By Kenneth W. Darling - 02/25/09 07:05 PM EST
In reading articles from The Hill regarding the Centers for Medicare and Medicaid Services’ (CMS) caps for patient care I wondered if the Social Security changes Congress made in 2000 are being looked at for any potential savings on hospice payments.
In 2000 Congress allowed hospice companies to switch from fee-for-service to per diem charges. When I saw the CMS payments for my mother’s hospice service I was amazed.
I felt as the family caregiver that I would have hospice come out occasionally. They didn’t provide any service that I wasn’t providing already. But it was nice to have a nurse check on Mom, a twice-per-month required minimum, for a 15-minute visit. However, when I found out from a CMS statement how much they were legally billing for only 30 minutes of work per month I canceled the service.
The per diem charge everyday regardless of actual service was $183, or $5,490 a month. That did not include the nurse, which added a charge of $229 per visit ($458 for the two 15-minute visits), adding up to $5,948. In our case the hospice service charged CMS the equivalent of $11,896 per hour.
And when the social worker “tagged along,” as she put it, with the nurse, it added another $229 per day.
They also attempted to push on us new equipment like a hospital bed, walker, commode, and so forth.
Hospice pales to the huge amounts for other medical care. But it definitely points to the tip of a very large “cash berg” we scrape each month in government payments.
Card-check would undercut recovery
From Brian Worth, chairman, Coalition for a Democratic Workplace (business association)
John Sweeney, the head of the AFL-CIO, recently took to the pages of The Hill to make a full-throated push for the Employee Free Choice Act (op-ed, “A strong economy is a more equal one,” Feb. 11).
The act is an anti-worker, job-killing piece of legislation that will undercut the efforts of President Obama and Congress to stimulate the economy through fiscal policy. The bill will drive up labor costs for employers, especially small businesses, at a time when they can least afford it.
The act is designed to bolster union membership at the expense of worker privacy. The bill’s main provision would effectively eliminate the secret ballot for union-organizing elections and replace it with a card-check scheme where the votes of workers would be made public to their employers, co-workers and union organizers. Without the protection of the secret ballot, there would be no guarantee that workers could vote their true wishes on the personal decision of whether to have a union in their workplace.
The act also contains a lesser-known provision that would impose government-mandated labor contracts on employers who are unable to reach agreement with unions after only four months of negotiations. Under the act’s binding arbitration rules, employers would have no right to appeal the decision of a federal arbitrator and workers would be unable to reject the terms of the employment contract. In essence, federal bureaucrats would be empowered to establish labor contracts for two years without any accountability to the employer or workers. Binding arbitration will tie the hands of employers and hinder their ability to manage their workforces during difficult economic times. Without this flexibility, many employers will struggle to remain viable in the face of global competition.
With all due respect to Mr. Sweeney, labor unions do not create jobs. Employers and small businesses do. In a time of economic crisis, it’s more important than ever for our policymakers to listen to what job providers have to say about legislation that impacts their ability to create jobs. The act is a poison pill for our ailing economy, which is why every major business organization from every industry sector has come out in strong opposition to it.