Monday, January 27, 2020



Massachusetts seeks to rein in largely unregulated urgent care industry

These clinics arose primarily as as way to escape the health bureaucracy and thus provide cheaper care.  But the bureaucrats resent them

For years, the urgent care industry has grown rapidly, with walk-in clinics popping up across Massachusetts to treat patients with colds, infections, cuts, sprains, and other common ailments.

Yet the industry remains largely unregulated. Urgent care has become a common term in health care — but it has no state definition in Massachusetts, making these centers difficult if not impossible to monitor, according to state officials.

Now policy makers appear poised to impose new requirements on urgent care centers, but they’re facing resistance from industry executives.

The lack of standards means any provider can market itself as “urgent care,” and patients don’t know what to expect when they walk in the doors, said Marylou Sudders, the state’s secretary of health and human services.

“There is no standardized definition or structure that exists for urgent care,” Sudders said. “In terms of consumer protection, we should define them and regulate them.”

Urgent care was a focus of sweeping health care legislation that Governor Charlie Baker proposed last fall. The Baker administration wants these centers to be licensed as clinics, to provide care to low-income patients who use MassHealth, and to offer some mental health services.

State lawmakers have filed more than a dozen bills pertaining to urgent care centers this session, and both House and Senate are working on additional legislation that is likely to include regulations for the industry.

Operators of urgent care clinics say such regulation could slow growth — or even kill an industry that provides convenient, affordable care. They have been frequent visitors on Beacon Hill, lobbying to try to prevent the passage of legislation that could disrupt their business model.

“Any regulation that increases cost and complexity could be damaging to the industry,” said Shaun Ginter, chief executive of CareWell Urgent Care and a board member of the national Urgent Care Association.

Because there is no definition of urgent care in Massachusetts, some centers are licensed as hospital facilities, some as clinics. But many operate as physician practices, which don’t require a license.

Individual health care providers, such as doctors and nurses, must be licensed to treat patients no matter where they work.

“We should be treated no differently than any other medical office,” Ginter said. “We feel very singled out and pulled out to the side when we shouldn’t be.”

Urgent care executives said it costs from hundreds of thousands to well over $1 million to open a clinic. Licensing requirements would increase those expenses, they said, especially if the state mandates that clinics be built to certain specifications — and such requirements could be devastating for the clinics that are already up and running.

“From a business perspective, nobody would open new centers,” said Lynne Rosen, chief executive of PhysicianOne Urgent Care, which operates four clinics in Massachusetts.

Rosen said the company plans to develop several additional sites, but she’s waiting to see what happens at the State House.

“I can’t sign that lease until I understand [the legislation],” she said. “We’re going to monitor what goes on in the first 90 days of the year. Certainly, it influences our decision-making.”

Urgent care companies are also objecting to the Baker administration’s insistence that they provide certain mental health services. Their centers usually are staffed by providers with backgrounds in primary or emergency care — not mental health care.

“That would require a change in staffing model, potentially,” Rosen said.

Jim Brennan, who owns six American Family Care clinics in Massachusetts, agreed, saying, “There is a need for behavioral health providers, but I’m not certain the urgent care platform is equipped to do that.”

Rather than implement new regulations, industry executives said, the state should lift burdensome requirements that make it difficult for MassHealth patients to seek care at urgent care clinics. Currently, MassHealth requires a referral from a primary care physician before covering urgent-care visits.

Administration officials say they can’t lift these restrictions unless the state first adopts standards for urgent care.

While they don’t have an official state definition, urgent care centers are typically open on nights and weekends when most doctors offices are closed. They generally promise to treat a variety of medical issues — except for life- and limb-threatening emergencies — at a fraction of the cost of hospital emergency rooms.

They offer walk-in service, accept health insurance, and are staffed by physicians, physician assistants, or nurse practitioners.

About 180 urgent care centers have opened in Massachusetts, most of them in the past decade, according to industry and state figures. Much of the growth has come from relatively new for-profit companies, though some traditional health care providers, including nonprofit hospitals, also have centers.

These facilities are distinct from retail clinics such as CVS MinuteClinics, which offer more limited services and are already regulated by the state.

But not everyone has equal access to urgent care centers. They tend to be located in middle-class and affluent communities — not in low-income neighborhoods.

Policy makers have begun to pay more attention to urgent care centers in recent years. In 2018, the Massachusetts House approved legislation to put hefty assessments on the centers. Urgent care companies lashed out at the proposal, which died when House and Senate lawmakers couldn’t agree on compromise legislation.

House majority leader Ronald Mariano, lead author of the 2018 House bill, said he has backed off the assessments but remains concerned that the centers are unregulated. He’s also worried they are “taking money out of” community hospitals, which he wants to protect.

“We should set some standards so we know what these people are doing and who they are servicing,” Mariano said.

The House is likely to take up urgent care this spring as part of a larger health care bill, Mariano said. The Senate is also considering new rules.

“Our goal is to provide high-quality, affordable, and accessible health care to everyone in the Commonwealth,” Senator Cindy F. Friedman, cochair of the Legislature’s Joint Committee on Health Care Financing, said in a statement. “Urgent care centers provide this kind of health care to our residents — so yes, they too should be subject to regulations and oversight.”

Lawmakers have until the July 31 end of the legislative session to compromise, while urgent care companies try to influence the debate.

At least one company, ConvenientMD Urgent Care, has accepted that regulations are probably coming.

ConvenientMD has opened eight centers across Massachusetts in the past 13 months. They are already licensed as clinics, said chief executive Max Puyanic.

“It is very costly to go through the licensing process,” he said. “[But] we assumed it was better to do it up front, assuming it might be required in the future.”

SOURCE 





Banning Conversion Therapy to Placate the Rainbow Mafia
Utah becomes the 19th state to ban what used to be a widely accepted practice


The state of Utah this week became the 19th state to ban conversion therapy for children who struggle with gender-disorientation pathology. In short, that means therapists are legally prohibited from working with young people to help them recalibrate their sexual desire or identity.

Here’s the Associated Press definition and explanation of conversion therapy:

Conversion therapy is a practice used to try to change sexual orientation or gender identity. Many people who have been through it say it deepened feelings of depression and increased thoughts of suicide. The new rule bans licensed Utah therapists from subjecting LGBTQ minors to the practice that the American Psychological Association has said is not based in science and is harmful to mental health. The Utah Psychological Association also spoke in favor of the rule.

The hypocrisy is so appalling it’s worth recasting that paragraph with a couple of links to prove the assertions:

Gender “reassignment” surgery is a practice used to try to “change” a person’s biological sex, despite the clear science that there are only two sexes. Many people who have been through it say it deepened feelings of depression and increased thoughts of suicide. In fact, an astounding 41% of “transgendered” individuals have attempted suicide, compared to just 4.6% of the overall population. Nevertheless, judges and doctors have subjected minors to the hormone therapy and more — sometimes over the objections of their parents — even though the American Psychological Association used to say this was not based in science and is harmful to mental health.

The American Medical Association also used to classify various gender pathologies as mental illness, even recommending conversion therapy until 1994, when the AMA reversed course and started recommending psychotherapy to help homosexuals “become more comfortable with their sexual orientation.”

Now, we’re not defending any particular brand of conversion therapy, as that would greatly depend on the therapist and vary widely depending on the patient. But it’s clear that over the last 30 years, the Rainbow Mafia has put the screws to doctors, psychologists, and scientists, who have done a total about-face from prior established practice in order to comply with a political agenda. When this sort of pseudoscience is done to teenagers or even elementary-age children, it is nothing less than child abuse.

And yet The Patriot Post has encountered censorship from Facebook on two specific occasions for talking about the science of two sexes and for opposing child abuse. Yet it’s not just memes on social media; it’s laws affecting parents, children, businesses, doctors, and others. Utah has joined 18 other states in criminalizing opposition to the accepted political point of view, and that’s what’s so dangerous.

SOURCE 





Diversity Isn’t Always the Answer

Walter E. Williams

It’s nearly impossible to have even a short conversation with a college administrator, politician, or chief executive without the words diversity and inclusion dropping from their lips.

Diversity and inclusion appear to be the end-all and be-all of their existence. So, I thought I’d begin this discussion by first looking up the definition of diversity.

Here’s my question to those who are wedded to diversity and inclusion: Are people better off the less they have in common with one another?

For example, women are less likely to be able to march 12.4 miles in five hours with an 83-pound assault load. They are also less likely to be able to crawl, sprint, negotiate obstacles, and move a wounded comrade weighing 165 pounds while carrying that load.

Would anyone argue that a military outfit would benefit from diversity by including soldiers who can and those who cannot march 12 miles in five hours while carrying an 83-pound load?

According to the Oxford Dictionary, diversity is “the practice or quality of including or involving people from a range of different social and ethnic backgrounds and of different genders, sexual orientations, etc.”

The definition gratuitously adds, “equality and diversity should be supported for their own sake.”

The standard definition given for inclusion is involvement and empowerment where the inherent worth and dignity of all people are recognized.

You say, “Williams, the military is an exception!”

What about language?

The International Civil Aviation Organization has decreed that all air traffic controllers and flight crew members engaged in or in contact with international flights must be proficient in the English language as a general spoken medium.

According to the United Nations Educational, Scientific, and Cultural Organization, there are about 7,000 languages in the world. The International Civil Aviation Organization could promote language inclusiveness by requiring language rotation.

Some years, Cebuano (of the Malayo-Polynesian language family) and in other years Kinyarwanda (of the Niger-Congo language family) could be the language of pilots and air traffic controllers.

Keep in mind that it is claimed that the great benefit of diversity and inclusiveness is that it promotes and fosters a sense of belonging. It values and practices respect for the differences in the talents, beliefs, backgrounds, and ways of living of its members.

Another issue is what should be done when people who should know better praise non-diversity and non-inclusiveness?

Civil rights leader Rev. Jesse L. Jackson said, “I applaud commissioner Adam Silver’s commitment to diversity and inclusion within the NBA.”

During the 2018-2019 season, more than 33% of NBA teams had head coaches of color. The number of assistant head coaches of color was over 42%. The number of black NBA players was 82%.

In the face of these statistics, Oris Stuart, the NBA’s chief diversity and inclusion officer said, “Diversity, inclusion, and equality are central to every aspect of our game and our business.”

I would like for Jackson and others who claim that there’s racial diversity and inclusiveness in professional basketball to make their case. The same question can be asked about professional football where 70% of NFL players are black, and 9% of team head coaches are black.

The thornier question and challenge is what can be done to make professional basketball and football look more like the American population?

Most of the diversity and inclusiveness insanity has its roots in academia.

An example is a paper titled “Equilibrium Grade Inflation with Implications for Female Interest in STEM Majors,” written by Naval Postgraduate School professor Thomas Ahn, Duke University economics professor Peter Arcidiacono, Duke University researcher Amy Hopson, and James R. Thomas of the Federal Trade Commission.

The authors argue that science, technology, engineering, and mathematics programs at colleges and universities lacking female enrollment can be attributed largely to harsh grading policies in these fields.

Their solution to increase the number of women’s involvement in STEM is to standardize grading curves, in order to grade less “harshly.” The insanity of this approach is to not only weaken standards for women but to weaken standards across the board.

This is more evidence that George Orwell was absolutely right when he said, “There are some ideas so absurd that only an intellectual could believe them.”

SOURCE 






Why I’m looking forward to celebrating Australia Day

Some Australians are tired of the constant protests that surround Australia Day. Some just want to celebrate their country and not be shamed for it.


Corrine Barraclough

When I first arrived in Australia 10 years ago, I’d never heard of Australia Day.

There was a lot of chatter in the office about what everyone was up to, talk of family gatherings, BBQs, fireworks, parties, yummy food and a real sense of pride in country.

We don’t have an “England Day”. There is no day when everyone comes together, waves flags and feels proud (that’s not connected to the royals).

Quite simply, Australia Day is the official national day of Australia. I loved the simplicity of that.

Australia Day is for all Australians; no matter where we’re originally from and it felt overwhelmingly inclusive.

I find it incredibly sad that now, years down the track, debate around our special, national day only seems to grow increasingly negative as time ticks by.

Anyone who calls it “Invasion Day” is looking to promote disunity. Anyone who calls it “Survival Day” is missing out on the warmth this day offers. There’s even talk about “paying rent” for stolen land.

There doesn’t need to be any controversy, angry hash tags or vitriol spat on social media. It’s meant to be a day of solidarity, peace, celebration and pride.

Australia Day is, of course, each year on 26 January and celebrates the arrival of the First Fleet of British on Australian soil.

Australia was not invaded – it was settled. There was no warfare, no organised military resistance or conflict. The First Fleet came here with convicts in chains; it was not an invasion force. Certainly, starting a new chapter doesn’t mean everything that’s gone before is forgotten.

There are records of celebrating Australia Day dating back to 1808.

Now, it’s a public holiday across all states and territories.

Doesn’t everyone love a public holiday? Doesn’t everyone look forward to an extra day off work?

And yet, here we are in 2020, and furious protesters are waiting in the wings, ready to preach their religion of division.

If you’re looking to find evidence of “oppression”, you will always be able to find it.

If you’re looking for opportunities to divide rather than bring people together, you will always find them.

If you’re seeking to shout about “shame”, you should take off your blinkers.

Australia is a wonderful country filled with caring, thoughtful, compassionate people. Just look at the incredible response to the bushfire crisis for proof of that.

This is not a racist country – and no one should feel “shame” for looking forward to celebrating this weekend.

This year, more than ever, we should be coming together.

Much as activists like to screech otherwise, the vast majority of people want to keep Australia Day on January 26 – and they want to celebrate freely.

A new poll from the Institute of Public Affairs (IPA) found that 75 per cent of Australians support Australia Day on January 26.

This is a huge number, especially considering the constant, monotonous and vocal efforts of the political left and pockets of mainstream media to oppose our national day.

The “woke” bullies with an agenda of bitterness have failed to divide us; that makes me even more proud. Perhaps I shall wave two flags.

“Mainstream Australians are fundamentally optimistic and positive about Australia and its values,” said IPA Foundations of Western Civilisation Program director Dr Bella d’Abrera.

The survey found 88 per cent of people were “proud to be an Australian”, with only 3 per cent disagreeing.

Only 10 per cent of Australians think the date should be changed. They will, no doubt, be the ones covered in glue this weekend.

On Sunday there are protests planned for “Invasion Day 2020” across the country, including Parliament House in Melbourne.

Perhaps we may see some familiar faces from other protests this year and some of the same loudmouths gluing themselves to the road in protest.

Its just noise, whether they’re screaming about “climate justice” or “invasion justice”.

People are sick of these disrupters.

The police should not be battling to maintain law and order against feral left-wing agitators. Their aim is to “burn down Australia”.

We’re in the middle of a bushfire crisis for god’s sake; no wonder most people aren’t on-board with the madness.

No, it doesn’t make me “selfish” for celebrating.

Nor does it make me “insecure”.

No, I’m not “ashamed”.

No, I don’t want to talk about “enslavement”.

And no, caring about Australia Day does not mean that I don’t care about the future of Aboriginal communities. Far from it.

I repeat: The majority of mainstream Australians are proud, they’ll be celebrating and if you’re not part of that, you’re simply a tiny, resentful fringe minority.

SOURCE  

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Political correctness is most pervasive in universities and colleges but I rarely report the  incidents concerned here as I have a separate blog for educational matters.

American "liberals" often deny being Leftists and say that they are very different from the Communist rulers of  other countries.  The only real difference, however, is how much power they have.  In America, their power is limited by democracy.  To see what they WOULD be like with more power, look at where they ARE already  very powerful: in America's educational system -- particularly in the universities and colleges.  They show there the same respect for free-speech and political diversity that Stalin did:  None.  So look to the colleges to see  what the whole country would be like if "liberals" had their way.  It would be a dictatorship.

For more postings from me, see TONGUE-TIED, GREENIE WATCH,   EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS and  DISSECTING LEFTISM.   My Home Pages are here or   here or   here.  Email me (John Ray) here.  Email me (John Ray) here

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