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The New Coffee Room

  1. TNCR
  2. General Discussion
  3. Working today

Working today

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  • LuFins DadL Offline
    LuFins DadL Offline
    LuFins Dad
    wrote on last edited by
    #21

    That is just as problematic as the Squad entries. American Flag, State Flag, nameplate. That’s it.

    The Brad

    jon-nycJ 1 Reply Last reply
    • LuFins DadL LuFins Dad

      That is just as problematic as the Squad entries. American Flag, State Flag, nameplate. That’s it.

      jon-nycJ Offline
      jon-nycJ Offline
      jon-nyc
      wrote on last edited by jon-nyc
      #22

      @LuFins-Dad

      The majority of them have just that. And if there’s a sign it’s either ‘welcome we’re open’ or something rah-rah about their state like a state Uni banner.

      They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

      1 Reply Last reply
      • taiwan_girlT Offline
        taiwan_girlT Offline
        taiwan_girl
        wrote on last edited by
        #23

        @jon-nyc Cool stuff you are doing!!

        1 Reply Last reply
        • jon-nycJ Offline
          jon-nycJ Offline
          jon-nyc
          wrote on last edited by jon-nyc
          #24

          Got two new cosponsors already. Both in the R column, which we most need to keep some sort of balance.

          Hoping for 5 from this trip, 7 as a stretch goal.

          They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

          1 Reply Last reply
          • JollyJ Offline
            JollyJ Offline
            Jolly
            wrote on last edited by
            #25

            Talk to Johnson, yet?

            “Cry havoc and let slip the DOGE of war!”

            Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

            1 Reply Last reply
            • jon-nycJ Offline
              jon-nycJ Offline
              jon-nyc
              wrote on last edited by jon-nyc
              #26

              No it isn’t realistic to get leadership as a cosponsor for a tiny bill like this.

              We met with Vern Johnson, who I believe is the ranking GOP member on Ways and Means. That’s probably a stretch. He probably considers himself umpire not player on things like this and would be unlikely to sponsor us. But it is worth a try. It would be a coup to get him.

              They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

              JollyJ 1 Reply Last reply
              • jon-nycJ Offline
                jon-nycJ Offline
                jon-nyc
                wrote on last edited by
                #27

                Keep in mind there will never be a vote on this bill per se. Our path to passage is to get 100 co-sponsors or so and get it attached to a must-pass healthcare bill and figure it’s too small to get cut during the back and forth of negotiations.

                They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                1 Reply Last reply
                • HoraceH Offline
                  HoraceH Offline
                  Horace
                  wrote on last edited by
                  #28

                  What's it for? Funding for research into your disease?

                  Education is extremely important.

                  jon-nycJ 2 Replies Last reply
                  • MikM Offline
                    MikM Offline
                    Mik
                    wrote on last edited by
                    #29

                    I hope you get it.

                    "The intelligent man who is proud of his intelligence is like the condemned man who is proud of his large cell." Simone Weil

                    1 Reply Last reply
                    • jon-nycJ jon-nyc

                      No it isn’t realistic to get leadership as a cosponsor for a tiny bill like this.

                      We met with Vern Johnson, who I believe is the ranking GOP member on Ways and Means. That’s probably a stretch. He probably considers himself umpire not player on things like this and would be unlikely to sponsor us. But it is worth a try. It would be a coup to get him.

                      JollyJ Offline
                      JollyJ Offline
                      Jolly
                      wrote on last edited by
                      #30

                      @jon-nyc said in Working today:

                      No it isn’t realistic to get leadership as a cosponsor for a tiny bill like this.

                      We met with Vern Johnson, who I believe is the ranking GOP member on Ways and Means. That’s probably a stretch. He probably considers himself umpire not player on things like this and would be unlikely to sponsor us. But it is worth a try. It would be a coup to get him.

                      Then hit up Letlow. She used to work for Tulane Medical School doing education or something and she's lost her husband pretty young due to COVID.

                      Might be sympathetic. And if you get her, she's real tight with Johnson.

                      “Cry havoc and let slip the DOGE of war!”

                      Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

                      1 Reply Last reply
                      • jon-nycJ Offline
                        jon-nycJ Offline
                        jon-nyc
                        wrote on last edited by jon-nyc
                        #31

                        Thanks for that. We have a very active volunteer not far from you (she brags that she lives in the only parish with no Walmart, no traffic light, and no elevator) who wants to help with advocacy. Good republican too with deep roots in LA.

                        They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                        1 Reply Last reply
                        • HoraceH Horace

                          What's it for? Funding for research into your disease?

                          jon-nycJ Offline
                          jon-nycJ Offline
                          jon-nyc
                          wrote on last edited by
                          #32

                          @Horace said in Working today:

                          What's it for? Funding for research into your disease?

                          Will reply at a real keyboard later today.

                          They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                          1 Reply Last reply
                          • HoraceH Horace

                            What's it for? Funding for research into your disease?

                            jon-nycJ Offline
                            jon-nycJ Offline
                            jon-nyc
                            wrote on last edited by jon-nyc
                            #33

                            @Horace said in Working today:

                            What's it for? Funding for research into your disease?

                            No, we do a pretty good job of funding research. The bill has to do with standards of care and modernizing Medicare.

                            In a nutshell, this disease comes down to people missing a functional level of a particular protein (alpha-1 antitrypsin). The current standard of care is to replace that protein by collecting it from healthy people (plasma donors) and infusing it (intravenously) weekly into people with this disease.

                            If you have commercial insurance (or even Medicaid), you get that weekly infusion at home, it takes about 30 minutes.

                            But if you are a medicare patient (IOW, elderly or disabled) you have to go into an infusion center for the treatment. In some places there are stand-alone businesses which are infusion centers but in less dense areas they're done in a hospital.

                            You can imagine that in the early months of covid it was quite stressful for elderly people with lung disease to go to hospitals to get treatment. Many decided to skip their treatment rather than risk it. Even ignoring covid, people with this disease are particularly susceptible to lung damage when contracting any respiratory disease. Especially the elderly and disabled (most of whom are disabled because their lung function is largely destroyed).

                            What our bill does is instruct CMS (the payor behind Medicare) to create a home infusion option under Medicare Part B for people with this disease. It's just an option ('if you like your infusion center, you can keep it'), not a requirement.

                            We approached this from a patient care angle, of course, but the more we looked into it the more we realized that it was actually cheaper to do it in the home. The average home infusion for Alpha-1 takes about a half hour, the bill instructs CMS to reimburse up to 2 hours of nursing time (they have to drive to your house and back).

                            Of course, a nurse in a center can do many more patients in 2 hours - but, the facility charges of the institutional setting make it more expensive.

                            But the result isn't that surprising, United Health Care isn't paying for me to have home infusions because I'm a great guy and they want me to have a nice day. They did the math and it's cheaper. Medicare hasn't kept up with the times. According to our calculations, the average cost for the administration of a home infusion is $180, in a hospital setting it's more like $380. In a specialty infusion center it's somewhere in the middle.

                            So the current situation is a breech of common sense - if you have private insurance, which generally means you're younger and more healthy, you get safer care than the people who are most at risk. Add to that the fact that the more risky substandard care is actually more expensive to provide, and this is even more of an obvious error.

                            Another selling point to certain congressmen is the fact that in rural areas you might have a 2 hour drive to your nearest infusion center/hospital. It's one thing to ask a healthy nurse to make that drive while being compensated for it, it's another to ask the 74 year old with 30% lung function to do it each week, there and back. Or ask the 80 year old to have her son or daughter drive her every week.

                            So we have a pretty good pitch to both parties - this bill improves health care access (a key Dem priority), especially for elderly (a key GOP constituency) and rural folks (another key GOP constituency), and saves money (a key GOP priority).

                            So it's not a hard pitch generally. The issue we have is just getting people's attention since it's such a rare disease and so much has been happening in Congress the last year.

                            They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                            George KG JollyJ KlausK HoraceH 4 Replies Last reply
                            • MikM Offline
                              MikM Offline
                              Mik
                              wrote on last edited by
                              #34

                              Makes perfect sense. I hope you are successful.

                              "The intelligent man who is proud of his intelligence is like the condemned man who is proud of his large cell." Simone Weil

                              1 Reply Last reply
                              • jon-nycJ Offline
                                jon-nycJ Offline
                                jon-nyc
                                wrote on last edited by
                                #35

                                Thanks.

                                They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                                1 Reply Last reply
                                • jon-nycJ jon-nyc

                                  @Horace said in Working today:

                                  What's it for? Funding for research into your disease?

                                  No, we do a pretty good job of funding research. The bill has to do with standards of care and modernizing Medicare.

                                  In a nutshell, this disease comes down to people missing a functional level of a particular protein (alpha-1 antitrypsin). The current standard of care is to replace that protein by collecting it from healthy people (plasma donors) and infusing it (intravenously) weekly into people with this disease.

                                  If you have commercial insurance (or even Medicaid), you get that weekly infusion at home, it takes about 30 minutes.

                                  But if you are a medicare patient (IOW, elderly or disabled) you have to go into an infusion center for the treatment. In some places there are stand-alone businesses which are infusion centers but in less dense areas they're done in a hospital.

                                  You can imagine that in the early months of covid it was quite stressful for elderly people with lung disease to go to hospitals to get treatment. Many decided to skip their treatment rather than risk it. Even ignoring covid, people with this disease are particularly susceptible to lung damage when contracting any respiratory disease. Especially the elderly and disabled (most of whom are disabled because their lung function is largely destroyed).

                                  What our bill does is instruct CMS (the payor behind Medicare) to create a home infusion option under Medicare Part B for people with this disease. It's just an option ('if you like your infusion center, you can keep it'), not a requirement.

                                  We approached this from a patient care angle, of course, but the more we looked into it the more we realized that it was actually cheaper to do it in the home. The average home infusion for Alpha-1 takes about a half hour, the bill instructs CMS to reimburse up to 2 hours of nursing time (they have to drive to your house and back).

                                  Of course, a nurse in a center can do many more patients in 2 hours - but, the facility charges of the institutional setting make it more expensive.

                                  But the result isn't that surprising, United Health Care isn't paying for me to have home infusions because I'm a great guy and they want me to have a nice day. They did the math and it's cheaper. Medicare hasn't kept up with the times. According to our calculations, the average cost for the administration of a home infusion is $180, in a hospital setting it's more like $380. In a specialty infusion center it's somewhere in the middle.

                                  So the current situation is a breech of common sense - if you have private insurance, which generally means you're younger and more healthy, you get safer care than the people who are most at risk. Add to that the fact that the more risky substandard care is actually more expensive to provide, and this is even more of an obvious error.

                                  Another selling point to certain congressmen is the fact that in rural areas you might have a 2 hour drive to your nearest infusion center/hospital. It's one thing to ask a healthy nurse to make that drive while being compensated for it, it's another to ask the 74 year old with 30% lung function to do it each week, there and back. Or ask the 80 year old to have her son or daughter drive her every week.

                                  So we have a pretty good pitch to both parties - this bill improves health care access (a key Dem priority), especially for elderly (a key GOP constituency) and rural folks (another key GOP constituency), and saves money (a key GOP priority).

                                  So it's not a hard pitch generally. The issue we have is just getting people's attention since it's such a rare disease and so much has been happening in Congress the last year.

                                  George KG Offline
                                  George KG Offline
                                  George K
                                  wrote on last edited by
                                  #36

                                  Good on ya, Jon. You guys have certainly done the homework.

                                  @jon-nyc said in Working today:

                                  The issue we have is just getting people's attention since it's such a rare disease

                                  Didn't you tell me that it's really not such a rare disease? It just hasn't been diagnosed because we're not looking for it?

                                  "Now look here, you Baltic gas passer... " - Mik, 6/14/08

                                  The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.

                                  1 Reply Last reply
                                  • jon-nycJ Offline
                                    jon-nycJ Offline
                                    jon-nyc
                                    wrote on last edited by
                                    #37

                                    Yes only about 10% diagnosed. But even if it were 100% diagnosed it would still qualify as a rare disease under US regulations (<200k). This is important because the Orphan Drug Act provides a lot of incentives for therapeutic development for rare diseases.

                                    They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                                    1 Reply Last reply
                                    • jon-nycJ jon-nyc

                                      @Horace said in Working today:

                                      What's it for? Funding for research into your disease?

                                      No, we do a pretty good job of funding research. The bill has to do with standards of care and modernizing Medicare.

                                      In a nutshell, this disease comes down to people missing a functional level of a particular protein (alpha-1 antitrypsin). The current standard of care is to replace that protein by collecting it from healthy people (plasma donors) and infusing it (intravenously) weekly into people with this disease.

                                      If you have commercial insurance (or even Medicaid), you get that weekly infusion at home, it takes about 30 minutes.

                                      But if you are a medicare patient (IOW, elderly or disabled) you have to go into an infusion center for the treatment. In some places there are stand-alone businesses which are infusion centers but in less dense areas they're done in a hospital.

                                      You can imagine that in the early months of covid it was quite stressful for elderly people with lung disease to go to hospitals to get treatment. Many decided to skip their treatment rather than risk it. Even ignoring covid, people with this disease are particularly susceptible to lung damage when contracting any respiratory disease. Especially the elderly and disabled (most of whom are disabled because their lung function is largely destroyed).

                                      What our bill does is instruct CMS (the payor behind Medicare) to create a home infusion option under Medicare Part B for people with this disease. It's just an option ('if you like your infusion center, you can keep it'), not a requirement.

                                      We approached this from a patient care angle, of course, but the more we looked into it the more we realized that it was actually cheaper to do it in the home. The average home infusion for Alpha-1 takes about a half hour, the bill instructs CMS to reimburse up to 2 hours of nursing time (they have to drive to your house and back).

                                      Of course, a nurse in a center can do many more patients in 2 hours - but, the facility charges of the institutional setting make it more expensive.

                                      But the result isn't that surprising, United Health Care isn't paying for me to have home infusions because I'm a great guy and they want me to have a nice day. They did the math and it's cheaper. Medicare hasn't kept up with the times. According to our calculations, the average cost for the administration of a home infusion is $180, in a hospital setting it's more like $380. In a specialty infusion center it's somewhere in the middle.

                                      So the current situation is a breech of common sense - if you have private insurance, which generally means you're younger and more healthy, you get safer care than the people who are most at risk. Add to that the fact that the more risky substandard care is actually more expensive to provide, and this is even more of an obvious error.

                                      Another selling point to certain congressmen is the fact that in rural areas you might have a 2 hour drive to your nearest infusion center/hospital. It's one thing to ask a healthy nurse to make that drive while being compensated for it, it's another to ask the 74 year old with 30% lung function to do it each week, there and back. Or ask the 80 year old to have her son or daughter drive her every week.

                                      So we have a pretty good pitch to both parties - this bill improves health care access (a key Dem priority), especially for elderly (a key GOP constituency) and rural folks (another key GOP constituency), and saves money (a key GOP priority).

                                      So it's not a hard pitch generally. The issue we have is just getting people's attention since it's such a rare disease and so much has been happening in Congress the last year.

                                      JollyJ Offline
                                      JollyJ Offline
                                      Jolly
                                      wrote on last edited by
                                      #38

                                      @jon-nyc said in Working today:

                                      Another selling point to certain congressmen is the fact that in rural areas you might have a 2 hour drive to your nearest infusion center/hospital. It's one thing to ask a healthy nurse to make that drive while being compensated for it, it's another to ask the 74 year old with 30% lung function to do it each week, there and back. Or ask the 80 year old to have her son or daughter drive her every week.

                                      In my part of the world, that's a big deal.

                                      “Cry havoc and let slip the DOGE of war!”

                                      Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton

                                      1 Reply Last reply
                                      • jon-nycJ Offline
                                        jon-nycJ Offline
                                        jon-nyc
                                        wrote on last edited by jon-nyc
                                        #39

                                        Yeah I’ll bet. I’m hoping we’ll sign the Republican who represents very southern part of FL including the Keys. I told him someone from Marathon Key probably has to drive to Miami for treatment, and it really resonated.

                                        They’ll end up, after a lot of drama, with the same formula they use every time they have a trifecta: take away health care and food assistance from low income families and use the money to fund tax cuts for their donors.

                                        1 Reply Last reply
                                        • jon-nycJ jon-nyc

                                          @Horace said in Working today:

                                          What's it for? Funding for research into your disease?

                                          No, we do a pretty good job of funding research. The bill has to do with standards of care and modernizing Medicare.

                                          In a nutshell, this disease comes down to people missing a functional level of a particular protein (alpha-1 antitrypsin). The current standard of care is to replace that protein by collecting it from healthy people (plasma donors) and infusing it (intravenously) weekly into people with this disease.

                                          If you have commercial insurance (or even Medicaid), you get that weekly infusion at home, it takes about 30 minutes.

                                          But if you are a medicare patient (IOW, elderly or disabled) you have to go into an infusion center for the treatment. In some places there are stand-alone businesses which are infusion centers but in less dense areas they're done in a hospital.

                                          You can imagine that in the early months of covid it was quite stressful for elderly people with lung disease to go to hospitals to get treatment. Many decided to skip their treatment rather than risk it. Even ignoring covid, people with this disease are particularly susceptible to lung damage when contracting any respiratory disease. Especially the elderly and disabled (most of whom are disabled because their lung function is largely destroyed).

                                          What our bill does is instruct CMS (the payor behind Medicare) to create a home infusion option under Medicare Part B for people with this disease. It's just an option ('if you like your infusion center, you can keep it'), not a requirement.

                                          We approached this from a patient care angle, of course, but the more we looked into it the more we realized that it was actually cheaper to do it in the home. The average home infusion for Alpha-1 takes about a half hour, the bill instructs CMS to reimburse up to 2 hours of nursing time (they have to drive to your house and back).

                                          Of course, a nurse in a center can do many more patients in 2 hours - but, the facility charges of the institutional setting make it more expensive.

                                          But the result isn't that surprising, United Health Care isn't paying for me to have home infusions because I'm a great guy and they want me to have a nice day. They did the math and it's cheaper. Medicare hasn't kept up with the times. According to our calculations, the average cost for the administration of a home infusion is $180, in a hospital setting it's more like $380. In a specialty infusion center it's somewhere in the middle.

                                          So the current situation is a breech of common sense - if you have private insurance, which generally means you're younger and more healthy, you get safer care than the people who are most at risk. Add to that the fact that the more risky substandard care is actually more expensive to provide, and this is even more of an obvious error.

                                          Another selling point to certain congressmen is the fact that in rural areas you might have a 2 hour drive to your nearest infusion center/hospital. It's one thing to ask a healthy nurse to make that drive while being compensated for it, it's another to ask the 74 year old with 30% lung function to do it each week, there and back. Or ask the 80 year old to have her son or daughter drive her every week.

                                          So we have a pretty good pitch to both parties - this bill improves health care access (a key Dem priority), especially for elderly (a key GOP constituency) and rural folks (another key GOP constituency), and saves money (a key GOP priority).

                                          So it's not a hard pitch generally. The issue we have is just getting people's attention since it's such a rare disease and so much has been happening in Congress the last year.

                                          KlausK Offline
                                          KlausK Offline
                                          Klaus
                                          wrote on last edited by
                                          #40

                                          @jon-nyc said in Working today:

                                          The current standard of care is to replace that protein by collecting it from healthy people (plasma donors) and infusing it (intravenously) weekly into people with this disease.

                                          Did you get that treatment before the transplant?

                                          Do you get it now?

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