Fed Funds-Bad Medicine for Oklahoma

Kaye Beach

April 6, 2011

I have read hundreds of pages of documents regarding Oklahoma’s health information systems.  I have studied the various exchanges, our state policies, looked at the grants offered and accepted, read meeting minutes, white papers, power points and more.  I still am no expert on the Insurance business but I do know enough to say that we are being gamed.

The bottom line is that Oklahoma will be part of the universal health care system by virtue of the decisions made, federal funding accepted and the programs implemented by our elected officials unless there is an abrupt about face and fast!

Health policy expert, Michael F. Cannon, in this recent interview on America In The Balance gives a very clear explanation of where Oklahoma stands regarding the federal health reform law and how our implementation of the health insurance exchanges is a really a very bad idea.  http://www.truthinfocus.org/radio/america_in_the_balance.html

Also, for a collection of source documents, flyers and articles detailing how Oklahoma Republican leaders who campaigned against “Obamacare” are in reality working to implement it, go to http://www.ok-safe.com/

One more item, There is going to be a rally at the Capitol today-Wednesday April 6th 2011  11:00 AM        No Obama and/or O’Fallin Care

More info here

 

A few days ago after reading and reading I did something I rarely do.  I was so angry with what I was discovering from all of my reading that I let fly with a pure diatribe, a rant, just for the sake of venting my spleen.  Everything I wrote was pure assertion and I provided no evidence to back up any one of them.  I don’t usually do this for a reason.  Personally, I like to be given the facts so that I can make up my own mind about things and I try to provide for others material that I would find worthy of reading myself.  The only reason I indulged is because I was certain that I could back up everything I said.  I can and now I will.

As you are probably aware, Health care reform in the United States in 2010 was enacted nationally by two bills: the Patient Protection and Affordable Care Act which became law on March 23, 2010 and was shortly thereafter amended by the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) (which became law on March 30). (source Wikipedia)

In 2009 the American Recovery and Reinvestment Act (ARRA) often referred to as simply the “stimulus bill” passed.

If you are like me, you may remember that the ARRA was subject to plenty of controversy but I don’t remember hearing much about the HITECH [Health Information Technology for Economic and Clinical Health] portion of the bill.  The American Recovery and Reinvestment Act came before the health care reform bills that passed in 2010, so the provisions in the HITECH portion likely just seemed like just more government pork.   I have been surprised to find out how just much money was allotted to the states for the express purpose of the creation of the health information infrastructure that would soon be needed in order to implement the controversial government takeover of our medical care that was soon to become law.

“Our state is also taking an aggressive approach, with federal grant funding, to improve both quality and efficiency through use of electronic health records.”

Source-Oklahoma Health Care Authority State Fiscal Year 2010 Annual Report

They weren’t kidding.

Four Key HITECH Sections

•          SEC. 3012. HEALTH INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE

•          SEC. 3013. STATE GRANTS TO PROMOTE HEALTH INFORMATION TECHNOLOGY

•          SEC. 3014. COMPETITIVE GRANTS TO STATES AND INDIAN TRIBES FOR THE DEVELOPMENT OF LOAN PROGRAMS TO FACILITATE THE WIDESPREAD ADOPTION OF CERTIFIED EHR TECHNOLOGY

•          SEC. 4201. MEDICAID PROVIDER HIT ADOPTION AND OPERATION PAYMENTS; IMPLEMENTATION FUNDING

If the United States is to have a Nationalized Health Care program it must first have a national health care information infrastructure.  The federal government has already built their portion and now it’s time for the states to get plugged in.

What is the NHIN?

“The National Health Information Network (NHIN) is an ambitious modernization plan proposed by the U.S. government. The idea is to move as an entire nation from paper medical files to electronic medical files that are shared. Specifically, the government goal is to digitize patients’ health records and medical files and create a national network to place the information in. The network, called the NHIN, would be a sophisticated network that hospitals, insurers, doctors, and others could potentially access. Such a network brings patient privacy, security, and confidentiality issues into sharp relief.” link

Take a look at the NHIN timeline

Sharing

The billions of dollars in planned federal incentive payments over the next five years are meant to spur the adoption of electronic patient records. But the investment will pay off only if the data is shared (Emphasis mine)

Read more Feb. 2011 U.S. Tries Open-Source Model for Health Data Systems


“The Affordable Care Act requires state-based American Health Benefit Exchanges to be established and working by 2014.  Exchanges are, for most states, new entities that will function as a marketplace for buyers of health insurance. . .” read more

The health information infrastructure is essential in the development of a federally managed universal health care system.  For the federal government to control our health care it has to have access to the data pertaining to finances, information to determine our eligibility for and our actual health care data.

The federal government actually prefers that the states do the work of developing these subsystems for them and D.C. is happy to feed our tax dollars back to us to pay for the work.

An electronic health record (EHR) is essential for collecting and sharing this information rapidly and widely.  The ARRA made sure to provide plenty of incentives for the state as well as hospitals and individual doctors to ensure that EHR would be in place. Electronic Health Records store their information in databases and use national standards to enable health information to be shared between various agencies across the nation.  The federal government needs the states to collect the information and share it in order for them to implement “Obamacare”

Carrots and Sticks

“In order to get hospitals, doctors and other health care providers to comply with the creation of EHRs for “each person in the United States by 2014,” the stimulus law provided for federal bonus payments to be made to providers who generate records complying with the federal standards by 2014 Health care providers that do not use EHRs that meet the federal standards by 2014 will have their Medicare and Medicaid payments progressively diminished as a penalty for failure to comply.” link

The EHR’s serve to collect data-The information technology infrastructure, just like our highway infrastructure, lets that data travel.   Unfortunately, this new superhighway is built like a perpetual toll road.

The $54 million dollar “early innovator grant” is about the infrastructure.

Everyone is talking about the $54 million “early innovator” grant that Gov. Fallin accepted for just this purpose-to build the health information infrastructure according to federal specifications.

(Read the grant application here)

Cooperative Agreements to Support Innovative Exchange Information Technology Systems
On Oct. 29, 2010, the Office of Consumer Information and Insurance Oversight made a Funding Opportunity Announcement that it will provide competitive incentives for states to develop the information technology infrastructure needed to operate Health Insurance Exchanges.

The actual amount that Oklahoma has accepted to build this infrastructure for the pending federal takeover of health care is actually much, much more than $54 million.

According to the OKLAHOMA REVISED HEALTH INFORMATION EXCHANGE OPERATIONAL PLAN – MARCH 2011

“ARRA appropriated more than $45 billion to assist in electronically transforming the health care system.”

And

“The total ARRA funds awarded to Oklahoma are approximately $3.2 billion”

The Tulsa World in this article, Health exchange plan paid by federal grant still alive stated that “The application [for the "early adopter" grant] does not contain a straightforward commitment to Obama’s health-care agenda.”

I disagree.

On page 8 of the application it is acknowledged that the “The Cooperative Agreement to Support Innovative Exchange Information Technology Systems presented by the Patient Protection and Affordable Care Act (ACA). . . ”

If money is being paid to the state on the authority of the Affordable Care Act, for the purposes of creating something required by that act then how is that not a committment?

The Tulsa World writer also noted that the application is a half-inch thick and dense with jargon.” He is right on the money there!  It has been some chore to try and untangle this gobbledygook and none of it is very straightforward. The writer, Wayne Greene, does bring out some important information in his article and it is definitely worth reading. Health exchange plan paid by federal grant still alive

The “early innovator” grant, formally referred to as ‘The Cooperative Agreement to Support Innovative Exchange Information Technology Systems’ states;

“The Cooperative Agreement to Support Innovative Exchange Information Technology Systems presented by the Patient Protection and Affordable Care Act (ACA) provides Oklahoma the opportunity to explore more widespread system access and market based changes.”

Sure.  We can explore all we want to as long as we stay within the confines of the federal government’s fences.  From what I am reading, these fences will be getting progressively closer over the next few years.

The purpose of this grant as stated by the Dept. of Health and Human Services;

Purpose – The overall purpose of this program is to facilitate and expand the secure electronic movement and use of health information among organizations according to nationally recognized standards.

Here is the funding opportunity notice released by The US Dept. of Health and Human Services on Sept 29, 2010.  On page 5 under “Authority” it states;

“Section 1311 of the Patient Protection and Affordable Care Act (P.L. 111-148) authorizes the funding for this opportunity”

The application filed by our state also says that;

“The development of the Cooperative Agreement in Oklahoma will be referred to as the “Oklahoma Health Infrastructure and Exchange Project (OHIEP)”.

In my recent blog rave,An Open Challenge to Oklahoma Elected Officials HOW DO YOU DARE!” I said;

“You have painted good legislators into a corner and tied their hands making it next to impossible for them to protect the rights of their constituents.”

Unfortunately the policies adopted by the state of Oklahoma have tainted just about every aspect of our health information infrastructure in such a way as to guarantee that any of our health information that utilizes computer technology such as electronic health records, will be assimilated by the federal government to further the unconstitutional Health Care Reform laws passed in March of 2010.

Data systems that are all connected by the dictates of the federal government, using standards set by the federal government and that collect and submit information required by the federal government are effectively one huge system.  The federal government is the boss and the states are the local administrators for the boss. That boss is dead set on universal health care and we are participating in spite of the fact that the legality of such a program is being challenged and has yet to be decided.

Our entire state health care information infrastructure both the existing and future aspects of it, are neatly threaded into the new universal care system due to our state’s acceptance of BILLIONS in federal funds and the requirements that go along with those funds.

Senate Bill 1373 in 2010 created the Oklahoma Health Information Exchange Trust (OHIET).

“The purpose of OHIET is to ensure complete coverage of the state by health information exchanges (HIEs) and the secure and appropriate transmission of electronic health data both intra and interstate.” (Emphasis mine)

“Stakeholders of OHIET greatly value this opportunity to both expand Oklahoma’s existing and future HIT/HIE initiatives as well as help offset the provider costs of implementing the electronic information systems required to support Electronic Health Records (EHRs).” link

What this means is that all of Oklahoma’s existing and future health information technology and exchanges have been or will be altered to suit the wishes of federal government. They are making the rules here which likely mean that they will also win the game. And this is what I meant when I stated “You have made it so that any information technology related to health care in this state cannot be extricated from a national system limiting the people of Oklahoma from utilizing technology free from federal control that could improve their lives and health.

Oklahoma “Obamacare” Bill Tracking

In 2011 several bills in Oklahoma have been identified as “Obamacare” supporting or enabling bills.  The National Conference of State Legislators is one of the most authoritative sources there is for state legislation and they have a developed a Federal Health Reform: State Legislative Tracking Database

The intro to the database reads;

“Welcome to the State Legislative Tracking Database on bills filed in response to the Affordable Care Act!”

For those who have read enough the national and state documents describing the health exchanges and how the system will work and that are also weary of having to tediously explain and show how these bills (which unfortunately don’t have the word “ObamaCare” spelled out in flashing lights on every page) this database should provide some relief. All bills related to the health care reform acts are listed including bills that are in opposition to the federal health care reform bills.

Have a look: Federal Health Reform: State Legislative Tracking Database

Recently the updated federal Health IT Strategic Plan was released.  It is 80 pages long and the public may make comments about it until April 22, 2011.

Here is a link to the report and the following news item about the release of the updated plan;

“A draft of a Federal Health IT Strategic Plan for 2011-2015 provides a roadmap that the next national coordinator for health IT may use in spearheading many efforts, including protecting the privacy of healthcare information. But much of the content is a rehash of projects that were mandated in the HITECH Act, enacted in 2009 as part of the economic stimulus package.” Read more

In 2009, Mary Fallin, along all of Oklahoma’s US Representatives, signed a “Resolution on Preserving States’ Rights Regarding Federal Health Insurance Exchanges and a Public Plan , which deems the public plan anti-competitive and invokes the Tenth Amendment to the U.S. Constitution in calling the national health insurance exchange a “federal takeover” of the states’ role in regulating health insurance.” Read the petition

The letter introducing the Resolution begins;

Dear Senator Reid and Speaker Pelosi:

We are writing to reiterate our concern with recent federal health reform efforts—particularly, the Medicare-modeled “public plan” and a national health insurance exchange—which we believe would trample states’ rights and lead Americans down the road to single-payer health care.

There is just one acceptable response to such an attempted “federal takeover”.  Governor Fallin and Oklahoma lawmakers should take the advice of former First Lady Nancy Reagan and JUST SAY NO!

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2 responses to “Fed Funds-Bad Medicine for Oklahoma

  1. It’s worse that I thought. Been going back and forth with my Rep. Scott Martin about this. The only thing I got as to why he supported it was the talking points memo from the Gov’s PR person….

  2. Good job…You hit this nail square on the head!

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