What hath codes wrought?

The New Neo Posted on by

A doctor describes how billing codes have changed the medical profession:

Hospitals’ reimbursements for their Medicare-patient treatments were based on another coding system: the Diagnosis Related Group (DRG). Each diagnostic code is assigned a specific monetary value, and the hospital is paid based on one or a combination of diagnostic codes used to describe the reason for a patient’s hospitalization. If, say, the diagnosis is pneumonia, then the hospital is given a flat amount for that diagnosis, regardless of the amount of equipment, staffing, and days used to treat a particular patient.

As a result, the hospital is incentivized to attach as many adjunct diagnostic codes as possible to try to increase the Medicare payday. It is common for hospital coders to contact the attending physicians and try to coax them into adding a few more diagnoses into the hospital record.

Medicare has used these two price-setting systems (RBRVS for doctors, DRG for hospitals) to maintain its price control system for more than 20 years. Doctors and their advocacy associations cooperated, trading their professional latitude for the lure of maintaining monopoly control of the ICD and CPT codes that determine their payday.

It goes on…and on. And expect a lot more of the same sort of gaming with Obamacare, only at an even more convoluted level.

The new immigrants: come for the liberty, stay for the welfare

The New Neo Posted on by

Surprised that the Tsarnaevs of Massachusetts received welfare benefits?:

The Tsarnaevs’ parents are former recipients of transitional assistance benefits, and both Dzhokhar and Tamerlan Tsarnaev received benefits through their parents when they were younger. Separately, Tamerlan and his family received benefits until 2012, when the family became ineligible based on their income.

Well, don’t be. The Tsarnaevs are hardly unusual in that respect. Back in November of 2012, Jillian Kay Melchior detailed just how common it is for immigrants to receive benefits, and how the government actively encourages it:

But despite their entrepreneurial vigor, immigrants are disproportionately dependent on welfare. Senator Jeff Sessions (R., Ala.), crunched numbers from the Department of Agriculture and found that the number of non-citizens on food stamps has risen to 1.634 million, roughly quadrupling since 2001. Moreover, in August, the Center for Immigration Studies found that 36 percent of immigrant-headed households received at least one major welfare benefit. Food assistance and Medicaid have become especially popular among immigrants.

Two policy trends are driving the problem. First, the United States has promoted broader welfare use in recent years, also leading campaigns that market social aid specifically to immigrants. And second, our immigration rules are not crafted to weed out would-be freeloaders and give preference to highly skilled, highly educated applicants.

I highly recommend you read the whole thing.

So, when did this happen? It certainly seems to have arrived under the radar screen, for the most part. Who is promoting it, and why? One very obvious possibility is Democrats, in order to create more dependent Democratic voters, and more cultural and societal chaos, although the article doesn’t make it clear that these policies have been supported only by Democrats. And although the article says this “represents a major cultural shift,” it doesn’t say exactly when and how and why this shift occurred, although I’d hazard a guess that it’s been under Obama’s charge:

…[G]overnment marketing has shifted, and any number of “outreach” programs, both public and private, now seek to persuade immigrants to utilize the benefits newly available to them. Legal immigrants are potentially eligible for dozens of welfare programs, and even illegal immigrants can benefit indirectly, provided at least one member of their household is here legally.

What’s more, laws are ignored:

Federal law states that the U.S. should not admit immigrants who are likely to become a “public charge.” Yet the Department of Homeland Security and the Department of State examine only the Supplemental Security Income and Temporary Assistance for Needy Families programs when making this assessment. That ignores more than 75 other federal-assistance programs. Even so, State Department data show that only 0.068 percent of visa applications were denied in fiscal year 2011 because a prospective immigrant was at risk for becoming welfare-dependent.

The federal government also largely ignores educational attainment, which is probably the biggest indication of whether an immigrant will become a lifelong welfare recipient.

Where is the public outcry against this? It’s one thing to offer immigrants benefits if they happen to fall on hard times, it’s another to say “Come, come, you’ll get free stuff!!”

[NOTE: Ralph Peters has a few things to say on the subject, too. See Lesson #3, here.]

[ADDENDUM: The ever-witty Iowahawk (David Burge) has this to say: “The Tsarnaev brothers were state-supported terrorists. The state was Massachusetts.”]

Somehow methinks that…

The New Neo Posted on by

…this might have something to do with the fact that there’s not a whole lot of upset about the failure of the gun bill.

Nothing concentrates the mind on the subject so much as a spectacle in which America watches as a violent homicidal terrorist runs loose in a city, and citizens are told to remain in their homes. A gun can go at least part of the way to ward off that feeling of helplessness.

The affidavit and what it reveals

The New Neo Posted on by

Some interesting disclosures in the affidavit, including the fact that the bombers may have used cell phones to detonate their deadly cargo. For example, a little while after Bomber 2’s (Dzhohkar’s) backpack is placed on the ground, and about 30 seconds before the first explosion, he puts his cell phone to his ear for eighteen seconds, and shortly afterward people are seen reacting to first bomb.

Virtually every head turns toward the east (towards the finish line) and stares in that direction in apparent bewilderment and alarm. Bomber Two, virtually alone among the individuals in front of the restaurant, appears calm.

Dzhohkar then walks away, leaving his backpack behind where he had placed it earlier. Approximately ten seconds later an explosion occurs in that spot.

Think about it. Ten seconds.

As for the carjacking, one of the bombers tapped on the window of the victim’s car to get him to roll down the window, at which point the bomber reached in and opened the door, climbed aboard, and pointed a gun at him. It was at that point that he identified himself as the marathon bomber, showed the victim the gun was loaded, and added “I’m serious.” This may possibly clear up the mystery as to why the victim was told who the carjackers were. They apparently wanted him to understand they were dangerous, and that therefore he should do what they say. Their focus seemed to be on getting the car, and on coercing him to get them some money from an ATM, rather than how they would ultimately dispose of him.

There were security cameras at the ATM that showed the bombers, as well as cameras at the gas station where they stopped (and where the victim escaped). They seem to have either been unaware of the ubiquity of cameras, or not to care. The same is true of the original crime; it seems they had to have known that the Boston marathon is one of the most photographed events on earth, and yet acted as though they’d never be caught (or didn’t care if they were caught) by (in Dzhohkar’s case, anyway) not disguising themselves very well, and not even attempting to escape the Boston area afterward. They either had contempt for law enforcement’s investigative capacities, or in some sense didn’t mind if they were caught.

I vote for the latter. What good is it being one of the Boston bombers if nobody knows what a badass guy you are?

The inevitable rise of the Tsarnaev truthers

The New Neo Posted on by

It was a foregone conclusion that almost as soon as the bombing occurred and evidence began to churn out—and especially after the photos of the young and somewhat telegenic Dzhohkar were flashed around—a certain segment of people would begin (along with the Tsarnaev brothers’ parents, who at least have the excuse of being their parents) proclaiming the brothers’ innocence.

Sure! The Tsarnaevs were framed. Patsies! And all those people in the crowd with all those photos were part of the plot. As for the cop killing and the final shootout and all that—well, after all, wouldn’t anybody act that way?

All we lack to complete the picture is for a Jack Ruby to step forward and shoot Dzhokhar in his hospital bed, inciting spinoff conspiracy theories.

I predict that there will soon be a market for T-shirts with Dzhohkar’s picture on them a la Che, if it’s not already happening.

Oh. I see that it’s already happening.

And in other news…

The New Neo Posted on by

Did you know that Israel appears poised to become a massive exporter of natural gas and oil? Seems that way:

Israel became energy independent on March 30, when the Tamar offshore gas field began pumping natural gas to Israel. In two to three years, when the Leviathan gas field comes online, Israel will become one of the most important producers of natural gas in the world. Moreover, in 2017, Israel will likely begin extracting commercial quantities of oil from its massive oil shale deposits in the Shfela Basin near Beit Shemesh.

Geologists assess that the field alone contains some 250 billion barrels of oil, giving Israel oil parity with Saudi Arabia. Chinese, Russian and Australian firms are lining up to sign contracts with Israeli energy companies. International analysts assess that Israel’s emergence as an energy power will have a stabilizing impact on the global economy and international security. Israel can end Asia’s oil and gas hunger. It can reduce European dependence on Russia. It will remove OPEC’s ability to dictate world oil prices through supply manipulation.

More emerging Boston bombing stories

The New Neo Posted on by

I speculated some time ago that Dzhokhar Tsarnaev might kill himself before capture. And in fact, I was very surprised later to learn that he’d been taken alive. It turns out, though, that there’s a very good chance he made a serious attempt at suicide and failed, succeeding only in robbing himself of speech (perhaps permanently) because of injuries from a gunshot wound to his tongue and throat.

A few days ago I also wondered why the bombers released the guy whose car they hijacked. Now there are reports that they didn’t release him, but that he escaped at a gas station when the two left the car to buy snacks. I can’t say that makes a whole lot more sense to me, since it would seem to be an obvious rule of thumb that two perps shouldn’t both leave the car together if they want the victim to stay put. Perhaps the report is in error, or perhaps they were so rattled (or so hungry?) they forgot the most elementary rule that any moviegoer would know.

Since the FBI had already been alerted to older brother Tamerlane as a potential terrorist, why didn’t his 6-month visit to Dagestan and his attendance at a militant mosque there raise some very large red flags? Did he, perhaps, travel under an alias? And why, even after the photos were released, did the FBI seemingly fail “to cross-reference the photograph with a man whose picture they already had on file”? the kindest interpretation might be that his sunglasses may have obscured enough of his face to make the photos hard to match.

Here’s an article about Tamerlane Tsarnaev’s American-born wife, who met him and converted to Islam. She will certainly be asked a lot of questions by the authorities, but my guess is that her husband didn’t confide in her very much about his plans to blow up a crowd of people.

Nor does the article shed all that much light on her own transformation from all-American college student to dropout and Muslim wife. (And just as an aside: I had no idea there were leopard-print hijabs.)

Some of these inconsistencies are probably due to bad reporting. Some are purposeful obfuscation by the authorities, perhaps to hide their methods and knowledge. Some are probably the result of the fog of terrorism, and as more facts emerge they may come clearer. And those of a conspiracist bent will no doubt have a field day with it all.

[ADDENDUM: Re Tamerlane Tsarnaev’s recent travel going undetected, Lindsay Graham says it was because his name was misspelled by the airline. This is pretty shocking; doesn’t the FBI have capacities like Google, to alert to alternate spellings? If not, it should. Or at the very least we shouldn’t be relying just on airlines for this, since a passport had to be involved as well.]