[font size="3"]Is it any shock that AMA committee has often significantly overvalued medical procedures by specialists?[/font]


Some of the most important players in setting the rates that Medicare and private insurers pay doctors are — surprise — doctors themselves. And — no surprise — certain procedures end up costing more than they should.

Here's how the system works: A little-known committee run by the American Medical Association, the trade association for doctors, analyzes thousands of procedures that doctors perform and recommends "relative values" to Medicare. More often than not, Medicare accepts the AMA data for its own complex process of setting doctor reimbursement rates.

In some ways, this make sense. Who knows more about the complexities of medical procedures than the people who actually perform them? The AMA's Relative Value Update Committee volunteers for the job and spends huge amounts of time in numbingly detailed discussions about how to value what doctors do.

But the committee is also a flawed operation that operates in semisecret. The panel gathers its raw data by surveying doctors about the time and intensity of the procedures they perform — helpfully reminding physicians that the survey can help set their pay. Is it any shock that the committee has often significantly overvalued procedures by the cardiologists, ophthalmologists and other medical specialists who make up most of its 31 members?

In 2010, for example, The Wall Street Journal reported that the committee was under fire from medical experts for overstating the time it took to place a cardiac stent in a patient's artery or perform carpal tunnel surgery on someone's wrist.
(more)

More than three-quarters of the Senate Republican caucus signed onto legislation introduced Wednesday by Sens. Tom Coburn (R-OK) and Rand Paul (R-KY) that could render it virtually impossible for Congress to enact any legislation intended to improve working conditions or otherwise regulate the workplace. Had their bill been in effect during the Twentieth Century, for example, there would likely be no nationwide minimum wage, no national ban on workplace discrimination, no national labor law and no overtime in most industries.

Like many Tea Party proposals to neuter the federal government, Coburn and Paul’s bill is marketed as an effort to bring America back in line with a long-ago discarded vision of the Constitution. It’s named the “Enumerated Powers Act of 2013,” a reference to the provisions of the Constitution outlining Congress’ specific powers, and it claims to require all federal legislation to “’contain a concise explanation of the specific authority in the Constitution’ that is the basis for its enactment.”

The key provision in this bill, however, would revive a discredited interpretation of the Constitution that America abandoned nearly eight decades ago. Although the text of the bill is not yet available online, a press release from Coburn’s office explains that it

“(p)rohibits the use of the Commerce Clause, except for ‘the regulation of the buying and selling of goods or services, or the transporting for those purposes, across boundaries with foreign nations, across State lines, or with Indian tribes.’”

To translate this language a bit, in the late 19th Century, the Supreme Court embraced an unusually narrow interpretation of the Constitution’s provision enabling Congress to “regulate commerce . . . among the several states.” Under this narrow reading, which lasted less than half a century, the justices said that they would only permit federal laws that regulated the transport of goods for sale or a sale itself. Manufacturing, mining, production and agriculture were all held to be beyond federal regulation. This theory was the basis for several decisions striking down basic labor protections, including a 1918 decision declaring a child labor law unconstitutional.
(more)

2 August 2013

US Senator Tom Coburn (Republican, Oklahoma) helped to insert language in a law that restricts federal political science research funding.

US political scientists are usually busy in early August, polishing proposals for grants from the US National Science Foundation (NSF). But not this year.

Less than one month before an annual mid-August application deadline, the funding agency has scrapped new political-science funding for the rest of 2013. The NSF declines to explain its reasons for eliminating the grant call, one of two that typically take place each year. But leaders in the field are blaming Congress, which on 21 March passed a bill requiring that NSF-funded political-science research benefit either national security or economic interests.

~~
~~


The NSF’s decision removes one of the main financial lifelines for political-science research. “This is somewhere between devastating and crippling,” says Henry Farrell, a political scientist at George Washington University in Washington DC and an author of the Monkey Cage, a widely read political-science blog. But Farrell blames the political climate rather than the funding agency for the cut. “The NSF is in an extremely awkward situation,” he says.
(more)

A measure limiting National Science Foundation funding for political science research projects passed the U.S. Senate on Wednesday, quietly dealing a blow to the government agency.

Sen. Tom Coburn (R-Okla.) submitted a series of amendments to the Continuing Appropriations Act of 2013, the Senate bill to keep the government running past March 27. One of those amendments would prohibit the NSF from funding political science research unless a project is certified as "promoting national security or the economic interests of the United States."

[font color="red"]"Studies of presidential executive power and Americans' attitudes toward the Senate filibuster hold little promise to save an American's life from a threatening condition or to advance America's competitiveness in the world," [/font]Coburn wrote in a letter to NSF director Subra Suresh last week explaining his proposal.

Coburn's NSF amendment was approved by the Senate during a voice vote on Wednesday afternoon.
(more)

The auto industry got off to a powerful start to the second half of the year in July, with a 14% sales increase due to strong demand for pickups and small, fuel-efficient cars.

Now the test is to see whether it can be maintained.

General Motors occupied the top spot on overall sales, with a 16.3% increase over the same month a year earlier. But in a surprise, Toyota rode a 17.3% increase to take the second spot in cars sold, usually occupied by Ford, which had an 11.3% boost. Toyota was ahead by only 314 vehicles out of 193,394 it sold during the month.

Honda was in fourth place with a 20.9% increase, and Chrysler Group came next with a 11.1% rise, Autodata reported Thursday.
(more)

WASHINGTON — Democratic-aligned super PACs raised more than twice as much as Republican groups during the first half of the year, newly filed campaign reports show.

Democratic groups collected $31.9 million between Jan. 1 and June 30, while organizations affiliated with Republicans brought in $13.7 million, according to a USA TODAY analysis of super PACs that raised at least $100,000.

It's a stark reversal from the 2012 presidential and congressional elections when Republican groups dominated spending.

Americans for Responsible Solutions, a gun-control group created in January by former Arizona congresswoman Gabrielle Giffords, led the way, bringing in $6.6 million. Other groups backing Democratic politicians and policies also posted strong fundraising totals.

The House Majority PAC, working to elect Democrats to the House, raised nearly $3.4 million — more than four times the $773,246 raised by the two leading groups (Congressional Leadership Fund and YG Action Fund) working to retain the Republican majority in the House.
(more)

This week the President offered Republicans a corporate tax reform plan that basically gives them everything they want (before negotiations even begin,) in exchange for please allow We the People to have some jobs and infrastructure and education. The Republican leadership pre-demanded additional tax cuts for the wealthy, while rejecting out-of-hand the idea that government should do anything to help the economy or people. Tea Party Republicans went further, saying taxes are theft and and government is socialism, and demanding an end to or at least drastic reductions in government programs that help people, plus the repeal of Obamacare, or they will both shut down the government and force a default when the debt-ceiling is reached.


The President’s Proposal

In Chattanooga President Obama offered a new “Grand Bargain for the Middle Class,” offering huge corporate tax cuts and a huge “tax holiday” on profits parked overseas to avoid taxation, saying he offers this “as long as we use the money … for a significant investment in creating middle-class jobs.”

Specifically the President asked for funds to:

> Put construction workers on the job rebuilding our infrastructure

> Expand our network of high-tech manufacturing hubs

> Strengthen job training at community colleges


Also, the President wants Congress to raise the minimum wage. (Note: 40% of Americans now make less than the 1968 minimum wage, had it kept up with productivity gains. The difference went — well, see if you can guess where it went.)
(more)