hummingbirdminds

No clear-cut answers left behind after suicides in WY & WI & CA

2009-11-28T11:26:00.024-07:00

My wife Chris and I attended a funeral yesterday for Charles, one of my son's best friends from high school. I will use just his first name, out of respect to his family which I barely know. Charles hanged himself at home. He was 24.

Charles and my son Kevin were both hyperkids -- impulsive kids diagnosed at a young age with ADHD. Often in trouble at school -- when they went. They spent many days skateboarding and riding bikes and playing video games. They also drank and used drugs.

We ferried Kevin to a treatment center in Florida when he was 17. He was there for a year and came home clean and sober and has remained so. He lives in Tucson.

Charles took the rocky road. He was in jail for a time but worked his way out with the help of a transition program. Met a girl. Married. They had a baby girl a few months ago.

Things seemed to be looking up for Charles.

The day before Thanksgiving, Charles hanged himself at home. Yesterday was the very sad funeral. Always is when a young person leaves us in this way.

Last March, James Weigl, an Army veteran of Iraq, hanged himself in his garage in Cedarburg, Wisc. He was 25, not much older than Charles. He's one of 129 soldiers and marines who committed suicide during the first half of 2009.

Meg Kissinger wrote an incredible story for the Milwaukee Journal-Sentinel about Sgt. Weigl's life and death. His parents are outraged at the Army that their son didn't get the mental health care he needed. Some say that Weigl shouldn't have been in the service, that he had two medical conditions that should have made him ineligible. One of those was a diagnosis of Attention Deficit Hyperactivity Disorder.

I'll leave it up to you to read this sad story. Getting to the bottom of events like this is what real newspaper reporters do well. We'll miss them when they're gone. Read the article at http://www.jsonline.com/news/wisconsin/70721137.html

Is this weren't enough, NPR this morning featured a pair of stories about teen suicides in California. During the past six months, four Palo Alto teens have killed themslves by jumping in front of trains.

From Palo Alto Online:

Between 20 percent and 23 percent of deaths ruled suicides in Santa Clara County in the past two years were individuals under 30 years old, according to the Santa Clara County Medical Examiner's Office. In both 2007 and 2008, the county had 31 suicides of people under 30. The coroner did not provide city-by-city breakdowns.

Philippe Rey, a psychotherapist and executive director of Adolescent Counseling Service, said Palo Alto's teen suicide rate is in line with national statistics.

That's discouraging. Fifteen suicides a year by young people in a mid-sized city is "in line with national statistics."

Those 129 soldiers and marines who committed suicide in the first six months of 2009 must be "in line with national statistics."

And here are some stats about teen suicides in Wyoming (a bit dated, but still relevant):

Mortality data from the Centers for Disease Control and Prevention (CDC) spanning the five-year period from 2001-2005 show that suicide rates for Wyoming teens ages 15-19 are more than twice as high as national rates for this same population (WY rate of 17.48 per 100,000 deaths versus U.S. rate of 7.70 per 100,000 deaths). An alarming one in six Wyoming high-school students reported making suicidal plans within the previous year according to the 2007 Youth Risk Behavior Survey, representing a 13 percent increase over 2005 data.

It appears that Wyoming's teen suicide numbers ARE NOT "in line with national statistics."

They're much worse.

Dems meet Nov. 30 in Cheyenne

2009-11-28T00:28:00.008-07:00

The Laramie County Democrats and the Democratic Grassroots Coalition meet together on the LarCoDems' regular meeting night on Monday, Nov. 30, 6-8 p.m., at the IBEW Hall, 810 Fremont Ave., in Cheyenne.

Menu includes hot dogs and chili, as well as hamburgers donated by Mae Kirkbride. Donations accepted.

Democratic State Senator Kathryn Sessions will be the speaker.

FMI: http://www.laramiecountydemocrats.org/

If Dallas can re-vision, why can't Cheyenne?

2009-11-27T22:38:00.011-07:00

I have nothing against Dallas. It's a good city, a sprawling megalopolis that creeps as far as Fort Worth to the west and sends tentacles into surrounding counties in all directions.

But who would have thought that Dallas would be the model for "Green" city planning?

The city recently held a competition to submit eco-friendly designs for a block near the city center. The winning design recreates a hillside in the city -- with some amazing results.

Here's some samples from last week's article in Re:Vision Dallas that I thought were interesting:

Forwarding Dallas is modeled after one of the most diverse systems in nature, the hillside. The site is a series of valleys and hilltops, the valleys containing trees and more luxurious plants which transition into more resistant plants as the altitude increases. Atop the hills, solar thermal, photovoltaic and wind energy is harvested.

Other design components include open ‘green’ spaces, housing options from studio apartments to three bedroom flats, a rooftop water catchment system designed to recycle water collected from rooftops and store underground for later use, a 100% prefabricated construction system and public green houses, including a sensorial greenhouse, swimming pool green house and meeting point green house.

A spiritual space, gymnasium, café and exhibition space are also planned to accommodate various lifestyles. There is a temporary accommodation center as well as a daycare center designed for both children and the elderly.

“What I would love to see is an entire section of downtown notable for innovative, sustainable design–an attraction in the southern part of downtown balancing the Arts District in the northern part of downtown," said John Greenan, Executive Director for Central Dallas CDC. "There are already some interesting, green projects in The Cedars immediately to the south of downtown.
A sustainable district that extends from downtown all the way into The Cedars neighborhood is a very reasonable possibility.”

For more information on Urban Re:Vision, visit http://www.urbanrevision.com/

I like the fact that Dallas is thinking big. What's more Texas than that? Wish that my much-smaller city of Cheyenne, Wyoming, would take a few leaps forward. Lots of empty buildings downtown. There is a big hole that's been sitting vacant on our main drag ever since a building burned down. Perhaps we could hold a similar competition to come up with an ecological design for Cheyenne's Big Hole.

And the Dallas CDC guy's quote includes talk about the city's Arts District. I prefer the term "Artists' District," as in Phoenix's Roosevelt Row, a place where artists live and also exhibit their work, sometimes in the same building. Arts districts that just feature galleries and museums can be as dead as any downtown block when the businesses close. Make a place for artists, and you have a lively neighborhood.

It can be one that replicates a Texas Hill Country hillside. Or it can be one in which artists rehab abandoned buildings to make live-work spaces. Just takes some imagination and creativity.

We thankfully provide Sen. Alexander food for thought on Thanksgiving

2009-11-26T11:50:00.005-07:00

From Think Progress, which always provides such great links (http://thinkprogress.org/2009/11/21/alexander-medicaid-ghetto/):

While Alexander may think he is too good for Medicaid coverage, a 2005 Kaiser Family Foundation poll found that 74 percent of Americans consider Medicaid very important and most would oppose cuts to the program. Families USA has pointed out that, despite its flaws, Medicaid is cost-effective and provides a solid foundation on which to expand coverage:

Medicaid is cost-effective compared to private health insurance. After controlling for health status (since Medicaid enrollees tend to have greater health care needs), it costs more than 20 percent less to cover low-income people in Medicaid than it does to cover them in private health insurance.

Sen. Alexander: Come on down to the Medicaid Ghetto and learn something

2009-11-25T22:56:00.006-07:00

As always, 4&20 blackbirds blogging from the wilds of Missoula, Mont., provides a forum for westerners to debate (and rant about) current events. Health care reform was on the agenda yesterday. A great post by JC prompted a flurry of responses. It focused on Tenn. Sen. Lamar Alexander and his remarks equating Medicaid coverage with living in a ghetto. As I can't do justice to the post and the attendant responses, go to http://4and20blackbirds.wordpress.com/2009/11/22/a-medical-ghetto-called-medicaid/.

I had to respond. Couldn't help myself. Here's my comment:

I know it's superfluous to address the details of JC's post, but let me take a stab at it.

First, Lamar Alexander's quote: "a medical ghetto called Medicaid that none of us or any of our families would ever want to be a part of for our health care.”

Our family actually requested entry into the Medicaid "ghetto" when our teen daughter was in a mental health residential treatment center in 2008. She was self-mutilating and had threatened to kill herself, and was eventually diagnosed as bipolar. She was in treatment for 330 days. My insurance covered 45 of those days, with a 20 percent co-pay.

What to do? The Wyoming Dept. of Health funds a Medicaid Waiver Program that picks up the bill for children and teens that need long-term treatment but are either uninsured or under-insured, the fate of most Americans who work full-time. This is especially true when it comes to mental health care.

It took me awhile to find out about the program and to fill out the correct paperwork. Once enrolled, taxpayer dollars (yours, mine and maybe even a few from Lamar Alexander) picked up the tab for my daughter's care. We traveled 400 miles round trip to see her each weekend and participate in therapy sessions.

When she was released in January 2009, she received after-care in the form of medication and therapy. Trained specialists documented her progress, and on Sept. 30 she was cleared to come off the waiver.

I'm still calculating the costs covered by Medicaid. Somewhere in the neighborhood of $150,000. We never could have afforded it.

We met a lot of our Medicaid ghetto dwellers along the way. Middle class folks. Most grief-stricken that their kids were in trouble. But thankful that there was an alternative to letting their kids travel alone and untreated down the dead-end road of teen suicide and schizophrenia and bipolar disorder and drug/alcohol abuse.

My daughter's doing fine (thanks for asking) and is back in school and staying on her meds. My insurance company, for all its shortcomings, is paying the bills and we pick up the co-pays. We learned a few things from our time in the ghetto. Sen. Alexander should take some time out from pontificating and explore the lives of real people.

Sunlight of a Cheyenne autumn morning

2009-11-25T10:27:00.009-07:00

Driving my daughter Annie along I-25 this morning to visit a friend. She commented that she liked this part of the morning, about 9 a.m. The way the light looks and feels, the way it lights up the prairie. I had to admit that it was a beautiful November morning. Great light for an artist. Wispy horsetail clouds lit up on the eastern horizon. Even the gray Wyoming steppes looked brighter.

As I drove home alone, I paid more attention to the light. On top of the College Drive overpass, I saw a UP train traveling east, its dozens of white freight cars lit up by the sun. I wondered if it was a coal train. How funny that a coal train chugs east under the bright blades of Cheyenne's wind farm just west of the hulking white Wal-Mart distribution center. Between the rail line and the wind farm, I-80 stretches out, trucks pulling uphill toward the Laramie Range Summit and some all the way to San Francisco. Eastbound truckers are damn happy to be out of the mountains and Wyoming's crappy late-autumn weather and wild winds.

Not sure why autumn's morning light made me think of energy and transportation. But the College Drive overpass on top of I-25 gave me a great view of Cheyenne's reasons for being. Highway crossroads. Railroads. Wind farm to the west and Frontier Refinery to the east. If I look hard enough, I can see a few pumping oil wells out in the county. Up north is F.E. Warren A.F.B. and its many nukes. Guess you could call this an energy issue, although Warren's nukes are wrapped up in strategic metal and pointed at targets in the former Soviet Union. Odd to think that the former Commie powerhouse may now be a bigger threat as an energy-producing giant than it was as a Cold War "We Will Bury You" opponent.

Are nukes one of the solutions to the energy crisis? Right now, uranium is being mined again in northeast and central Wyoming. An in-state nuke plant could be in our future.

Deep thoughts on the day before Thanksgiving. Autumn's morning light shines on the present, provides clues to a possible future which often doesn't look so bright.

In the trenches with Dick "5 Deferments" Cheney

2009-11-24T20:02:00.008-07:00

Casper's Dick "Five Vietnam War Draft Deferments" Cheney knows war from the grunt's P.O.V. Just listen as he speaks on right-wing radio:

I worry that there’s a lack of understanding there of what this means from the perspective of the troops. You know, if you’re out there on the line day in and day out and putting your life at risk on a volunteer basis for the nation, and you see the Commander in Chief unable, to or appearing to be unable, to make a decision about the way forward here — you know that raises serious doubts. Nobody wants to think of volunteering to be participate in that kind of operation.

[...]

It may in part be inexperience on Obama’s part. It may be that there’s confusion on the staff. But I’m not encouraged by it.

Think Progress shares some insights (and a clip) at http://thinkprogress.org/2009/11/24/cheney-military/

Full disclosure: I also had five draft deferments, 1968-1973, one while I was in ROTC. I never served in the active-duty military, yet I also never served as U.S.V.P. and invaded sovereign countries for bogus reasons, causing untold death and suffering.

Local physician sees need and steps in

2009-11-24T11:06:00.007-07:00

From the Associated Press 11/24:

A doctor in Cheyenne says he'll open an interim free clinic to help patients that will be otherwise without care when the Cheyenne Community Clinic closes at the end of the year.

Dr. Jason Bloomberg with Access Health Care says he'll have Tuesday evening free clinics at his practice starting next year to keep patients from having a gap in treatment.

Bloomberg says he'll offer the clinics for up to six months, or until there is another provider who can offer free medical care in the region.

Murray Lou Rex is the director of the Cheyenne Community Clinic. She says it's a tremendous undertaking, and she hopes other providers will volunteer to help Bloomberg in his efforts.

Dr. Bloomberg was a Hillary Clinton delegate to the May 2008 Wyoming Democratic Convention in Jackson and was selected as a delegate to the August 2008 national convention in Denver. While his preferred candidate was not chosen, he worked hard to get out the vote for Obama.

A community-minded citizen. To read a an 8/1708 pre-c0nvention profile, go to http://hummingbirdminds.blogspot.com/2008/08/meet-dnc-delegates-jason-bloomberg.html.

Find out more about Access Health Care at http://www.accesshealthcheyenne.com/. It's located at 3100 Henderson Dr., Cheyenne. Call 307-426-4673.

UW's Science Posse gets big NSF grant

2009-11-24T09:12:00.007-07:00

Phil Noble at the Cowboy State Free Press reported two science-related stories on 11/23. The first was about the new supercomputer being built west of Cheyenne. Great news for Wyoming's science footprint and also economic development -- the kind that actually has a huge impact on the economy and education. Sure, credit card call centers are keen, and Wal-Mart distribution centers even keener, but this NCAR-supported supercomputer will be a research hub and employ a highly educated work force. Not a huge work force, but one with clout. UW Trustee Dr. Taylor Haynes of Cheyenne says that this project “will be the first true diversification of Wyoming’s economy.”

The more intriguing story was about the University of Wyoming Science Posse. Here's the story:

A nearly $3 million grant from the National Science Foundation will help the Science Posse, a group of University of Wyoming graduate students whose primary goal is to raise awareness and understanding of science, expand its offerings to schoolchildren across the state.

The five-year grant — awarded to Don Roth, the Science Posse’s principal investigator and a UW professor of molecular biology and pharmacy — will allow the Science Posse to add education on the complexities between water and energy to its already expansive list of offerings.

The NSF grant will continue through 2013 at $575,463 per year, contingent upon the availability of funds and the project’s scientific progress.

The Science Posse has worked with about 70 teachers and 2,500 students in 12 Wyoming counties and 34 schools since its creation in 2006. The group’s goals are to increase public appreciation and awareness of science, improve students’ understanding of science, inspire students to consider careers in science, technology, engineering and mathematics and develop and enhance partnerships between UW and the Wyoming energy industry.

Go to the Science Posse web site at http://www.scienceposse.org/.

This is not about a billion-dollar computer. It's about some faculty and graduate students getting together to spread the word about science. Maybe you could call them techie community organizers. I will.

Wyoming's future: from Equality State to Land of the Dumb & Sick

2009-11-23T10:18:00.009-07:00

Digby recounts a Chris Matthews interview with Mississippi Governor Haley Barbour talking about how Mississippi has all the answers to our health care woes. An excerpt:

Barbour: ...candidly, a lot of Republicans, including me, believe it would be much better to let the states do some things like we've done in Mississippi where we've had serious tort reform and our medical liability reform has brought down insurance premiums by 60 percent in four years, we have reformed Medicaid so that we are saving the taxpayers money. We think let the states go for a while, see what works see what doesn't and then come together with a rational bill at the federal level is a better approach.

Mississippi rates 51 (out of 50 states plus DC) in health care ranking.

In the same ranking by The Commonwealth Fund, Wyoming ranks right in the middle at number 25 [http://www.commonwealthfund.org/Charts-and-Maps/State-Scorecard-2009/DataByState/State.aspx?state=WY].

Not great but not terrible. Our adjoining Rocky Mountain and High Plains states do a little better, with Montana at 18th, Utah at 19th, Colorado at 24th, Nebraska at 13 and South Dakota at 12. Wyoming's only neighbor that ranks lower is Idaho at 29.

I wonder how many Nebraskans and Montanans would trade their health care for that enjoyed by the lucky people of Mississippi? If Republicans ruled the world of health care reform, we could say "We’re all Mississippians now!" If we were still alive to do so.

This could be especially bad in Republican-controlled states such as Wyoming and Idaho if health care were left up to the states.

The South always ranks at the bottom in those categories that count, such as health care and education. They tend to send Republicans to D.C. to illuminate the rest of us on education and health care reform, not to mention the inerrancy of the Bible. If Wyoming’s delegation keeps voting with their Deep South counterparts, we too could be the land of the dumb and the sick. And we’d be praying like hell for something different.

Fact Check: Wyoming Sen. Barrasso's statement on health care reform

2009-11-22T20:55:00.005-07:00

The Wyoming Democratic Party did a little research and came up with a fact check on some health care reform comments by Wyoming Sen. John Barrasso, M.D. (hope he's a better doctor than researcher):

Brianna Jones, WyoDems communications director: Please see below for a fact check of the claims made by Senator Barrasso on the floor of the Senate just now on how the Patients Protection and Affordable Care Act would affect Medicare:

Sen. Barrasso: “When you look at the details of this bill, this is going to cut almost $500 billion. $500 Billion from our seniors who depend on Medicare for their health care.” [Barrasso Floor Speech, 11/20/09]

REALITY: MEDICARE SAVINGS DO NOT CUT BENEFITS

AARP: Statement That Reform Would Cut Medicare Benefits Is “Misleading And Alarmist,” And “The Proposed Medicare Savings Do Not Limit Benefits, They Do Not Impose Rationing.” The Wall Street Journal reported that, “[t]he Republican Party issued a new salvo in the health debate Monday with a ‘seniors' health care bill of rights’ that opposed any moves to trim Medicare spending or limit end-of-life care to seniors. Intended as a political shot at President Barack Obama, the Republican National Committee manifesto marks a remarkable turnaround for a party that had once fought to trim the health program for the elderly and disabled, which last year cost taxpayers over $330 billion…The country's largest lobbying group for seniors, AARP, said it welcomed the RNC's commitment to protect Medicare. But the group, which supports efforts to overhaul the health-care system, also dismissed the RNC statement as misleading and alarmist. ‘Change by itself is anxiety producing, but as we have analyzed the various bills [before Congress], the proposed Medicare savings do not limit benefits, they do not impose rationing and they do not put the government between patients and their doctors,’ said John Rother, AARP's executive vice president.” [Wall Street Journal, 8/25/09]

Hospitals Group Refuted CMS Actuary Report: “Hospitals Always Will Stand By Senior Citizens. This Summer, Hospitals Agreed To Contribute Substantial Medicare Savings Are Part Of Our Shared Sacrifice To Reform Health Care.” Politico Live Pulse reported: “The following statement was released today by Chip Kahn, President of the Federation of American Hospitals: Hospitals’ commitment to our mission of serving the health care needs of seniors in communities across America is steadfast. A memorandum recently issued by the CMS Actuary analyzing the effects of “America’s Affordable Health Choices Act of 2009” (H.R. 3962) concludes that some providers may end their participation in the Medicare program. Hospitals always will stand by senior citizens. This summer, hospitals agreed to contribute substantial Medicare savings as part of our shared sacrifice to reform health care and achieve near universal coverage for all Americans. We are pleased with the legislative progress as well as the movement towards market-based solutions. And we look forward to working with Congress and the Administration to enact legislation that will enable hospitals to continue to provide our patients, including seniors, with ready access to the highest quality health care possible.” [Politico Live Pulse, 11/16/09]

Medicare Advantage Health Economist: 86 Percent Of Extra MA Payments Went To Profits, Only 14 Percent Went To Extra Benefits – “Cuts To MA Should Be A No Brainer.” Health Economist Austin Frakt, a professor at Boston University, has studied Medicare Advantage plans extensively and wrote on his blog about his findings: “Payment to MA plans has gone way up since 2003. Did the payment increase largely benefit beneficiaries or not? This is a current political and policy debate, about which much has been written in the media (both traditional and blogospheric). It turns out the answer is known and quantifiable. My work (with Steve Pizer and Roger Feldman) shows that for each additional dollar spent by the federal government (taxpayers) on the program since 2003, just $0.14 of it can be attributed to additional value (consumer surplus) to beneficiaries (see also: findings brief). What do we make of the other $0.86? That goes to the insurance companies but doesn’t come out “the other end” in the form of value to beneficiaries. In part it is accounted for by the costs of the additional benefits and in part it is captured as additional insurer profit. So, do higher MA payments produce little value to beneficiaries, as Obama claims, or are the benefits they fund important to maintain, as Republicans would have us believe? The balance of the evidence is on Obama’s side. In fact, it is a landslide: for each dollar spent, 14% of the value reaches beneficiaries and 86% of it goes elsewhere (profit or cost). Cuts to MA should be a no brainer.” [Incidental Economist - Austin Frakt, 9/28/09]

REALITY: REFORM WOULD STRENGTHEN MEDICARE

CBO On Senate Bill: Medicare Savings Amount To $491 Billion. In its estimate of the Senate reform bill, CBO wrote: “Other components of the legislation would alter spending under Medicare, Medicaid, and other federal programs…In total, CBO estimates that enacting those provisions would reduce direct spending by $491 billion over the 2010-2019 period.” [Congressional Budget Office, 11/18/09]

Senate Bill Includes $500 Shrinkage Of Medicare Prescription Drug Donut Hole In 2010. Politico Live Pulse reported that, “[i]n what can be viewed as an election-year sweetener for senior citizens, the coverage gap in the Medicare prescription drug program would shrink by $500 in 2010 only under the Senate bill. A Senate leadership aide described it as a ‘downpayment’ on closing the donut hole. ‘Our goal is to get it closer to the House bill,’ which would eliminate the coverage gap over the next decade, the aide said.” [Politico Live Pulse, 11/18/09]

AARP CEO: House Bill “Includes Critical Priorities For Seniors…Provides And Strengthens Medicare For Today’s Seniors And Future Generations.” The Hill reported on AARP’s endorsement of House Democratic health reform. AARP CEO A. Barry Rand said, “[t]his bill includes critical priorities for seniors – critical – ensures quality, affordable health coverage options for all Americans, provides and strengthens Medicare for today’s seniors and future generations and puts us on a path to improving our long-term health system.” [The Hill, 11/5/09]

New York Times: Reform Will Enhance Drug Coverage, Reduce Premiums, and Help Keep Medicare Solvent. “Far from harming elderly Americans, the various reform bills now pending should actually make Medicare better for most beneficiaries — by enhancing their drug coverage, reducing the premiums they pay for drugs and medical care, eliminating co-payments for preventive services and helping keep Medicare solvent, among other benefits.” [New York Times, Editorial, 9/27/09]

Progressives bring opposing P.O.V. to Casper teabagger rally

2009-11-22T14:14:00.005-07:00

Casper progessives joined with a contingent from Laramie to present an opposing point of view at a teabagger rally Saturday across the street from Wyoming Medical Center. According to Laramie's Meg Lanker, the Casper tea party rally was co-sponsored by the Wyoming 9/12 Project, Wyoming Watchdogs and Wyoming Patriot Alliance worked with Docs 4 Patient Care. The rally was held Saturday just before the U.S. Senate held an historic vote to debate the health care reform bill. That debate will start after Thanksgiving. But we can give thanks now that the bill won't be stopped by a Repub filibuster. By the way, Wyoming's two senators voted with fellow Repubs to try to thwart health care reform for America. One of those senators is a physician, or so he says. Thanks to Meg Lanker for the photo

11/23 UPDATE: Read the Casper Star-Trib's account of the event at http://trib.com/news/local/article_5d19ef65-7f8e-5705-acd5-ab088fa7e7d7.html.

Letter from D.C. -- and my response

2009-11-20T17:17:00.009-07:00

Letter from Wyo. Rep. Cynthia Lummis, with her comments in red and mine in blue:

Dear Michael:

Thank you for contacting me regarding healthcare reform. It is good to hear from you.

Congressional Democrat leaders are working to create a new government-forced healthcare system that would put government bureaucrats between you and your doctor. The House Democrats' proposal - the Affordable Health Care for America Act of 2009 (H.R. 3962) - requires all individuals to purchase health insurance and all employers to provide health insurance to their employees or face steep tax penalties. The bill creates at least 111 new offices, programs and other bureaucracies - including a "Health Choices Commissioner" - that together will dictate to all Americans what health insurance they will be forced to purchase and how much the government should pay medical providers. The bill contains no prohibitions on federal bureaucrats denying access to life-saving treatments for patients.

No prohibitions exist at this time to prohibit health insurance company bureaucrats from denying access to necessary life-saving treatments to patients. Often, those insurance flunkies have no medical background and are making some pretty big decisions on long-term hospital stays, operations, and mental health treatment. You could call this rationing, and is exists now.

I don't know how many times I've chided Republicans for using "Democrat" instead of "Democratic" when referring to the party. We don't say "Republic Party," although some 10th amendment teabaggers might prefer the term. One of these days, the Republics will learn.

I agree with President Obama that people should be able to keep their health coverage if they like it, but this is not the case under H.R. 3962. While estimates range from several million to up to 114 million, experts agree that millions of Americans will end up being enrolled in the new government-run health plan created by H.R. 3962, many not because of choice but because of coercive government policies. Members of Congress, however, will not be required to enroll in the government-run health plan. Members of Congress who support this bill should be subjecting themselves to the same big government policies they wish to impose on the American people.

Members of Congress such as Rep. Lummis now are enrolled in a government-run health care system. Don't hear many complaints. Rep. Lummis underwent an operation earlier this year in Casper. Wonder if she used her taxpayer-funded health insurance to cover the bills.

To partially finance this over $1 trillion expansion of big government, the House Democrat health reform bill imposes over $700 billion in new taxes on individuals and businesses of all sizes. This includes $135 billion in taxes on individuals and businesses who cannot afford to purchase government-approved health insurance. Individuals would be subject to this tax regardless of their income, violating President Obama's pledge not to raise taxes on anyone making less than $250,000 a year.

I agree with Rep. Lummis that this tax issue is disturbing. I do think that some of that $700 billion in new taxes will come from rescinding Pres. Bush's tax cuts for the wealthy. I will check this.

Our nation's seniors would also have to foot some of the bill. The non-partisan Congressional Budget Office estimates that H.R. 3962 will raise seniors' Medicare prescription drug premiums by 20 percent, even as Social Security benefits are estimated to stay flat for the next few years because of the bad economy. H.R. 3962 also slashes $150 billion from the Medicare Advantage program in which nearly 3,000 seniors in Wyoming are enrolled and from which they can obtain extra benefits and lower copayments.

Translation: seniors vote -- don't cross them.

I joined both Democrat and Republican Members in calling for the final language of H.R. 3692 to be posted online 72 hours before the House is expected to vote. Within this 72 hour period, I offered amendments to H.R. 3962 to allow states to protect their citizens from government-forced insurance, unfunded mandates, taxes and possible imprisonment for not buying bureaucrat-approved coverage, and government policies that come between patients and their doctors. My amendments and dozens of others were not allowed consideration on the House floor by the House Rules Committee, which also made several last minute changes to the bill the night before it was considered on the House floor. I voted against H.R. 3962, which passed by a vote of 220-215. A similar bill is now pending in the Senate.

I am urging our senators to vote for the Senate health care bill. They will not, but I shall continue urging them on until I am blue in the face. All over my body, and in my heart, too.

As an alternative, I support the Empowering Patients First Act (H.R. 3400). Under H.R. 3400, low-income, uninsured individuals would receive a tax credit to help them purchase private insurance. All Americans would receive a tax deduction for healthcare insurance costs, not just those that receive coverage through their employee. H.R. 3400 would devote more federal funds for state-based high-risk pools for those with pre-existing conditions that are unable to obtain private insurance. The plan would also allow small businesses to join together across state lines and create their own affordable health insurance plans. To safeguard access to medical care for Wyoming's seniors, H.R. 3400 prevents a scheduled 20 percent cut in Medicare payments to physicians. Perhaps most importantly, H.R. 3400 respects and upholds the notion that individuals, not the government, should be in charge of their healthcare dollars.

This sounds like more Republican dithering. This is supposed to be reform, not tinkering.

H.R. 3400's cost to the taxpayer is fully offset. It accomplishes this in part by imposing a one-percent cut in non-Defense spending and repealing unspent economic stimulus funds. H.R. 3400 would also step up efforts to eliminate waste and fraud in our entitlement programs and reduce defensive medicine through targeted medical liability reforms.

Let's impose a 1 percent cut in non-Defense spending and a 2-percent cut in Defense spending. This can be accomplished by finally getting the hell out of Iraq. It's time to stop bringing democracy and security and higher education and better healthcare to Iraqis and start bringing it to Americans.

As the healthcare reform debate continues, I will continue focusing on patient-centered and not government-centered solutions to improve access to affordable healthcare in rural and frontier America. In Wyoming, it's not just cost that gets in the way of your healthcare, it's a lack of providers, whether for primary, specialty or mental health care. I have joined the House Rural Health Care Coalition to address the unique healthcare challenges we face in Wyoming that are not fully understood by our urban counterparts, such as reimbursing doctors and hospitals more fairly for Medicare patient procedures.

I am impressed that Rep. Lummis addresses accessibility to health care in Wyoming. I'm even more impressed that she mentions mental health care in our 97,000-square-mile state with not one pediatric psychiatrist. Thank you for joining the House health Care Coalition.

As for government-centered vs. patient-centered care... How can she call the current system "patient-centered?" Yes, Wyomingites with insurance can make the claim that they can visit the doctor or dentist or surgeon of their choice. I do that. Often those professionals are located down I-25 in Fort Collins, Loveland and Denver. Still, most are in the Great West/CIGNA network and I usually pay only the 20-percent deductible. I am employed and am lucky to have insurance for myself and my diabetic wife and my daughter with epilepsy and mental health issues. I also have the advantage of living in the state's largest city, Cheyenne, and right on the border of a more populous and more health-conscious state

But Wyomingites in small towns don't have much choice. The town may only have a few doctors and maybe a dentist. That's their choice. They can drive 50 or 100 or 300 miles to the nearest cancer or pulmonary specialist. Veterans have a choice of V.A. Hospitals in Cheyenne and Sheridan, and across the border in Rapid City. The V.A. sponsors shuttles to get these vets to a doctor. Sometimes they don't have a choice of doctors, but... Hold on. Vets have the best health care system that taxpayer funding can buy. Popular with Vets, too. Just ask one. Doggone that terrible government-centered health care!

Speaking of government-funded solutions... Thousands of the state's citizens get Medicaid funding. These are people with no insurance, or insurance that's inadequate for required medical or mental health treatments. Approximately 75,000 of our people are covered under Medicaid, including 50,582 children (2008 Children's Defense Fund figures).

Thank you again for sharing your thoughts with me on an issue of importance to all of Wyoming's citizens. Please keep in touch, and I look forward to seeing you in Wyoming.

Sincerely,

Cynthia M. Lummis
Member of Congress

You're welcome, Rep. Lummis. Be seeing you next time you're in Wyoming.

CIGNA -- can you hear me now?

2009-11-20T11:46:00.008-07:00

This comes from Badtux the Snarky Penguin (via Skippy the Bush Kangaroo), a blog that's new to me. Then again, lots of things are new to me. Oh brave new world that has such blogs in't! And I'm always partial to prog-blogs with animal names.

CIGNA denies hearing implant to child who will never be able to hear if she doesn't get it within the next few months [link to think progress].

Isn’t it wonderful that in the right wing's wonderful free market world this child doesn’t have to worry about the evil government getting between her doctors and her health care? And the magical Free Market Fairy smiles because that's $20,000 higher bonus that CIGNA's CEO can get next year. Why do you want to make the Free Market Fairy frown by, well, saying that this girl should be receiving the health care that her parents paid insurance money for? Heresy!

So why are we bothering with protecting these bastards, again?

Good question, Badtux. Cigna is my health insurer, mysteriously taking over from Great West Life about a year ago. The State of Wyoming pays the majority -- but not all -- of my health insurance premium which goes to a company that denies health coverage to six-year-olds whose families pay health insurance premiums. All those premiums get bundled together to pay a bonus to the CIGNA CEO who gets rich denying health care to little girls.

It's again time to share the new CIGNA logo

New revised logo by Ryan O'Connell and featured on Sick for Profit.

Dear Rep. Lummis: You'll be known by the company you keep

2009-11-19T21:52:00.008-07:00

Rep. Cynthia Lummis toes the Republican National Committee line on most issues. She's consistently voted against health care reform, health insurance coverage for children, climate legislation and equal rights for gays. She loves the Department of Defense yet despises the gubment's role in almost all other things. So odd how Repubs hate gubment but have never met a defense appropriations bill they didn't like. "For the troops," they will say. What they really mean is, "For the lobbyists."

Rep. Lummis is fearful that Khalid Sheik Mohammed is scheduled for a jury trial in New York City. Most Republicans won't give New Yorkers (except the rich mayor) the time of day. Now they're all worked up, afraid that a raggedy band of Islamic extremists are so powerful that their very presence will instill terror in cops and firefighters and cab drivers and the other 9 million or so battle-hardened city dwellers.

Here's Lummis's statement today:

“The decision by the Obama Administration to allow the murderers of more than 3,000 Americans access to the federal court system will have serious negative implications for national security and the justice system. The terrorist attack orchestrated by KSM and his gang of brutal killers was an act of war against the United States and should be prosecuted by a military commission, not a common criminal court.

“It is unconscionable to think that these terrorists will enjoy the same legal rights and benefits guaranteed to U.S. citizens under the Constitution. That is why I joined Rep. Louie Gohmert in introducing legislation to amend the Military Commissions Act of 2009 to make it mandatory to try terrorists, like KSM, through military commissions.”

Obviously Rep. Lummis is not picky about the company she keeps in D.C. Rep. Louie Gohmert is a right-wing Texas fundamentalist. Lee Fang at Think Progress wrote about Rep. Gohmert's bizarre speech during the October House debate over the Matthew Shepard Hate Crimes Bill. He said that the bill

would lead to a legalization of necrophilia, pedophilia, and bestiality. Later in the speech, after reading lengthy passages from the Bible against homosexuality, Gohmert said that taking away “moral teaching in America” would create a situation similar to that of Germany in the “1920’s and 1930’s” when a “little guy with a mustache” took over:

GOHMERT: If you’re oriented toward animals, bestiality, then, you know, that’s not something that can be used, held against you or any bias be held against you for that. Which means you’d have to strike any laws against bestiality, if you’re oriented toward corpses, toward children, you know, there are all kinds of perversions, [...] pedophiles or necrophiliacs or what most would say is perverse sexual orientations but the trouble is, we made amendments to eliminate pedophiles from being included in the definition. [...] But people have always been willing to give up their liberties, their freedoms in order to gain economic stability. It happened in 1920 and 1930’s. Germany gave up their liberties to gain economic stability and they got a little guy with a mustache, who was the ultimate hate monger. And this is scary stuff we’re doing here when we take away what has traditionally been an important aspect of moral teaching in America.

Several times in the speech, Gohmert credited the conservative Christian “C Street” leader Chuck Colson for inspiration. Oddly, Gohmert also meandered into a self-defensive monologue about how he is not racist because he once voted for Alan Keyes, the birther leader who has said that President Obama is “a radical Communist” who “is going to destroy this country, and we are either going to stop him or the United States of America is going to cease to exist.”

That's odd. Don't those "C Street" Republicans revere old-line dictators such as the little guy with a mustache? Isn't it cute how a former judge, U.S. Army veteran and East Texas tough guy such as Gohmert can't even utter the name "Hitler?" Maybe it hits too close to home.

Rep. Lummis better watch out who she teams up with. Wyomingites, as a rule, don't care for extremists, whether they be from the right or the left. Hatred and fear don't seem to be family values in Cheyenne, at least not in my middle-class neighborhood. Maybe it's a different story for Lummis, who grew up in Cheyenne. Maybe she knows something I don't.

But I doubt it.

Sen. Mike Enzi tours Wyoming to probe brains of voters

2009-11-18T18:46:00.008-07:00

Brianna Jones at the WyoDems sends this:

This is a heads up that Senator Enzi’s staff will be holding sessions in the following communities over the next few weeks and starting tomorrow. Please share this information!

Buffalo – Thursday, Dec. 10 – Town Hall – 11 a.m.-12 p.m.
Cowley – Tuesday, Nov. 24 – Town Hall – 10:30-11:30 a.m.
Kaycee – Thursday, Dec. 10 – Town Hall – 9-10 a.m.
Torrington – Thursday, Nov. 19 – Platte Valley Bank – 11 a.m.-12 p.m.
Wheatland – Thursday, Nov. 19 – Platte Valley Bank – 2:30-3:30 p.m.

This is a great opportunity to encourage community members to speak to Enzi’s staff, ask him about some of his recent votes and impart the urgent need for robust health reform.

These are all solidly Republican outposts. I expect lots of softball questions for Enzi. But it's a small victory if even a few Dems show up and ask a real question without getting beat up. I expect a few Dems showing up in Wheatland due to the fact that the Platte County Dems are feisty. Check out their blog at http://plattedems.blogspot.com/.

A few questions for Enzi:

Why did you vote against the Matthew Shepard Hate Crimes Act?
Why are you a health care reform obstructionist?
How can you continue to use my first name? Have you no shame?

What would you like to ask Sen. Enzi? I'm happy to pass any and all questions on to the senator via e-mail.

Learning something new from "WWII in HD"

2009-11-18T07:08:00.010-07:00

B-17 Stratofortress, B-24 Liberator, M-1 rifle, dogface, Tarawa, D-Day, Kasserine Pass, Patton, Mt. Suribachi, panzer, blitz...

And so it goes.

Watching "WWII in HD" on the History Channel, I realized that all these terms -- and many more -- are etched permanently into my brain. Chris and I have been transfixed on the couch for the past three nights watching the personal WWII stories unfold in HD. Both of our fathers were WWII veterans. Chris's father was an Army lifer and also a veteran of Korea and Vietnam. It's not so much the HD but the new color footage that makes the difference. And I'm learning some new things in the process.

Baby Boomer boys devoured war stories. Those stories usually came from magazines and books and black-and-white TV and other boys. Fathers often didn't share the real stories about war. Maybe they thought it would damage our fragile sensibilities. Maybe they just wanted to forget.

I turned to books. In the fourth grade, I pulled Richard Tregaskis' "Guadalcanal Diary" from my dad's packed shelves and read it over the course of a couple days. It was more exciting than "Ivanhoe" and "Treasure Island," other books on my father's shelves. But Tragaskis' book was about recent history. It was also about my father and our neighbors and my Little League coach. I was pleased to see that the character of Tragaskis, the war correspondent, is being featured on the History Channel series.

After "Guadalcanal Diary," I turned to Bill Mauldin and Willie and Joe. I tried some of the war's "big books," such as "Berlin Diary" by William Shirer and Churchill's six-book series. Just couldn't get into it. Boring. Too much about politics. Too little action.

Not sure what makes "WWII in HD" so vivid. The only true HD is the film shot of living veterans. The old footage has been high-def'd, which may make it a bit more vivid. But most of the footage was shot from cockpit cameras or G.I. photographers dodging bullets. I credit story and editing. The twelve featured witnesses to that era have distinctive voices. Pilot Bert Stiles was obviously a talented writer and left behind some samples for the series. He was killed in action. There's an Army nurse and a Nisei soldier who wonders at the irony of being held behind barbed wire in a German prison camp while his family was being held behind barbed wire in an Idaho internment camp.

For me, it always comes down to story.

Cheyenne Zonta Club announces "16 Days of Activism Against Gender Violence"

2009-11-16T22:11:00.008-07:00

Mona Pearl at the Zonta Club of Cheyenne sent out this announcement today:

The Zonta Club of Cheyenne is again participating in 16 Days of Activism Against Gender Violence. The campaign formally kicks off on Nov. 25. Proclamation signings by Governor Dave Freudenthal and Cheyenne Mayor Rick Kaysen will take place on Nov. 20 and Nov. 18, respectively. The Wyoming Division of Victim Services' “Silent Witness” display in the Laramie County Public Library will open on Nov. 30.

The Cheyenne Zonta Club has invited other organizations to join the campaign, including Safehouse, Cheyenne Community Clinic, United Way of Laramie County Women’s Leadership Council and Prevent Child Abuse-Wyoming.

Since 1991, the 16 Days Campaign has helped to raise awareness about gender violence and has highlighted its effects on women globally. Each year, thousands of activists from all over the world utilize the campaign to further their work to end violence against women. The campaign has celebrated victories gained by women’s rights movements, it has challenged policies and practices that allow women to be targeted for acts of violence, it has called for the protection of people who defend women’s human rights and it has demanded accountability from states, including a commitment to recognize and act upon all forms of violence against women as human rights abuses.

Contact Mona Pearl at 307-772-9001; 307-421-3788; pearl@wslc.com

Nobody would be surprised to hear that violence against women is a problem in Wyoming. In a Sept. 23 article in the Wyoming Tribune-Eagle,

Cary Heck, a professor of criminal justice at the University of Wyoming, believes domestic violence is a problem in the state. “I think that is linked a little to socio-economic status, and we sort of have a frontier mentality,” he said. “Wyoming is a drinking state -- and I think those things are linked.”

The professor said domestic violence is hard to prevent from a public policy perspective and that past domestic violence can be linked with future domestic violence. “Generally it’s an explosion that occurs,” he said. “It’s hard to make public policy that will keep those explosions from happening because they’re really not rational events.”

Eileen Gavagan, victim/witness coordinator for the Laramie County District Attorney’s Office, said the state needs tougher domestic violence laws, more counseling for offenders and education for family members.

In the article, the Violence Policy Center in D.C. ranked Wyoming third in the number of domestic violence murders. Wyoming usually places in the top ten in this category.

Not a pretty picture.

But it's not only murder. Most cases of violence against women end up in broken broken bones and broken homes. A woman and her children fleeing to a battered women's shelter. Traumatized kids, and the possibility that they may repeat the behavior as adults -- as either batterer or victim.

Take some time to go see the "Silent Witness" display when it opens Nov. 30 at the library.

If you still need to be pursuaded that gender violence is a problem, go to the Wyoming Coalition Against Domestic Violence web site at http://www.wyomingdvsa.org/domestic/facts.htm

And if you're curious about how this subject fits into the current health care debate, go to my Sept. 15 post at http://hummingbirdminds.blogspot.com/2009/09/sen-enzi-please-explain-why-getting.html

An issue of morality -- "Healthcare For All Americans"

2009-11-15T15:10:00.003-07:00

Cheney/Palin in 2012? How about Palin/Cheney?

2009-11-15T14:25:00.004-07:00

The talking heads were having fun this morning over at Fixed News Sunday. Did I watch it? No. I was working on my own fiction in the form of a new book of short stories. I prefer fiction that comes out of my head (and heart) to that manufactured by Fixed News.

But Crooks & Liars reports that Liz Cheney was pumping up the volume for a return of her pops to the political scene.

Appearing on Fox News Sunday, Liz Cheney dropped the former vice president's name as the panel was discussing President Barack Obama's decision to respect the Japanese Emperor by bowing during a formal greeting.

Fox News felt compelled to cover Obama bow to Japanese Emperor Akihito and Empress Michiko after conservative blogs attacked the president. "Sarah Palin would not have bowed to the Emperor of Japan. She wouldn't have even curtsied to him," said Bill Kristol.

But for Liz Cheney, Palin wasn't the only answer to replacing a president that would dare to pay respect to a foreign leader. "You can look at the comparison and think Cheney 2012," teased Cheney. It wasn't clear if Dick Cheney's daughter was joking but the Fox panel seemed warm to the idea.

"That's all I'm going to say," she said.

Kristol, who has long been an advocate for Sarah Palin, had an even better idea. Cheney/Palin," he suggested.

"Or Palin/Cheney. Don't be sexist," replied Chris Wallace.

Ha ha! A Fixed News reporter trying to be politically correct. That's a news item in itself.

But ponder the reality of a presidential ticket featuring the Wyoming-bred Lord of Darkness and the Idaho-bred and Alaska-trained Rouge Rogue. Yes, the mind reels. It would be a wonderful gift to us Democrats, and it might even help us elect some Wyoming Dems. Oh boy, I keep cracking myself up. Elect Wyoming Dems to national office? I suppose it could happen. But if a smart and savvy Dem entrepreneur such as Gary Trauner can't even beat the likes of the GOP's Cynthia Lummis in 2008, what chance do other candidates have?

I keep wondering if Dick Cheney can do more damage as president than he did as Veep. What do you think?

A president with ties to Casper and Jackson could bring some much-needed economic development to Wyoming. In the last year of the Bush Administration, Cheney and his oily cohorts spent a lot of time approving energy leases in the western half of the state. It doesn't seem like such a wise move now that natural gas prices are tanking, but if he could do a similar thing as president, we would no longer have to worry about wildlife and wilderness because every square inch of the state would be filled with roads and wells and poisoned prairie.

If any wild animals do survive, Sarah Palin can shoot them from helicopters. That will cut down on any excess population.

I don't know about you, but I'm going to shout it from the roof tops: "Cheney/Palin in 2012!"

Montana progressive org hiring director

2009-11-14T13:59:00.008-07:00

This comes from the always-alert jhwygirl at 4&20 blackbirds

Forward Montana (FMT), a homegrown organization dedicated to training, mobilizing, and electing a new generation of progressive leaders based in Missoula, Montana, and Forward Montana Foundation, dedicated to engaging young Montanans in civic life, seek an energetic Managing Director to manage and grow the organizations. The Managing Director will work closely with the boards of directors as well as staff to achieve the organizations' financial and programmatic goals. The Managing Director will report to the Chief Executive Officer and work closely with the Board of Directors.

Deadline is Dec. 7. Go to http://www.forwardmontana.org/index.php?option=com_content&task=view&id=277&Itemid=10

Wyoming progressives, feeling lonely and forlorn, have been known to migrate north to Missoula for various forms of liberal-minded employment and/or education (just ask jhwygirl and Left in the West's Matt Singer). We hate to lose you, WyoProgs, but duty calls. Don't forget to write (or blog or twitter or FB)!

Got wood? A modest proposal from Digby

2009-11-13T20:58:00.005-07:00

Digby is the Jonathan Swift for our times:

I have a moral objection to paying for any kind of erectile dysfunction medicine in the new health reform bill and I think men who want to use it should just pay for it out of pocket. After all, I won't ever need such a pill. And anyway, it's no biggie. Just because most of them can get it under their insurance today doesn't mean they shouldn't have it stripped from their coverage in the future because of my moral objections. (I don't think there's even been a Supreme Court ruling making wood a constitutional right. I might be wrong about that.)

Many of the men who are prescribed this medication are on Medicare, so I think it should be stripped out of that coverage as well. And unlike the payments for abortion, which actually lower overall medical costs (pregnancy obviously costs much, much more) banning tax dollars from covering any kind of Viagra would result in a substantial savings.

For more, go to http://digbysblog.blogspot.com/

Rep. Millin and WyoDems thank veterans

2009-11-11T10:34:00.007-07:00

Representative Lori Millin, Democrat of Cheyenne, is my rep in the Wyoming House. She issued the following statement to mark Veterans Day:

“On Veterans Day, the Wyoming Democratic Party would like to take a moment to thank the past and present service members who have selflessly devoted their lives to the service of our country.

“To Wyoming’s 58,000 veterans and the thousands of men and women currently serving in the armed forces and the Wyoming National Guard, thank you. We are extremely grateful for your dedication and the sacrifices you and your families have made.

“To all active Wyoming troops, including the 800 currently deployed men and women of the Wyoming National Guard, we hope and pray for your safe return.”

Millin's district is in the northwestern part of Cheyenne, including the Wyoming Air and Army National Guard Bases. Also my neighborhood, which butts up against the Air Guard base. The Guard is a good neighbor. Some of the people at the base are my neighbors. They also come from all over Wyoming, Colorado and Nebraska. I hear them fly their choppers and C-130s overhead and I thank them for their service, especially on this Veterans Day.

You can chat with Lori on Facebook. See her web site at http://www.lorimillin.com/

And happy trails to Wyoming Gov. Dave Freudenthal, visiting the state's National Guard troops in Kuwait and Iraq.

Instead of imagining "Medicaid cheats," Wyoming legislators should ensure mental health coverage

2009-11-09T21:25:00.012-07:00

More on the Wyoming Medicaid situation by Wyoming Tribune-Eagle reporter Bill McCarthy:

Bob Peck, Wyoming Department of Health chief financial officer, met with the Wyoming Legislature's Joint Appropriations Interim Committee last week.

Without federal money from the American Recovery and Reinvestment Act of 2009, he said, the state's general fund would face about a $66 million deficit for Medicaid spending.

Medicaid is the health program for low-income people that is funded by the states, as well as the federal government. It is managed by the states.

"I want everybody to understand the stimulus funds are a temporary relief from the general fund obligation," Peck said.

The "biggest drivers," he said, are increased enrollment and use of the program.

Expenditures jumped from $466.7 million in fiscal year 2008 to $512.1 million in fiscal year 2009. Enrollment fluctuates month to month, he said, but this year it is up about 6,000 or 7,000 people. Not all enrollees access services, but the number of
people using services also is on the rise. Since fiscal year 2007, he said, enrollment is up 2.3 percent, but the number of people receiving services jumped 9.8 percent.

"We do think there are things that we can do to control costs," Peck said, but the state may potentially face future deficits.

But Appropriations Committee co-Chairman Sen. Phil Nicholas, R-Laramie, said there are some balances that have to be weighed. If the state lowers payments to providers, for example, a family practice doctor might decide not to see Medicaid recipients. Those patients could then end up in the emergency room instead. Peck said his department is trying to be analytical about cost savings and to gather more data on the trends in the claims data to find cost-effective ways of delivering care.

Committee member Sen. Ray Peterson, R-Cowley, said he sees people who seem
to be living quite well, yet their children are using Medicaid. Peterson said he would like to see the requirements tightened.

"We're aware there's abuse out there," Peck said, but often the state is prevented by federal regulation from acting. For example, Peck said at times single mothers live with boyfriends who make plenty of money, but the mother's children are not legally his dependents. The children's income status is reliant on the mother's income solely.

Remember the "welfare cheats" of the Reagan era? Newspapers and airwaves were filled with stories of men and women (mostly black) driving their Cadillacs up to the local grocery and using food stamps to buy steaks and desserts and other high-end edibles. There were stories about food stamps being traded like money, even used to buy drugs.

Did it happen? Probably. Did it happen often? Who knows. The stories caught on like wildfire and before long, every black person on food stamps and school-lunch programs and unemployment was a "welfare cheat" and not to be trusted with our hard-earned taxpayer dollars. Various remedies were attempted, but the Clinton administration brought us workfare programs. Most states (including Wyoming) had success with getting people off the welfare rolls. Single moms in Cheyenne found themselves working two or three jobs to make ends meet off welfare. Kids were often left to fend for themselves. Not a rarity among any working person in Wyoming. During most of our time in this state, my wife and I have worked at least two jobs each. There was a span of two years when my wife worked three jobs. There's a joke that goes something like this: Q: "What do you call a Wyomingite with two jobs?" A: "Underemployed." I have a tendency to mangle jokes, but you get the point.

I hope we're not getting to a point where we have a plague of "Medicaid cheats." Are there people who game the system? Yes. Is there an instance of a Cheyenne resident driving a Hummer to the Health Dept. to sign up for Medicaid? Maybe. But more than likely these are apocryphal stories that we just might want to believe if they are repeated often enough.

Is that what Sen. Nicholas and Sen. Peterson and Dept. of Health CFO Bob Peck have in mind? Wyoming is a conservative state, to be sure, but most its people are fair-minded. But we live in combative times. Media and the Internet Tubes are filled with all kids of opinions and rants and even lies. People says lots of things when they're under stress.

If the presiding phrase becomes "Medicaid cheats," we can look forward to lots of yelling and screaming on all sides of the issue. And families around the state will be left without much-needed medical and mental health care. It's hard enough to come by already, but shrinking budgets and narrow minds can turn it into tragedy.

The Wyoming Dept. of Health, especially the Mental Health Division, is staffed with caring, helpful people. The department's Children's Mental Health Waiver, complete with its strategy for family "wraparound care," is visionary. Because this is a Medicaid-funded program, it's also being stressed during hard times. It's undergone some changes since our daughter was enrolled in the program from March 2008 through Sept. 2009. Let's hope the misguided words of a few conservative politicians don't sink it.

If you've been a part of Medicaid or are concerned about this issue, call or write to your state representative or senator. Find contact info at http://legisweb.state.wy.us/. Do it before they get to Cheyenne for the next legislative session.

Increased demand stresses Wyoming Medicaid funding

2009-11-09T07:52:00.011-07:00

A story in Monday's Wyoming Tribune-Eagle addressed the state's Medicaid and CHIP programs.

The number of children on Wyoming Kid Care CHIP is declining, but the number of children on Medicaid is going up.

Bob Peck, chief financial officer for the Wyoming Department of Health, said one explanation could be that parents are losing their jobs.

Formerly working parents who had their children on the Kid Care program for child health insurance may be having to enroll their families directly into Medicaid, he said.

Medicaid is the health program for lower-income people that is funded by the states, as well as the federal government. Kid Care CHIP offers health insurance coverage for Wyoming's children and teens through age 18 that are uninsured and meet income and eligibility guidelines.

Peck said the number of Kid Care children dropped from 6,200 to 5,400 over the past year. The number of children enrolled in Medicaid in fiscal year 2008 was 49,719, while in fiscal 2009 it was 52,185.

The number of children receiving Medicaid services in fiscal 2008 was 44,114, while in fiscal 2009 it was 45,746. Medicaid expenditures for children jumped from $126.4 million to $143.8 million, according to information Peck provided to the Wyoming Legislature's Joint Appropriations Interim Committee last week.

My daughter Annie was one of the 44,114 on the Medicaid rolls in FY 2008 and one of the 45,746 children receiving Medicaid services in FY 2009.

As I've said in earlier posts, Annie qualified for Medicaid coverage under the Children's Mental Health Waiver. In that program, teens can qualify for Medicaid coverage because the Wyoming Health Department factors in their income and not their parents. If the incomes of my wife and I were factored in, Annie would not have qualified. She would not have received intensive inpatient mental health services and we don't know where she would be now. Still dealing with her mental illness, and untreated. Still suicidal and still cutting her arms and her legs.

But she did get the appropriate care, thanks to federal health care programs, and she is now back in school and taking mainstream classes instead of special ed courses. I have nothing against accommodations made for K-12 students. In fact, I'm all for it. My tax dollars -- and yours -- at work. Those taxes being spent on special ed and mental health care come mainly from the feds, as Wyoming has ridiculously low tax rates -- and no state income tax.

But educational services such as I.E.P.s and special classes don't have to last forever. They exist to give young people a helping hand and when that helping hand is no longer needed, it is released and can be used for another deserving student. There always are more deserving students.

All told, Annie spent 11 months in mental health rehabilitation centers, both in Colorado and Wyoming. The Wyoming Mental Health Waiver kicked in when our insurance ran out after 45 days. Medicaid paid for 225 more days on treatment by nurses and psychiatrists and other mental health professionals. Total bill for her care was in six figures.

As parents, we did the paperwork and wrangled with insurance companies. We visited every weekend and went to family therapy sessions once or twice a week. We checked out Annie for short shopping excursions and spent the weekend with friends in Casper so we could see Annie another day before driving the 180 miles back to Cheyenne to our jobs and other responsibilities.

Chris and I have means. I work for the state and Chris works for the YMCA. We don't have big salaries. We do own a house and have two used cars. We eat on a regular basis, and occasionally take a vacation. We don't own any solid gold umbrella stands, unlike the Wall Street rip-off artists who ran this country into the ground. We aren't war profiteers like Dick Cheney. He may not own a solid gold umbrella stand, as umbrellas are as rare in Wyoming as humidity. But I hear tell that Cheney has a gilded shotgun.

Wyoming is notoriously cheap. I worked for ten years without a raise. When Annie was born in 1993, my wife was unemployed and we enrolled in the WIC program so we could get milk and juice and cereal for our family. My wife's workplace offers health insurance but at a price so steep that she and my daughter are on my state plan. If the House health care bill passes the Senate (not likely) and its provisions enacted immediately, my 24-year-old son could be covered for three years under my insurance plan. Alas, even if the Senate concurred with the House bill, most of its provisions won't be enacted until 2013. My son will be a year too old for the 27-year-old coverage stipulation.

That's the problem. As we dither over health care reform, real people are getting sick and dying. Rep. Grayson had it right when he described the Repubs' health care plan: "Don't get sick. If you get sick, die quickly."

But my subject is mental health. The Medicaid plan is crucial for those families faced with a bipolar or depressed or suicidal teen -- and no idea what to do or where to go for help. Help is hard to find in this state. When you do, it has a cost.

Much more on this subject in the coming weeks...