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It's October 1, ObamaRomneycare Kicks Into High Gear With Enrollment.

Obamacare open enrollment: Here's everything you need to know

STORY HIGHLIGHTS

• 48 million Americans lack health insurance, according to the Census Bureau
• In 2014 every American will have to have some form of health insurance
• If you don't have some form of health insurance next year you will be fined at least $95

(CNN) -- Amy Braun-Gross is counting the hours until October 1.

It's not her birthday nor her anniversary.

October 1 is the day that marks the first time ever she will be allowed to buy health insurance.

Like more than 48 million other Americans, the Wisconsin stay-at-home mom does not have insurance to pay for doctor bills if she gets sick. It's particularly disconcerting when she thinks about her husband, Chris, who runs a tree-cutting business. Being an arborist is physically demanding. He has fallen out of trees.

Oct. 1 -- March 31 open enrollment for health insurance marketplaces.

Dec. 14 -- buy your plan through the exchange by this date if you want it to start by January 1, 2014

Jan. 1, 2014 -- all legal residents and U.S. citizens must have qualifying health coverage

Oct. 15- Dec. 7, 2014 --the next Open Enrollment Period for the marketplaces.

48 million Americans without health insurance

"You know something as simple as a sprained ankle, none of that is covered right now, none of it," Braun-Gross said. "To add the cost of that to the debt we already have, we'd basically be up a creek."

Braun-Gross and her husband have tried to get insurance before, but they don't qualify. They both work hard, and they're college educated. But because of some pre-existing conditions, including Braun-Gross' weight, insurance companies haven't wanted their business.

Obamacare will change all that. The law forbids insurance companies from rejecting people like Braun-Gross because of their pre-existing conditions. To make that affordable, though, one of the most controversial parts of the Affordable Care Act is about to go into effect.

Health care timeline

By 2014 every American, with some very few exceptions, will have to have some form of health insurance or be fined. The idea is that more healthy people will buy insurance, and the money the insurance companies save on them will cover the costs of insuring the older and sicker people who will now be in the insurance system.

Obamacare: Everything you need to know

Employers will provide insurance for three out of every five Americans in 2014, according to the Congressional Budget Office. Another 12% get it through Medicaid or the Children's Health Insurance Program. For those Americans and for the Americans covered by Medicare, October 1 won't mean much.

Foes Go All Out To Undermine Obamacare

But for people without insurance, October 1 will be the first time they will be able to shop for private insurance in health insurance marketplaces, also known as exchanges. Many will be eligible for government help to pay for those plans.

Clinton asks Obama about Obamacare

With so many politicians fighting over this controversial legislation, the details about how to sign up may have gotten a little lost. So, here is what Braun-Gross and the other millions of Americans like her need to know when open enrollment starts on Tuesday:

The deadline

Open enrollment runs between October 1 and March 31. You don't have to sign up that first day. In fact, you may want to put off paying for it until December. Plans bought through the exchanges won't start until January 1.

December 14 is the cut-off date if you want your plan to start January 1. Open enrollment runs through March 31. If you sign up in January or February your coverage will start the following month.

Opinion: Worried about Obamacare? Fear not

When Massachusetts rolled out a similar health insurance mandate in 2007, the biggest spike in enrollments came in the two months before people would be charged a penalty for not having coverage, according to Jon Kingsdale who ran the state's health benefit exchange then. He also noticed many people came back to the state's website to evaluate the potential plans more than once.

The experts advise you to take your time. Comparison shop to find the policy that works best for you.

Where to start

If you have Internet access, start with the Web. Beginning October 1, Healthcare.gov will have the information you need. The government site will link to where you sign up for the program.

Go first to "get insurance." That tab will get you to a page that will walk you through whatever marketplace is available to you. Some states set up their own; the federal government runs the rest. On this site you can also compare the plans available in your area.

You may also want to see if you are eligible for Medicaid here. So far, 26 states are moving toward expanding who is eligible for the federal government-funded health program for lower income families and individuals.

You can also enroll by mail.

Obama offers funding to help communities understand Obamacare

The government has set up call centers to help people with open enrollment. Call 1-800-318-2596 (TTY: 1-855-889-4325). The number is staffed around-the-clock. Information is available in more than 150 languages.

There will also be specially trained advisers in communities. These "navigators," as they are known, can help you in person. There will also be federally authorized marketplace-designated organizations. They will be based in community health centers, at the mall, in drug stores and in churches.

Depending on state law, traditional agents and insurance brokers can also help.

Unlike brokers or agents, navigators and marketplace-designated organizations can educate you about the plans, but they cannot tell you which plan to pick. Their advice is free. If someone who is a navigator or a federally designated organization tries to charge you, it is a scam.

Most common Obamacare scams so far

The health care plans

There are several. The bronze level will be basic, silver midrange, while gold and platinum will be higher-end. There will also be a catastrophic option. Catastrophic insurance covers three doctor visits per year at no cost and preventive care such as screenings and vaccines. This plan will carry a higher deductible.

All plans bought through the exchanges must offer the same coverage benefits. All offer free preventive care. Nearly all cap out-of-pocket costs to $6,350 and $12,700 per family. No one can be turned away. No one will be penalized because of their gender (women often paid more in the old insurance system). Only smokers may be penalized in some plans and some older people may pay more.

The cost

What varies with the plans is cost. Some will carry higher deductibles. Some ask for higher co-pays. Costs will vary based on where you live. If you want to see what your bill may look like, be sure to check out the calculator the Kaiser Family Foundation put together. The nonpartisan foundation's tool provides an estimate of your costs depending on where you live and based on the kind of coverage you pick.

The majority of people uninsured today can find a policy for $100 or less a month, taking into account subsidies and Medicaid eligibility, according to the Obama administration.

No matter what the cost, you will pay a monthly premium, and may also have a co-pay or be asked to meet a deductible when you go to the doctor or hospital.

Millions eligible for Obamacare subsidies, but most don't know it

The good news is if you go through the exchanges rather than buy directly from an insurance company, you will likely be eligible for tax breaks and subsidies to pay for your insurance. The assistance is available to those with incomes of up to four times the federal poverty level -- this year, that's $45,960 for an individual or $94,200 for a family of four -- and will be calculated on a sliding scale.

You can take this subsidy as a tax credit or the government will pay the insurance company directly.

Exemptions

Some Americans will be exempt from the health insurance mandate, according to the Congressional Budget Office.

These are people who can't afford it: For example, people who make so little they don't have to file a tax return are exempt.

People who are in this country without authorization are exempted, as are members of a federally recognized American Indian tribe who are eligible for services through an American Indian health care provider and people with certain religious beliefs that conflict with acceptance of the benefits of private or public insurance.

 People with certain hardships are also exempt; so are people in states that don't expand Medicaid.

If you don't get insurance

If you don't sign up to get insurance, you'll list that on your 2014 tax return.

The fee for the first year is $95 per adult and $47.50 per child (up to $285 per family), or 1% of your income, whatever is higher.

In 2015, it jumps to 2% of your income, or $325 per adult and $162.50 per child. In 2016, it will jump to 2.5% of your income.

No thanks, Obamacare I'll pay the penalty

While some may rather pay the small fee the first year than pay premiums that would cost more, experts predict most people will sign up for insurance.

"I think the penalties should be higher, but they are still enough to make the law effective," said

Jonathan Gruber an economist at MIT who was an architect on both the Massachusetts and U.S. health plans. "In Massachusetts we had people flooding in to sign up. You know Americans are almost uniquely law-abiding people, we massively overpay our taxes in terms of what people do in the rest of the world. When you say it is the law to have health insurance I think people will get health insurance."

Enroll America, a nonpartisan nonprofit that is helping educate Americans about the program, said it has had a positive response once people have an explanation of what's coming.

"For the most part the people we encounter are thrilled that they will finally have health care," said

Enroll America's Jessica Barbara Brown. "For many people this will be the first time they have ever had access to care. This can be life changing."

Taxpayer guide to Obamacare

Brown cautions that while we will keep hearing about October 1, really this is a "marathon" and people should take as much time as they need to figure out which plans are best for them.

Amy Braun-Gross said she will be doing just that.

"Once Obamacare is in effect, I am excited that I will not have to worry about pre-existing conditions any longer," Braun-Gross said. "I will be getting quotes online and making some phone calls to get the ball rolling for my husband and me."

The Kentucky Board of Medical Licensure Restricts Bowling Green Cardiologist Dr. Fred Gott From Prescribing Controlled Substances, As He “Departed From Or Failed To Conform To Acceptable And Prevailing Medical Practices And That [He] Demonstrated Gross Negligence, Gross Ignorance And/Or Gross Incompetence In His Practice Of Medicine”! OUCH!!

Doctor faces Rx restrictions

Board says Gott 'decided to enter into field of pain management' via practice

The Kentucky Board of Medical Licensure issued an emergency order Thursday restricting Bowling Green cardiologist Dr. C. Fred Gott from prescribing controlled substances.

A board consultant reviewed Gott’s patient charts and found that he “departed from or failed to conform to acceptable and prevailing medical practices and that the licensee demonstrated gross negligence, gross ignorance and/or gross incompetence in his practice of medicine,” according to the Findings of Fact in the written order filed in Frankfort.

About 25 state, federal and local law enforcement officers executed a federal search warrant on Gott’s office in February. Gott was not present during the search and has not been charged with any crime. The federal search warrant is a sealed document. During the search, law enforcement officers carried out computer hard drives and boxes of papers.

“Our criminal investigation is proceeding, and we anticipate a conclusion in the near future,” Bowling Green-Warren County Drug Task Force Director Tommy Loving said.

The search warrant was the result of a joint investigation by the drug task force, the Kentucky State Police, the Kentucky attorney general’s Medicaid Fraud and Abuse Control Division, the FBI, the Drug Enforcement Administration’s Drug Diversion Section and the Kentucky inspector general’s Drug Enforcement and Professional Practices Branch, according to a news release in February from the task force.

The joint investigation began after the Warren County Coroner’s Office reported that several of Gott’s patients had suffered overdose deaths attributed to prescription drugs, according to the Findings of Fact in the medical board’s order.

The medical board consultant who reviewed Gott’s patient files noted that “Gott is a licensed cardiologist ... who has now decided to enter into the field of pain management and to provide services as a pain management physician. I do not see any type of formal training or any training remotely associated with his ability to want to all of a sudden practice pain management.”

After review of the charts, the consultant also noted that Gott’s diagnoses “seem unsubstantiated” in many cases.

“There is a failure of using diagnostic testing such as MRI scans, and there is also a failure in obtaining appropriate consultations with regards to pain related topics or pain related disorders. His treatment plans consist of prescribing methadone, and very limited use of other meds,” the consultant wrote.

“It appears that when patients enter into this practice, the only scope of care given is opioid treatment. The only reason patients are there, is to obtain medications,” according to the consultant’s opinion in the Findings of Fact.

Gott graduated from the University of Louisville School of Medicine in 1978. He obtained his medical license Sept. 18, 1980, according to KBML online records.

Gott has privileges at TriStar Greenview Regional Hospital, but is on the courtesy staff, which means he admits a limited number of patients to the facility, Greenview marketing director Alan Palmer said.

Gott had medical privileges in February at The Medical Center, but did not perform cardiac catheterization at that facility, said Doris Thomas, vice president of marketing and development for Commonwealth Health Corp., the parent company of The Medical Center, in an interview shortly after the search warrant was executed. A Medical Center spokeswoman was unable to obtain Gott’s current status at that facility by press time today.

Kentucky Judge Gives Governor Steve Beshear OK To Continue Implementation Of Obamacare In State.

 

Kentucky Medicaid expansion, healthcare exchanges proceed with judge's approval

What’s next

• Lead plaintiff David Adams said he will ask the Kentucky Supreme Court to hear his appeal of both rulings.
• On Oct. 1, Kentuckians may enroll in insurance plans for 2014 offered through the state’s healthcare exchange, which is called kynect.

FRANKFORT, KY. — The Beshear administration’s plans to expand Medicaid and begin enrollment in Kentucky’s new healthcare exchange survived their first court challenge Tuesday.
In separate rulings, Franklin Circuit Judge Phillip Shepherd upheld both decisions by Gov. Steve Beshear intended to expand access to healthcare to 640,000 uninsured Kentuckians under the Affordable Care Act, also known as Obamacare.

The rulings swept aside the legal challenge by Nicholasville Tea Party activist David Adams and others who insisted that Beshear’s actions must be ratified by the legislature.
“The Kentucky Supreme Court has held that this legislative power may be delegated to the executive branch of government in these circumstances, so long as there are standards governing the exercise of discretion, and the legislature retains the authority to withdraw the delegation,” Shepherd wrote in the case upholding the expansion of Medicaid. “Those conditions are clearly met here.”

Beshear said in a statement that his administration’s work to expand Medicaid and establish the exchange have not been slowed by the litigation.
“All our systems to assist Kentuckians in finding quality, affordable health insurance will be ready to go on Oct. 1,” Beshear said in a statement.

But Adams said he will appeal both orders and ask that the case go directly to the Kentucky Supreme Court.
“Gov. Beshear had to lie in court and break state law in order to pretend to have authority specifically denied him by statute, case law and the constitution. He needed a judge to ignore these facts,” Adams said in a statement. “Now he needs four of seven who are elected in districts whose people understand and oppose Obamacare. I don’t think he can do it.”

Sen. Julie Denton, a Louisville Republican who chairs the Senate Health and Welfare Committee, said she foresees major problems as the Beshear administration proceeds.
“My overriding concern from the beginning is that Medicaid is not being run well now; they’ve never gotten their hands around managed care,” Denton said. “Do we really want to expand a broken system? And do we want the government to take on another new project like the healthcare exchanges?”

But Rep. Jimmie Lee, D-Elizabethtown and chairman of the House Health and Welfare Committee said, “I agree with the court because the governor did these things with powers we delegated to him. I’m pleased, because to lose the cases would have really been a disruption.”
Late last year, Beshear issued an executive order starting the healthcare exchange — an online marketplace where Kentuckians and small businesses can shop for insurance policies by comparing benefits, costs and provider networks.

The 2013 General Assembly failed to ratify that move. Its failure to act meant that Beshear’s order became invalid 90 days after the session. However, Beshear issued a new order this summer, making substantial changes in the structure of the exchange, Shepherd said in his ruling.

The judge said Beshear was well within his authority in issuing the order, “which does nothing more than implement a very specific section of a federal law that has been upheld against constitutional challenge by the U.S. Supreme Court.”

Beshear announced last May that Kentucky would expand its Medicaid program under the Affordable Care Act — a move expected to bring an additional 308,000 newly eligible Kentuckians into the health-insurance program for the poor and disabled.

At the time he announced expansion, Beshear said a study by the Cabinet for Health and Family Services predicted that the move will create nearly 17,000 jobs and have a $15.6 billion impact on the state between 2014 and 2021.

In the case challenging the Medicaid expansion, Adams challenged the constitutionality of a state law in which the General Assembly established a policy to “take advantage of all federal funds that may be available for medical assistance.”

But Shepherd said this directive by the legislature was not an arbitrary delegation of its powers to the governor.
“The goal of the statute, self-evidently, is to provide for expanded healthcare benefits for indigent citizens, which is clearly a valid state objective,” Shepherd wrote. “It is up to the legislature to determine the means by which this goal is to be reached.”

Kentucky's Governor Introduces State's Obamacare Health Exchange Website.

Beshear introduces website for Kentucky's health insurance exchange

FRANKFORT — After expanding the state's Medicaid program last week to about 308,000 Kentuckians, Gov. Steve Beshear launched several public education and awareness efforts Wednesday to help 332,000 more Kentuckians in need of health care coverage.
Beshear said Kentucky's Health Benefit Exchange, a key part of the federal Affordable Care Act is preparing to open for business. During a Capitol news conference, the Democratic governor introduced a website, Kynect.ky.gov, to help Kentuckians learn more about the program.
Beshear signed an executive order last July to create the exchange, which is an online marketplace offering health insurance plans for Kentuckians.

Beshear said the program, called "Kynect: Kentucky's Healthcare Connection," will help more than 600,000 Kentuckians get health care coverage through private insurance plans, Medicaid or the Kentucky Children's Health Insurance Program.
"Individuals, families and small businesses will be able to use Kynect for one-stop shopping to find health coverage and determine if they are eligible for payment assistance or tax credits to help cover costs," Beshear said.
Carrie Banahan, executive director of the state exchange, said open enrollment for those seeking to buy insurance begins Oct. 1 and runs through March 31, 2014. Insurance coverage can begin as soon as Jan. 1. Open enrollment for small businesses also begins Oct. 1, but businesses with fewer than 50 employees will be able to enroll employees in plans offered through Kynect at any point after that date.

During open enrollment, Kentuckians will be able to compare and select health insurance plans and find out whether they qualify for Medicaid, KCHIP or other programs by using the Kynect website.
With Kynect, individuals can find out if they qualify for payment assistance and special discounts on deductibles, copayments and co-insurance. Small businesses can enroll their employees in health plans, and businesses with fewer than 25 employees may qualify for tax credits.
A toll-free hotline will open Aug. 15 at 1-855-4kynect or 1-855-459-6328.

Kentucky has received $252 million from the federal government to set up the exchange.
The development and operation of the state's exchange will be financed entirely with federal dollars until Jan. 1, 2015, after which it will be wholly financed with revenues it generates, Beshear said.
Beginning in January, most Americans will be required to have health insurance or pay a penalty. Under the law, no one can be denied coverage due to a pre-existing health condition or lose coverage because a family member gets sick.

Insurance companies will be prohibited from charging women more than men for the same coverage, and children will be allowed to stay on their parents' health insurance plan until they reach the age of 26.
Banahan said five insurance companies — Anthem, Humana, Bluegrass Family Health, United Healthcare and Kentucky Health Cooperative — have filed notice of intent to offer programs on the Kentucky exchange.
They have not yet filed rates, she said.

Tea Party activist David Adams of Jessamine County has filed a lawsuit in Franklin Circuit Court challenging the legality of the state's health exchange.
Adams claims that Beshear did not receive "proper approval" from the Kentucky General Assembly to create the exchange.
A hearing is scheduled for Monday in Franklin Circuit Court to consider a request by Beshear to dismiss the lawsuit.
Beshear said Wednesday he is not concerned about the lawsuit.
"I think it is very clear that as governor I have the authority under the Constitution and the laws of Kentucky to implement this exchange," he said.

Breaking news: Kentucky Governor, Steve Beshear, A Democrat, Opts To Expand Medicaid Coverage Uuder "Obamacare" Mandate.

Feel free to read more here and here.

New device an advance in treating strokes

Stent-retriever traps and removes obstructing clot

 

Common stroke warning signs

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden severe headache with no known cause.
Source: U.S. Centers for Disease Control & Prevention

While hospitalized with an irregular heartbeat in March, Chris Hodges took Tylenol for an odd pain concentrated in a quarter-sized spot in his head.
The pain only worsened, though, and on the way back from the bathroom a little later, he collapsed, unable to move his left side — the victim of a stroke.
But surgery with a new medical device stopped the stroke in its tracks, saving the 33-year-old single father’s brain from severe and permanent damage.
“He goes back to take care of his kids, versus being in a nursing home, fed through a tube,” said Norton Healthcare neurosurgeon Dr. Shervin Dashti, who used a “stent-retriever” to trap and remove a large clot in a brain artery. “This really changes the game as far as being able to help people.”

The first stent-retriever used in the United States, called Solitaire and made by the Ireland-based Covidien, was approved by the U.S. Food and Drug Administration in March of 2012 and is being used at area hospitals such as Norton Brownsboro, University, Jewish and Baptist Health Louisville.
A second model, Concentric Medical’s Trevo, was approved for the market in August and is also being used at many hospitals.

While these devices don’t eliminate serious complications or deaths, doctors say they promise better outcomes for patients whose prospects once would have been bleak.
“It’s a revolution in terms of ease of use, safety and success,” said Dr. Alex Abou-Chebl, director of neurointerventional services at University Hospital.

Stroke kills almost 130,000 Americans each year, or one person every four minutes, federal figures show. Kentucky has the seventh-highest prevalence in the nation, with 3.3 percent of residents reporting in 2010 that they’ve had a stroke. The rate in Indiana was 2.7 percent.
Hodges, of Bardstown, Ky., said he’s grateful to be alive and back to cooking and fishing with his daughters, ages 7 and 11.
“I get to watch my girls grow up,” he said.
“It was a miracle,” added his mother, Tammy Hodges.

Trapping brain-killing clots

“These devices are only used when all other means of treatment have been exhausted,” said Dr. Jonathan Hodes, chairman of the neurosurgery department at the University of Louisville, who has used stent-retrievers in many surgeries, most of them at Baptist. In Hodges’ case, he was on a blood thinner for atrial fibrillation, so he couldn’t get the clot-busting drug.
After his stroke, he was rushed from Norton Audubon Hospital to Norton Brownsboro, where Dashti began the minimally invasive surgery by putting a guidewire and micro-catheter into Hodges’ leg and threading them through the vessel to the clot.

The device includes a self-expanding stent-retriever, which compresses and traps the clot. Dashti said he left it in for about five minutes, then began pulling it out slowly, along with the clot, while also using suction from the balloon guide catheter so that no pieces of clot remained.
The blocked vessel was reopened, and Hodges wound up with a small stroke that caused no symptoms, instead of the massive stroke he was in the process of having.
While doctors were working, Hodges’ family was scrambling to get to him, and his mother said that by the time she arrived, the surgery was over.
“In 10 minutes (Dashti) had the clot out, in a box, and showed it to my husband,” she said.
Every minute counts during a stroke, since about 2 million brain cells die every minute and abilities controlled by that area of the brain are lost. Outside of eight hours after a stroke begins, Dashti said, patients are “out of luck.”

Doctors said stent-retrievers outperform earlier stroke-treatment devices.
A study last August in the medical journal The Lancet, by researchers at UCLA, said Solitaire opened blocked vessels without causing brain bleeding in 61 percent of cases, and mortality rates three months after a stroke were 17 percent — both much better rates than doctors achieved with an older device called the Merci Retriever.
“It’s definitely an advance,” said Dr. Rick Paulsen, an interventional neuroradiologist at KentuckyOne Health, who treats patients from throughout that system at Jewish. “It’s probably the best system we’ve had so far.”
Tammy Hodges said when they saw Chris after his Solitaire procedure, he was moving his left hand and foot.
“He knew who we all were,” she said. “He could move his left side very well. He even knew his feet were cold.”

Complications possible

But not every patient experiences such a dramatic result.
Dashti said serious complications occur around 5 percent of the time, including hemorrhaging in the brain or leg, or vessel rupture in the brain, which is potentially deadly.
Abou-Chebl pointed to a recent clinical trial showing treatment with a clot-removing device in patients who had already received a clot-busting drug wasn’t any better than getting the clot-busting drug alone.

The study, led by a University of Cincinnati researcher and published in the New England Journal of Medicine in March, allowed doctors to choose between Solitaire and older devices. The study was stopped early after showing “no significant difference in functional independence” between the group getting the drug plus surgery and the one getting the drug alone.
That study didn’t separate out the Solitaire device, however. And doctors said that many times when they use Solitaire, the patient could not have been given the clot-busting drug.
Using a clot-removing device is far more expensive than drug treatment. Although local doctors couldn’t say how much the Solitaire procedure cost, an article in Neurology Today, a publication of the American Academy of Neurology, said the cost of a hospitalization is about $28,000 nationally when a device is used, versus $12,000 for a hospitalization involving the clot-busting drug alone.
University’s Hodes said there’s a place for all of these treatments — including the older clot-removing devices.
“One doesn’t really supplant the other,” Hodes said of the devices. But he said the new stent-retrievers do blend two important functions, combining “the suction device and the corkscrew device all in one.”

Dashti said Hodges was the perfect candidate and had the sort of outcome he always strives to achieve.
“His prognosis is good,” Dashti said. “He’s the same person he was before.”
Hodges said he tries to stay well by cutting sodium from his diet and taking walks each day. He said that after a temporary layoff he’s been cleared to return to his job at a company that builds storage containers for explosives and weapons.
In the meantime, he’s been spending time with his girls, who stay just a little bit closer to him since his stroke.
“I feel like I’ve had my second chance,” he said.

 

DR. FRED GOTT'S OFFICES SEARCHED PURSUANT TO FEDERAL WARRANT.

About 25 state, federal and local law enforcement officers executed a federal search warrant this morning at the office of Dr. C. Fred Gott, a Bowling Green cardiologist who has been practicing medicine for 32 years.

Gott was not present during the search and has not been charged with any crime.

“This search warrant is the result of a joint investigation by the Bowling Green-Warren County Drug Task Force, Kentucky State Police, Kentucky Office of the Attorney General, Medicaid Fraud and Abuse Division, Federal Bureau of Investigation and Drug Enforcement Administration Drug Diversion Section and the Cabinet for Health and Family Services, Office of the Inspector General, Drug Enforcement and Professional Practices Branch,” according to a release from the drug task force.

“DTF was notified several months ago by the coroner’s office of several overdose deaths, and that is what initiated this investigation,” task force director Tommy Loving said this morning as law enforcement officers moved around in Gott’s office.

The federal search warrant is a sealed document. Law enforcement officers carried out computer hard drives and boxes of papers this morning and loaded those items into trucks. The computers will be taken to the Bowling Green Police Department’s computer forensic lab, Loving said. Loving referred all other questions to the U.S. Attorney’s Office in Louisville.

During their work assessing deaths in Warren County, the coroner’s office has received calls from families and law enforcement regarding concerns about overdose deaths in general, Warren County Coroner Kevin Kirby said. Overdose deaths here are attributed to prescription drugs.

“Anytime there is a problem concerning deaths, whether it be auto accidents or drug overdoses, we try to be proactive and we try to stop it,” Kirby said. “That’s where law enforcement and the coroner’s office work hand in hand.”

In 2012, the coroner’s office determined that 12 people in Warren County died from drug overdoses. That number is down from 2011 when 18 people in Warren County died from drug overdoses, according to the coroner’s annual report.

In Kentucky, about 82 people a month die from overdose deaths with the majority of those deaths attributed to prescription drugs.

“It’s a problem all over the country,” Kirby said. “Yes, we do have a problem with it (here),” Kirby said.

Gott, whose area of practice is listed on the Kentucky Board of Medical Licensure website as cardiovascular disease, graduated from the University of Louisville School of Medicine in 1978. He obtained his medical license Sept., 18, 1980, according to KBML online records.

Gott also provides pain management services, Loving said.

KBML online records note prior board action on Gott but the website does not specify what that action was. Previous disciplinary actions of the board are available only after the board receives written requests for such information. It was not possible to obtain that information prior to press time today.

Gott holds medical privileges at The Medical Center but does not perform cardiac catheterization at that facility, said Doris Thomas, vice president of marketing and development for Commonwealth Health Corporation, the parent company of The Medical Center.

Gott does not hold privileges at TriStar Greenview Regional Hospital, but is on the courtesy staff there, which means he can admit patients to that facility, Greenview marketing director Alan Palmer said.

HOW YOU WILL BE AFFECTED BY OBAMAROMNEYCARE (THE AFFORDABLE CARE ACT).

How will the coming changes in health care coverage affect you?

Now that the U.S. Supreme Court has upheld the controversial law to overhaul health care, millions of Americans are asking the same question: How will it affect me?

“It’s going to affect everyone,” said Jodi Mitchell, executive director of Kentucky Voices for Health, a coalition of health departments and groups. “... People want to know what’s in it.”

The Courier-Journal consulted health care experts, government agencies and others to answer some of the common questions people are raising about the law, which runs more than 2,000 pages, and how it could affect their daily lives, whether they are young people, working-age parents, senior citizens or business owners.

Experts agree the changes will be sweeping. Some provisions have already taken effect, such as one allowing young adults up to age 26 to stay on a parent’s health plan, and another forbidding health insurers from excluding a child from coverage because of a pre-existing health condition. Adults with pre-existing conditions can get insurance through a federal program until 2014, when insurers won’t be able to exclude them, either.

Many more rules are scheduled to take effect in 2014, including one of the most controversial — the individual mandate that people carry health insurance or pay a penalty.

That mandate — which the Supreme Court upheld under the federal government’s taxing power — is at the heart of a divisive debate that continues today.

Many health officials, including Dr. LaQuandra Nesbitt, director of the Louisville Metro Department of Public Health and Wellness, say the law is a step in the right direction, affirming that access to health care is a right and not a privilege. But many others say it’s an assault on individual freedom. Senate Minority Leader Mitch McConnell, R-Ky., has called it “the single worst piece of legislation passed in modern times.”

Earlier this month, the GOP-controlled U.S. House passed a bill to repeal the law, known formally as the Affordable Care Act. But Dewey Clayton, a political science professor at the University of Louisville, said he sees the law surviving in the long run.

“Politics will come into play,” he said. “... But many Americans will say, ‘It’s law; now let’s move on. We’ve got too many other pressing problems.’ ”

Still, some health care experts said it’s unclear what could happen if the political landscape changes.

“That’s the big mystery of the 2012 election,” said Susan Zepeda, president and chief executive officer of the nonprofit Foundation for a Healthy Kentucky, which strives to address unmet health needs of Kentuckians. “If the balance of power in Congress changes, if the person in the White House changes, it’s conceivable that Affordable Care may be repealed.”

Another issue that remains hazy is how many states will expand the Medicaid program for the poor and disabled, as called for in the health care overhaul. The Supreme Court’s June 28 decision said the federal government can’t withhold current Medicaid funds from states that refuse to comply with the expansion.

Officials in seven states have announced plans to opt out of the Medicaid expansion. Kentucky and Indiana officials have not yet decided. States that opt in face a financial burden down the road, since the federal government will reduce its contribution to the expansion costs from 100 percent to 90 percent in 2020 and later years.

“In light of the Supreme Court’s decision, a great deal of questions remain about how an expansion of Medicaid would affect Kentucky, particularly the long-term cost to the state after the three-year period of full federal cost coverage expires,” said Audrey Tayse Haynes, secretary of the Kentucky Cabinet for Health and Family Services.

Zepeda pointed to figures from the Kaiser Family Foundation showing more Kentuckians stand to gain than those in other states from a Medicaid expansion, with about 57 percent of uninsured adults becoming newly eligible for coverage.

As states sort out these unknowns, here are answers to some common questions about the law:

All residents
All residents

Q:
What is the “individual mandate”?

A: The mandate means virtually all Americans must have health insurance by 2014 or pay a penalty.

If you already have insurance, you’ve met this requirement. The Congressional Budget Office says about 80 percent of the 272 million Americans under 65 would be insured in 2014 even without the new law.

For individuals, the penalty for not having insurance will start at $95 a year, or up to 1 percent of income, whichever is greater. By 2016, it rises to $695 a year for individuals and $2,085 for families, or 2.5 percent of income.

The law includes a carrot as well as a stick — namely, subsidies to help working-class and middle-class people buy private insurance through new, state-based health insurance exchanges beginning in 2014. These will be available to people with incomes up to 400 percent of the federal poverty level, or about $90,000 for a family of four.

Those who make less will get a bigger subsidy. For example, a family of four earning $33,075 a year will have to pay 4 percent of their income, or $1,323 a year, for insurance premiums — with the remainder paid by the subsidy.

According to the U.S. Census Bureau, an average of 15.5 percent of Kentuckians, or 663,000 residents, lacked health insurance from 2008-2010; and 12.8 percent of Hoosiers, or 813,000 people, were uninsured during that period.

Q: Might I become eligible for Medicaid under the new law?

A: That’s unknown, since Kentucky and Indiana leaders haven’t yet decided whether to participate in the Medicaid expansion. If they opt in, starting in 2014, Medicaid would effectively cover people who earn up to 138 percent of the federal poverty level, which is currently $15,415 for an individual and $31,809 for a family of four.

Q: I haven’t been able to get insurance because of a pre-existing condition. Will the law change that?

A: For the next couple of years, people can get coverage from a federal program known as the Pre-Existing Condition Insurance Plan, or PCIP, which began in July 2010. This is separate from a state high-risk pool known as Kentucky Access, which has existed for more than a decade.

To qualify for a PCIP, you must be a U.S. citizen who has been uninsured for at least six months and have a pre-existing condition or have been denied coverage because of a health condition. To apply, go to www.pcip.gov. There are three types of plans — standard, extended and HSA — and the monthly premium for a 45- to 54-year-old getting a standard plan in Kentucky is $226; in Indiana it’s $284.

Both the PCIP and Kentucky Access will stop operating in 2014, when the law says people can no longer be denied coverage or charged higher premiums for having a pre-existing condition.

Q: How will I find health insurance?

A: New state health insurance exchanges will start up in 2014 as marketplaces for affordable coverage — primarily serving individuals buying insurance on their own, and small businesses.

Kentucky Gov. Steve Beshear issued an executive order on Tuesday creating an exchange in Kentucky, but Indiana officials have not committed to creating one, with Gov. Mitch Daniels saying it will be up to the next administration to decide whether to do so. If a state doesn’t create its own exchange, the federal government will step in to establish and operate one.

According to Kentucky’s Office of Health Policy, open enrollment for Kentuckians will begin in October 2013 and will take effect in January 2014.

Beshear said the exchange will enable eligible individuals to receive tax credits and subsidies to help reduce the cost of premiums, and qualify small businesses for tax credits through the Affordable Care Act.

Although the exchange is still being developed, Mitchell of Kentucky Voices for Health said she expects it to be not only a place to shop for insurance, but a clearinghouse for insurance-related information that people can call to ask questions.

The federal government says the exchanges will help make insurance more affordable by offering people choice, and encouraging competition among insurers on a level playing field. People will also be able to find out if they qualify for programs to make insurance more affordable, such as advance payments of the premium tax credit or Medicaid. Also, a Small Business Health Options Program, SHOP for short, aims to give small businesses the clout big businesses have when they buy insurance.

Q: Are any new taxes included in the new law?

A: The Supreme Court upheld the individual mandate under the federal government’s ability to tax, so the penalty for not having health insurance can be viewed as a tax. Also, starting in 2013, people who earn more than $200,000 a year and married couples earning more than $250,000 will pay a Medicare payroll tax of 2.35 percent, up from 1.45 percent. Such high earners will also face a new, 3.8 percent tax on unearned income such as dividends.

Starting in 2018, the law imposes a 40 percent excise tax on the portion of most employer-sponsored health coverage worth more than $10,200 a year for individuals and $27,500 for families, which some have dubbed “Cadillac” plans.

Though there are rumors to the contrary, the law does not contain a real estate sales tax or real estate transfer tax.

Young people
Young people

Q: I’ve heard that young adults can stay on their parents’ health insurance plans. What are the details?

A: Health plans that offer coverage for dependents now must allow young adults to stay on their parents’ insurance until their 26th birthday. So far, 35,600 young adults in Kentucky and 38,400 in Indiana have gotten insurance this way.

At this point, the provision applies to individual plans and new employer-based health plans. If young adults can get insurance through their own jobs, their parents’ existing employer-based plans don’t have to cover them. But that changes in 2014, when they can stay on a parent’s plan even if their employers offer coverage.

Call your insurance company, insurance agent or your company’s human resources department to find out when during the year an adult child can be added to your policy.

Q: What if my young adult child gets married or becomes pregnant?

A: Married young adult children up to age 26 still qualify for coverage. And if the parent’s plan covers pregnancy, the child’s pregnancy should be covered. But the plan doesn’t have to cover the new baby.

Q: How does the law affect coverage for young children still at home?

A: Insurers can no longer exclude children from coverage because of pre-existing conditions, impose lifetime limits on how much they’ll cover or drop them from coverage when they get sick. Starting in 2014, new health plans must cover basic pediatric services as well as dental and vision needs for kids.

Working-age

adults
Working-age adults

Q:
Will my premiums rise if I get my insurance through my job?

A: That’s unclear. The Kentucky Department of Insurance points out that employers will continue to make decisions about plans offered to employees.

“There are some folks who believe that insurance companies have already factored in the higher-risk patients” they’ll have to cover under the law, said Zepeda, of Foundation for a Healthy Kentucky. “I wouldn’t expect premiums to continue to go up.”

Jose Fernandez, an assistant professor of economics at the University of Louisville, said the law’s impact on premiums is largely unknown at this point. He said there are provisions that could push up premiums slightly, such as the elimination of lifetime caps on coverage, but there are also provisions that could push them down, such as the influx of many more healthy young people.

Q: I get my insurance through a large company. Besides possibly affecting my premiums, how else might the law affect me?

A: New health plans have to cover preventive services, such as cancer screenings, with no co-pays. They also can’t drop you from health coverage if you get sick, and they cannot deny your child coverage because of a pre-existing condition. If you have a Health Savings Account, you can keep it.

In 2014, insurers won’t be able to deny coverage to adults with medical conditions or refuse to renew their policies. They also won’t be able to limit coverage based on pre-existing conditions or charge higher rates to people in poor health.

Q: What if I work for a small company?

A: If you have insurance through your job, the provisions listed above would apply. Also, starting in 2014, insurance deductibles for small groups (50 employees or less) will be limited to $2,000 for individuals and $4,000 for families.

If you work for a small company that doesn’t offer health insurance, there’s no requirement that the company start offering it. Employers with fewer than 25 employees may be able to get tax credits for providing coverage, but they don’t have to do so and aren’t penalized if they don’t.

If you don’t get insurance at work, you can shop for it in the insurance exchange.

Q: Are there any insurance plans that aren’t affected by the new law?

A: Yes. The law “grandfathers” existing health insurance plans, meaning that if a person was enrolled in a plan on March 23, 2010, that plan has been grandfathered. It’s unclear whether changes to a health plan, such as what is covered, make it a new plan rather than a grandfathered plan.

Grandfathered plans are exempt from the vast majority of insurance changes under the law, but they do have to abide by some, such as bans on lifetime limits on essential health benefits, bans on health plan terminations and the requirement to allow children to stay on parents’ insurance up to age 26.

In 2014, grandfathered plans also won’t be able to make someone wait more than 90 days to be eligible to enroll in health benefits, and those providing group coverage won’t be able to exclude people based on pre-existing conditions.

Senior

citizens
Senior citizens

Q: Does the law affect my Medicare coverage?

A: Medicare benefits haven’t changed, but co-pays have been eliminated for preventive services such as mammograms and prostate cancer screenings, a provision that has affected more than 1.2 million seniors in Kentucky and Indiana so far. Seniors can still enroll in a Medicare HMO or Medicare Advantage plan, but the Advantage programs could change.

The law reduces payments to Medicare Advantage plans while rewarding high-quality plans. Experts say insurers may respond by charging higher premiums, reducing their network of health care providers or getting out of the market altogether.

Q: Does the law address the “doughnut hole” gap in Medicare drug coverage?

A: In 2010, seniors who had reached the doughnut hole (which in 2010 meant they had spent $2,830 on prescriptions) got $250 rebates. Last year, people in the doughnut hole received a 50 percent discount on brand-name drugs. In 2020, the doughnut hole is slated to be eliminated, although seniors will still have to pay the standard 25 percent of drug costs until they reach the threshold for Medicare catastrophic coverage, when co-pays drop to 5 percent.

Business

owners
Business owners

Q: How does the law affect me if I own a small business?

A: A lot depends on the size of your business.

Small firms with fewer than 50 employees aren’t required to offer health insurance.

Very small businesses can get tax credits — although just for two years. Those with fewer than 25 full-timers and average annual wages of less than $50,000 and which pay at least half the cost of health insurance for employees are eligible for credits. Through 2013, the maximum credit is 35 percent for small businesses and 25 percent for small charities — rising to 50 percent and 35 percent, respectively, the next year.

“It’s a way of giving a Groupon to these small employers,” said U of L’s Fernandez.

But there’s a potential penalty for small businesses with more than 50 employees. They’ll have to start paying a fee in 2014 if any employee receives a federal subsidy to buy private coverage through the health insurance exchange. The penalty, which rises over time, initially equals $2,000 multiplied by the number of workers in excess of 30. For example, an employer with 75 workers would pay a penalty of $90,000, or $2,000 times 45 employees.

Q: What if I own a larger business?

A: Businesses with fewer than 100 workers will be able to buy coverage starting in 2014 through a program in the health insurance exchange called Small Business Health Options, or SHOP.

Starting in 2014, businesses with more than 200 employees must automatically enroll workers in a health plan and won’t be able to impose a waiting period of more than 90 days. Employees can opt out if they choose.

Also, large employers could face penalties if their coverage is deemed inadequate or too expensive, with premiums higher than 9.5 percent of a worker’s income.

Before 2014, firms may be eligible to take part in an early retiree program that provides financial assistance to employers and unions to help them cover early retirees ages 55 to 64. The U.S. Department of Health and Human Services has received applications from more than half of Fortune 500 companies, all major unions, and government entities in all 50 states. Approved sponsors in Kentucky include Brown-Forman., Humana and others. The program ends in 2014, when early retirees can find insurance through the exchanges.

Sources: Kentucky Voices for Health, Foundation for a Healthy Kentucky, Kentucky Department of Insurance, Kentucky Cabinet for Health and Family Services, U.S. Department of Health and Human Services, the White House, Kaiser Family Foundation, The Urban Institute, Congressional Budget Office, Congressional Research Service, U.S. Census Bureau, National Association of Realtors, Internal Revenue Service

HIGH FRUTOSE CORN SYRUP IS KILLING US. STOP THE INSANITY, PEOPLE! WATCH VIDEO.

Kentucky General Assembly Passes Reasonable Bill To Help Curb Meth Manufacturing, Governor Steve Beshear Should Sign It Into Law.

Senate sends anti-meth bill to Beshear
By Jack Brammer

FRANKFORT – The Kentucky Senate gave final passage Friday to a bill that would further limit the amount of cold medicines containing pseudoephedrine that consumers could buy without a prescription.

Pseudoephedrine is a key ingredient used in making methamphetamine, a major problem in the state.

Senate Bill 3, sponsored by Senate Majority Leader Robert Stivers, R-Manchester, now goes to Gov. Steve Beshear for his signature or veto.

The Senate voted 29-8 Friday in concurring with changes the House made to the bill.

SB 3 would require Kentuckians to get a doctor’s prescription to buy more than 7.2 grams of pseudoephedrine a month and 24 grams a year. A generic box of pseudoephedrine with 48 pills, each with a 30-milligram dosage, contains 1.44 grams of the medicine.

The bill’s sponsors had wanted lower limits, but they compromised with opponents who worried about inconveniencing cold and allergy sufferers.

The pharmaceutical industry has lobbied aggressively against the state requiring prescriptions for pseudoephedrine at any level.

Gel caps and liquid pseudoephedrine would be excluded from the limits in SB 3 because making meth from those forms is considered more difficult.

ANYONE Who Believes That Government (CONgress) Can CONSTITUTIONALLY Force Us To Buy A Commodity, Such As Health Insurance, At The Pain Of A Penalty, Belongs In A COMMUNIST Country As A Comrade!

Yes, you heard me: If there is anyone out there who thinks that CONgress has the power to FORCE consumers to buy healthcare, or any other consumer item, at the pain of monetary penalty, that someone needs to IMMEDIATELY move to a COMMUNIST country, and become a COMRADE.

Having said that, permit me to say this: I have a cure for the healthcare debacle>

The cure is: CONgress needs to give each one of us THE EXACT SAME insurance coverage each of their members have; EXACT SAME ONE! NO ifs, ands or buts.

After that, we promise not to bother the CONs anymore.

So, who's with me?!

BY the wa: I can't wait for the U. S. Supreme Court to strike down OBAMACARE's mandate to buy insurance or face the GESTAPO!

Kentucky Senate Passes A "Watered Down" Version Of Methamphetamine Bill That's A Little "Easier To Swallow".

Kentucky Senate approves bill limiting purchases of cold pills with pseudoephedrine
Pseudoephedrine caps sought to fight meth

The Kentucky Senate has sent to the House a bill that would still allow consumers to purchase common over-the-counter cold and allergy medications with pseudoephedrine.
Written by Jessie Halladay

FRANKFORT, KY. — Allergy and cold suffers will still be able to buy over-the-counter medicines containing pseudoephedrine, but in more limited quantities under a bill the Senate passed Friday to curb methamphetamine production in Kentucky.

Senate Bill 3, approved 25-11 Friday morning, would allow consumers to buy up to 7.2 grams of medicine containing pseudoephedrine per month and up to 24 grams annually. Industry experts say that is the amount an allergy sufferer would need for daily doses.

A doctor’s prescription would be required to get as much as an additional 7.5 grams per month and 90 grams annually.

Gel caps and liquid forms of the drug, which cannot be easily converted to meth, will not be restricted. And the medicines will still require a signature at the pharmacy and will be tracked with an electronic-monitoring system.

The bill will now go to the House for consideration, where it is considered to have a good chance of passage.

The Senate bill passed Friday falls short of sponsor Sen. Robert Stivers’ desire to have a prescription-only law for medications containing pseudoephedrine.

“I still don’t think it’s the best situation,” Stivers said. “It’s what we could get passed. Let’s see what this does.”

Stivers, a Manchester Republican, said because of extensive lobbying efforts by the Consumer Healthcare Products Association (CHPA) and others who represent drug manufacturers, it was a struggle to get support for the prescription-only measure he originally proposed.

Both Stivers’ original bill and the version passed Friday would block some drug offenders from buying the medicines.

After withdrawing his prescription-only bill, Stivers proposed a bill that passed the Senate Judiciary Committee on Thursday that would have limited sales to 3.6 grams per month and 15 grams annually.

But Stivers said Thursday night that version did not have enough support, and Sen. Jerry Rhoads, D-Madisonville, filed an amendment that would increase the over-the-counter limit to 7.2 grams monthly and 24 grams annually.

That amendment was approved by the Senate Friday morning. And after much floor discussion, the entire bill was approved.

“It’s been a reasonable compromise,” said Rhoads, who has repeatedly expressed his concern over legitimate cold medicine users having enough of the drug, while still trying to slow down those who are buying the drug for making meth.

“The final result is a step in the right direction,” he said.

The bill will now go to the House for consideration.

But opposition to the measure continues.

The CHPA again reiterated its displeasure with the bill on Friday and urged members of the House to change it.

“We are disappointed with the outcome of the vote today on Senate Bill 3,” said Scott Melville, president and chief executive of CHPA in a statement. “CHPA is committed to working with legislators to win the battle against methamphetamine, but gaining the upper hand against meth producers and dealers does not require unnecessary restrictions imposed on many Kentucky families — particularly seasonal allergy sufferers — by burdening them with increased health-care costs, lost wages, and unnecessary trips to the doctor.”

Sen. Julie Denton, R-Louisville, spoke against the bill on the Senate floor Friday and cast one of the 11 no votes.

“This is an imposition on the majority of Kentuckians,” she told the Senate. “In the Ohio Valley, we are known for our allergy season.”

Denton said that she would like to find a solution to the meth problem in Kentucky, but that she does not believe the current proposal will be effective.

Senate President David Williams, R-Burkesville, spoke passionately for the bill, saying that 90 percent of pseudoephedrine buyers in the state already buy within the limits of the bill.

“It’s a very minimal imposition compared to the good it will do,” Williams said. “I’m convinced that there will be lives saved.”

Rep. John Tilley, D-Hopkinsville, said previously that House members have been following the progress of the Senate bill and he believes there is a chance it will pass that chamber as well.

Roll Call

Democrats for: (12) Blevins, Carroll, Jones, Neal, Palmer, Parrett, Pendleton, Rhoads, Ridley, Shaughnessy, Turner and Webb.
Democrats against: (2) Clark and Harper Angel
Republicans for: (12) Carpenter, Gibson, Givens, Harris, Higdon, Hornback, Jensen, McGaha, Smith, Stivers, Williams and Wilson.
Republicans against: (9) Bowen, Buford, Denton, Kerr, Schickel, Seum, Stine, Thayer and Westwood.
Independent for: (1) Leeper.
Not voting: (2) Stein and Winters.

The Myth Of Oregon And Mississippi Strict Meth Laws Requiring Prescriptions For The Cold Remedy Pseudoephredine.

Strict Meth Laws Hurt Consumers, Have Little Effect on Meth Supply
By maureen

Since 2006, the state of Oregon has had the strictest pseudoephedrine laws in the country. The popular decongestant, a common additive to over-the-counter cold and allergy medications, is also used to make black market methamphetamine. As meth use soared and volatile homemade meth laboratories proliferated in the early 2000s, many states began to put restrictions on the sale of the drug. The most common such restriction was to move the medications behind the counter, and require customers to show identification before purchasing them. But Oregon was the first state to require a doctor’s prescription to purchase cold and allergy medication. After a drop in meth lab seizures across the state in the years after the law was enacted, several other states have considered the prescription requirement, although so far, only Mississippi has passed one.

According to a new report (wanna read the press report instead? Click here) published by the Cascade Policy Institute in Portland, the law hasn’t been nearly as successful as its proponents claim. The report was funded by the Consumer Healthcare Products Association, a trade group that represents the manufacturers of over-the-counter medications. But the data are compelling.

For example, while it’s true that methamphetamine “lab incidents” have dropped by 90 percent in Oregon since 2004, the report points out that the bulk of that decline took place before the state’s prescription requirement took effect in 2006. Moreover, the report points out that six other states near Oregon showed similar declines in meth lab incidents over the same period, despite not having a prescription requirement. The report also notes that while Oregon did experience a 23 percent drop in methamphetamine-related admissions to substance abuse treatment centers from 2006 to 2009, that figure mirrors a similar drop across the entire country.

The prescription requirement also has some significant costs. A trip to the doctor requires a fee for an office visit, transportation costs and missed time from work, all of which can be especially burdensome on parents. The Cascade report points out that the hassles associated with visiting a doctor likely cause many patients to seek less effective treatment or no treatment at all, resulting in a longer recovery and lost productivity. One 1992 study published in the Journal of Law and Economics found that the increasing availability of over-the-counter cold and allergy remedies prevented 1.6 million annual doctor visits. That number would likely be much higher today if all states had Oregon’s law, resulting in higher health care costs, lost productivity, and lost time for doctors who would be spending time with sneezy patients that they could be spending with those suffering more serious illnesses.

Meth is also still readily available in Oregon, which suggests the decline in overall abuse may have more to do with general trends in drug use or better awareness of meth’s particularly nasty effects than with supply-side policies. According to a 2011 report from the Office of National Drug Control Policy, there remains a “sustained high level of methamphetamine availability” in Oregon. But instead of coming from makeshift labs in basements and backyard sheds, like much of the country the state now imports its meth from “superlabs” in Mexico by way of international drug smuggling syndicates, the report says. That shift also could bring the ancillary effects of organized crime.

The aftermath from the Oregon law — its heralded success, followed by a sober reassessment finding that the problem has merely taken a new form — is nothing new. In 2006, Congress passed a provision, tacked on to the Patriot Act renewal, that imposes daily and monthly limits on the amount of pseudoephedrine — the decongestant — that one person can purchase, requires customers to show identification before making a purchase, and puts various restrictions and requirements on manufacturers and retailers. It was similar to the law already in effect in many states.

The national results have been similar to what has happened in Oregon: a steep drop in meth lab incidents and seizures, but no real decline in the drug’s availability. The laws largely put an end to homemade meth labs, but opened market space for the superlabs and international cartels. It also may have created new black markets and a new class of criminals. The Associated Press reported last year that the law has dramatically increased the black market value of cold medication. College students, homeless people and others interested in quick and easy money have become “pill brokers,” selling medication that retails for six or seven dollars per box to the meth cooks for $40 or $50.

The laws restricting the decongestant have had some other unintended effects. They’ve given rise to a new way of making meth that requires less pseudoephedrine, called the “shake and bake” method, and it has taken off. The AP reported in 2010 that the new method, which involves shaking a cocktail of volatile chemicals in a two-liter bottle, only makes enough of the drug for one or two people. But if done wrong, the resulting chemical burns can be worse than those from exploding backyard and basement labs.

Overeager enforcement of the meth laws has also ensnared some innocent people, including several incidents in which parents and grandparents (especially families with multiple children with severe allergies) have been arrested for inadvertently exceeding their legal allotment of cold medication. In fact, when the federal government made its very first arrest under the new meth law, the Drug Enforcement Adminstration celebrated with a press release. William Fousse of Ontario, New York, the release explained, had purchased nearly three times the amount of cold medication he was allotted under the new law. But even federal prosecutors would later admit they had no evidence Fousse was manufacturing meth. He says he was unaware of the new law, and was stocking up on cold medication because it helped him recover from hangovers. He was still convicted and sentenced to a year of probation.

In 2005, 49 convenience store clerks in Georgia were arrested by federal law enforcement officials for selling the ingredients to make meth to undercover officers. Of the 49, 44 were Indian immigrants who didn’t speak English as their primary language, yet they were expected to understand the meth-maker lingo the agents used in their stores. (Defense attorneys would later point out that the agents were in fact using terms used more in TV and movies than by actual meth cooks.) In Mississippi, which like Oregon requires a prescription to purchase pseudoephedrine products, a woman was pulled over, searched and arrested this month for driving to Alabama to buy cold medication. Mississippi law also bars state residents from crossing the state border to purchase the medication.

Policy makers have consistently taken a “shoot first, ask questions later” approach to pseudoephedrine policy. Back in the early 2000s, politicians lambasted manufacturers of over-the-counter cold medications for their alleged complicity in the meth trade because they were marketing drugs containing pseudoephedrine when they could have been using phenylephrine, which has no value to meth cooks. The problem, as cold sufferers would soon learn, is that phenylephrine also happens to be useless as a decongestant. This inspired Rep. Henry Waxman (D-Calif.) to call for an investigation of one manufacturer (Pfizer) for marketing a useless drug.

Proponents of laws restricting consumer access to pseudoephedrine argue that the dramatic drop in the number of meth labs across the country alone justifies the policy. The volatile labs are dangerous not only to the meth cooks, but to neighbors and to the police officers who attempt to shut the labs down.

But drug war opponents argue that such labs can be the result of the government’s broader prohibition on amphetamines. Opponents such as the late economist Milton Friedman have long highlighted the similarities between particularly noxious illicit drugs like homemade meth and crack cocaine and toxic, prohibition-era concoctions like wood alcohol or bathtub-distilled gin. Legalizing alcohol all but eliminated them.

For now, lawmakers seem committed to ratcheting down access to pseudoephedrine. Over the last few years, at least a half dozen states and several local governments have considered following Oregon’s lead in requiring a doctor’s prescription for cold medication. The evidence suggests these laws may well put the few makeshift domestic meth labs out of business for good. But they’re likely to have little effect on the overall supply of the drug. It will also likely mean more business for international cartels. And more hassle and possible legal trouble for cold and allergy sufferers who need effective cold medicine.

Governor Steve Beshear Makes A Very BOLD Move, Rejects Louisville Hospitals Merger As Not Being In The Public Interest.

Listen to the Governor below:



You may also be interested in reading Jack Conway's report on the merger, and you can read more of the news account below:

University Hospital merger with Jewish, Catholic Health Initiatives rejected by Governor Steve Beshear
Written by Laura Ungar

Gov. Steve Beshear on Friday rejected a controversial merger that would have united three Kentucky hospital companies to create the state’s largest health care system.

“… After exhaustive discussions and research, I have determined that this proposed transaction is not in the best interest of the Commonwealth and therefore should not move forward,” he said in a statement. “In my opinion, the risks to the public outweigh the potential benefits.”

The merger — which cannot proceed without the governor’s blessing — was assailed by critics because a Catholic health system would have had majority ownership of Louisville’s public hospital, and many residents and community leaders expressed concern that reproductive and end-of-life care could be curtailed.

University Hospital, Louisville’s main safety-net hospital for the poor, had hoped to merge with Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System in Lexington, owned by Denver-based Catholic Health Initiatives.

CHI follows Catholic health directives, and other merger partners agreed not to perform certain procedures banned by the directives: elective abortions; sterilizations; contraceptive dispensing for the purpose of contraception only (except in cases of sexual assault when the victim isn't already pregnant); artificial insemination and in-vitro fertilization; and euthanasia.

That raised concerns among many community members and leaders, who also worried about the possibility of more limitations in the future if Catholic directives change.

Beshear said “significant legal and policy concerns” were raised, including Constitutional and public policy questions such as those regarding reproductive care. He also pointed to the potential costs of unwinding the merger if it had gone forward.

“However, most troubling to me is the loss of control of a public asset. University Hospital is a public asset with an important public mission, and if this merger were allowed to happen, U of L and the public would have only indirect and minority influence over the new statewide network’s affairs and its use of state assets. Many of these issues have been raised and analyzed in a report from Attorney General Jack Conway, who recommends not going forward with the merger.”

Lexington Herald Leader Editorial Gets UNREAL "About Fighting Meth".

Get real about fighting meth

Methamphetamine would be a scourge if it hurt only those who ingested it. But the harm is far more widespread than that.

Highly mobile and as compact as a large soft-drink bottle, the meth-making process creates a risk of toxic exposure, respiratory injury and fire to all who come close.

The victims of meth-making in Kentucky include children and law enforcement personnel.

The unique public health and environmental threats posed by this illegal drug are why we support reinstating a prescription requirement for obtaining cold medicines that include meth precursors such as pseudoephedrine.

A move to require a prescription for meth precursors was blocked by a well-funded wall of opposition from the over-the-counter drug industry during this year's legislature.

The Consumer Healthcare Products Association, which represents non-prescription drug companies, spent $343,777 on lobbying, including $300,000 for phone banks to fuel opposition to the bill.

A prescription requirement will be introduced again when the legislature convenes in January by Rep. Linda Belcher, D-Shepherdsville, but with a few changes that should make it more palatable to the public.

Medicines in the form of gel caps would be excluded from the prescription requirement because it's hard to extract the precursors from gel caps. Also, the requirement would sunset in three years to give everyone a chance to assess its effects and give Kentuckians a chance to adjust to the 130 cold and allergy medicines that cannot be put to use in meth labs.

Meanwhile, Rep. Brent Yonts, D-Greenville, recently held a Capitol new conference to unveil what he called a compromise approach. Yonts' bill would create a state registry of meth-related offenders and block them from purchasing medicines that contain meth precursors without a prescription.

Yonts says his approach would punish criminals, not law-abiding Kentuckians, who just happen to suffer from colds and allergies.

Unfortunately, there's no reason to think that Yonts' bill would make a dent in methamphetamine production.

Meth cookers could find plenty of "smurfers" who have no criminal records to make the buys of over-the-counter drugs for them. It also seems to be asking a lot of pharmacists to police who can and can't buy a legal drug, possibly having to say "no" to convicted criminals.

Giving the prescription requirement a three-year try, as Belcher is proposing, is a much more realistic response to the public health and environmental hazards created by meth production.

Read more: http://www.kentucky.com/2011/12/09/1988446/get-real-about-fighting-meth.html#ixzz1g3LLJsd4