Healthcare march and forum set for Feb. 25 in Cheyenne

How many marches, rallies and rabble-rousing events can one be expected to attend before collapsing in a heap?

That's what people are asking themselves. In normal times, exhaustion already would have settled in. But these are abnormal times. Protests seem to have a bigger impact than just getting on the phone to your elected reps or mailing them a postcard. Trump got to the White House via the adulation of crowds. He will be ushered out of the White House the same way. So, here are a few more ways for concerned citizens to gather together to stump Trumpism which is a mean-spirited, destructive philosophy that will ruin our country.

Healthcare march on Saturday, Feb. 25, 10 a.m., Depot Plaza in downtown Cheyenne, 16th St. and Capitol Ave. Free. Bring a sign. FMI: https://www.facebook.com/events/1348316418561808/

Save the Affordable Care Act forum on Saturday, Feb. 25, 3-6 p.m., at the Laramie County Public Library, 2200 Warren Ave., downtown Cheyenne. Free. FMI: https://www.facebook.com/events/1861553744059620/

Here's a short description:

Do you want to know what is included in the Affordable Care Act? Are you worried about having health insurance for you or your family? Would you like more information about the Affordable Care Act? Are you wondering what "pre-existing conditions" means? Do you have children covered on your health insurance who are young adults? Come and find out these details & more!

Refreshments will be served.

Rally for the Uninsured Jan. 9 in Cheyenne

Isn't it swell to be in the same group of health-conscious states as Louisiana, Alabama, Idaho and Missouri?

From the Rally for the Uninsured Facebook page: 

Come and participate in a Rally of Support for Medicaid Expansion in Cheyenne, at the Herschler Building Plaza next to the Capitol Building on Thursday, January 9 at 11:45 am until 12:45 pm. Let the legislature know what you think!

Here's what Tom Forslund, Republican Gov. Matt Mead's appointee to direct the Wyoming Department of Health, says about Medicaid Expansion:

Wants the facts on the ACA? Go to the sources

Keep a few things in mind when trying to understand the Affordable Care Act.

Go to the correct sources for information. The main web site is http://healthcare.gov. That's where you find out the facts, ma'am (and sir). In Wyoming, look up Enroll Wyoming at http://enrollwyo.org. If you prefer talking on the phone, call 2-1-1. That's what smartphones are for.

Enroll Wyoming has a batch of navigators spread around the state. Three of them were at the town hall meeting in Cheyenne on Monday night. Their director said that she and her crew had given more than 30 presentations last week in Laramie County alone. At this point, there is probably no question that they haven't heard.

A crowd of 40 or so people heard a panel of experts spell out the ACA details at the Monday meeting.

In Wyoming, we are bombarded with misinformation from Know-Nothings. If you want to know the facts, avoid any comment or communique from the Republican Party. Don't read Rep. Cynthia Lummis's e-mail missives about Obamacare. Senators Barrasso and Enzi are no help either. Neither are state legislators with an "R" after their names. They all are so blinded by hate for our president that their lies never cease.

And Medicaid expansion? According to Phyllis Sherard, Cheyenne Regional Medical Center Population Health Officer, who was at the meeting, the Wyoming Hospital Association has spelled out the four main objections to Medicaid expansion and refuted each one. Go to http://wyohospitals.com. Here are some highlights of a recent press release from the WHA:

There are at least three key reasons that legislators should support the full expansion.   

First, the full expansion is good for Wyoming’s patients. One of the surest ways to improve overall health and control costs is for patients to receive the right care, from the right provider, at the right time. 

Providing coverage for more than 28,000 Wyoming citizens – often described as the working poor – will provide that access to care. We know that patients who receive preventive care, or who receive care earlier, tend not to be as sick when they do need care.

Second, the full expansion could save the state $47 million over six years, according to a study released by the Department of Health. These savings can only be achieved, however, if the Legislature supports the full expansion of the program. 

Finally, the full expansion will help ensure that Wyoming’s providers can continue to provide care for our vulnerable populations. In 2011, Wyoming hospitals provided about $200 million in uncompensated care – up from about $126 million in 2007.  At the same time, federal assistance for hospitals that treat large numbers of low-income and uninsured patients has been slashed. The impact of both the dramatic growth in uncompensated care and the reductions in this federal assistance would be significantly offset through the full Medicaid expansion.,

Who cares about hospitals? We do. Every community wants its own hospital so its citizens can be close to quality medical care. This isn't possible in Wyoming with its low population and great distances between centers of medical care. Casper currently is discussing the wisdom of adding a third hospital to its ranks. Cheyenne Medical Center recently added a cancer center and a state-of-the-art ER. Meanwhile, hospitals in Colorado and Montana and Utah beckon us with slick ads and promises of big-city medical care just a short drive over the border.

Medicaid expansion, it seems, is one way to ensure that our home-grown hospitals stay solvent and able to treat our rapidly aging population. I spent a fair amount of time and treasure this year at CRMC. As is the case with many in Cheyenne, I cast a dubious eye on our local hospital. I had a heart attack in late December and on January 2 had to be rushed to CRMC. I could have gone to Fort Collins or Denver but "minutes mean muscle" as those alliterative cardiologists say. The longer a heart patient goes without treatment, the more heart muscle can be lost. It's important that good care is close to home especially when it comes to the beating heart. I discovered that the Kardiac Kids at CRMC run a tight ship and make minutes count. There's a fine cardiac lab and a top-notch telemetry unit for recovery and a whole regimen of rehab.

I spent several hundred thousand dollars on my heart. I was lucky as I have insurance that I (and the State of Wyoming) has been paying into for 22 years. Some of those payments go toward paying some of $83 million over the past three years that CRMC has written off in uncompensated care. That shortfall has to come from somewhere. I've done my part and I'm not sorry. I could resent those "freeriders" that I paid for, but that wouldn't be very Christian of me, would it?

So get on with it, Wyoming Legislature, and expand Medicaid.

Much more difficult to register for health care in red states

Justin Baragona writing on PoliticusUSA about Republicans sabotaging health care registrations in Red States (Wyoming, for instance):

The one huge point that needs to be hammered home again and again and again is that that millions and millions or Americans would already be signed up for insurance or be covered by Medicaid if Republicans would have just accepted the law instead of trying to sabotage it at every turn.  The fact that 1.2 million got coverage by the end of last month is miraculous when you consider the roadblocks that were laid in place. The sad fact is that if you currently live in a state that is mostly controlled by Democrats, it is quite easy to get covered. If you are in a state controlled by Republicans, it is much more difficult for you to get coverage for no other reason than the people governing your state, as well as the majority of citizens occupying it, just plain hate the President.

Read the entire article at http://www.politicususa.com/2013/12/13/rachel-maddow-highlights-ap-story-showing-red-states-sabotaging-uninsured.html

Democratic response to Gov. Mead's decision on Medicaid expansion

From the Wyoming Democratic Party web site (Dec. 2):

Today, Pete Gosar, Chairman of the Wyoming Democratic Party made the following statement regarding Governor Mead’s decision to not recommend Medicaid expansion in Wyoming.

 “Governor Mead made sure that the day after Thanksgiving was the blackest of all Fridays for Wyoming's entire health care system.  His refusal to support Medicaid expansion all but ensures that Wyoming's less fortunate and working poor will continue to be without access to Wyoming's healthcare system.”

Rest the rest here.

Many left behind as Wyoming continues its opposition to Medicaid expansion

Wyoming is one of those Obamacare-hatin' states that have (thus far) refused Medicaid expansion.

This snippet by Virally Suppressed on Daily Kos seemed to be relevant to the issue:

With the implementation of the Affordable Care Act, Medicaid expansion and mental health parity law all taking place at the present, it is difficult to anticipate where we will end up in ten years time. It is a fairly safe bet that Federal spending on mental health will continue to rise at a lightning pace due to the nature of the Medicaid expansion, which places a minimum of 90 percent of the costs on the Federal government while extending comprehensive mental health care to tens of millions of low income Americans. It is also more than likely that the health gap in this country will become exacerbated by this new legislation, an idea which seems counterintuitive considering the entire point of the Affordable Care Act is to reduce barriers to health care and create a more egalitarian health system. However, thanks to the infinite wisdom of The Supreme Court, state governments have been given an irresponsible amount of power in their legal right to refuse Medicaid expansion and essentially tell their constituencies that they will have to forgo medical care because of an ideological tiff between two political parties who don't have their best interest in mind. This latitude which has been given to state governments and which is arguably in violation of the supremacy clause of the Constitution, will create a two-tiered mental health system in which the healthy get healthier and sick continue to be ignored by the system that is supposed to be protecting them. Thus far, 24 states (and DC) have said that they will be participating in Medicaid expansion, while 14 states have stated that they will not be taking part. Of those 14 states, only 3 are in the top half of the nation's health rankings and 5 rank among the bottom 10. It looks like some states are replacing old state funding with Federal funding, while other states aren't replacing old state funding with anything.

Read the rest here.

Kerry Drake on Wyofile: Governor and Republican legislators blew it when they killed Medicaid expansion

On Wyofile, veteran Wyoming journalist Kerry Drake takes a long, hard look at the Medicaid expansion question in Wyoming:

Facts, common sense, what’s good for the people — they all fly out the window when some conservative Wyoming politicians are determined to show how much they distrust the federal government. 

It’s happened many times before, but never to the absurd level it did when Gov. Matt Mead and 22 state senators killed Medicaid expansion in Wyoming this session. 

No matter how one looks at the issue, they blew it — far worse than most people realize.

Read the entire sordid tale here. Progressive blogger Rodger McDaniel at Blowing in the Wyoming Wind has been writing about this issue for months. Check out his columns here. 

President Obama: “We are going to need to work on making access to mental health care as easy as access to a gun”

This is but a small part of President Obama's Plan to Protect our Children & Communities, which was announced this morning. I'm including it because mental health is one of my blog's key issues. And tackling the many gun parts of the document is too much to bear. Read more here.  

IMPROVING MENTAL HEALTH SERVICES 
Though the vast majority of Americans with a mental illness are not violent, we need to do more to identify mental health issues early and help individuals get the treatment they need before dangerous situations develop. As President Obama has said, “We are going to need to work on making access to mental health care as easy as access to a gun.” 
• MAKE SURE STUDENTS AND YOUNG ADULTS GET TREATMENT FOR MENTAL HEALTH ISSUES: Three quarters of mental illnesses appear by the age of 24, yet less than half of children with diagnosable mental health problems receive treatment. To increase access to mental health services for young people, we should: o Provide “Mental Health First Aid” training to help teachers and staff recognize signs of mental illness in young people and refer them to treatment. o Support young adults ages 16 to 25, who have the highest rates of mental illness but are the least likely to seek help, by giving incentives to help states develop innovative approaches. o Help break the cycle of violence in schools facing pervasive violence with a new, targeted initiative to provide their students with needed services like counseling. o Train 5,000 more social workers, counselors, and psychologists, with a focus on those serving students and young adults. 
• ENSURE COVERAGE OF MENTAL HEALTH TREATMENT: The Affordable Care Act is the largest step to increase access to mental health services in a generation, providing health coverage for 30 million Americans, including 6 to 10 million people with mental illness. The Administration will take executive actions to ensure that millions of newly covered Americans, and millions more who already have health insurance, get quality mental health coverage by: o Finalizing regulations to require insurance plans to cover mental health benefits like medical and surgical benefits. o Ensuring Medicaid is meeting its obligation to cover mental health equally.

Note to Wyoming Sens. Enzi and Barrasso and Rep. Lummis: NO CUTS!

Overpass Light Brigade posted this: From the San Diego Labor Council's candlelight event outside Sen. Dianne Feinstein's downtown office to avoid cuts to Social Security, Medicare and Medicaid programs; instead to pressure Congress to raise taxes on the wealthiest 2% of Americans. NO CUTS!

Republican political purity trumps the need for mental health and substance abuse services

The need is huge for effective mental health and substance abuse programs in Wyoming. The Wyoming Department of Health has been on the forefront of proving those services through its Medicaid-funded waiver programs. They fund treatments for low income residents but also for middle income people who have no health insurance, or insurance that limits coverage for mental health and substance abuse. National insurance parity legislation has helped some, but treatment is expensive, especially if you have to send a child out of state, which our family has had to do three times. And President Obama's Affordable Care Act has helped in the areas of pre-existing conditions and the ability of families to keep their kids insured until age 26. Thanks Obamacare!

Current treatment tactics in wraparound care call for keeping family members close to home. A worthy goal but not always practical in a rural state such as Wyoming. Your regional treatment center may be full so those located in surrounding states may be your only option. Face it, a person in southeast Wyoming has a slew of treatment options along the Colorado Front Range, from Fort Collins down to Pueblo. Same goes for southwest Wyoming. Yes, the state hospital is in Evanston but not everyone qualifies for a stay there, so residents look to Utah's Wasatch Front for alternatives.

And now the Wyoming Department of Health announces cuts to its mental health and substance abuse treatments. These cuts are in keeping with demands by Republican lawmakers to make budget cuts when none are needed. The current budget-cutting mania is prompted less by necessity than by Tea Party-inspired, We Hate Gubment, politics.

From a Wyoming Public Radio story by Willow Belden:

The Wyoming Department of Health plans to cut millions of dollars of funding for Medicaid and for mental health and substance abuse services. That’s to meet a budget reduction required by the state Legislature. Lawmakers directed the Health Department to reduce spending by 4 percent for fiscal year 2014 and to prepare for additional 8 percent cuts in the following two years. Health Department Director Tom Forslund says the cuts will be painful. “The Department of Health provides critical services and funds critical services, and so we can’t cut our budget without impacting those services,” Forslund said.  He says the cuts will mean healthcare providers won’t be reimbursed as much for treating Medicaid patients, which make it harder for low-income people to get medical care. “There will be some healthcare providers who elect not to serve as many Medicaid patients,” he said. “And that’s what’s happened to a lot of states around the country – that the more they cut payments to healthcare providers, the less healthcare providers are willing to see Medicaid patients.” Forslund says for every dollar that the state cuts in Medicaid funding, Wyoming loses a dollar of federal funding as well.

Dear Gov. Matt Mead: Expand Medicaid to cover Wyoming's uninsured

From the Rev. Rodger McDaniel and friends:

A group of us are putting together a letter to Governor Matt Mead to urge him to expand Medicaid under the Affordable Care Act. If you would like your name to appear on the letter, please respond and let me know exactly how you'd like it to appear. If you have friends who will sign, please let me know. I will need their e-mail authorization. A copy of the draft letter is attached. The more the better...by the end of this week. The letter will be hand-delivered to the Govenor by former State Rep. Pete Jorgensen.

I've added my name to the letter. You can too. Rodger's e-mail is rodger.mcdaniel@bresnan.net

Read the details in Rodger's Saturday column at http://blowinginthewyomingwind.blogspot.com/2012/07/mead-thinks-insuring-uninsured-is-not.html

Dear Gov. Mead: Make Wyoming a healthier place by embracing Medicaid expansion

When Rodger McDaniel writes about mental health and substance abuse treatment in Wyoming, he knows his subjects. Under Gov. Dave Freudenthal, the Rev. McDaniel was Director of the Mental Health Health and Substance Abuse Division of the Wyoming Health Department. Today in his blog (and on the op-ed pages of the Wyoming Tribune-Eagle), he makes the modest proposal that the Great Conservative State of Wyoming should embrace Medicaid expansion. It's a hard sell because Wyoming and its Governor were parties to the Affordable Care Act lawsuit that recently was spured by the conservative-dominated Supreme Court. Read on:

The enormous investment Wyoming made in mental health and substance abuse treatment in the last decade puts the state in a position to cash in big on the implementation of the Affordable Care Act (Obamacare). Governor Mead and state legislators should weigh the opportunity before rushing to join other Republican governors rejecting federal funding of Medicaid expansion. 

Today Wyoming taxpayers spend more than 95 million dollars each budget period on mental health and substance abuse services. If Wyoming implements the Medicaid expansion under Obamacare, most of that money can be returned to the general fund.

Read the rest here.

Wyoming is not always a trailblazer when it comes to mental health and substance abuse programs. But its Children's Medicaid Waiver has been a godsend to many Wyoming families in crisis. The Medicaid Waiver has helped both uninsured and underinsured families who've sent their children to a treatment program that is usually hours away from home, often out-of-state. When our daughter was diagnosed as bipolar, we had to send her to treatment for four months in Colorado and seven months in Casper. We signed her up for the Medicaid Waiver which kicked in when our insurance company limited her treatment. Before Obamacare, insurance companies either placed caps on mental health treatment or disallowed it as a pre-exisiting condition. The same held true for substance abuse treatment. When our son needed help for substance abuse almost ten years ago, our insurance lapsed after 50 treatment sessions. Since he was in a residential center and had daily sessions, the insurance was up way before the therapy could bear fruit -- nine months before he successfully returned home, clean and sober. We spent my father's inheritance to pay for some of the treatment and our son worked on the center's landscaping crew to pay for the rest. Expensive but worth it.


Many other families share our experience. Others will face problems in the future. The Medicaid Waiver helped pay for our daughter's treatment and for the "wraparound care" that followed her return to the home. A treatment team of parents, siblings, relatives, friends -- led by a certified mental health professional -- guided her back into her community. This beats the old approach of letting our teens sink or swim on their own, which didn't work our too well. Teens with mental illnesses or substance abuse problems have enough problems without having to readjust to school and home and work all by themselves.


Many families never use the Medicaid Waiver or similar programs because they don't know about it. There's a great statewide organization, UPLIFT, that is a resource for these services. I'm on the UPLIFT board and that's how I found out about the waiver. Get more info by calling UPLIFT at 307-778-8686. And be not afraid to go directly to the source at the Wyoming state offices. Yes, I know, it's a big state agency located in a monolithic grey building. But you can talk to real people there -- I did.


This web site is a good place to start: http://www.health.wyo.gov/mhsa/treatment/SystemofCare.html. As you'll see, the waiver program is now focused on keeping the child in the community by providing that wraparound care I talked about earlier.


I do not know how Obamacare, with or without Medicaid expansion, will affect these programs. But in a time of budget cuts in state funds, more Medicaid money from the Feds is a good thing, is it not?


No surprise that health care will be a major topic at this week's National Governors Association conference in Virginia. Also on the agenda is a discussion about the needs of military members returning home from the wars. Gov. Mead co-chairs the NGA committee addressing this issue. Some of the most pressing needs involved mental health care, not only for veterans but their families. The Veteran's Administration Hospital in Cheyenne recently expanded its services by hiring four new psychologists. 

Come hear the facts about the Affordable Health Care Act May 23 in Cheyenne

Tired of the health care misinformation and disinformation being spewed out by Wyoming Republicans?

Come hear the facts.

The next meeting of the Laramie County Democratic Party is Monday, May 23, at 7 p.m at the IBEW Hall, 810 Fremont Street in Cheyenne.

Click here for directions.

Guest panel: Members of Consumer Advocates Project Healthcare presenting The Affordable Care Act and its ongoing implementation in Wyoming: What's in it for you?

For more information, please contact Linda Stowers at 307-634-0768.

Republicans make up their own stats about Medicaid in Wyoming

Great article on the Equality State Policy Center blog by Barb Rea about the May 9-10 Wyoming Legislature’s Joint Labor, Health and Social Services Committee meeting in Evanston.

Committee Co-Chairman Sen. Charles Scott, R-Casper, felt the need to add his personal interpretation to almost every piece of information presented. He painted Medicaid as a perennial problem in the state, and assured the committee that the new federal health care law, which he dismissively terms “Obamacare,” will be repealed or at least defunded. He also continues to portray his pet project, Healthy Frontiers, as a viable program which could be used to replace both Medicaid and the benefits offered in the new legislation.

First, one has to wonder why so many wacko Republican legislators come from Casper. Second, one has to wonder why Sen. Scott feels he has to bully other members of the committee. Third, why does Sen. Scott have such an unhealthy interest in the very flawed Health Frontiers program? Right, it’s his pet project and he is single-minded in pursuing that over any other alternative to rising health care costs and the stone-cold fact that thousands of Wyomingites are uninsured.

But Scott wasn’t the only one with a suspicious agenda.

The state’s new Director of the Department of Family Services, Steve Corsi, who made a stunning assertion that 30% to 40% of people who enroll in Medicaid in Wyoming, come dressed like he was (black suit and new haircut) and driving an Escalade, “and there is nothing we can do about it.”

Senator Scott let the committee’s disgust percolate until Wyoming’s Medicaid Director, Teri Green, was able to question the validity of Mr. Corsi’s numbers. Mr. Corsi later apologized for using an inflammatory example and a “guesstimate.”

Later we learned from another presenter, that nationally less than 10% of Medicaid payments are claimed fraudulently, and in Wyoming the figure is less than 6%. Moreover, research tells us most of the fraud by far (80%) is committed by providers (primarily medical-device and pharmaceutical companies). Less than 10% of the fraud is committed by patients.

Mr. Corsi’s hysterical assertions seem to be cut from the same cloth as the “Welfare Queens” of the 1980s, those mythical creatures who drove up to welfare offices in their Cadillacs to rake in the big welfare bucks. What nonsense. A director of a state agency should know better.

At this point, in the interest of full disclosure, I have to admit that our family has benefited from the Wyoming Medicaid Children’s Waiver. This program fills in the insurance holes when your son or daughter needs long-term care for mental health diagnoses or drug and alcohol treatment.

Our daughter benefited from the tax-supported program on several occasions. I will have to note that she is now 18 and a healthy contributing member of society and is currently working and her taxes go to help other young people in Wyoming who have experience health care emergencies. She doesn’t seem to mind.

And I also have to admit that I had a new haircut the last time I filled out the paperwork for the Medicaid Waiver. I have always admired Mr. Corsi’s tonsorial discipline and thus was inspired to follow his example. I wasn’t wearing a black suit as I didn’t want to be mistaken for a bureaucratic blockhead (note to self: no name-calling) such as Mr. Corsi. And I left my Escalade at home. Mr. Corsi may be able to afford to Escalade on his director’s salary, but most of us state employees have to make do with four-year-old Fords and Chevy compacts.

UPDATE: AT last night's Laramie County Democratic Party meeting, I learned that Mr. Corsi was referring specifically to the state's S-CHIP program in his good haircut/dark suit/Escalade remarks. Our family has never been involved in the S-CHIP program. A good thing, considering my lack of attention to hair, clothes and gas-guzzling personal mobility devices.

Read the entire Equality State Policy Center post at http://equalitystatewatch.blogspot.com/2011/05/medicaid-is-helpful-and-should-be.html

Points to ponder for Wyoming's Congressional delegation during Children's Mental Health Week

During National Children’s Mental Health Awareness Week, May 1-7, here are some points to ponder on the subject. I challenge Republicans to reconsider their rash moves to decimate Medicaid, which is crucial to the states for children's mental health care. This is a specific challenge to Wyoming's Congressional delegation, all three of whom have marched in lockstep with those who have no problems with cutting funds for children and families and working people but are quick to defend tax cuts for millionaires and continuing bloated U.S. defense budgets that channel money to outdated weapon systems and away from veterans' health care. Let's name the names: Sen. Mike Enzi, Sen. John Barrasso, and Rep. Cynthia Lummis.

The following info comes from the National Federation for Children's Mental Health. Find detailed documentation of the following at the org's web site.

2011 Prevalence of Mental Health Challenges & Extent of Service Use

Most children with mental health challenges do not get the help they need.

• 1 in 3 adolescents (aged 13 to 18) with mental disorders receive services for their diagnosis
• Half of adolescents with severely impairing mental disorders never receive treatment
• Service rates are highest for adolescents with ADHD (59.8%) and behavior disorders (45.4%)
• Fewer than 1 in 5 adolescents with anxiety, eating, or substance use disorders receive treatment for those disorders
• Hispanic and Black adolescents are less likely than their White counterparts to receive services for mood and anxiety disorders

Mental health is a nationwide public health issue.

The mental health and well-being of Americans are critical issues affecting each individual’s quality of life and the health of our communities, business and economic stability. It touches everyone– regardless of race, gender, class or religion.

• Half of all lifetime cases of mental and substance use disorders begin by age 14 and three-fourths by age 24
• Adults who began drinking alcohol before age 21 are more likely to be later classified with alcohol dependence or abuse than those who had their first drink at or after age 21
• More than 34,000 Americans die every year as a result of suicide—that’s approximately one every 15 minutes
• One estimate puts the total economic costs of mental, emotional, and behavioral disorders among youth in the United States at approximately $247 billion
• Racial incidents can be traumatic and have been linked to Post-Traumatic Stress Disorder (PTSD) symptoms among people of color
• LGBT individuals experience violence and PTSD at higher rates than the general population
• More than 6 in 10 U.S. youth have been exposed to violence within the past year, including witnessing a violent act, assault with a weapon, sexual victimization, child maltreatment, and dating violence. Nearly 1 in 10 was injured
• In a 2008 study by RAND, 18.5% of returning Iraq and Afghanistan war veterans reported symptoms consistent with post traumatic stress disorder (PTSD) or depression

Calling on Congressional Republicans to renounce their taxpayer-funded health coverage

Republicans in Congress (including Wyoming's lone U.S. Rep, Cynthia Lummis) have passed a bill to repeal the Affordable Health Care Act.

It will die in the U.S. Senate. But Repubs in both chambers will be bringing this up over and over and over again in an effort to unseat Pres. Obama in 2012. They are like pit bulls, those Republicans.  

Families USA, sponsor of the Health Action 2011 conference in D.C. Jan. 27-29, has developed a report entitled "H.R. 2: Guilty of a Double Standard." Here are the juicy parts:

...those who vote for repeal intend to keep these very health benefits and rights—which they enjoy courtesy of America’s taxpayers—for themselves:

Members of Congress enjoy government-subsidized health coverage for themselves and their family members. Congressional promoters of repeal would take away tax credits that will help make coverage affordable for hardworking American families.

Members of Congress are sheltered from the threat of discrimination due to pre-existing conditions. Congressional promoters of repeal would deprive ordinary Americans of this very same protection.

Members of Congress, when faced with an insurance claim that is denied, have a guaranteed right to appeal that denial. Congressional promoters of repeal would deny many Americans a similar right.

These are just three examples. There are more, and we’ve outlined them below.

What Congressional Promoters of Repeal Will Take Away from American Families—But Keep for Themselves:

1.   Affordable health coverage

2.   Guaranteed coverage, regardless of pre-existing conditions

3.   A right to appeal claims that are denied by insurers

4.   Protection against discriminatory premiums due to pre-existing conditions

5.   A complete package of health insurance benefits

6.   Guaranteed coverage that can’t be taken away

7.   A prescription drug benefit with no coverage gap

8.   Protection against catastrophic health care costs

9.   A choice of easy-to-compare health insurance plans

10.  Protection against unreasonable premium increases

11.  Fair and equal premiums for women

12.  Coverage for early retirees

13.  Access to free or low-cost preventive services

14.  Access to affordable care at clinics

Beginning on Equality Day, Republicans get to work promoting inequality in health care

Received this message from the Wyoming Democratic Party. It's all about addressing the fraud that is the Republicans' effort to repeal health care reform. These efforts are taking place in the U.S. House of Representatives and in our own state legislature. They are spurred on by Tea Party and corporate influence in the 2010 elections. You can see the Tea Party influence by the prominent display of "freedom" in the legislation. You can see the corporate influence in the fact that Republicans are always in the hip pockets of health conglomerates. They fought the Democratic Party's health care reform all the way. They had no ideas of their own. They were the party of no from 2008 to 2010. They are also the party of yes, as in always saying yes to their corporate overlords.


Get in the groove in opposing this chicanery. The Senate Judiciary Committee hearing begins tomorrow, on the Martin Luther King, Jr., holiday. In Wyoming, it is officially known as Equality Day. There is some irony in this. Starting tomorrow, Wyoming Republicans will be promoting a return to inequality in health care.


Here are some ways to start your opposition (from Brianna Jones at the WyoDems):


Two so-called "Health Care Freedom Acts" (SJ 02 and SJ 03) propose amending the Wyoming Constitution with language that is generally aimed at opposing implementation of the Affordable Care Act in Wyoming.  You can read the language and find out if one of your representatives is sponsoring the legislation by following the links above.

We need to make clear to the sponsors of these proposals that we do not want to take Wyoming backward.  We need to move forward!  

Below we have included some basic points you might find useful when discussing this legislation.  We are asking you to write the members of the Senate Judiciary Committee (listed below) and to also write letters to the editor about your opposition.  Finally, if you can, come to the hearing on Monday to show your support for constructive solutions to our country's health care crisis rather than divisive political posturing.

Senate Judiciary Committee Hearing
Monday, January 17th at 8:00 A.M.
Herschler Building, Room B63 in the basement

Email the Senate Judiciary Committee:
Sen. Drew Perkins (R-Casper)
Sen. Floyd Esquibel (D-Cheyenne)
Sen. Bruce Burns (R-Sheridan)
Sen. Leland Christensen (R-Jackson)
Sen. Larry Hicks (R-Baggs)


Talking Points:

• Tell your personal story.  Has a member of your family lost coverage or been denied care?  Is your child now able to get on your insurance?  Can you now get prescriptions because the Medicare Part D donut hole is closed?  Do you own a small business and can now get tax credits to provide your employees with insurance? Are you pregnant and can receive care for a healthy pregnancy?...and many more scenarios.
• So called "health care freedom" is not free.  A system needs to be in place where everyone can count on receiving the care they need and no one receives care at the expense of others.  
• Instead of playing political games with our constitution we should be trying to learn what parts of health reform can help Wyoming citizens.
• No one should have to worry about losing a loved one or losing their home because they cannot get insurance and cannot afford care.

WYO med licenses up, full-time docs down

Here's the good news:

Wyoming granted a record number of medical licences in 2009...

And now, of course, the bad news

...but fewer newly licensed doctors are setting up full-time practices in the state, newly released figures show.

How can this be? Reporter Joshua Wolfson at the Casper Star-Trib explains it all for you

Of the 301 doctors who received licenses so far this year, only 18 percent reported working full-time in Wyoming, according to statistics from the state Board of Medicine. Industry experts say the figures reflect growth in telemedicine and the number of outside physicians who come to the state to fill gaps in coverage.

The fact that fewer new doctors are starting full-time practices in Wyoming concerns Dr. James Anderson, a Casper surgeon who serves as the board's president. A shortage of primary-care doctors creates the potential for error as patients are treated by different physicians each time they seek medical help.

"It increases the risk, having multiple people taking care of you, without some sort of electronic medical records to know what's going on," Anderson said.

The Wyoming Office of Rural Health release a report this year that showed 13 of the state's 23 counties had a shortage of primary-care doctors. It's shocking to hear that the majority of our counties don't have enough family doctors. Are these 13 counties the most rural?

The WORH June 2009 survey [http://www.health.wyo.gov/rfhd/rural/index.html] carries a few surprises. First of all, primary care physicians aren't just family practice and general practice docs. The WORH definition includes doctors practicing internal medicine, pediatrics and OB/GYN. It also includes non-physicians such as physician assistants, nurse practitioners and nurse midwives. So, even if a rural county has no docs, it might at least have a nurse-midwife around the deliver a bay or two.

Washakie County in the Big Horn Basin hasn't a single primary care practitioner for its 8,000-some residents. No OB/GYN docs for healthy baby checkups. No pediatricians for when Johnny pokes his eye with a stick. No nurse practitioner to find out whether you have the flu or just a bad cold. Washakie County includes Worland, home to the new Washakie Museum (grand opening summer 2010), a sugar beet processing plant (major client: Pepsi) and a great cafe, the Brass Plum on Big Horn Avenue (great sandwiches and homemade potato chips)

I guess that Worland patients have to travel north to Lovell in Big Horn County which has two primary care people. They could go south to Hot Springs County, which actually shows a surplus of docs. Must be those healing hot springs' waters that draw the docs. Rounding out the counties in the Basin is Park, home to Cody and its small medical center adjacent to the much larger Buffalo Bill Historical Center, and Powell and its community college. But Park County is also showing a shortage primary care medicos. Most Wyomingites know that residents of the Big Horn Basin make frequent trips to Billings with its two hospitals and many docs. Bozeman, too. Over the Big Horn Mountains is the V.A. in Sheridan. Casper and its hospital isn't far either. Ditto Riverton in Fremont County.

But preventive medicine is very difficult when you have no family docs in the vicinity.

Rural areas all over the West have similar problems. Well-educated docs and their families aren't particularly attuned to remote small towns and their lack of amenities. Some of those are frivolous (what, no double-shot caramel mochiattos?) to important -- education, arts, hospitals and recreation. Yes, some pediatricians and nurse practitioners may love slow-paced and family-friendly Worland. But others may not like the fact they must drive 100 miles for shopping and surgery and symphony performances. Why not live in Billings if you go there every weekend?

I am not a small-town person. In my adult life, Cheyenne (pop. 55,000) is the smallest place in which I wish to dwell. Laramie County is the most populous in the state and it boasts the most primary care practitioners at 56 and that's not counting the specialists who fixed my knee and psychiatrists who regularly inspect my head for cobwebs and spiders. If I can't get the right specialist here, I can always cruise down I-25 to Fort Collins or Loveland or Greeley or Denver. On Tuesday, our family will take a little trip to Fort Collins to see my wife's endocrinologist for diabetes care. It will take us 45 minutes door-to-door unless we get snow and then it may take an hour or we may not get there at all so we'll have to reschedule. Chris wishes that there was an endocrinologist she liked in Cheyenne -- but there is not. So she doc-shopped and found one.

We have a choice because we have insurance and proximity. Worland citizens don't have proximity. What happens when they're also uninsured?

In the CST article, Dr. Anderson outlines some obvious problems

As challenges to addressing the shortage, the report noted rural doctors typically work longer hours and have lower incomes than their urban counterparts. They generally also receive lower Medicare and Medicaid reimbursements rates.

Wyoming's laws concerning medical liability also serve as a disincentive to doctors, Anderson said.

"That's going to drop us down on the list, being one of the states with minimal tort reform, basically none," he said.

The number of doctors being licensed in Wyoming rose 26 percent this year over 2008. That's attributable to a streamlined licensing processes put in place by the state Legislature earlier this year, Anderson explained.

There are signs the increase in doctors seeking Wyoming licenses may continue into 2010. More than 100 physicians have pending applications with the medical board.

The increase is having a positive effect, said Kevin Bohnenblust, the board's executive director. Traditionally, Wyoming's small population has made it difficult to support medical specialists. The new figures show more specialist are practicing in the state, albeit on a temporary basis. The state still needs to recruit more doctors, Bohnenblust said.

"Things are moving a lot in the right direction because we are getting more physicians who want to be licensed to provide care to Wyoming people," he said.
"That's a great thing. The trick is, we can't let up."

So, specialists are practicing here but living elsewhere. That's great when you're a local doc seeking a consultation with a neurosurgeon in L.A. or heart specialist in Houston. Dr. Anderson even mentioned a doc in Australia who recently received a Wyoming license so he could read X-rays remotely. And who knows how many of those newly-licensed docs are doing the same thing in India or Indonesia?

I'm obviously not a physician. I'm just a poor schlub in Cheyenne who needs the occasional check-up or operation. I'm going to have an easier time accessing healthcare than another 59-year-old who lives in Worland. There's something wrong with that. It's possible that technology and even the new healthcare reform bill may improve the situation. It's also possible that the current economic crisis that's hit the cities of the coasts may cause some docs to reconsider life in bucolic Wyoming. The "local" trend -- local eating, local working, local artmaking --may also boost the number of small-town healthcare providers.

Meanwhile, residents of Sweetwater, Carbon, Washakie, Big Horn, Park, Uinta, Albany, Converse, Lincoln, Weston, Crook, Niobrara and Platte counties will keep on logging those miles on visits to the family doc, many of them located across the Wyoming border in Billings, Rapid City, Fort Collins, Salt Lake City and Idaho Falls. That's not only tragic for efficient healthcare. It also costs Wyoming's economy. On Tuesday, we're going to Chris's specialist in Fort Collins and eating lunch out and Chris is having her Saturn serviced and my daughter Annie is spending her Christmas cash in Old Town. I may visit my favorite place in Old Town, Ben & Jerry's, for an infusion of Chunky Monkey.

Economic development for Colorado but not for Wyoming.

CST reporter Joshua Wolfson has a blog at tribtown.trib.com/JoshuaWolfson/blog

We offer advice to WYO GOP Sen./Doc Barrasso: "Physician, heal thyself!"

From the Bible, Luke 4:23 (King James Version):

And he said unto them, Ye will surely say unto me this proverb, Physician, heal thyself: whatsoever we have heard done in Capernaum, do also here in thy country.

Physician John Barrasso, one of Wyoming's two U.S. Senators, released his critique of the Senate's health care reform bill this morning.

He calls it the "Reid healthcare bill." One of the GOP talking points is to blame Democratic Sen. Harry Reid because he pushed and cajoled and ramrodded this bill. The GOP has its sights on Reid's seat in Nevada. They hope that by equating this bill with the senator from the tiny Nevada desert mining town of Searchlight, voters in the Silver State will see the error of their ways and vote him out. They want another senator as clean and pure of heart as Republican John Ensign, who cheated on his wife, tried to cover it up through sexual harrassment and may be guilty of violating campaign finance laws. Ensign was selected for Top Ten Scandals of 2009 by Citizens for Responsibilty and Ethics in Washington (CREW).
Ensign also made the "50 Assclowns of the Year" list at http://welcomebacktopottersville.blogspot.com/2009/12/assclowns-of-week-year-79-top-50.html

But hummingbirdminds digresses (what else is new?). HM has always been flummoxed by Dr. Barrasso's negativity toward true healthcare reform. Here is a physician that most Wyomingites know through his television "Health Care Minute," in which he imparts his 25 years of medical wisdom in one-minute sound bites. We also know him as a key sponsor of health fairs around the state and emcee of the Casper site of the annual Labor Day weekend Jerry Lewis MDA Telethon. He has a reputation as a pol with one eye on media exposure and one on public service. Can't fault any American for that. Usually you get one or the other. Those interested in All Public Exposure All the Time are usually vacuous celebrities whose only goal seems to be getting in front of the nearest camera. On the other hand, public servants don't necessarily crave the limelight but sometimes have it thrust upon them.

Sen. Barrasso might want to look inside himself to see which kind of human dwells within. He criticizes Reid and Dems for playing politics but says nothing about the underhanded tactics used by the Republicans during this process. At least Sen. Enzi, Wyoming's other senator and Gang of Six member, said early on that the Repubs' super-secret plan was to derail Obama. Who cares about healthcare reform? We want to sink Barack Obama.

So, before Sen. Barrasso gets all high and mighty on us -- "physician, heal thyself!" Look into your own heart and see if you are truly serving the Wyoming electorate or you are only towing the party line. You seem to love the TV camera, Sen. Barrasso. Is this vanity or service to your state? We wonder. So do Wyoming's 81,000 uninsured.

Here's Barrasso's statement from his web page:

“The Senate today passed a healthcare bill that represents politics at its worst. Promises of transparency, fiscal discipline and thoughtful policy debates were replaced with closed door meetings, billion dollar pay offs and partisan tactics.

“Instead of helping more Americans have access to affordable, high-quality health care, this 2700 page bill cuts Medicare, increases taxes, raises insurance premiums and burdens our grandchildren with even more debt.

“There is no reason to rush legislation that will impact one sixth of our economy and affect the health of each American.

“After practicing medicine for over 25 years, I know that this bill will not deliver better care to folks in Wyoming and across America. As this legislation moves to the House, I will continue to speak out against it and do everything possible to ensure that Congress finally passes reform that will increase the quality, availability and affordability of healthcare in our country.”

Contact Sen. Barrasso at http://barrasso.senate.gov/public/

Dr. Sherard: "Medicaid and Wyoming"

Dr. Brent Sherard writes a guest editorial, "Medicaid and Wyoming: Why It Matters," in today's Cowboy State Free Press. Sherard is head of the Wyoming Department of Health and the State Health Officer. To read the entire article, go to http://thewyonews.net/2009/12/22/medicaid-and-wyoming-why-it-matters/.

Here's a sample:

Wyoming EqualityCare, our state’s Medicaid program, pays for the healthcare many of our state’s low-income and medically vulnerable citizens desperately need. Medicaid is roughly a 50-50 financial partnership between states and the federal government. The federal contribution is calculated every federal fiscal year using the relationship of Wyoming’s average per capita income to the national average per capita income.

Approximately 81,000 Wyoming residents qualified for the program in the last fiscal year, which represents 15 percent of our population. Wyoming EqualityCare accounts for about 12 percent of the entire budget of Wyoming’s state government, annually spending about $500 million.

Any big change to the program or adjustment to its budget affects us all in one way or another. The money does not just disappear down a bureaucratic black hole; it is spent with local doctors, hospitals, nursing homes and other healthcare providers in every Wyoming community.

Included in the Senate health reform bill is a $1 billion Medicaid increase to states that provide visiting nurses and other in-home or community services to prevent low-income people from needing to be admitted to hospitals. Wonder if Wyoming will receive some of those funds?

We'll have to see how it all shakes out.