Medicaid Stimulus Provides South Dakota over $19M to Promote Electronic Health Records

We're still having trouble persuading Governor Dennis Daugaard to expand Medicaid to help South Dakota's working poor. All that Obamacare money is just too unreliable to dirty South Dakotans' hands.

But Governor Daugaard has had no problem handing out an extra $19,340,218.57 in extra Medicaid money from President Obama to South Dakota hospitals, doctors, and other caregivers. That's the amount of federal money, as of August 7, that the South Dakota Department of Social Services disbursed through its Electronic Health Record Incentive Payment Program. This money comes to South Dakota courtesy of the HITECH Act of 2009, which Congress folded into the American Recovery and Reinvestment Act—yes, our friend the 2009 stimulus.

So far 29 of South Dakota's 50 hospitals have received EHR incentive payments as a reward for adopting, implementing, and/or upgrading computerized record-keeping methods. Such rewards are money well-spent: electronic health records are good medicine, as demonstrated by the pioneering Veterans Health Administration.

The spreadsheet I received yesterday from DSS also shows 216 individual health care providers who have received EHR incentive payments. They include:

• 76 physicians
• 68 pediatricians
• 37 nurse practitioners
• 5 certified nurse midwives
• 7 dentists
• 24 physician assistants.

The first payments DSS lists went out on March 23, 2012, to the Mobridge hospital ($646,400), two physicians, ten pediatricians, and two NPs. A steady stream of disbursements has followed, including, on May 2, 2013, a payment of $21,250 to Annette Marie Bosworth.

Yes, the Annette Marie Bosworth who, one month and one day later, let leak her first public mention of her intent to run for Senate as a Republican determined to fight government involvement in health care.

Republicans from Governor Daugaard to candidate Bosworth understand the GOP drill: fulminate against federal money, but take all the money Uncle Sam offers.

Help Your Neighbors: Keep Affordable Care Act Alive, Vote Obama

A friend of mine is looking for health insurance. He got laid off (these things happen) and thus lost his employer-based health plan. He has a pre-existing condition. He's been turned down by Sanford, which needs to save its money to build sports complexes. He'll probably be turned down or charged impossible premiums by every other private insurer. To participate in the American health care system, he'll face two choices: become filthy rich or go bankrupt...

...at least until 2014, when the Patient Protection and Affordable Care Act takes full effect. President Barack Obama and the 111th Congress's single greatest piece of legislation recognizes that health care does not work under free market rules. Health care is a community affair that works only when everybody helps everybody else. No citizens other than plutocrats like Mitt Romney can afford their own health care. The only feasible way for the vast majority of Americans to access health care is through cooperative insurance, where we all agree to pay for other folks' medical bills, in return for the assurance that when we get hurt or sick, other folks will chip in to cover us. 

Private insurers pervert that system by denying that security to the folks who need it most, the folks who have been sick and who stand a greater chance of getting sick again and requiring our help.

The Patient Protection and Affordable Care Act fixes that problem. On September 23, 2010, it got rid of insurers' ability to exclude children from insurance coverage due to pre-existing conditions. On January 1, 2014, it will extend that sensible protection to Americans of all ages. If my job-seeking friend can hang on for fourteen months, he can walk back into Sanford and get a policy. 

But not if we do something silly like elect Mitt Romney.

Not if we do something silly like re-elect Kristi Noem to keep voting to repeal the PPACA.

The Patient Protection and Affordable Care Act is one of the best things the Obama Administration has done for this country. It is helping more people than Mitt Romney and Kristi Noem ever will. When it takes full effect in 2014, the PPACA will help even more people, including my friend.

Don't let Mitt Romney and Kristi Noem shut it down. Vote accordingly.

DWC Botches Facts on Reid Nay to 9/11 First Responder Bill

Senator Harry Reid, Democrat of Nevada, patriotic champion of 9/11 first responders... unlike Senator John Thune.

Or, Note to Cons — when attacking check your facts first.

Tyler Crissman steps to the conservative mic this afternoon and gets mom's spaghetti all over his sweater. In an attempt to deflect criticism from major Dakota War College ad-buyer and Senator John Thune for his unpatriotic obstruction of medical compensation for sick and dying 9/11 first responders, Crissman fumes that the Left blogo-hemisphere hasn't criticized Senate Majority Leader Harry Reid for his own nay on the Zadroga bill.

Why, oh why, wouldn't we liberals have issued such criticism of the Senate Majority Leader?

Fifty-seven Democrats voted for the bill and 41 Republicans opposed it. Sen. Harry Reid, the Democratic leader, switched his vote to 'no' at the last moment, a parliamentary move that allows him to bring the measure up again for a vote ["9/11 health 'Zadroga bill' fails in Senate test vote," AP via SILive.com, 2010.12.09].

I eagerly await Mr. Crissman's retraction. Or maybe they'll just delete that post and all the comments that follow. Revisionist deletion is the Dakota War College way.

Meanwhile, if you're from Nevada, call Senator Reid and tell him to keep fighting for H.R. 847. If you're from South Dakota, call Senator Thune and tell him to stop fighting H.R. 847.

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Update 19:04 CST: Dang it! How are we supposed to sustain a healthy blog snarkfest if we go issuing corrections and apologies and straightening out our facts? Mr. Crissman replies promptly with a mea culpa... and corrects my shoddy geography. Harry Reid is indeed senior Senator from Nevada, not New Mexico as I originally stated.

Thune Blocking Compensation for 9/11 First Responders

Mr. Feser alerts us to the guff Senator John Thune is rightfully catching for his opposition to the James Zadroga 9/11 Health and Compensation Act of 2010. What's this bill? Oh, just a little compensation for men and women who ran toward fire and sacrificed their health and lives to try saving their fellow Americans on September 11, 2001.

Senator Thune voted to block a vote on health care compensation for 9/11 first responders on December 9.

Now I can't tell whether Thune and his War College lackeys would call this bill pork or prosciutto. Since it would help New Yorkers and not South Dakotans, I suppose they'll bleat pork! I just call it fulfilling our obligation to our neighbors who risked their lives for us in the face of terrorism.

My friend Adam posts a couple of videos showing 9/11 first responders talk with Jon Stewart about the Zadroga bill. Below are some comments from OpenCongress.org's page on HR 847:

I'm a 40 year old retired cop from the First Pct. in lower manhattan. I was there the morning of 9/11 and worked over 2,100 hours in the pit the months that followed. My breathing ailments are too long to get into and I understand I will be heavily medicated for whatever time I have left. I'm writing this and urging passage of this bill for my kids sake. (Ages 8 & 6)What's done is done but at least give me the peace of mind of knowing they will be taken care of. Ret. PO Dave Smith.

I am one of the forgotten rescue workers who spent weeks and months in the "pit". I do not seek glory or a pat on the back for what I did. I live with the choices I made. I wouldn't change a thing except I hate to see my family watch me deteriorate. I can't do things I used to, I have no energy, I can't breathe, I can't sleep. I am waiting for the inevitable and it sucks. I never smoked and now I am on all kinds of respiratory meds and a machine at night. Please pass this bill, I am not the only one in this position. Passage will help the people and families of those who dedicated their time and for some, their lives, to help others in need. God Bless America!

John Thune has supported borrowing over a trillion dollars to kill people and break things in Iraq and Afghanistan. But he won't support spending $7.4 billion to treat the people who responded to the first shot of that war.

Senator Thune thought it was more urgent to rush tax cuts to his richest friends than to provide health care for dying patriots. Well, now that that baby's been put to bed, the junior senator from South Dakota should have no more reason to oppose Zadroga, right?

Congresswoman Stephanie Herseth Sandlin joined Speaker Nancy Pelosi and the House in passing this bill in September. Senator Thune, get on board. Make South Dakota proud and do right by these brave Americans by joining the Republican senators Kirsten Gillibrand says will support this bill.
----------------------
Update: Watch the Daily Show video, and you'll see Mike Huckabee tell the Republicans to pass this bill.

Update 2010.12.20 21:44 CST: The GOP is feeling the heat:

"I can tell you, whoever votes against 9/11 responders a couple of days before Christmas is truly un-American," said John Feal, a former New York Police Department supervisor who lost a foot when a steel beam fell on it during in recovery efforts at the World Trade Center and who launched the non-profit Feal Good Foundation to lobby on behalf of first responders [Laura Mascaro and Tina Susman, "GOP under Pressure for Opposition to 9-11 Responders Bill," Los Angeles Times, 2010.12.20].

Judge Hudson Reminds Me: We Need Single-Payer!

I am not fond of the health insurance mandate included in the Patient Protection and Affordable Care Act. I agree with Michael Moore that people aren't cars. If health insurance is so important that it warrants a government intervention in the free market as drastic as the insurance mandate introduced to us by Republican Mitt Romney in Massachusetts, then we should skip the middle man and move straight to a universal single-payer system that would guarantee coverage for every American.

Read More
SD Blogosphere Reaction:

• Dr. Blanchard finds Hudson's ruling reasonable but still prefers electoral to judicial remedies.
• Mr. Dahle finds Hudson getting money from a GOP PR firm.
• Mr. Woodring thinks Mr. Jefferson would be proud.
• Mr. Sanborn maintains it is unconstitutional to compel citizens to purchase anything. But does that apply to state governments, too, Michael?
  

I thus react with some ambivalence to Judge Henry Hudson's ruling in favor of the Commonwealth of Virginia challenging the insurance mandate on Constitutional grounds. The ruling is pretty thin gruel in some eyes, a thorough rejection of Obamacare in others.

Hudson rules on two key points. He accepts Virginia's argument that the enforcement of the insurance mandate is a penalty, not a tax. That may not matter to the average citizen—either way, it's money out of your pocket—but it matters to the court and the Constitution. If it's a tax, then Congress can act under the General Welfare Clause, and pretty much every court challenge to health care reform ends. If it's a penalty, then Congress is acting under the Commerce Clause.

That's where things get interesting. Virginia's challenge, like others, hinges on the idea that Congress act under the Commerce Clause to compel people to participate in interstate commerce by buying health insurance. The federal government says everyone eventually participates in the health care "market," and choosing not to buy health insurance shifts costs to everyone else in the market, so federal requirements to maintain financial responsibility for one's own health care via insurance are justified regulation of interstate commerce. Judge Hudson sides with Virginia: he says the government can regulate activity but not inactivity.

Yet state and local governments apparently retain the authority to regulate a host of other economic inactivities. South Dakota still penalizes you for not buying car insurance. The sheriff will nab you for vagrancy if you don't buy or rent a domicile of some sort, and the city or county will come after you again for nuisance violations if you don't engage in enough economic activity to maintain that domicile sufficiently. We punish parents if they don't purchase sufficient food, clothing, and shelter for their children. And not that I need much persuading, but the government will get on my case if I don't engage at some bare minimum in the clothing market.

Judge Hudson's ruling does not threaten state insurance mandates; Hudson appears concerned only with "unbridled exercise of federal police powers."

But the ruling brings me back to my basic argument for a universal single-payer health insurance system. Insurance works better when you get more people in the pool to share the risk. The best insurance possible would be the biggest pool possible: all 307 million Americans in one big pool. We all pay for one big army to protect the entire country from invaders and terrorists and other disruptive forces. We could all pay for one big army of doctors to protect us from the physical and economic devastation of disease and injury.

The right way to provide that universal protection is to stop viewing health care as a matter of commerce (health care doesn't work by free market principles) and start viewing at as a general welfare issue.

Thanks! Shorter Sentences, No Earthquakes, Generous Democrats

Some dressing for your turkey:

• Thankful cons: Governor M. Michael Rounds has brought 270 state prison inmates a few months closer to saying goodbye to creamed turkey on toast. The governor issued a batch of sentence reductions yesterday. Lake County's only winner: our own Stephanie Schumacher, who gets 90 days off her sentence. These commutations weren't free passes; inmates had to do 320 hours of community service, earn GEDs or firefighter certifications, or assist with special projects.
• Thankful for solid ground: We don't have much in the way of earthquakes in South Dakota. With the Keystone pipeline running underneath us and Keystone XL maybe joining it, Plains Justice reminds us we'd better hope it stays that way. Let's not go fault-finding....
• Thankful for Democrats: the new Congressional Republicans eager to activate their government health insurance face some calls to reject their own federal health coverage before they repeal Obamacare. A Public Policy Polling survey finds 53% of Americans think incoming freshpeople like Rep.-Elect Kristi Noem who campaigned against health care reform ought to reject their Congressional health coverage. 33% think they should take the Congressional benefit. Republicans and Independents are much harder on their freshpeople; Dems make the Reject! call by only a 40–46 margin. (I'm not so generous, Kristi: as insurance agents, you and Bryon can surely come up with a better policy on your own, right?)

Thanks, Barack: More Small Biz Offer Health Insurance

Repeal this, Kristi:

Some small businesses are benefiting from portions of the [health care reform] law, which includes a tax credit beginning this year that covers as much as 35% of a company's insurance premiums.

According to a report by Bernstein Research in New York, the percentage of employers with between three and nine workers and which are offering insurance has increased to 59% this year, up from 46% last year. The report relies on data from a September survey by the nonprofit Kaiser Family Foundation [Janet Adamy, "Health Benefits Appear on Rise," Wall Street Journal, 2010.11.02].

The tax credit isn't a full fix: health premiums are still going up, and small businesses have to do more paperwork to get Uncle Sam's help. But in a bad economy, shops with fewer than ten employees are exactly the businesses we would expect to have the hardest time offering benefits for their workers. Yet thanks to President Obama and health care reform, more of those smallest businesses are getting a tax credit that allows them offer their workers health insurance.

Go ahead, Kristi. Tell us why you don't like that. Tell us why reducing taxes and expanding small-biz health coverage is a bad idea.

----------------------------
Health care reform hasn't cut into insurer profits yet. A new report from Health Care for America Now finds that the big six insurers are insuring fewer people but allocating more money toward administrative overhead and profit:

On average, each of the six now devotes 20 cents on the dollar to non-medical services, compared to 16.5 cents last year and, according to HCAN, 5 cents in 1993.

March's healthcare overhaul will require insurers to spend at least 85 cents of every premium dollar on patient care. Those changes take effect next year [Elise Viebeck, "Health Insurance Companies Likely to Break Profit Records for 2010," The Hill:Healthwatch, 2010.11.16].

Health care CEOs also have the highest median pay in the country, $10 million.

Health care reform can't come soon enough.

Federal Money Benefits Mobridge Hospital

That darned Washington, throwing money away on wasteful projects...

...like providing better and safer medical services in Mobridge:

Gov. Mike Rounds has awarded Walworth County a $309,000 Community Development Block Grant (CDBG) to facilitate hospital upgrades.

“This is really a great project for Mobridge and Walworth County,” the Governor said. “These upgrades will allow the hospital to modernize and better serve patients, both in terms of more space and increased services.”

A new addition to the hospital will be built. Renovation of existing space, along with the new addition, will add more than 17,000 square feet to the hospital. As a result, many of the hospital’s departments will be enlarged.

...The federal Department of Housing and Urban Development funds the CDBG Program, and the Governor’s Office of Economic Development administers it ["Expansion, Upgrades in Store for Mobridge Regional Hospital," South Dakota Governor's Office of Economic Development press release, 2010.11.16].

Send that pork back, right, Kristi? Let Mobridge pay for its own hospital instead of relying federal handouts, right, Republicans?

Don't you just hate it when, contrary to all the anti-government rhetoric you've been fed by the Koch brothers and the GOP, the federal government makes life tangibly better for small-town South Dakotans?

Moody County Residents Resist Private Ambulance, Prefer Public Health Service

Folks in Moody County appear to lean my way on the proper role of government in health care. Faced with a county commission proposal to privatize the county ambulance service, more than 70 citizens packed the courthouse in Flandreau to tell local government to keep its hands on their health care:

One of the first speakers was Dr. Gary Bruning, a physician at the Avera Flandreau Medical Center. Bruning is the director of the Moody County Ambulance crew.

Bruning, addressing the five commissioners as they sat in the jury box area of the courtroom, said the commission should be less concerned with the financial aspect of the ambulance.

“It should be a service and not a business,” Bruning said. “The job of governments, whether it's federal or state or local, is not to run a business but to provide a service. And what we need to do is provide a service. You know services many times not profitable. And this is one of those services that may not be profitable.”

Bruning said cutting costs on the service could end up costing the county in other ways.

“So what we have to do, in essence, is place a price on somebody's well-being and possibly their life. And that's not a real good position to put ourselves in,” he said [Ryan Woodard, "Citizens Show up in Droves to Voice Ambulance Concerns," Moody County Enterprise, 2010.11.09].

Pay attention to what Dr. Bruning is saying:

1. The free market puts a dollar figure on human life at least as much as, if not more than, any government healthc are service.
   
2. Smaller government isn't always better government.
3. Good government is about service, not profit.
   

The Moody County Commission says it will not take action on its privatization plan until after three new commissioners take their seats in January.

Health Reform and You: Expert Panel on PPACA Brookings Nov. 13

Hey, don't take my word for it that President Obama's health care reform package is the best thing Congresswoman Hersth Sandlin didn't vote for. Come ask some professionals:

Health Care Matters
Public Information Forum

Patient Protection and Affordable Care Act
The Health Care Reform Bill
What does it mean for South Dakota?

Saturday, November 13, 2010, 1:30-3:30
Brookings Public Library Cooper Room

Panel:

• Mark Anderson: President/Financial Secretary, South Dakota State Federation of Labor
• Deb Fischer-Clemens: Vice President, Avera Center for Public Policy
• Randy Moses: Assistant Director, South Dakota Division of Insurance

sponsored by Dakota Grassroots Democracy

Come learn all the good things Congresswoman-Elect Noem wants to take away from South Dakota to satisfy the ideologues who write her talking points.

Noem's First Big Post-Election Lie: "I Read All the Bill"

Congresswoman-Elect Kristi Noem transitions smoothly from lying to win the election to lying after the election. In a discussion about repealing or at least defunding the Patient Protection and Affordable Care Act to take away numerous benefits from South Dakotans, Noem tells this whopper to Jon Walker:

Noem said she read the 2,700-page bill online during her campaign earlier this year.

"I read all the bill. It took me forever," she said [Jon Walker, "Noem Expects House to Starve Health Reform Bill," That Sioux Falls paper, 2010.11.07].

Bull. Noem couldn't even focus long enough to read the seven-page Tony Dean Cheyenne River Valley Conservation Act before parroting Senator Thune's opposition to the national grassland proposal.

Kristi Noem did not spend her summer reading every page of the health care bill. She hasn't read anything more substantial than the talking points sent by her GOP puppeteers.

Health Care Solution: Apply Presidential Disaster Declarations to Sick People

Here's how my brain works:

Wednesday evening on Marketplace, Jimmy Carter recalled how Ted Kennedy killed his plan to guarantee catastrophic health care coverage for all Americans and then expand that plan into universal coverage.

Then I (along with one of the lovely ladies with whom I was having dinner) thought about Kristi Noem's willingness to defend the enormous government handouts to her farm because "Agriculture's important, and it's a national security issue...." on the basis of national security.

Well, people are important, too, right? If people get sick, they can't work or pick up their shotguns to repel Chinese paratroopers. If consumers are mired in medical debt, they can't buy the houses and cars and other goods that keep the economy humming. And if folks can't afford care and thus die, well, they can't pay taxes to buy tanks and B-1 bombers. Those are all national security issues, right?

So maybe folks with catastrophic medical problems should get the same treatment as counties and states with catastrophic problems: declare them federal disaster areas. If get laid low by cancer or some other awful act of God that's going to cost, say, a whole year's salary to fix, let President Obama issue a Presidential Declaration of Individual Disaster. Let the President release federal funds—money from all of us, your fellow citizens—to cove your medical bills and help you get back on your physical and fiscal feet to rejoin the fight to keep America marching forward.

We do it for roads and bridges and flooded soybean fields. Why not do it for our fellow citizens?

Noem Says She'd Cut Budget By Cutting... Cuts?

Anyone else catch the SDPB Congressional candidates debate last night? GOP candidate candidate Kristi Noem once again demonstrated that she doesn't listen to the questions posed, only to the talking-point echoes pumped into her head.

The first question asked the candidates to cite specific cuts they would consider to get the federal budget under control. Both Noem and Democrat Stephanie Herseth Sandlin opened with the usual empty fluff—very good question, thank you SDPB, blah blah. However, about 30 seconds in, Herseth Sandlin launched into a good bullet list of specific budget line items she would go after.

Noem, however, launched into her programmed screed on repealing health insurance reform. Noem said we need to cut health insurance reform because it raises taxes and cuts spending in various health care programs.

Reread that: asked what programs she would cut from the budget, Kristi Noem says she would repeal a law that makes cuts in the budget. Essentially, she just said, "I'd cut the budget by cutting cuts."

Kristi Noem: constant nonsense.

Insurance Agent Noem Supports Denying Pregnant Women Coverage

Kristi Noem says the health care reform law has "some fatal flaws."

Funny—that's the same thing insurance companies say about hundreds of thousands of Americans to whom they want to deny coverage:

The nation’s four largest for-profit health insurers denied coverage to more than 651,000 people over a three-year period, citing pre-existing conditions, according to an analysis of insurer data detailed in a Congressional investigation.

Between Aetna, Humana, UnitedHealth Group, and WellPoint, that averages out to a denial of coverage for one out of every seven applicants, according to an Energy and Commerce Committee memo about the investigation.

...Individuals were denied coverage based on “an extensive list of medical conditions,” the memo noted. One company had a list of more than 400 medical diagnoses used to decline coverage to those seeking it, and common conditions such as pregnancy, diabetes, and heart disease were included on the list [Marian Wang, "Insurers Denied Health Coverage to 1 in 7 People, Citing Pre-Existing Conditions," ProPublica.org, 2010.10.13].

Pregnancy as a pre-existing condition. That's the status quo ante that President Obama and the Democratic Congress are changing. That's the status quo ante that purportedly pro-life Noem would return us to by repealing health care reform. If you get pregnant, Kristi Noem wants insurance agents like herself and her husband to be able to kick pregnant women, those darned financial risks, out of their office.

SDGOP Fibs on SHS and Health Care

The South Dakota Republican Party's shadow-cowboy mailer contains a gross distortion of Stephanie Herseth Sandlin's voting record on health care reform. The SDGOP makes it sound as if Herseth Sandlin voted for health care reform (if only she would have!). The SDGOP accuses thus:

Stephanie supported the near-trillion-dollar Baucus health care bill that would have put the government in charge of your health care.

They even include two sources to back this claim up. Dang, if they've got footnotes, how can this claim possibly twist the truth?

1. SDGOP first cites Jason Allen from The Hill. There is no Jason Allen from The Hill.
2. Jared Allen did write in The Hill that SHS "gave her blessing to the Baucus bill."
3. However, that "blessing" was not a vote: it was SHS saying in September 2009 that Baucus's draft had the best chance of becoming law.
4. SHS actually said this: "The draft released by Chairman Baucus addresses two central goals of the Blue Dog Coalition and the administration: It is deficit-neutral, and it takes real steps to bring down the cost of healthcare over the long term" [emphasis mine], goals the GOP should admire.
   
5. SHS said the above in part because the Congressional Budget Office found the Baucus bill would have cost $829 billion over ten years, well below the President's $900-billion budget target... and a bit of a stretch to call "nearly-trillion-dollar." That's like scoring at 82% and telling your parents, "I got nearly a hundred!"
6. The above dollar figures come from the Politico.com article the SDGOP cites on this claim... and that article that only mentions SHS as being skeptical about the long-term budget sustainability of health care reform. It supports nothing stated in the GOP flyer.
   
7. SHS never voted on the Baucus bill, S 1796. She voted against the Patient Protection and Affordable Care Act, HR 3590, the legislation that finally passed.
8. Nothing in the Baucus bill or the legislation that actually passed "put government in charge of your health care." Nothing in either cited source says that. The bill I wanted, HR 676, might arguably have done that by implementing a universal single-payer system... but SHS, Pelosi, and President Obama never let that idea come to the table.

The shadow cowboy grouses about the voting record but cites no actual votes on health care. South Dakotans are "strong and independent," but they're also straight shooters... unlike the South Dakota GOP.

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Bonus Noem Trick: On her previous flyer (you know, the one that almost lies about the NRA and breaks VoteSmart.org's acceptable use policy) Noem misrepresents Herseth Sandlin's score from the Gun Owners of America. VoteSmart.org lists that rating as a D. The Gun Owners of America themselves currently list SHS's rating as B-. So which rating does Noem choose: the rating posted at the original source, or the lower rating at a secondary source that needs updating? Of course, Noem chooses her pitch over reality.

All this makes me wonder what kind of stories Noem makes up when the Highway Patrol pulls her over.

Blog Readers Favor Legal Medical Marijuana 55%-45%

The latest Madville Times poll on Initiated Measure 13 drew a lot of eager readers' attention. I asked, "Do you support IM13, legalizing medical marijuana in South Dakota?" 200 of you voted (thank you!) and broke slightly in favor:

Yes	110 (55%)
No	90 (45%)

Votes: 200

The somewhat close result indicates either that readers of this humble blog aren't so ravingly liberal as you might think or that the issue of legalizing marijuana, even for medical purposes, doesn't break neatly along stereotypical liberal/conservative lines. Remember that one of the biggest advocates for IM 13, Bob Newland, is a red-in-tooth-and-claw libertarian who thinks the best government is just slightly more restrictive than the state of nature... and only during business hours.

I do sympathize with Mr. Newland on the issue of medical marijuana. I also enjoy the hay that can be made holding purported conservatives' feet to their own rhetorical fire: if you're all for government leaving us alone, and if you're incensed at the thought of government coming between you and your doctor, how can you not vote for IM13? You legalize medical marijuana, and you transfer power from government to doctors and patients. Those docs who dig dope can prescribe accordingly. Those docs who haven't come to that studied medical opinion can still direct their patients toward industrial pharmaceuticals and other non-herbal treatments. Why would any conservative want to see Congress, the Legislature, and the local sheriff making that decision instead of patients and their doctors?

By the way, I check stats from the government's Drug Abuse Warning Network and learn that nationwide in 2008, marijuana was responsible for 133,201 trips to the emergency room. Alcohol was responsible for 656,661 ER visits.

For deaths, I review this hefty DAWN report and count 1046 reported deaths linked to marijuana. The reporting metro areas include about 38% of the population, and DAWN notes some jurisdictions don't report marijuana as a specific cause of death. So multiply by 6: suppose there were really over 6000 marijuana-related deaths in 2008. The CDC reports that in 2007, alcohol was connected to 23,199 deaths.

And we don't even make you get a doctor's note to buy alcohol.

Noem Advocates Obama Agenda on Medicare Fraud

Kristi Noem has updated her issues page, piling some new blurbs about her support for social programs at the top of her GOP talking points. Among the substanceless, specifics-less suggestions, Noem opines that we must "work harder" to curb fraud and abuse in Medicare.

Isn't that exactly what President Barack Obama is doing?

1. President Obama is spending $9 million to educate old folks to prevent fight Medicare fraud. (Hey! Where's South Dakota's piece of that pie?)
   
2. The Centers for Medicare and Medicaid Services (CMS) will adopt new billing software that will catch fraud before the money leaves Uncle Sam's cash box. The software, much like what credit card companies use to protect you from unusual activity on your Mastercard, could save over $20 billion a year. This anti-fraud measure was part of the Small Business Lending Act, sponsored by Democrat Barney Frank, voted for by Democrat Nancy Pelosi, and signed into law by Democrat and President Barack Obama. Remarkably Democrat Stephanie Herseth Sandlin voted against this bill, along with Senator Thune and most Republicans.
   
3. President Obama's AG Holder and HHS Sec. Sebelius announced the Medicare Fraud Strike Force's biggest bust yet this summer when they announced charges against 94 tricky docs and other Medicare swindlers.
4. CMS is proposing a rule to classify Medicare providers by risk, do background checks and fingerprinting on the high-risk group, and suspend payment to providers upon credible allegation of fraud. But that rule proposal comes from President Obama's health care reform law, so surely Noem wants to repeal that anti-fraud effort.
   
5. President Obama also signed the Improper Payments Elimination and Recovery Act last July to fight fraud against all government agencies, including Medicare. Herseth Sandlin got with the program and voted with Pelosi on this one... as did everyone else in Congress.
   

"Work harder" to fight Medicare fraud, Mrs. Noem? Sounds like President Obama is already at least five policy steps ahead of you.
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Bonus Health Care Refudiation: Perhaps Noem could work harder to stop scaring seniors. The Kaiser Family Foundation's September 2010 Health Tracking Poll finds 30% of senior citizens still think the new law includes "a government panel to make decisions about end‐of‐life care for people on Medicare"—i.e., Sarah Palin's death panels. Health care reform includes no death panels. Senator Charles Grassley said so... last year.
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Update 2010.10.14: Obama's G-Men catch another 73 Armenian gangsters who allegedly set up a ring of at least 118 bogus clinics and tried cheating Medicare out of $163 million. President Obama keeps working harder....

Weiland: Health Care Reform Too Good to Repeal

Dr. Kevin Weiland has hit the papers again. In Thursday's edition of that Sioux Falls paper, he explains to South Dakotans why repealing this year's health care reform law would hurt South Dakotans. Among the damage Dr. Weiland says we could do by sending repeal dittoheads to Washington:

1. 90,000 South Dakota kids lose protection from discrimination and denial of insurance coverage due to pre-existing conditions.
2. Current and future medical students lose expanded scholarships and loan repayment assistance.
3. Doctors choosing lower-paying primary care and setting up shop in rural and other high-need areas lose tax relief.
   
4. Not-for-profit community health centers (one of George W. Bush's really good ideas) lose $9 billion.
5. Medicare patients fall right back into the donut hole.

Ohio Congressman Dennis Kucinich and other Democrats understood the good health care reform promised for South Dakota. Our Senator Tim Johnson understood from the start that passing health care reform would be one of his proudest moments in the Senate. Stephanie Herseth Sandlin needed a primary threat to come to Jesus on this issue.

Health care reform is already doing good, and it will do more as its biggest provisions kick in. It's not perfect, but it's progress over a rotten status quo. Oh yeah, and don't forget: over ten years, it will cut the deficit by $138 billion.

Health care reform is working. Repealing it or even playing funding games as Noem and the GOP are plotting is not preferable. I am pleased that Dr. Weiland is making that case. Congresswoman Herseth Sandlin needs to make that case more loudly. And we Dems need to get up and vote to keep Republicans from retaking Congress and driving our health care system back into the rocks.

New Madville Times Poll: IM13 -- Legalize Medical Marijuana?

It's the last hour at the office. The long weekend is almost here. You don't really want to review that report from Marketing. Skip it! Do something really important: vote in the latest Madville Times poll!

This weekend's question: Do you support Initiated Measure 13, legalizing medical marijuana in South Dakota?

If you're not familiar with IM13, feel free to peruse the following resources before voting:

1. the IM13 explanation in SD's official Ballot Question Pamphlet
2. "pro" info from the South Dakota Coalition for Compassion
3. "con" info from Vote No on 13

You can also get a whole heap of pro-IM13 discussion (and some spirited opposition in the comment section) from Bob Newland at the Decorum Forum.

Vote here in the right sidebar through Tuesday morning, 8 a.m. Then we'll talk about the results. Tell your friends, and vote now!

Daugaard Policy Armor Cracks; Heidepriem Primed for Offensive

South Dakota GOP candidate for governor Dennis Daugaard must be reading too much War College. Daugaard apparently believes the propaganda that the campaign is over, it's a blowout, it's hopeless for Heidepriem... believes it so much that he's starting to slip.

First Team Daugaard puts out an ad so doggedly designed to deny reality that even mild-mannered journalist Bob Mercer, not the most obviously liberal journalist in the state, felt obliged to point out that the ad outright lies when it claims we balanced our state budget without raising taxes. Mercer catalogs a few tax and fee increases propping up our state budget; contact your local county commission and school board to learn the tax hikes they've had to pile onto your local assessment to make up for the state's budgetary neglect.

Then Daugaard tells nursing homes that they probably won't get the $21 million in medicaid stimulus Washington sent them. "We need to guard against the increasing tendency to look for the government to save us," Daugaard lectured the nursing home workers' convention in Sioux Falls Wednesday, even as he defended Pierre's pouring that stimulus money into the general fund to save our budget. That's the same shell game Daugaard and his boss are playing with the $26.3 million in education stimulus approved in August, diverting it from its intended purpose and guaranteeing it won't have the stimuluative effect lawmakers intended.

Now Daugaard skips a great opportunity to defend his record and his plans on a major state policy issue. Tonight's Inside KELOLand (10:30 p.m. CST) will discuss the recent Zogby poll, sponsored by the Associated School Boards of South Dakota, on South Dakota voters' views of K-12 education. Democrat Scott Heidepriem will be there. So will an ASBSD official. Daugaard was invited, but he won't be there. Team Heidepriem is telling supporters that Daugaard said he doesn't want to debate this issue with Heidepriem. Maybe Daugaard, like fellow Republican Kristi Noem, is just getting tired of having his indefensible claims challenged and thinks he can coast to victory in November with fluffy ads and nice hair.

Whatever Daugaard's reason for skipping this discussion, Heidepriem gets free shots for a half hour on the highest-rated TV station in the state. And what will those free shots include? Paraphrasing the latest Team Heidepriem e-mail, Heidepriem will likely cite various expenditures the state has incurred even while breaking its promise to schools and shorted K-12 education this year:

• Rounds and Daugaard happily sent TransCanada an extra $10.5 million in tax refunds to incentivize a pipeline TransCanada had already built through our state.
• The current administration has given over $533,000 dollars in pay raises to their top 19 executive branch staffers... who have turned around and given Daugaard over $62,000 in campaign contributions.
• They've refused to sell any of the state airplanes.
• They closed the Black Hills Playhouse while spending over $200K to renovate "Valhalla," the historic Peter Norbeck cabin just up the trail that Governor Rounds has turned into his personal playground.
  

Tonight's KELO broadcast is the beginning of what could be a big media week for Heidepriem. His big 30-minute documentary is already making the rounds at Dems events and hits the airwaves on all the major South Dakota channels this week Thursday. And by dodging a discussion of education and papering over bad policy with cheery optimism and plainly false claims, Daugaard may be making it that much easier for Heidepriem to grab folks' attention and make the big push for November.