01:42:32 PM EST
    There goes the $1 billion prize....

    Not quite (none / 0) (#10)
    by CoralGables on Thu Mar 20, 2014 at 01:59:01 PM EST
    but in ESPN brackets 81% would already be eliminated.

    Parent
    Whoa, wish I'd watched that one (none / 0) (#12)
    by Towanda on Thu Mar 20, 2014 at 02:56:22 PM EST
    for excitement, after the <yawn> blowout by the Badgers.

    Parent
    Pitt-Colorado (none / 0) (#13)
    by jbindc on Thu Mar 20, 2014 at 02:58:41 PM EST
    Now THAT was a blowout!

    Parent
    Now this (none / 0) (#14)
    by jbindc on Thu Mar 20, 2014 at 03:28:48 PM EST
    is what should be on the banner at CNN...

    It's Futile to Fight the Tide: AP Will Now Accept 'Over' as a Synonym to 'More Than'

    Nooooes (none / 0) (#24)
    by Towanda on Thu Mar 20, 2014 at 06:00:06 PM EST
    I don't teach journalism, so:  Futile?  I think not, AP.  

    My students still will be instructed to use "more than" -- and the Oxford comma, which AP abandoned, eons ago.

    Signed,

    A Fighter of Tides, and Dare I Say, Even Tsunamis

    Parent

    Proper Grammar (none / 0) (#27)
    by MKS on Thu Mar 20, 2014 at 06:23:35 PM EST
    is really just the accepted, current conventions of your target audience.  But such conventions are always changing.

    Grammar is really an artificial construct.  The English of Shakespeare was the common, street language of its day.  Now it is viewed as highly stylized and only for the educated.  

    And, if you ever try to find the definitive recitation of Grammar, "THE" book on grammar and usage, good luck.  Academics liked Fowlers at one time.

    Computer screens have done much to truncate everything......

    Parent

    Computer screens? No, not generally (5.00 / 2) (#28)
    by Towanda on Thu Mar 20, 2014 at 06:44:22 PM EST
    . . . but cellphone screens?  Yes.

    I have had to inform students in online classes that it really is not a good idea to go to college on their cellphones.  I can spot those assignments in an online minute.  

    Also, I inform them, autocorrect is the spawn of Satan.

    They're all just tools, new technologies.  Books generally were a lot bigger before Gutenberg, too.  But moveable type did not destroy literacy; indeed, it accomplished the opposite -- and established standards.

    Parent

    Hand scribed books were larger? (none / 0) (#36)
    by ZtoA on Thu Mar 20, 2014 at 07:44:22 PM EST
    Details please. I will be visiting the Getty tomorrow which has a fabulous collection of old illuminated books and they always have some on display. It takes comittment to view them tho since the sun is bright and the buildings are white. It takes about a half hour, sitting in the darkened gallery, for my eyes to adjust to see them. It has paid off. Sent from my cell phone.

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    The Book of Kells (none / 0) (#41)
    by Towanda on Thu Mar 20, 2014 at 08:19:17 PM EST
    is a biggie.  So are some early Bibles that I have seen.  Vellum seems thicker than paper, making them heavier, too.  Plus, the covers in wood or leather added to the massiveness of such books I've seen.

    Often one of a kind, they were not planned to be portable, according to intriguing reading on the era before moveable type and mass production.  I recommend very readable work by Elizabeth Eisenstein on "print culture;" one that I have is a paperback with lots of helpful illustrations, and a quick skim of even the first chapter or so -- I think it's on Googlebooks? -- could be great in getting the most from your day at the Getty. <envy!>

    Parent

    4th try to comment using my cell phone..grrr... (5.00 / 2) (#48)
    by ZtoA on Thu Mar 20, 2014 at 09:44:31 PM EST
    Last time I was at the Getty I saw a show of small books (scribed) which were portable. Beautifully illuminated. They were extremely expensive. Easy way to quickly save assets in a raid. Was especially fun for me since I spotted the use of the pigment smalt (cobalt frit - first cobalt pigment) .

    Ever been to the Huntington ? Gutenberg bible, first folio, Blake hand illustrated books. The collection and gardens are great too!

    Parent

    I love the Getty (5.00 / 2) (#50)
    by CaptHowdy on Thu Mar 20, 2014 at 10:05:19 PM EST
    I have spent while days in the manuscript building with those little magnifiers.

    Parent
    The Getty Villa (5.00 / 1) (#117)
    by MKS on Sat Mar 22, 2014 at 01:01:42 AM EST
    is a really nice place to have lunch.

    One exhibit has the likeness of teenage male on the outside of a sarcophagus.  It was so lifelike and seemed like young kids we all have known.....

    Parent

    I love the Huntington. (5.00 / 2) (#71)
    by caseyOR on Fri Mar 21, 2014 at 09:37:07 AM EST
    A most amazing place inside and out. The gardens are spectacular, and the collections are so eclectic.

    Parent
    I think the Huntington (5.00 / 1) (#118)
    by MKS on Sat Mar 22, 2014 at 01:03:18 AM EST
    has original Shakespeare Folios, no?

    Glitzy L.A. has all this hidden culture?

    Parent

    You are in my 'hood! (5.00 / 1) (#106)
    by sarcastic unnamed one on Fri Mar 21, 2014 at 02:51:21 PM EST
    I'll be there next week. How was your visit?

    Parent
    Loved it! (none / 0) (#125)
    by ZtoA on Sat Mar 22, 2014 at 12:14:23 PM EST
    No manuscrip show tho. One just closed next one opens after I leave. But will be up when you visit. I spent lots if time with the stained glass which was exciting and very rewarding. One guard was very helpful with my geeky questions and Google helped too so I learned a lot. The Getty lets people get very close to work and even take close up photos.

    There's an exhibition of a large polluck mural restoration which is fascinating! The painting is beautiful and the room outlining the restoration is fabulous. Getty restorers are the best.

    Parent

    Excellent, can't wait! (none / 0) (#130)
    by sarcastic unnamed one on Mon Mar 24, 2014 at 01:08:24 PM EST


    Parent
    Say buh-bye to Cincy, 61-57. (none / 0) (#26)
    by Donald from Hawaii on Thu Mar 20, 2014 at 06:04:49 PM EST
    Guess the Bearcats didn't pay much attention to what happened to New Mexico in last year's tourney. Harvard don't get no respect, no respect at all, I tell ya!

    And while we're on the subject of no respect, Auburn coach Bruce Pearl -- who's offered his basketball expertise to ESPN this postseason because, well, his team sucked this year and is sitting at home as a result -- deserves nothing but boos and hisses for bringing the stupid with him to the studios, per a remarkably insipid remark about the Dayton Flyers, 60-59 victors over Ohio State today:

    "And Linda, you hit on it, this is special for Dayton. If there could be a team in the tournament that they could play and have that kind of moment, it would be a team like Ohio State. Those kids all would have loved to have been Buckeyes, but they weren't quite good enough." (Emphasis is mine.)

    Wow. The Dayton Flyers were good enough to beat the Ohio State Buckeyes, but their players aren't "quite good enough" to actually BE Buckeyes. Uh-huh.

    And every 18-year-old high school basketball player craves to go to a so-called "power conference" school, and will only accept a scholarship from a mid-major as a disappointing afterthought, because mid-majors are the collegiate sports world's equivalent of sloppy seconds. Right.

    You know, there's a very good reason why Pearl was fired at Tennessee, and why Auburn finished near the bottom of a relatively weak SEC this year. Because while the Northwestern State Demons were more than good enough to whip Pearl's Tigers by double figures last November, given the Auburn coach's logic, their players aren't quite good enough to be Tigers themselves.

    What a maroon! The arrogance of pundits like Pearl makes me really hope that Wichita State runs the table this year, and leaves these so-called experts smeared across the table top, as so much nattering roadkill.

    Aloha.

    If you post urls (none / 0) (#57)
    by Jeralyn on Fri Mar 21, 2014 at 12:45:32 AM EST
    in comments they must be in html because long ones skew the site. You can use the link button at the top of the comment box. If you are on a device that doesn't show the link box, then at least get a short link from tinyrul.com or similar place.

    I cannot edit comments, only delete them.

    Sorry I spent some time (none / 0) (#62)
    by CaptHowdy on Fri Mar 21, 2014 at 08:17:05 AM EST
    Practicing last night.

    Parent
    oculus!!! (none / 0) (#59)
    by Donald from Hawaii on Fri Mar 21, 2014 at 03:39:51 AM EST
    The San Diego Opera is closing its doors at the end of its current season on April 13. You will now have to travel up to L.A. to get your culture fix.

    A real ahock. I heard the news on (5.00 / 1) (#95)
    by oculus on Fri Mar 21, 2014 at 12:03:30 PM EST
    public radio while I was driving to see th MT HD encore of Massenet's "Werther."  A few days earlier I enjoyed the San Diego Opera's production of Verdi's "Masked Ball."  I may spring for a season ticket for L A Opera for next season and venture to Long Beach Opera (they are doing "Death of Klinghoffer" soon.

    I really hope Irving and Joan Jacobs decide to rescue our opera company. They have given large donations in the past.  

    Parent

    Excited about this (none / 0) (#66)
    by CaptHowdy on Fri Mar 21, 2014 at 09:21:09 AM EST
    In 2012, it was announced that FX was developing a new television series based on the Academy Award-winning film Fargo with the Coen brothers as executive producers.[4] It was later announced that adaptation would be a 10-episode limited series.[5] On August 2, 2013, it was announced that Billy Bob Thornton had signed on to star in the series. On September 27, 2013, Martin Freeman also signed on to star.[6] On October 3, 2013, it was announced that Colin Hanks would be cast in the role of Duluth Police Deputy Gus Grimly.[7] Production began in the fall of 2013 with filming taking place in and around Calgary, Alberta.[8]

    FX is kickin it.  American Horror Story is the best thing ever and it have become addicted to The Americans.  About Russian spy's in America in the 70s.

    Something new to TIVO

    Btw (none / 0) (#68)
    by CaptHowdy on Fri Mar 21, 2014 at 09:22:40 AM EST
    That's coming on April 15

    Parent
    If the TV show (5.00 / 2) (#72)
    by Zorba on Fri Mar 21, 2014 at 09:41:25 AM EST
    is as black a comedy as the movie, then there is something rather appropriate about it coming out on Tax Day.   ;-)

    Parent
    I expect it will be if not even darker. (none / 0) (#78)
    by CaptHowdy on Fri Mar 21, 2014 at 10:05:37 AM EST


    Parent
    Saw the ads during Justified (none / 0) (#90)
    by ruffian on Fri Mar 21, 2014 at 11:51:07 AM EST
    It does look worth a watch or two..can I like it without Frances McDormand? Remains to be seen....

    So, rather late, I have started watching 'Game of Thrones'.  I just had too many other shows going when it started, so never got into it. I am almost through Season 1 - It is habit forming, if a bit gruesome. (And that is from one who loved Dexter). I had preconceived ideas base on ads about which characters I would like, and they are pretty much all being proved wrong. Never thought I would like the blond dragon girl, but she is very cool.

    Parent

    Yeh, the lack of Frances McDormand (none / 0) (#98)
    by Zorba on Fri Mar 21, 2014 at 01:19:05 PM EST
    is a problem for me, too.  But if the writing and acting are good, I will no doubt watch it.
    Mr. Zorba has watched The Game of Thrones since it began, so that means that I have caught many of the episodes, too.
    Yes, it's gruesome.  But well-acted.
    Personally, I like Peter Dinklage.     ;-)

    Parent
    I was also late to GoT (none / 0) (#105)
    by CaptHowdy on Fri Mar 21, 2014 at 02:45:57 PM EST
    But I am hooked.  The blonde dragon girl is the best but one of the cool things about the show is that it is really impossible to pick a side.

    As for Fargo agree about FD but the rest of the cast looks amazing.  And more important, the Cohens are involved.

    Parent

    So, there's this.... (none / 0) (#83)
    by jbindc on Fri Mar 21, 2014 at 10:46:24 AM EST
    Putin's quiet Latin America play

    Reason number 5341 (none / 0) (#89)
    by CaptHowdy on Fri Mar 21, 2014 at 11:43:51 AM EST
    To go to flea markets

    Flea market find: Faberge egg for $14,000, may be worth $33 million

    LINK

    Ok entirely new problem (5.00 / 1) (#92)
    by CaptHowdy on Fri Mar 21, 2014 at 11:52:33 AM EST
    Here is the actual link

    LINK


    Parent

    March Madness! | 128 comments (128 topical)

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