Note: this article was originally written in 2014 and is posted on my old website: channelingreality.com .
In 2014, I received a copy of a legislative proposal by one of Idaho’s “good Christian” legislators, Steve Thayn. Excerpts from it using a search on the term Community Health:
Let me point out a few problems with this argument. First, there is another way to take care of those in need without expanding Medicaid. An alternative to Medicaid expansion is explained in this report (expand Community Health Centers and reallocate the state CAT fund).
If the legislature and the governor can agree to work toward alternatives to ObamaCare that empower the people, then other marvelous opportunities open up; opportunities that will truly bless the lives of all Idahoans. They include: Medicaid reform, CAT fund restructuring, expansion of Community Health Centers, and county indigent fund reform.
A. Repeal the Idaho Catastrophic Indigent Fund (CAT Fund) ($40 – $50 million) B. Take the funds from the CAT Fund and use them to help set up Community Health Centers (CHCs). The funds could be used for start-up monies, buy equipment, and provide a cost-share program for pharmaceuticals.
C. Repeal or greatly reduce county indigent funds. The key to self-fund Medicaid is to reduce medical costs by 50 percent by creating a cash market using HSAs, DPC, etc
C. Initiate a program to replace Medicaid with private charity Community Health Centers with the goal of self-funding the Medicaid program within 5 years.
Bill #3: The goal of this bill is to eventually self-fund Medicaid. Its immediate consequences are more concrete.
First, the State Catastrophic Indigent Fund would be eliminated. The funds ($40 -$50 million) would be used for three purposes: seed money to set up Community Health Centers; provide funds to buy medical equipment, and to fund medical drugs on a cost-share basis.
Second, facilitate growth of Community Health Centers (CHC). The goal is to re-create the private charity model of care that existed before 1965 where doctors and nurses voluntarily gave a charity care.
More reality. Obama had nothing to do with “ObamaCare”. The Affordable Care Act was actually several pieces of legislation put in a single package that had been sitting and waiting for an opportunity to get them passed. And those pieces of legislation were part of an on-going, step by step plan to redesign the American health care system by members of a group called the Jackson Hole Group.
The Nation; Looking Back At Jackson Hole
New York Times, March 22, 1998
“The unadulterated Jackson Hole plan was simple, at least in theory. Called managed competition, it envisioned a Government-guided system of private health plans and insurance companies that would compete to enroll large regional pools of workers and other groups. Vigorous competition to win contracts with employers would drive down the cost of care. The savings would then be used to extend health care to the uninsured. Plans that enrolled disproportionately high numbers of young, healthy workers would subsidize plans with older and sicker workers.”
Hillary Clinton’s Potent Brain Trust on Health Reform
New York Times, February 28, 1993
Managed competition is still, as Mr. Clinton’s political adviser James Carville puts it, a term that “no person has ever heard of, only intellectual forces.” And it has its critics, including those who call it a kind of Insurance Industry Preservation Act and those who question whether it alone will truly control medical costs. But it has gained a wide following in recent years.
In theory, it would band employers and individuals into large cooperatives to purchase health insurance, giving small businesses and individuals the same bargaining power as big companies. On the other end, it would force doctors, hospitals and insurers to form partnerships that would compete for the cooperatives’ business, each trying to offer the highest-quality but least-expensive health plan….
Two of the principal advocates of managed competition are Alain C. Enthoven, a professor of economics at Stanford University, who began formulating these ideas back in the 1970’s, and Dr. Paul M. Ellwood, a pediatric neurologist from Minnesota who is widely considered a father of health maintenance organizations.
Dr. Ellwood, who practiced medicine for 17 years, has been advising and consulting on health policy and planning for many years through the research group he founded, called InterStudy. Mr. Enthoven, a former economist with the Rand Corporation and an assistant Secretary of Defense under President Johnson, has also consulted and written extensively on health issues. Along with Lynn M. Etheredge, a Washington-based health-care consultant, those two are considered the principal architects of the Jackson Hole initiative.
Medical Care’s Next Revolution
Fortune, October 10, 1988
(Page 2) ”What HMOs haven’t done, which I had hoped, is manage the content of medical care,” Ellwood says. Why not? ”HMO doctors are ignorant, just like all doctors.” Having shaken up the medical system once, Ellwood seeks to do it again. He wants the records of millions of encounters between doctor and patient, whether in HMOs or in the traditional fee-for-service system, recorded in computers and the results of treatment routinely monitored through follow-up questionnaires to patients. ”When we’re spending a half trillion dollars a year on health care,” Ellwood says, ”we ought to know what works.” Dr. Arnold S. Relman, editor of the influential New England Journal of Medicine, says that ”assessments” and the general concern about quality are ”the third revolution in medical care,” the first being the spread of health insurance and the second the revolt of the payers. Physicians must be in charge of the third revolution,
The project to redesign our health care system was initiated by George H.W. Bush. The first move by a member of Congress on the initiative was in 1990 when Senator John Glenn asked the GAO to do a study on the potential benefits of automation of medical records. But in fact, the Department of Energy and NIH had already signed a Memorandum of Understanding in 1988 “to foster interagency cooperation that will enhance the human genome research capabilities of both agencies”.
New Reality – Community Health Centers – Charity Care. Same as the Old Reality of charity care. It is first world implementation of third world health care – for a purpose.
The new president of the World Bank is Dr. Jim Yong Kim. Mr. Kim is the former Director of the HIV/AIDS initiative of the World Health Organization and a Co-Founder of Partners in Health with Dr. Paul Farmer.
What is a Community Health Center? Watch the 3 minute video to find out.
That’s the intro. Now we go back to the third world storyline to see what Jim Yong Kim was up to in Peru.
From multidrug-resistant tuberculosis to the HIV/AIDS pandemic, Dr. Jim Yong Kim has taken on some of the most difficult challenges of global health and found innovative ways to make progress. “I like to change people’s sense of what’s possible,” he told Newsweek in December 2003 after receiving a MacArthur Foundation genius grant. “Now I have a chance to do it on a global scale.”
… Scroll down
Lima’s shantytowns. This shed some light on the clusters of patients the Partners In Health doctors were seeing who were taking their drugs but not getting better.
Treating patients with multidrug-resistant TB was not only expensive; it was dangerous. “Our own health workers,” Kim recalls, “asked us questions like, ‘You’re asking us to take care of these patients, and we’re scared. Aren’t you scared?’ And I’ll never forget the answer that Paul [Farmer] gave was, ‘Yeah, I’m scared. Everyone’s scared. But look — it’s here, it’s in the community, and the only way to deal with this is to take it head-on and begin to treat the patients.’ You’ve got to treat people with MDR-TB to prevent it from spreading to others.”
Along with Farmer, Kim designed elaborate cocktails of rare drugs for their patients in Peru. Their means of getting the drugs to South America were unconventional, to say the least, bringing drugs in their personal luggage from Boston and into Peru. With these drugs come unpleasant side effects — nausea, fatigue, depression, joint pain — and patients were required to take them for two whole years. “We had to go and stand by them and convince them: ‘Please, you need to continue taking your medicines, because if you don’t, you’re going to die,'” Kim remembers. Doubts lingered as to whether the treatment would work, but it was crucial that the effort be made to treat these patients, not only for their own sake, but to prevent the strain of tuberculosis from spreading more widely throughout the community and the world.
Partners In Health developed powerful alliances with the local community, training health workers to visit patients in their homes and encourage them to take their medicines.
Look at the set up. In Peru, they trained community health workers that were illiterate. In the United States, they won’t be much more than that because they are being “produced” at the community colleges.
Let’s go back to the World News videos on Community Health. The video on the front page is titled Training at the Front Lines of Community Health. It’s a video produced by the University of Chicago on Common Core. Dr. Kohar Jones
Do pay close attention to her speech. She’s highly trained in “Nurse Ratchet” voice modulation. She slips up on the word “after” though… she is just a little to breathy making her training discernable. Also note that ABDC – Asset Based Community Development is mentioned.
Here is an article written by Dr. Kohar Jones:
Health Care Shouldn’t Start in the Emergency Room
Chicago Sun-Times November 2, 2012
The purpose of a health-care system should be to keep people well, with emergency rooms reserved for back-up care when health fails…. I practice in the Chicago Family Health Center, a community health center that is affiliated with the University of Chicago Medicine through the South Side Healthcare Collaborative. When patients go to the emergency room for care that is better handled in a community health center, patient advocates let them know about the possibility to make my health center their medical home.
We have the social workers, psychologists, nutritionists, case managers and health educators that patients need for a comprehensive approach to staying healthy.
Now… this woman Dr. Kohar Jones is supposedly also a bioethicist.
In my role as Director of Community Health and Service Learning at the University of Chicago’s Pritzker School of Medicine, I helped facilitate a discussion for first year medical students about the ethics of student run free clinics. This got me thinking about their future.
Student run free clinics are society’s stop-gap measure for the uninsured, a place for those without the means to see a doctor to connect with a physician via the intermediary of a student.
Providing acceptable-quality care to the patients who receive their care through student run free clinics will include providing information on how to sign up for health insurance through the exchanges. Ethical care will be connecting patients to the medical homes they need.
What will happen to student run free clinics when there are no more uninsured?
The impoverished uninsured may be those most likely to use the clinics now, and those most likely to be covered by Medicaid’s expansion in the states where Medicaid is expanding in the future. Is it fair for people who could be connected to a medical home, to instead be seen in a student clinic with a rotating cast of provider-learners? Ethical practices would need to have volunteers signing up eligible patients for health insurance through Medicaid or the exchanges.
That’s the bait and switch… dumping Medicaid patients into the hands of medical students with the “health care” provided including medical research – personalized medications, applied genetics research, etc.
This is even worse than I originally thought. I thought that at least they would provide Nurse Practitioners and Physician’s Assistants. Looks like Medicaid and the poor won’t even get that – which is all the better for genetics researchers working in the background and through the fiber optic cable of the Internet. When things go wrong and if it’s discovered, local officials won’t want to admit what they allowed to be set up and the student will take rap with no consequences because they are students.
But if you happen to have medical insurance and your own doctor, don’t be too smug because the above is the model for the new American system of non-health care. It’s so much cheaper to provide the illusion of health care without providing anything except a way to finance a large scale applied genetics research project on an unsuspecting population.
Forbes, December 5, 2011
…[Jim Yong Kim] Not the type to do anything halfway, he’s now, with increasing crescendo, trying to forge a market-driven solution to the nation’s unsustainable health care costs and using Dartmouth as a laboratory to do so. “My goodness,” he exclaims, “somebody needs to stand up and say, here’s a better way to do it.”
There’s never been a more critical moment. The Affordable Care Act, better known as ObamaCare, provides for universal coverage but is proving anything but affordable. Yes, there are billions projected in cost savings from modernizing our health system, but the law provides little framework for getting that done, just lots of money to study it.
“We’re trying to create a field here–it’s not a single discipline–where heads of hospitals, physicians, nurses, pharmacists, engineers and business specialists are all talking together about how to do health care better.”
Much of those costs–up to 30%–are unnecessary. Kim comes from the camp, based on two decades of Dartmouth research, that believes this waste can be eliminated by rewarding health care providers for better patient outcomes rather than more procedures. The trick is navigating a system of dizzying complexity: coordinating treatment across physicians and health systems, using universal medical records to avoid duplicative testing, employing Excedrin-level headache than any type of results.
But Kim has a tool that can potentially provide answers to the cost issues ObamaCare simply raises. This fall he launched the Center for Health Care Delivery Science. On paper it’s a master’s program. In reality it’s a grand experiment that mixes disciplines (management and systems engineering, economics, insurance, as well as medicine and health policy) and personalities (researchers and practitioners are paired). Four dozen of the best minds in their fields–the average age is 45, and most with two decades of top-flight experience–will meet weekly, usually virtually and sometimes in Hanover, N.H., for the next 18 months to participate in what Kim terms a “fundamental revolution in the way we think about health care.”
The Global Health Delivery Project, a joint initiative of the Brigham and Women’s Hospital, Harvard Business School and Harvard Medical School, is launched by World Bank Group President Dr. Jim Yong Kim, Dr. Paul Farmer, and Professor Michael Porter. Dr. Rebecca Weintraub is Faculty Director.
I’ll end with this loop around – connecting the dots.
Mr. Cluster**** Michael Porter
January 6, 2014
Reality Check. It was the big Foundations – Carnegie, Rockefeller and Harriman Foundations that provided funding for the Eugenics Movement that led to the eugenics programs in Nazi Germany.
Eugenics and the Nazis — the California Connection Eugenics would have been so much bizarre parlor talk had it not been for extensive financing by corporate philanthropies, specifically the Carnegie Institution, the Rockefeller Foundation and the Harriman railroad fortune. They were all in league with some of America’s most respected scientists from such prestigious universities as Stanford, Yale, Harvard and Princeton. These academicians espoused race theory and race science, and then faked and twisted data to serve eugenics’ racist aims.
In 1904, the Carnegie Institution established a laboratory complex at Cold Spring Harbor on Long Island that stockpiled millions of index cards on ordinary Americans, as researchers carefully plotted the removal of families, bloodlines and whole peoples. From Cold Spring Harbor, eugenics advocates agitated in the legislatures of America, as well as the nation’s social service agencies and associations.
The Harriman railroad fortune paid local charities, such as the New York Bureau of Industries and Immigration, to seek out Jewish, Italian and other immigrants in New York and other crowded cities and subject them to deportation, confinement or forced sterilization.
The Rockefeller Foundation helped found the German eugenics program and even funded the program that Josef Mengele worked in before he went to Auschwitz.