Tuesday, November 27, 2012

Jones’ Biz Agenda

In a series of interviews, Speaker Tim Jones has been sketching the scope of where he wants the House to go legislatively.


The center ring of next session looks to be making the state “more business-friendly,” and Jones continues to talk about the changes in Kansas’ tax rates.  However there’s a lot of reluctance among legislators to simply imitate Kansas.  The zeroing out of taxes for LLCs seems both extreme and uneven in favoring on corporate structure over another for no discernible rationale.


It does appear that the House will revisit several issues which will draw the ire of trial attorneys.


Those would include issues of occupational disease, the Missouri Human Rights Act, and a return to caps on medical malpractice.


Additionally there’s the bankrupt Second Injury Fund where the trial attorneys and the Missouri Chamber have sought common ground.  Jones wrote in a recent News-Leader op/ed that the House would address it, but “we will not do is support a massive tax increase on employers to put additional dollars into what is a tragically flawed model.”



Not To Beat A Dead Horse But

We ALL said this months ago, yet here we are.  Some of these issues will face the possibility of a gubernatorial veto.  The governor’s veto is much weaker after House Dems lost four seats earlier this month.  Those loses came as the governor horded his cash and won by double digits – just as he did four years.


Still, because there will be a few Republicans who are either pro-attorney or pro-labor enough to defect, Republicans will have to be considerate in crafting bills which will keep them on-board for a possible veto override next summer.



New York Times and St. Louis

Yesterday the New York Times ran an article about a marketing effort underway in St. Louis: Rally St. Louis.  See it here.


That article was passed around the twitterverse, but the more important article is this one because it involves money, folks!


Here’s the meat: “Medicare last month began levying financial penalties against 2,217 hospitals it says have had too many readmissions. Of those hospitals, 307 will receive the maximum punishment, a 1 percent reduction in Medicare’s regular payments for every patient over the next year, federal records show.


“One of those is Barnes-Jewish Hospital in St. Louis, which will lose $2 million this year. Dr. John Lynch, the chief medical officer, said Barnes-Jewish could absorb that loss this year, but ‘over time, if the penalties accumulate, it will probably take resources away from other key patient programs.’


“The crackdown on readmissions is at the vanguard of the Affordable Care Act’s effort to eliminate unnecessary care and curb Medicare’s growing spending, which reached $556 billion this year… The readmission penalties will recoup about $300 million this year…. The maximum penalty is set to double next October and then reach 3 percent of reimbursements in October 2015. Medicare also is expanding the list of conditions it will assess in setting punishments.”


BJC presents their point of view later in the article.  The short rebut is that as a top tier hospital in a geographic area with an above average poverty, they face two difficult and dissimilar challenges.  They get the hardest medical cases, and they have a population with economic obstacles to receiving follow-up treatment.


Pull Quote:  “At Barnes-Jewish Hospital, Dr. Lynch said physicians from all over the Midwest referred their sickest heart patients to his facility for transplants and other major interventions. But those patients can skew his hospital’s readmissions numbers, he said: ‘The weaker your heart, the more advanced your emphysema, the more likely you are to be readmitted to the hospital.’


“Dr. Lynch said Barnes-Jewish set up follow-up appointments for patients who didn’t have their own doctors. But about half of the patients never showed up, he said, even after the hospital made reminder phone calls and arranged for free rides. Sending nurses to see patients at home did not significantly reduce readmission rates either, he said…


“Various studies, including one commissioned by Medicare, have found that the hospitals with the most poor and African-American patients tended to have higher readmission rates than hospitals with more affluent and Caucasian patients. But the studies also determined that some safety-net hospitals performed better than average, showing that hospitals can overcome the challenges posed by the kinds of patients they treat.”

Brian Nieves is Fired Up

It looks like a self-help version of Amway that has Sen. Brian Nieves so excited.


From his Facebook:  “I'm fired up! Julie & I just finished up another Double Power Player, we'll be Visiting Our Awesome Leadership Team in Farmington tonight, Hosting a Leadership Group Tuesday Night, Helping a Friend finish up his First Power Player Group in Joplin on Wednesday, Claude Hamilton will be in WashMo. on Thursday Night to do a BIG Leadership Meeting, Friday we'll sort out the particulars of Rick & Milly going DOUBLE Power Player… the next week leads directly in to the BIG Seminar in STL with Raymond Abernathy and Orrin Woodward on Saturday, Dec. 8th where Team Kaizen will have Many MANY New Leaders crossing stage for various different significant accomplishments in the Leadership World! God has Blessed me with Meaningful Work and has Blessed the efforts of Our Team as we work our craft and help turn this ship called America around! Not everyone is called to do what Team Kaizen is doing but for those of us who have jumped in... We're Loving it!! TOGETHER, as a TEAM, we are Launching a Leadership Revolution!! TOGETHER, as a TEAM, we are Having FUN, Making MONEY, and Making a DIFFERENCE! Many of you have expressed interest in joining in some capacity and I apologize for not following through with you as well as I should but please understand that this movement, if you will, has EXPLODED faster than I thought it would! People are hungry for the training and even hungrier for the Association through Teams we are coordinating! This is BIG and it's getting Bigger, our work is significant and meaningful and we want YOU with us as we Bull Doze Forward toward a Million People!! If you live anywhere remotely close to WashMo. - Joplin - Farmington - STL or the surrounding areas, we can probably get you hooked up with a TEAM! Mark your calendars for THIS Thursday at 8pm in WashMo and then Saturday, Dec. 8th in STL at 5pm and even if you have to drive a Long Long way... Get there for one or Both of these get togethers as it may very well change your life!”



Post-Dispatch Endorses Bonding Program

Yesterday the Post-Dispatch weighed in the on the bonding proposal, citing Republican governor Kit Bond as an inspiration and endorsing a package in the $1.4 billion realm. Read it here.


Question we all know the answer to: does the PD’s stamp of approval help or hurt with the Republican Caucuses?



Health Exchanges

Although the issue appears dead, Rep. Jay Barnes continues to shift through the arguments to advance his assertion that the state would be better off creating its own exchange instead of ceding it to the federal government.  In this installment, he outlines the reasoning which could lead the Obama administration to adopt rules to limit the competitiveness of Missouri’s exchange, a prospect he thinks would be morally wrong even if it brings lower costs.  Read it here.



Ed Kemp Dies

Ed Kemp, a long-time Jefferson County official including a stint as commissioner, who ran unsuccessfully for House 110 in 2010, died.  See Post-Dispatch obit here.



Lobbyist Registrations

From the Pelopidas website:


Zachary Brunnert, Franc Flotron, Kent Gaines, Janet Hirschman, David McCracken, Richard McIntosh, and Larry Rohrbach added Strack Excavating LLC.

Melissa Palmer deleted State of Missouri, Department of Insurance.



$5K+ Contributions

Stand Up Missouri - $15,200 from World Acceptance Corporation.

Citizens to Elect John Wright - $15,000 from John Wright.

House Republican Campaign Committee Inc - $5,005 from Citizens for Timothy Jones.




Happy birthday to Ron Casey (60).



MOScout News

Anyone remember when Sen. Claire McCaskill tweeted that she was tired of feeling fat?  She went public with her attempt to change.


Well, I’m going to do the same this morning.  I’m tired of fighting – and often losing to – a 9am deadline.  I’m going to put the Update out at 7:30am from now on.  And I will proof-read it at least once before sending.  Call it an early New Year’s Resolution.