Monday, June 30, 2008
An entire city wants out
California is changing into Socialist Mexifornia.
Tax money goes into Social (READ--WELFARE) programs. It DOES NOT go to build roadways, buildings, or new water systems.
The main reason California hospitals are in trouble and going bankrupt is the combined influence of:
A. U S Federal Government Mandate...
The Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act. It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. As a result of the act, patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment.
EMTALA applies to "participating hospitals", i.e., those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Services, and military VA hospitals. The combined payments of Medicare and Medicaid, $602 billion in 2004, or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, and not just to Medicare patients.
The cost of emergency care required by EMTALA is not directly covered by the federal government. Because of this, the law has been criticized by some as an unfunded mandate. Similarly, it has attracted controversy for its impacts on hospitals, and in particular, for its possible contributions to an emergency medical system that is "overburdened, underfunded and highly fragmented". More than half of all emergency room care in the U.S. now goes uncompensated. Hospitals write off such care as charity or bad debt for tax purposes. Increasing financial pressures on hospitals in the period since EMTALA's passage have caused consolidations and closures, so the number of emergency rooms is decreasing despite increasing demand for emergency care. There is also debate about the extent to which EMTALA has led to cost-shifting and higher rates for insured or paying hospital patients, thereby contributing to the high overall rate of medical inflation in the U.S.
And B:who is the group least likely to have Medical Insurance?
ILLEGAL ALIENS. From my own personal experience, Illegal Aliens are a protected group in California. You hard working, tax-paying wage earners are forced into supporting them.
Needles tired of being stuck to California
NEEDLES, Calif. — People in Needles, a parched railroad town clinging to the eastern edge of California, call it the poor stepchild, the redheaded stepchild, the ugly stepchild of San Bernardino County.
They grouse about not getting roads paved, about being 220 miles from the county seat, about being a dumping ground for parolees and sex offenders, all while gazing enviously across the Colorado River at boomtowns in Arizona and Nevada.
"The building codes are stricter here, the taxes are higher," said Patricia Scott, a nurse. "I cross into Arizona, and it's growing by leaps and bounds. We are the only community in the tri-state area that hasn't grown, and it's probably because we are in California."
Kohl's, Target and Sam's Club stand like beacons on the not-so-distant shore. Gas is almost $1 a gallon cheaper across the river. Casinos beckon. Cities mushroom. And meanwhile, Needles slowly fades away.
Resentment has been mounting for years, but the county's decision to reduce the Colorado River Medical Center, the town's once-proud hospital, to a small urgent-care facility triggered open rebellion. Needles is considering leaving California to join Nevada or Arizona or to create its own independent county.
"This is not a publicity stunt. We are serious about secession," former Mayor and Councilman Roy Mills said. "Look at Nevada, they are booming. Look at Arizona, they are booming. ... I was initially skeptical about splitting off, but the more I learn about it, the more doable it seems."
In many ways, Needles people already have left; they just haven't moved. They often dine, shop and work across the river. School sports teams compete against teams in Nevada and Arizona, not California. For fun, residents usually head to Las Vegas, Lake Havasu or Laughlin, not west to Barstow.
"I think leaving California may be our last chance," City Councilman Richard Pletcher said. "Are we supposed to just dwindle down to a puff of smoke?"
A city commission is investigating the options. Not that leaving would be easy. Under the U.S. Constitution, Congress would have to approve.
"It will be tremendously challenging, but people don't feel their voices are being heard," City Manager William Way said. "At one time, Needles was the place to be."
Founded in 1893 with the arrival of the railroad and named after the pointy mountains south of town, Needles calls itself "The Best Kept Secret on the Colorado River." But the sun-blasted city is struggling.
A few businesses dot old Route 66 as it meanders through the dusty downtown past decades-old burger joints, weathered homes and the gritty railroad depot. Shade is scarce, and the temperature can hit 125 degrees.
Yet the tightly knit community rallies when threatened.
In 1965, it prevented the rerouting of Interstate 40, a move officials believe saved Needles from winding up a ghost town. In the late 1990s, it helped defeat attempts to put a nuclear-waste dump nearby.
The 25-bed hospital is the latest battleground. It has treated patients for 56 years and remains one of the few services residents don't need to cross a bridge to use.
Needles took over the hospital. To cut costs, employees are working without benefits or overtime. Yard sales are being held to raise money.
"The county of San Bernardino has never liked us," said Pam Andrade, a respiratory therapist. "They led us to believe they would turn this place around. They are like a lying spouse in a relationship that keeps lying and lying, and eventually you can't believe anything they say."
Brad Mitzelfelt, a San Bernardino County supervisor who represents Needles, disputes that. The town is home to 11 county offices and benefits from numerous county services, including a library, an airport, a regional park and law enforcement, he said.
"Needles may be better served in another state, but that's because California has a disadvantageous business climate that hurts them when they try to compete against Nevada or Arizona," he said.
Tom Bright owned two NAPA auto-parts stores: one in Bullhead City, Ariz., one in Needles. He said he paid 10 times more in workers' compensation in California than in Arizona. A gas can at his Needles shop cost $19.99. In Arizona, it was $5.99. He sold chemicals and paint in Arizona that he couldn't sell in California because of environmental rules.
"The labor laws, the overtime laws, the environmental laws are all stricter in California," he said.
But quitting the state is an uphill battle for Needles.
With the exception of West Virginia leaving Virginia during the Civil War, U.S. secession movements generally fail.
Mayor Jeff Williams thinks secession is a bad idea.
"The county has bent over backward to help us," he said. "I think this is saber-rattling."
Talk of secession is often met with a raised eyebrow or wry grin. Yet it taps into a sense of alienation.
"I think it's extremely ridiculous in this day and age that the county supervisors can't come out and see what we need," said Sandi DeLeon, part owner of a shop downtown. "They think this is Egypt out here. They may get lost and wander around the desert for 40 years."
Barely a mile from downtown, along the river, Needles feels very different. It's as much as 10 degrees cooler. The homes are well-tended, the views stunning. This is the "coastline" some believe is Needles' best selling point to a new state.
Jack Murray, 82, likes to sit in his front room and watch the ducks float by. And he loves Needles — Needles, Calif.
"It's so calming and peaceful here," the retired locomotive engineer said. "I think having a hospital is vital, but I don't think leaving California is a real good idea. I think it's utter nonsense in all reality."