(Washington, DC) – Last week, the House Energy and Commerce Committee released an update to their legislative framework that would replace the current Sustainable Growth Rate (SGR) system with a fair and stable system of physician payment in the Medicare program. This announcement comes after a draft of the legislation was released at the end of June and is the next step in a transparent, bipartisan process to ensure our seniors are receiving quality, efficient care.
As a physician, Representative Larry Bucshon (R-Ind.) helped to shape components of the draft legislation, including the use of Medicare data in developing new models of care and improving the quality and patient care.
Rep. Bucshon released the following statement regarding the updated legislation to reform SGR:
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“I applaud the work of Energy and Commerce Committee on another critical step forward in a transparent and bipartisan process to reform our broken Medicare physician payment system. The current system is not working and is unfair to seniors and their physicians. The reforms in the draft legislation are vital to ensuring seniors have access to predictable, quality care and that physicians are afforded necessary certainty. I look forward to continue open discussion on how we can improve this legislation.â€Â Â
The draft legislation unveiled last week incorporates feedback received from a broad range of bipartisan lawmakers and over 80 stakeholder organizations, representing ideas of committee Republicans and Democrats. The policy would get rid of the SGR for an improved fee for service system in which providers report quality measures that will lead to better care in a more efficient manner. Better quality care will lead to better outcomes and put a greater emphasis on efficiency which can lead to cost savings. In addition, providers will have the option of leaving the fee for service system and opt instead for new ways of delivering care that put an even greater emphasis on quality and efficient care, particularly those that can mean more time with patients and more savings to the system.
The Subcommittee on Health has announced a markup for this week on the draft legislation, which is authored by Health Subcommittee Vice Chairman Michael C. Burgess, M.D. (R-TX), Rep. Frank Pallone, Jr. (D-NJ), Full Committee Chairman Fred Upton (R-MI), Full Committee Ranking Member Henry A. Waxman (D-CA), Health Subcommittee Chairman Joe Pitts (R-PA), and Rep. John Dingell (D-MI).
IS IT TRUE the long anticipated and fumed about McGladrey report that conducted an extensive and invasive examination of the state of the Information Technology Department of the City of Evansville has finally been made public by the Office of the Mayor of Evansville?…it is fair to say that this report does not give the City of Evansville or Vanderburgh County high marks for anything that has to do with IT?…from paying skinflint wages that are insufficient to attract qualified candidates to the less than exemplary results that whomever the City was able to slot for the jobs were able to do Evansville once again looks like a misguided banana republic?…the remainder of this IIT will provide select excerpts from the McGladrey report and finish with a link to the full document so our readers can spend as much time as they wish dissecting this latest series of Fs earned by our city government for execution of critical tasks in a planned manner as opposed to reactionary based pissing out of fires?
Excerpts: “we have found the City’s and County’s Service Provider to be reactive and less strategic than we would like to see, we believe this stems from inexperience of the former CIO.â€
“the City and County lack strategic planning and this does not empower the departments to create real change that would improve the departments business. This also prevents the executives from planning and prioritizing large scale strategic initiativesâ€
“We also found the City and County support “Shadow IT†(IT Personnel that exist in other departments that have IT responsibilities but no budgetary link to IT) . This is a hidden cost that is hard to quantify.â€
“The current Service Provider contract to manage the Ford Center is outside the norm for the industry. Although there are some perceived benefits of shared networking and resources, this does not justify the 8-10 thousand dollar monthly excess. The best course of action is to allow VenuWorks to manage the event hall and its entire infrastructure. Their estimated cost is $4,500.00 a month. This would be a projected Operational saving to the Ford Center between 96K and 120K a year.â€
“Over the past 6 years the City and County have been operating with a CIO who lacked the proper qualifications needed to run a 300 Million dollar organizations. This has created a void in governing the relationship between the business stakeholders and the IT organization. Many organizations face this problem but struggle to fix it due to the cost of attracting a qualified CIO who can drive strategy and ensure tactical delivery. This role often exceeds 200K yearly salary in the Evansville marketplace – Gartner Group 2012 Wage Study.â€
“The current IT Services Provider has done a good job of keeping the lights on in the absence of strong IT leadership (CIO). The current Service Provider’s contract does not create an environment that would facilitate and reward innovation, systemic improvement and cost reduction. The current contract invites an environment to increase devices and discourage the retirement of any devices. The contract does not provide an incentive to impart strategic vision.â€
“Our investigation showed a lack of traceability around break-fix and without this documentation the city and county have no way to proactively prevent future issues and foresee system replacements.â€
“The Data Center in the City Building is one of the biggest risks found in this assessment. The datacenter sites in front of a large glass window and would be wiped out by a tornado or high winds. The physical security and access to this center is below best practices for data centers housing critical HIPPA, PCI and financial data. No one should be able to enter this facility without an independent signature and ID check.â€
“A few years ago the City and County embarked on selected a new financial system that would allow the City and County provide better services to the citizens and replace the antiquated financial system that existed for over twenty years. We believe the City and County selected an application that will meet those goals. They did not engage in a process that would identify key stakeholders and placed the project management responsibilities on an employee who was not qualified to implement a Financial System of this size and scope.â€
“Unfortunately the Service Provider was limited by a 90K dollar spend. The average mid-level project manager in the Evansville Marketplace cost over 110K. This project requires a senior level PM with ERP (Enterprise Resource Planning) and financial systems roll out experience. These employees cost over 125K dollars. The 90K employee provided by the Service Provider was over his head and not empowered to affect the change needed to improve the implementation of Munis by Tyler Technology. The Service Provider should not have provided this resource and the result has reflected negatively on both the PM and the Service Provider.â€
“We do not believe the comingling of city and county assets and services to be beneficial… The City and County comingle services and hardware. There is no governance to support this structure.â€
IS IT TRUE there are several references to people who did a “good job†while over their head technically in carrying out simple tasks?…the unfortunate conclusions and the recommendations are for Evansville to stop hiring under-qualified people into positions that require important skills and to pony up market rates to attract the kind of talent to do their IT business in a state of the art manner?…nothing more and nothing less could be expected from a governance team that was born and raised into a system dominated by patronage as opposed to merit?…this is the culmination of 50 years of poor public policy that finally came home to roost?
The City County Observer was in the house today in Marshall County, Kentucky when Evansville City Councilman and the Chairman of the Financed Committee faced authorities for three charges made against him by local water enforcement.
Two of the charges were dropped by the judge and Councilman Friend was fined $150 for the infraction of driving a boat under the influence of alcohol.
When asked about why Councilman Friend was jailed the Assistant Marshall County Attorney, Jason F. Darnall told the CCO  that  “jailing is optional and the arresting officers made that call themselves”. He made no further elaboration about the incident.
Below is a list of felony cases that were filed by the Vanderburgh County Prosecutor’s Office on Friday, July 19, 2013.
Lauro Quiazon Theft-Class D Felony
Alan Vanwinkle Dealing in Methamphetamine-Class A Felony
Maintaining a Common Nuisance-Class D Felony
Criminal Recklessness-Class B Misdemeanor
Thomas Boswell Dealing in Methamphetamine-Class A Felony
Maintaining a Common Nuisance-Class D Felony
Criminal Recklessness-Class B Misdemeanor
Johnny Forest Jr Operating a Motor Vehicle after Forfeiture of License for Life-
Class C Felony
Resisting Law Enforcement-Class A Misdemeanor
For further information on the cases listed above, or any pending case, please contact Kyle Phernetton at 812.435.5688 or via e-mail at KPhernetton@vanderburghgov.org
Under Indiana law, all criminal defendants are considered to be innocent until proven guilty by a court of law.
Detroit’s fall into bankruptcy is being pitched as a cautionary tale for governments at every level. And while there are extraordinary circumstances unique to the Motor City, there are general lessons in what’s happened here that could benefit others.
Foremost is that debt does matter. Detroit borrowed against both its structural assets and its anticipated future revenues to sustain a budget that was hopelessly out of balance. Even over the past year, when it was obvious it could never conquer its mountain of debt, they city spent more than $80 million of borrowed funds to maintain operations.
Emergency Manager Kevyn Orr is fond of noting that even if Detroit committed every discretionary dollar for the next 50 years, it wouldn’t be enough to pay off the $18 billion it owes. Servicing that debt consumes 25 percent or more of the general fund, an amount projected to grow to 70 percent in five years if left unchecked. At the federal level, no one even talks about paying off the $17 trillion national debt. The ostensible goal is to reach a point where we’re no longer adding to it. The prevailing view has been that as long as the country can meet the debt payments, the size of the debt doesn’t matter.
But last year, the government spent nearly $360 billion on debt service, roughly 10 percent of the budget. If interest rates rise — and they will — and borrowing continues — and it will — that percentage could easily double. And just like in Detroit, money that should be spent on services to taxpayers will have to be diverted to debt service. Detroit’s experience also teaches the value of confronting problems early instead of deferring them to the crisis point. Detroit has known for at least 25 years that it was headed toward a meltdown of its pension system.
An increasing number of pensioners and a decreasing number of active workers made it inevitable that the funds would be at risk. But instead of adjusting benefits and increasing payments into the system, the city kept borrowing money from the funds and refused to make rational benefits reforms. As long as Detroit could write its pension checks each month, it ignored the looming disaster.
Sounds a lot like Social Security and Medicare, doesn’t it?
Detroit also lost focus on its core mission, which should have been providing essential services to its residents. The city saw itself as a jobs provider, bloating its payroll and providing services in-house that could have been easily outsourced. It allowed the services residents deem most important — public safety, education, transportation — to deteriorate. And so residents left for other places where they could get those services. They took their tax dollars with them, compounding the city’s fiscal troubles.
A government that focuses on serving its taxpayers first is less likely to lose its tax base. Detroit learned that the hard way. The key lessons Detroit’s situation can teach other governments is to borrow with extreme care and don’t make promises you can’t keep.
Detroit Suburb from Air Statism is turning America into Detroit – Ayn Rand’s Starnesville come to life
By Daniel Hannan
You thought Atlas Shrugged was fiction?
Look at this description of Detroit from today’s Observer:
What isn’t dumped is stolen. Factories and homes have largely been stripped of anything of value, so thieves now target cars’ catalytic converters. Illiteracy runs at around 47%; half the adults in some areas are unemployed. In many neighbourhoods, the only sign of activity is a slow trudge to the liquor store.
Now have a look at the uncannily prophetic description of Starnesville, a Mid-Western town in Ayn Rand’s dystopian novel, Atlas Shrugged. Starnesville had been home to the great Twentieth Century Motor Company, but declined as a result of socialism:
A few houses still stood within the skeleton of what had once been an industrial town. Everything that could move, had moved away; but some human beings had remained. The empty structures were vertical rubble; they had been eaten, not by time, but by men: boards torn out at random, missing patches of roofs, holes left in gutted cellars. It looked as if blind hands had seized whatever fitted the need of the moment, with no concept of remaining in existence the next morning. The inhabited houses were scattered at random among the ruins; the smoke of their chimneys was the only movement visible in town. A shell of concrete, which had been a schoolhouse, stood on the outskirts; it looked like a skull, with the empty sockets of glassless windows, with a few strands of hair still clinging to it, in the shape of broken wires.
Beyond the town, on a distant hill, stood the factory of the Twentieth Century Motor Company. Its walls, roof lines and smokestacks looked trim, impregnable like a fortress. It would have seemed intact but for a silver water tank: the water tank was tipped sidewise.
They saw no trace of a road to the factory in the tangled miles of trees and hillsides. They drove to the door of the first house in sight that showed a feeble signal of rising smoke. The door was open. An old woman came shuffling out at the sound of the motor. She was bent and swollen, barefooted, dressed in a garment of flour sacking. She looked at the car without astonishment, without curiosity; it was the blank stare of a being who had lost the capacity to feel anything but exhaustion.
“Can you tell me the way to the factory?†asked Rearden.
The woman did not answer at once; she looked as if she would be unable to speak English. “What factory?†she asked.
Rearden pointed. “That one.â€
“It’s closed.â€
Now here’s the really extraordinary thing. When Ayn Rand published those words in 1957, Detroit was, on most measures, the city with the highest per capita GDP in the United States.
The real-life Starnesville, like the fictional one, decayed slowly, then collapsed quickly. I spent a couple of weeks in Detroit in 1991. The city was still functioning more or less normally, but the early signs of decomposition were visible. The man I was staying withn, a cousin of my British travelling companion, ran a bar and restaurant. He seemed to my teenage eyes to be the embodiment of the American dream: he had never been to college, but got on briskly and uncomplainingly with building a successful enterprise. Still, he was worried. He was, he told me, one of a shrinking number of taxpayers sustaining more and more dependents. Maybe now, he felt, was the time to sell up, while business was still good.
He wasn’t alone. The population of Motown has fallen from two million to 700,000, and once prosperous neighbourhoods have become derelict. Seventy six thousand homes have been abandoned; estate agents are unable to shift three-bedroom houses for a dollar.
The Observer, naturally, quotes a native complaining that ‘capitalism has failed us,’ but capitalism is the one thing the place desperately needs. Detroit has been under Leftist administrations for half a century. It has spent too much and borrowed too much, driving away business and becoming a tool of the government unions.
Of Detroit’s $11 billion debt, $9 billion is accounted for by public sector salaries and pensions. Under the mountain of accumulated obligations, the money going into, say, the emergency services is not providing services but pensions. Result? It takes the police an hour to respond to a 911 call and two thirds of ambulances can’t be driven. This is a failure, not of the private sector, but of the state. And, even now, the state is fighting to look after its clients: a court struck down the bankruptcy application on grounds that ‘will lessen the pension benefits of public employees’.
Which brings us to the scariest thing of all. Detroit could all too easily be a forerunner for the rest of the United States. As Mark Steyn puts it in the National Review:
Like Detroit, America has unfunded liabilities, to the tune of $220 trillion, according to the economist Laurence Kotlikoff. Like Detroit, it’s cosseting the government class and expanding the dependency class, to the point where its bipartisan “immigration reform†actively recruits 50–60 million low-skilled chain migrants. Like Detroit, America’s governing institutions are increasingly the corrupt enforcers of a one-party state — the IRS and Eric Holder’s amusingly misnamed Department of Justice being only the most obvious examples. Like Detroit, America is bifurcating into the class of “community organizers†and the unfortunate denizens of the communities so organized.
Oh dear. No wonder the president would rather talk about Trayvon Martin. If you want to see Obamanomics taken to its conclusion, look at Starnesville. And tremble.
Mole #3 Nostradamus of Local Politics IS IT TRUE July 22, 2013
IS IT TRUE that the IS IT TRUE column in the City County Observer will be coming to you from the island of Maui from today until August 5th?…there is a 5 hour time difference between Evansville and Maui is 5 hours so our readers can expect IIT to be published at about noon during that time period?
IS IT TRUE for the second time in less than a week, a high ranking employee of the local Emergency Management Agency has been asked to resign by Mayor Lloyd Winnecke?… Adam Groupe, who was appointed as interim director right after he fired longtime head Sherman Greer last week, was asked to resign this morning?…Winnecke then appointed two men to run the EMA on an interim basis?…Evansville Fire Department District Chief Cliff Weaver and Evansville Police Department Capt. Andy Chandler are the latest recipients to be caretakers for the job that Sherman Greer did for over 20 years?..the reasons given for the two forced resignations are allegations by the mayor’s office that EMA officials approved 1,100 hours of inappropriate overtime for an agency secretary and violated city bidding practices in the 2011 purchase of radio equipment?…Winnecke stated that an internal review of EMA showed preference given to specific vendors in bid processes?…no charges have been filed against either Greer or Groupe and none have been alleged?
IS T TRUE it was quite pleasing on Sunday to see the Evansville Courier and Press awaken from its 10 year coma regarding calling out the office of the Mayor of Evansville for making backroom deals in a non-transparent way?…the firing of Sherman Greer and the quiet approval of some plastic crosses made by some children are the straws that broke the camel’s back for the Courier?…there are of course dozens of other sneaky backroom deals that were orchestrated by former Mayor Weinzapfel and his successor but none of those things rose to the level of taking the CP out our cheerleader mode for the Mayor of Evansville?…the attempt to snatch the Homestead Tax Credit from the resident homeowners of Vanderburgh County in a classic backroom sneaky (SNEGAL) way resulted in nothing more than a couple of infomercial pieces after the CCO exposed it?…the subversion of the funding authority of the City Council by Mayor Winnecke in the Earthcare Energy debacle and the same sort of stunt by former Mayor Weinzapfel just before leaving office that saddled the people of Evansville with the Johnson Controls dilemma didn’t raise the Sunshine flags over at the CP?…the sneaky firing of Marilee Fowler and others, the idiotic purchase of the McCurdy parking lot, the capricious way in which tax abatements are handed out, and the ramrod awarding of three different hotel contracts to companies that never secured financing was never even questioned?…the CCO is pleased to see the entity that should be the biggest watchdog of the citizens interest in Evansville awaken and show its tooth?
IS IT TRUE the only real reason that local media exists is to keep local government honest and to inform the populace in a way that helps with decisions come election time?…the CP has not been doing that for a long time?…every mayor has a person called the press secretary (cheerleader) to dispense sunshine and lollipops in attempts to propagandize to the huddled masses and secure power for their party in perpetuity?…that method has worked well for 50 years in Evansville and much of that been aided and abetted by a local media that has served as a willing propaganda distribution outlet for whomever happened to be mayor?…we encourage the CP to keep its guard dog of sunshine and sanity awake this time?…if every media outlet in Evansville would have scrutinized the offices of the mayor for the last 50 years the way the CCO has for the last 4 years Evansville may not be a candidate for a Detroit inspired future as it is today?
