#physician billing solutions

[unifyhealthcareservices]

Outsourcing Physician Medical Billing in Healthcare 

Outsourcing physician medical billing in healthcare offers a strategic advantage for practices looking to improve efficiency and maximize revenue. By entrusting billing processes to experienced professionals, physicians can focus more on patient care rather than the complexities of billing and coding.

Read Full Blog: https://gossips.blog/outsourcing-physician-medical-billing-in-healthcare/

[ensurembs]

Qualifications for Patient Eligibility with Medicaid

Medicaid is a joint venture of state and federal programs whose aim is to facilitate low-income families and individuals with healthcare coverage. The patient eligibility criteria to qualify for this program is that one must be a state resident in which they receive this insurance program. The patient must be either United States resident or lawful permanent resident (non-citizen). Furthermore, some eligibility groups are limited by pregnancy, age, disability, or parenting status. In some states, Medicaid programs have expanded to cover older adults below a certain income level. Patient eligibility criteria for this program vary from state to state due to particular states’ Medicaid programs. However, specific qualification criteria for the Medicaid program are mandatory for all states to follow. The article will discuss the fundamental requirements for the eligibility of patients. Read More…

For further details and daily updates, Follow us on LinkedIn or Visit.

[newtechitrcm]

Physician Billing Company - Efficient Billing, Maximized Revenue

Newtech IT and RCM Solutions offers expert physician billing services across the USA, focusing on accurate coding, timely claims submission, and optimized revenue cycles. Our tailored solutions streamline billing processes, reduce errors, and accelerate reimbursements, allowing healthcare providers to enhance financial performance and concentrate on patient care.

[pmedicalbilling]

The Ultimate Guide to Physician Medical Billing Services

Introduction to Physician Medical Billing Services

Physician medical billing offerings are critical components of healthcare manage. They make sure that healthcare corporations get hold of well timed bills for the services rendered, minimizing monetary disruptions and permitting physicians to awareness on affected character care. In this guide, we will walk you through everything you want to understand approximately scientific doctor medical billing services, from their importance to a way to choose the right service in your exercising.

Understanding the Importance of Accurate Billing in Healthcare

Accurate clinical billing is critical for numerous reasons:

Financial Stability: Ensures that healthcare vendors receive a commission directly and as it should be.

Compliance: Reduces the risk of audits and consequences through manner of adhering to regulatory necessities.

Patient Trust: Enhances transparency and be given as authentic with amongst healthcare companies and patients via making sure correct billing.

Step-by way of way of-Step Guide on How to Choose the Right Medical Billing Service

Step 1: Assess Your Needs

Before you begin searching out a billing provider, examine your workout's specific needs. Consider factors which incorporate the amount of claims, specialties, and present billing issues.

Step 2: Research and Shortlist

Look for valid medical billing services with experience for your robust factor. Ask for referrals from colleagues and take a look at on line evaluations.

Step 3: Evaluate Features and Services

Ensure the billing service offers:

Claims scrubbing and submission

Denial control

Compliance with HIPAA and extraordinary hints

Robust reporting and analytics

Step 4: Check Technology and Integration

The billing company has to use updated software program that integrates seamlessly in conjunction with your Electronic Health Records (EHR) machine.

Step 5: Consider Cost

Compare pricing models—percentage-based totally definitely or flat charge—and ensure they align together along with your budget.

Step 6: Request Demos and References

Request a demo to understand the platform's usability and ask for references to gauge the issuer's reliability.

Best Practices for Efficient Communication and Collaboration with Your Billing Service

Regular Meetings: Schedule regular check-ins to speak approximately performance and cope with any troubles.

Clear Expectations: Set easy expectations regarding duties, timelines, and performance metrics.

Open Channels: Maintain open strains of communication via cell phone, electronic mail, and committed structures.

Feedback Loop: Provide optimistic comments and be open to suggestions from the billing provider.

Common Mistakes to Avoid in Medical Billing

Incorrect Patient Information: Ensure all affected person records is correct and up to date.

Coding Errors: Use accurate analysis and manner codes to avoid claim denials.

Missing Documentation: Attach all critical documentation to assist the claims.

Not following Up on Denials: Regularly monitor and take a look at up on denied claims to reduce sales loss.

The Future of Medical Billing Services: Trends and Technologies

AI and Automation: Automation equipment and AI can streamline billing strategies, lessen errors, and improve efficiency.

Telemedicine Integration: With the upward push of telemedicine, billing services are adapting to include digital visit claims.

Blockchain for Security: Blockchain era is being explored to enhance information protection and transparency in billing.

Patient-Centric Billing: Future billing services will cognizance greater on enhancing affected man or woman revel in and statistics of medical payments.

Conclusion

Choosing the right health practitioner scientific billing service can considerably effect your workout's performance and economic fitness. By following the steps outlined in this manual and fending off common errors, you could make sure smoother operations and higher patient care. We're eager to pay attention your thoughts and hints on how we can decorate our services similarly. Share your remarks with us and assist us growth the same old of scientific billing.

---

Thank you for analyzing! If you discovered this guide useful, please percentage it with your network. For personalized assist and extra facts on our offerings, contact us nowadays.

[ziaccu]

Effective Ways of Improving the Patient Collection 

Healthcare is the vastest field, and it requires professionals to take care of all the aspects, let it be patient registration, patient data collection, insurance, or payment collection from the patients.  For healthcare organizations to be financially stable and continue offering patients high-quality care, effective patient collection is essential. However, managing the intricacies of medical billing and being paid by patients can be difficult. Healthcare providers must put measures in place to enhance patient collection operations at a time when medical expenditures are on the rise and patients are bearing a greater financial burden. Healthcare organizations can improve patient experiences and improve patient collection efforts by implementing several strategies such as transparent billing methods, clear communication, and flexible payment choices using medical billing software. This blog outlines practical tactics to maximize revenue collection and simplify the billing process for both patients and providers. It also discusses many effective ways to improve patient collection. 

Maintaining a healthcare organization's financial stability requires improving patient collection, which is the process of getting paid by patients for the services they receive. The following are some practical methods for enhancing patient collection: 

Clear communication: 

Improving patient-gathering procedures in healthcare organizations requires effective communication. The intricacies of medical billing, insurance coverage, and out-of-pocket costs frequently leave patients perplexed. Therefore, before, during, and after receiving medical services, healthcare practitioners must communicate with patients clearly and understandably regarding their financial responsibilities. Providers may empower patients to make educated decisions about their healthcare expenditures by giving them upfront cost estimates, outlining insurance coverage and deductibles, and simplifying billing statements. Furthermore, open communication lessens miscommunications and billing conflicts by fostering confidence between patients and doctors. Patients are more likely to pay when they understand their financial responsibilities in full and feel comfortable navigating the invoicing process. 

Transparent billing: 

Improving patient collection procedures in healthcare organizations requires transparent billing policies. Patients are better able to grasp their financial obligations and make on-time payments when they receive billing statements that are easy to read and comprehend. Billing that is transparent includes giving patients thorough descriptions of the services they received, the associated charges, any adjustments for their insurance, and any out-of-pocket expenditures that may arise. Healthcare providers may empower patients to confidently manage their bills by demystifying prices and using simple language free of medical jargon. Transparent billing also fosters positive relationships and lowers the risk of billing disputes by increasing confidence and credibility between patients and providers. Patients are more likely to pay their bills on time if they are made to feel educated and valued throughout the billing process. Therefore, giving billing transparency a top priority.

Provide pre-service estimates: 

All patients have a different financial background, some may be financially strong belonging to the elite class others may not have a strong financial position. So, Patients may plan and budget appropriately with the help of these estimates, pre-service estimates provide them with important information about the possible expenses of their medical treatments. Healthcare providers give patients the financial tools they need to make educated decisions by providing precise and transparent estimates of all out-of-pocket costs, including deductibles, copayments, and uncovered treatments. Pre-service estimates also reduce the possibility of surprise bills, which may cause a customer's displeasure and cause them to postpone payment. Patients who are informed upfront about the expected charges are more likely to participate actively in the billing process and pay their bills on schedule. In addition, offering pre-service estimates shows patients that healthcare practitioners are accountable and transparent, which builds patient confidence. Offering pre-service estimates can ultimately help healthcare organizations increase patient satisfaction. 

Payment options: 

Healthcare providers can support patients' different financial needs and preferences by offering flexible payment methods, including credit card payments, online portals, payment plans, and automatic deductions. By allowing patients to select the payment option that best fits their needs, this strategy increases the possibility that payments will be made on time and lowers the number of delinquent cases. Additionally, providing a variety of payment choices shows a dedication to patient-centered care and accessibility, which boosts client loyalty and happiness. Convenient payment choices also minimize administrative constraints and boost overall efficiency by streamlining the collection process for both patients and providers. In the end, healthcare organizations may maximize their efforts to collect payments, preserve financial stability, and provide an improved patient experience by giving priority to a range of payment choices. 

Effective use of Technology: 

By boosting transparency, improving ease, and streamlining processes, technology may greatly improve the patient-gathering process inside healthcare organizations. The use of mobile applications and online payment gateways is one method technology supports collecting efforts. These platforms lower payment obstacles and increase the possibility of timely payment by enabling patients to safely make payments at any time, from any location. 

Furthermore, billing software with features like payment tracking and automatic reminders can assist healthcare providers in better managing outstanding accounts. Automated text messages or email reminders can be used to remind patients to pay their bills, and payment monitoring features let providers keep an eye on payment statuses and effectively follow up on past-due accounts. 

Educating patients for timely payments: 

Patients who prioritize healthcare costs are more likely to understand the value of paying bills on time, which reduces the likelihood of past-due balances and lessens the financial burden on both patients and healthcare providers. Educating patients about the consequences of non-payment—such as potential late fees, damage to their credit, and challenges in obtaining medical attention—also encourages fiscal responsibility and accountability. Healthcare organizations have the potential to promote positive financial behaviors among patients, strengthen revenue streams, and ultimately improve the overall sustainability of the healthcare system by implementing educational initiatives that highlight the need for timely payment. 

Patient follow-ups: 

It's critical to establish efficient follow-up protocols for patient payments if healthcare organizations are to remain financially stable. These processes entail informing patients in a methodical and prompt manner of any unpaid amounts, serving as a reminder of their financial responsibilities, and offering support as required to enable payment. Frequent follow-up shows patients how much value is put on their contributions to the healthcare system and also raises the possibility that payments will be made on time. Through the implementation of follow-up measures, healthcare organizations can mitigate the risk of unpaid balances building up over time by swiftly addressing any billing difficulties or concerns. Furthermore, regular follow-up promotes confidence and openness in the billing process by keeping lines of communication open with patients. Patients are more likely to participate if they receive prompt reminders and help with payment. 

In conclusion, the financial sustainability and stability of healthcare organizations depend critically on the adoption of efficient patient collection strategies. Healthcare providers can improve patient satisfaction and expedite the collection process by emphasizing clear communication, open billing procedures, pre-service estimations, and a range of payment choices. Moreover, healthcare organizations can maximize revenue collection while upholding strong patient-provider relationships by utilizing technology and putting follow-up procedures for patient payments into place. Effective patient collection techniques also must include informing patients of the significance of making payments on time and offering assistance during the invoicing process. In the end, healthcare organizations may enhance their financial performance, reduce outstanding debt, and guarantee that patients will always have access to high-quality care by implementing these strategies. If you are also tired of patient collections and looking for a revolutionary change then Zi Accu, a proficient team of medical billing specialists can help to levy off your burden and help to improve the payment collection procedure. 

[dreamhealthplanet]

Choosing the Right Medical Billing Company: Key Considerations for Healthcare Providers

[unifyhealthcare]

In terms of Durable Medical Equipment (DME) billing, healthcare facilities often struggle with complicated processes, strict regulations, and fluctuating reimbursement rates. With DME billing services from Unify RCM, healthcare providers can stay on top of their billings. Healthcare regulations, growing administrative burdens, and mounting financial pressures keep them evolving.

[forsoobado137]

Nations and Medical Treatment

I feel like nations in Hetalia don't have good histories with hospitals. Due to their mysterious functions and inhuman nature, it's difficult to find solutions to their complex medical issues. I have a list of headcanons on how nations are treated medically. tw for medical malpractice.

In the modern day, nations are usually assigned an extensively trained physician. Multiple nations often see the same doctor.

Certain hospitals that are frequented by nations are often equipped with trained staff. Training videos are provided to every hospital.

Anaesthesia was historically administered rather poorly to nation people. They were either given too little, none at all, or way too much based on biases on how nations tolerate pain. The latest publicized incident occurred in 2014, when America underwent an appendectomy without any anaesthesia. This event and the following lawsuit resulted in a bill being passed making it illegal to deny anaesthetic to nations.

Nations often have physical medical conditions confused for symptoms of being a nation, and vice versa. As a result, a nation’s concerns may be blown off as untreatable, while others are overmedicated for something that is caused by domestic events.

Female nations are less likely to receive proper treatment than male nations. The reasons behind this are due to the lack of studying on female nations as well as misogyny.

It’s a common occurrence for nation medicine to not be government approved or tested properly. Very rarely are nation medications actually tested on nations. They are usually run through human trials and then magnified to meet perceived “nation levels”. The largest ever recall for nation medicine was in 2010, when a popular anti-depressant was causing paradoxical side effects.

It’s a common occurrence for hospitals to turn away nations due to the perceived difficulty of treating one.

Many medical textbooks used for training doctors often perpetuate misinformation about proper treatments and dosages, such as the myth that nations have extremely high pain tolerances compared to humans.

Some doctors have expressed contempt for nations requiring medical assistance, believing it to be a “waste of time” due to overestimating their regeneration abilities. Another common belief is that nations are “seeking attention” so they can mimic human experiences.

Due to negative experiences with doctors, many nations have developed hospital-related anxieties and phobias. They often refuse to seek medical attention until it’s life-threatening.

Psychological issues are rarely treated properly. It's common for bosses and government officials to hold off on what they think is unnecessary treatment. Though not all nation psychiatrists are bad, many are only really interested in the paycheck.

[malamira]

QUIET LOVE, OH HOW IT SCREAMS

synopsis: "i'd never let anything happen to you, if i could help it."

a/n: GOD, i love doctor!au inukag. i did a lot of editing and revising for this, so it's a different beast from what it was when smutmas version came out. i'm not 100% happy with the ending, but i mean. if i did any more i had a feeling i would just ruin it instead of help it.

— 💓 —

“You’re going to love me,” Sango sing-songed, sliding into the seat next to Kagome’s.

Kagome grunted, massaging her temple. The bar wasn't too crowded, thankfully, but the noise level was high enough that she had to speak up to be heard. “Why? Did you kill the hospital director yet?”

“No,” Sango said primly; Onigumo Industries owned the hospital Kagome was a surgeon at, and Sango's father was vice president of one of the subsidiaries. “But,” she said, grasping her friend’s arm, “I kind of have a solution to your extended shift problem.”

“You mean the hospital is hiring another surgeon?” Kagome mumbled grumpily, knocking back her watered down whisky. The moisture that collected outside the glass splattered unto the bar when she slammed it down. 

“No! A guy!”

Kagome stared at her best friend, first blankly, then sourly. “Sango, I love you and I know you only have my best interests at heart, but seriously? I barely have time to bathe Buyo. I don’t have time for a guy.”

“No, I mean like to fuck!” her friend said encouragingly. “It’s been rough the past few weeks. Maybe a good orgasm will fix you right up!"

Kagome's cheeks colored. "I don't—"

Sango wasn't having any of it. "Aw, come on! It's just some harmless fun. He’s right over there, by the booth—”

“Now?” Kagome said incredulously. “I’m in my scrubs. I have a stain on my shirt!”

“So? Is it a shit stain?” 

“I’m not even going to correct you on how many hospital protocols I would’ve broken if it were a shit stain.”

“Lighten up, Kagome!” Sango insisted, jumping up from her chair and tugging at her friend's arm. “It’s Friday and you deserve to get laid. Come on.”

“It is a testament to our ten-year friendship that I am choosing to trust you,” Kagome said flatly, throwing a few bills on the counter to cover her drink. She called over the bartender before letting Sango pull her away.

“Hello, gentlemen,” Sango said brightly, then brandished her friend from behind her. “As promised, my lady doctor friend.”

“Hi,” the guy at the edge of the booth said, dark hair and bright, blue eyes. He was cute, Kagome could admit, if a little too... pedestrian, for her tastes. He extended a hand to shake. “I’m Kōga.”

“Kagome,” she introduced herself, taking his hand for a brief shake. He scooted over and motioned for her to sit next to him. 

Sango had already settled into the side of a guy who had a short ponytail and earrings. “I’m Miroku,” that guy said. 

She only just managed to land her butt on the leather seat of the booth, she felt a familiar vibration pattern in her pocket. Her emergency pattern.

Before Kōga—or Sango, for that matter—could utter a word, she’d straightened and fished out her phone. “Hospital. Gotta go.” 

Without so much as a look back, she bolted.

—

“I’m here,” Kagome panted, running into the ER. "I'm here!"

“Doc!” Jinenji, one of the nurses on shift, called out, timidly holding a clipboard to his chest as he approached from the nurses' station. “I know you just got out—”

“It’s fine.” She waved away his concern. “What do you need?”

“We did a test for Nazuna, the one who had the appendectomy earlier today, and the results required a change in dosage,” he informed her, then turned sheepish when he continued, “I’m really sorry; her mother was getting… irate, and I couldn't get another physician—”

Kagome shook her head and let out a breath. “It’s okay, Jinenji; it's not your fault. Good thing I was nearby.” A bar two blocks away wasn't necessarily nearby, but Jinenji didn’t have to know that. She took the clipboard. "Nazuna... the one with anemia, right? Can we check if she needs a transfusion? Her RBC's looking pretty low..."

“Dr. Higurashi!” another nurse cried as soon as Jinenji took off with her advice. “Thank God you're here; I need you!”

Kagome sighed and got to work.

—

A few hours later, she yawned as she pushed back against the desk in the middle of the doctor's lounge, her chair screeching against the floor. "Oh my God," she groaned, exhausted.

“I hear Higurashi,” a gruff voice called a few hours later, and a light-haired head popped into the admin room doorway. Gold eyes peered at her with interest. “Hey. Isn’t your shift over? Why are you still here?”

Kagome stretched in her chair and rubbed her eye with the back of her hand. She smiled tiredly at Inuyasha, who regarded her with curious eyes. “Had to do something. You haven’t left yet?”

He strode into the room, hands in his pockets. He’d forgone his lab coat and scrubs, changing into jeans and a button-up shirt. “About to, yeah. Where'd you come from? Your house?”

She shook her head. “No, I was at the bar two blocks down. You know Shikon?”

Inuyasha smirked and jerked his head. “Come on. I’ll drive you back. Unless you wanna walk…?”

“Nah, you’re good,” she said, collecting her things and leaving the room. She fell into step next to him. “And excuse you, I had one drink.”

He opened the door to the stairwell and let her pass; the elevator to the parking was under repair. “Shikon’s for kids anyway. Why not head to, I don’t know, Totosai’s, or something?”

“I didn’t pick the place,” Kagome mumbled. Her phone vibrated in her pocket and she fumbled for it, shoes echoing as they made their way down the cement steps.

“Oh? Were you out with friends, then?”

"Yeah." Kagome groaned, pausing in the middle of the stairwell, "And she’s fucking pissed at me.”

Inuyasha raised an eyebrow, curious. He hopped back up a few steps to get back to her level and peered at her phone, eyes widening at the slew of texts she'd apparently ignored.

Sango 23:44 Is everything ok?

Sango 00:22 Kagome we’re still at the bar in case u wanna come back, I’m telling Koga ur coming back

Sango 00:28 Can u reply so i can give an update

Sango 01:18 Kagome PLS!! Trying to call u, pls answer

Sango 01:31 Koga left. He’s kinda pissed and I’m super embarrassed

Sango 01:56 Leaving too, it’s been 2 hours

Sango 02:03 Call me in the morning when I’m more important than your job

He whistled lowly. “She’s really mad, huh?”

“No, really? What gave that away?” Kagome said blankly, furiously typing back. Sorry, stuff at the hospital got hectic. Will make it up to you tomorrow. She sent the message and pocketed her phone, pressing a hand to her forehead. She took a deep breath before turning to climb back up the stairs.

“What’s up?”

“You go on ahead,” she said.

“What?" She could hear Inuyasha climb up after her. "Why?”

“I’m heading home,” she said, looking back at him. She lived on the other side of town, opposite the direction of Shikon.

Inuyasha put his hands in his pockets and looked at her like she was crazy. “Are you crazy? It’s two in the morning, Higurashi. I’ll drive you home."

She gaped. “Are you crazy? I live an hour away!”

“Traffic won’t be too bad,” he said with a shrug, not looking at her. “I don’t mind. Seriously.”

“But—”

He sighed and climbed further up the stairs until they were a step apart, his eyes meeting hers with barely a tilt of his head. “Kagome, seriously. You work too hard and give too much."

She rolled her eyes, "I'm fine—"

"Oh, come on," Inuyasha said, clearly exasperated. "Don’t think I hadn’t heard of you being wheeled out of the operating room after that cystectomy last week.”

She flushed at that. “I—How’d you know about that?”

“Jinenji’s very easy to manipulate.” 

She gaped and lightly smacked his arm. “That’s mean! You know he’s scared of you.”

“He’s scared of a lot of things,” Inuyasha shot back. “And I would’ve known anyway.”

“How?”

“Kagome,” he said, one of his hands slipping out of his pocket to gently grasp her wrist. He raised it so it hovered in between their faces. “You’re shaking.”

Her hand twitched before her eyes, and she bit her lip. “I'm fine, I'm just tired—"

"Tired? But you're consistently taking 24-hour shifts?" He lowered her hand, but didn't let go of her wrist. "Come on, Kagome. Admit it; you're overworking yourself."

She sniffed. "I didn’t know you watched me so closely.” It was meant to corner him, but it came out feeble and shy.

He sighed and lowered their clasped hands. “Seriously, Kagome,” he mumbled as he, to her surprise, rubbed his thumb over the back of her hand. “You need to take care of yourself more.”

She looked down at his hand, watching as his thumb dragged tenderly over her skin.

Her relationship with Inuyasha was both surprisingly simple and terrifyingly complicated. They had met in medical school, when she was a sophomore and he was in his last year. They'd gone to different schools—rival schools—but they had a mutual friend who introduced them, thinking they’d be perfect for each other.

It couldn’t have gone more wrong.

She looked too much like his ex, he said, while she claimed that he was too big of an asshole. While they were both planning to eventually become surgeons, it seemed like the similarities stopped there. Whenever they managed to come across each other it was like they wanted to bite each other’s head off for the smallest of things—like breathing too loud, or walking too slow—until they discovered that they’d work together in the same hospital, in the same operating team.

They'd learned to deal with each other. At least until the day Kagome’s brother had been wheeled in into the ER.

Sōta had been shot.

Kagome had nearly lost her mind with worry, snapping at anyone who denied her access to her brother, until Inuyasha had to practically manhandle her to sit down on the couch in the physician’s lounge. He had talked her down, told her that he was handling the operation, he'd be the one to take care of her brother, but she needed to calm the fuck down, okay? 

She'd grabbed his hand and made him promise to do everything—everything—he could.

He'd kissed her forehead, unbidden, and left the room. The shock of it was like the icing on the proverbial cake, rendering her speechless. It was too much all at once, and she ended up sleeping on the lounge couch. A few hours later, Inuyasha woke Kagome up and she bolted to see her brother.

Sōta had made it, albeit looking a little worse for wear. Her mother had screamed at the police on the phone, the angriest Kagome had ever seen her. Turned out Sōta had been shot by an unknown assailant after being mugged, and the man was still on the loose. 

The police had found him eventually, Kagome had told Inuyasha when he asked, and she hadn't known anything beyond that. The other surgeon nodded, looking pensive. Kagome had realized she hadn’t thanked him yet, for all he’d done. She had suggested that she pick up his shifts in return.

He'd declined (surprisingly politely). Instead, he'd offered to pick up her shifts while she took a break. When she'd asked what for, all he said was, "To take care of your brother," and left it at that.

She'd thought he'd take one or two shifts, but he'd crossed her name out of the shift sheet for a total of three weeks, declaring that hanyōs didn't really need sleep, and therefore could take on more work. ("I'm the ideal ER doctor, if you think about it," he'd said.)

"Inuyasha," she said.

His thumb resumed its motions. "Hm?"

"Why are you being so nice to me?" she asked him.

That seemed to snap him out of whatever stupor he'd landed himself in, and he let go. She kind of missed it.

With a blush on his face, he scoffed and looked away. "I—You know, I pick up your shifts when you're out, you know? I—You shouldn't take—If you get sick, I'll have to take more shifts."

Awkward silence settled over them, and Kagome stepped down to stand closer to him. They were practically nose to nose, and Inuyasha's gold gaze met hers with an intensity that made her want to shiver.

"You're lying," she challenged boldly, and that made him scoff again, sounding completely offended this time around.

"Why would I lie?" he said with a roll of his eyes, turning away and stepping down.

Kagome was growing frustrated. She couldn't put into words what she wanted to tell him.

"You're always—" She shook her head. She was ready to yell, but she wasn't angry. Once upon a time, she would have snapped, called him a coward, and stomped past him. But gone was the pure loathing that defined the early stages of their relationship. So where did that leave them?

Where did that leave her?

He turned and looked back up at her. "Look. I can drive you home, and I—" He ran a frustrated hand through his hair. "Just get some rest, okay? You've had a long day. I can take your shift tomorrow, just... just get some rest."

The next thing she knew, she was watching his back as he climbed down the stairs, and that's when it dawned on her.

Her brother, her job, her wellbeing—why hadn't she realized sooner that—

"Inuyasha."

He paused and sighed, turning back to face her. "Kagome, just—"

Maybe it was the exhaustion, but the way he looked at her made her eyes prick with heat. She bounded towards him and wrapped her arms around his neck, burying her face in his shirt collar. "Thank you."

He was clearly taken aback, but managed to keep both of them upright. "Wh—For what—"

"For taking care of me," she mumbled. "That's what you're doing, right?"

She felt his body go rigid before relaxing. His arms slowly came around her middle. "Stupid girl," he murmured with so much affection it made her heart skip, "Only because you're doing a terrible job at it."

She sobbed. "I'm sorry for worrying you."

"It's okay."

"And I'm sorry for not noticing sooner," she sniffled. "I'm sorry for being a workaholic, and for being exhausted, and for crying."

His arms tightened just a bit. "It's okay."

"I'm sorry for being annoying about it."

His low laughter rumbled in his chest. "It's okay."

She hugged him tighter. "And I'm sorry I never thanked you for Sōta."

He lets out a breath and turn his head. "You don't have to apologize or thank me for that, Kagome," he told her gently. Pressing a soft kiss to the shell of her ear, he continued, "Your family is important to you. I'd never let anything happen to them." Then, softer yet louder at the same time, "I'd never let anything happen to you, if I could help it."

That made her gut wrench and heart swell and it made her cry harder.

He held her close as she did.

[meret118]

Anna Goldman, a primary care physician at Boston Medical Center, got tired of hearing that her patients couldn't afford the electricity needed to run breathing assistance machines, recharge wheelchairs, turn on air conditioning or keep their refrigerators plugged in. So she worked with her hospital on a solution.

The result is a pilot effort called the Clean Power Prescription program. The initiative aims to help roughly 80 patients with complex, chronic medical needs keep the lights on.

The program relies on 519 solar panels installed on the roof of one of the hospital's office buildings. Half of the energy generated by the panels helps power Boston Medical Center. The rest goes to patients who receive a monthly credit of about $50 on their utility bills.

. . .

"I had a conversation recently with someone who had a hospital bed at home," Dr. Goldman said. "They were using so much energy because of the hospital bed that they were facing a utility shut off. "Goldman wrote a letter to the utility company requesting the power stay on. Last year, she and her colleagues at Boston Medical Center wrote 1,674 letters to utility companies asking them to keep patients' gas or electricity running.

. . .

"Boston Medical Center's been focused on lower-income communities and trying to change their health outcomes for over 100 years," said Biggio. "So this just seemed like the right thing to do."Standing on the roof amid the solar panels, Goldman pointed out a large vegetable garden one floor down.

"We're actually growing food for our patients," she said. "And similarly, now we are producing electricity for our patients as a way to address all of the factors that can contribute to health outcomes."

. . .

Boston Medical Center officials estimate the project cost $1.6 million, and said 60% of the funding came from the federal Inflation Reduction Act. Biggio has already mapped out plans for an additional $11 million in solar installations at the Boston Medical Center.

-------

The Inflation Reduction Act is a Biden program that republicans voted against.

[dailyanarchistposts]

Topics: health care, monopoly

In a recent article for Tikkun, Dr. Arnold Relman argued that the versions of health care reform currently proposed by “progressives” all primarily involve financing health care and expanding coverage to the uninsured rather than addressing the way current models of service delivery make it so expensive. Editing out all the pro forma tut-tutting of “private markets,” the substance that’s left is considerable:

What are those inflationary forces? . . . [M]ost important among them are the incentives in the payment and organization of medical care that cause physicians, hospitals and other medical care facilities to focus at least as much on income and profit as on meeting the needs of patients. . . . The incentives in such a system reward and stimulate the delivery of more services. That is why medical expenditures in the U.S. are so much higher than in any other country, and are rising more rapidly. . . . Physicians, who supply the services, control most of the decisions to use medical resources. . . . The economic incentives in the medical market are attracting the great majority of physicians into specialty practice, and these incentives, combined with the continued introduction of new and more expensive technology, are a major factor in causing inflation of medical expenditures. Physicians and ambulatory care and diagnostic facilities are largely paid on a piecework basis for each item of service provided.

As a health care worker, I have personally witnessed this kind of mutual log-rolling between specialists and the never-ending addition of tests to the bill without any explanation to the patient. The patient simply lies in bed and watches an endless parade of unknown doctors poking their heads in the door for a microsecond, along with an endless series of lab techs drawing body fluids for one test after another that’s “been ordered,” with no further explanation. The post-discharge avalanche of bills includes duns from two or three dozen doctors, most of whom the patient couldn’t pick out of a police lineup. It’s the same kind of quid pro quo that takes place in academia, with professors assigning each other’s (extremely expensive and copyrighted) texts and systematically citing each other’s works in order to game their stats in the Social Sciences Citation Index. (I was also a grad assistant once.) You might also consider Dilbert creator Scott Adams’s account of what happens when you pay programmers for the number of bugs they fix.

One solution to this particular problem is to have a one-to-one relationship between the patient and a general practitioner on retainer. That’s how the old “lodge practice” worked. (See David Beito’s “Lodge Doctors and the Poor,” The Freeman, May 1994).

But that’s illegal, you know. In New York City, John Muney recently introduced an updated version of lodge practice: the AMG Medical Group, which for a monthly premium of $79 and a flat office fee of $10 per visit provides a wide range of services (limited to what its own practitioners can perform in-house). But because AMG is a fixed-rate plan and doesn’t charge more for “unplanned procedures,” the New York Department of Insurance considers it an unlicensed insurance policy. Muney may agree, unwillingly, to a settlement arranged by his lawyer in which he charges more for unplanned procedures like treatment for a sudden ear infection. So the State is forcing a modern-day lodge practitioner to charge more, thereby keeping the medical and insurance cartels happy—all in the name of “protecting the public.” How’s that for irony?

Regarding expensive machinery, I wonder how much of the cost is embedded rent on patents or regulatorily mandated overhead. I’ll bet if you removed all the legal barriers that prevent a bunch of open-source hardware hackers from reverse-engineering a homebrew version of it, you could get an MRI machine with a twentyfold reduction in cost. I know that’s the case in an area I’m more familiar with: micromanufacturing technology. For example, the RepRap—a homebrew, open-source 3-D printer—costs roughly $500 in materials to make, compared to tens of thousands for proprietary commercial versions.

More generally, the system is racked by artificial scarcity, as editor Sheldon Richman observed in an interview a few months back. For example, licensing systems limit the number of practitioners and arbitrarily impose levels of educational overhead beyond the requirements of the procedures actually being performed.

Libertarians sometimes—and rightly—use “grocery insurance” as an analogy to explain medical price inflation: If there were such a thing as grocery insurance, with low deductibles, to provide third-party payments at the checkout register, people would be buying a lot more rib-eye and porterhouse steaks and a lot less hamburger.

The problem is we’ve got a regulatory system that outlaws hamburger and compels you to buy porterhouse if you’re going to buy anything at all. It’s a multiple-tier finance system with one tier of service. Dental hygienists can’t set up independent teeth-cleaning practices in most states, and nurse-practitioners are required to operate under a physician’s “supervision” (when he’s out golfing). No matter how simple and straightforward the procedure, you can’t hire someone who’s adequately trained just to perform the service you need; you’ve got to pay amortization on a full med school education and residency.

Drug patents have the same effect, increasing the cost per pill by up to 2,000 percent. They also have a perverse effect on drug development, diverting R&D money primarily into developing “me, too” drugs that tweak the formulas of drugs whose patents are about to expire just enough to allow repatenting. Drug-company propaganda about high R&D costs, as a justification for patents to recoup capital outlays, is highly misleading. A major part of the basic research for identifying therapeutic pathways is done in small biotech startups, or at taxpayer expense in university laboratories, and then bought up by big drug companies. The main expense of the drug companies is the FDA-imposed testing regimen—and most of that is not to test the version actually marketed, but to secure patent lockdown on other possible variants of the marketed version. In other words, gaming the patent system grossly inflates R&D spending.

The prescription medicine system, along with state licensing of pharmacists and Drug Enforcement Administration licensing of pharmacies, is another severe restraint on competition. At the local natural-foods cooperative I can buy foods in bulk, at a generic commodity price; even organic flour, sugar, and other items are usually cheaper than the name-brand conventional equivalent at the supermarket. Such food cooperatives have their origins in the food-buying clubs of the 1970s, which applied the principle of bulk purchasing. The pharmaceutical licensing system obviously prohibits such bulk purchasing (unless you can get a licensed pharmacist to cooperate).

I work with a nurse from a farming background who frequently buys veterinary-grade drugs to treat her family for common illnesses without paying either Big Pharma’s markup or the price of an office visit. Veterinary supply catalogs are also quite popular in the homesteading and survivalist movements, as I understand. Two years ago I had a bad case of poison ivy and made an expensive office visit to get a prescription for prednisone. The next year the poison ivy came back; I’d been weeding the same area on the edge of my garden and had exactly the same symptoms as before. But the doctor’s office refused to give me a new prescription without my first coming in for an office visit, at full price—for my own safety, of course. So I ordered prednisone from a foreign online pharmacy and got enough of the drug for half a dozen bouts of poison ivy—all for less money than that office visit would have cost me.

Of course people who resort to these kinds of measures are putting themselves at serious risk of harassment from law enforcement. But until 1914, as Sheldon Richman pointed out (“The Right to Self-Treatment,” Freedom Daily, January 1995), “adult citizens could enter a pharmacy and buy any drug they wished, from headache powders to opium.”

The main impetus to creating the licensing systems on which artificial scarcity depends came from the medical profession early in the twentieth century. As described by Richman:

Accreditation of medical schools regulated how many doctors would graduate each year. Licensing similarly metered the number of practitioners and prohibited competitors, such as nurses and paramedics, from performing services they were perfectly capable of performing. Finally, prescription laws guaranteed that people would have to see a doctor to obtain medicines they had previously been able to get on their own.

The medical licensing cartels were also the primary force behind the move to shut down lodge practice, mentioned above.

In the case of all these forms of artificial scarcity, the government creates a “honey pot” by making some forms of practice artificially lucrative. It’s only natural, under those circumstances, that health care business models gravitate to where the money is.

Health care is a classic example of what Ivan Illich, in Tools for Conviviality, called a “radical monopoly.” State-sponsored crowding out makes other, cheaper (but often more appropriate) forms of treatment less usable, and renders cheaper (but adequate) treatments artificially scarce. Artificially centralized, high-tech, and skill-intensive ways of doing things make it harder for ordinary people to translate their skills and knowledge into use-value. The State’s regulations put an artificial floor beneath overhead cost, so that there’s a markup of several hundred percent to do anything; decent, comfortable poverty becomes impossible.

A good analogy is subsidies to freeways and urban sprawl, which make our feet less usable and raise living expenses by enforcing artificial dependence on cars. Local building codes primarily reflect the influence of building contractors, so competition from low-cost unconventional techniques (T-slot and other modular designs, vernacular materials like bales and papercrete, and so on) is artificially locked out of the market. Charles Johnson described the way governments erect barriers to people meeting their own needs and make comfortable subsistence artificially costly, in the specific case of homelessness, in “Scratching By: How the Government Creates Poverty as We Know It” (The Freeman, December 2007).

The major proposals for health care “reform” that went before Congress would do little or nothing to address the institutional sources of high cost. As Jesse Walker argued at Reason.com, a 100 percent single-payer system, far from being a “radical” solution,

would still accept the institutional premises of the present medical system. Consider the typical American health care transaction. On one side of the exchange you’ll have one of an artificially limited number of providers, many of them concentrated in those enormous, faceless institutions called hospitals. On the other side, making the purchase, is not a patient but one of those enormous, faceless institutions called insurers. The insurers, some of which are actual arms of the government and some of which merely owe their customers to the government’s tax incentives and shape their coverage to fit the government’s mandates, are expected to pay all or a share of even routine medical expenses. The result is higher costs, less competition, less transparency, and, in general, a system where the consumer gets about as much autonomy and respect as the stethoscope. Radical reform would restore power to the patient. Instead, the issue on the table is whether the behemoths we answer to will be purely public or public-private partnerships. [“Obama is No Radical,” September 30, 2009]

I’m a strong advocate of cooperative models of health care finance, like the Ithaca Health Alliance (created by the same people, including Paul Glover, who created the Ithaca Hours local currency system), or the friendly societies and mutuals of the nineteenth century described by writers like Pyotr Kropotkin and E. P. Thompson. But far more important than reforming finance is reforming the way delivery of service is organized.

Consider the libertarian alternatives that might exist. A neighborhood cooperative clinic might keep a doctor of family medicine or a nurse practitioner on retainer, along the lines of the lodge-practice system. The doctor might have his med school debt and his malpractice premiums assumed by the clinic in return for accepting a reasonable upper middle-class salary.

As an alternative to arbitrarily inflated educational mandates, on the other hand, there might be many competing tiers of professional training depending on the patient’s needs and ability to pay. There might be a free-market equivalent of the Chinese “barefoot doctors.” Such practitioners might attend school for a year and learn enough to identify and treat common infectious diseases, simple traumas, and so on. For example, the “barefoot doctor” at the neighborhood cooperative clinic might listen to your chest, do a sputum culture, and give you a round of Zithro for your pneumonia; he might stitch up a laceration or set a simple fracture. His training would include recognizing cases that were clearly beyond his competence and calling in a doctor for backup when necessary. He might provide most services at the cooperative clinic, with several clinics keeping a common M.D. on retainer for more serious cases. He would be certified by a professional association or guild of his choice, chosen from among competing guilds based on its market reputation for enforcing high standards. (That’s how competing kosher certification bodies work today, without any government-defined standards). Such voluntary licensing bodies, unlike state licensing boards, would face competition—and hence, unlike state boards, would have a strong market incentive to police their memberships in order to maintain a reputation for quality.

The clinic would use generic medicines (of course, since that’s all that would exist in a free market). Since local juries or arbitration bodies would likely take a much more common-sense view of the standards for reasonable care, there would be far less pressure for expensive CYA testing and far lower malpractice premiums.

Basic care could be financed by monthly membership dues, with additional catastrophic-care insurance (cheap and with a high deductible) available to those who wanted it. The monthly dues might be as cheap as or even cheaper than Dr. Muney’s. It would be a no-frills, bare-bones system, true enough—but to the 40 million or so people who are currently uninsured, it would be a pretty damned good deal.

[ensurembs]

Unveiling Patient Eligibility Coverage with Medicare

Medicare is a national health insurance program the US government administrated by CMS (Centers for Medicare and Medicaid Services). This program first pays for services, but Medicaid never pays first for services but after. Generally, This program provides health services to those who are 65 years and, other individuals with disabilities, and those suffering from end-stage renal disease. This program covers everything from hospital insurance to Medicare insurance and even drug coverage for patients. The program is specially designed to offer health insurance coverage to eligible patients who best fit the patient eligibility criteria. The article will unveil patient eligibility coverage. There are several factors to consider to determine patients’ eligibility. These factors are described in the following paragraphs. Read More…

For further details and daily updates, Follow us on LinkedIn or Visit.

[religion-is-a-mental-illness]

By: Christopher F. Rufo

Published: Jun 18, 2024

The “gender-affirming care” business has always had an aura of madness around it. Wielding the authority of white coats and prestigious degrees, doctors have convinced large swaths of the public that some children are “born in the wrong body.” The solution? Stop puberty, prescribe cross-sex hormones, and then, with the stroke of a knife, remove body parts—most commonly breasts, less frequently genitalia.

These medical practices use scientific rhetoric to affirm what is, at bottom, an ideological program. And gender activists have been successful enough at capturing the legitimizing institutions—medical societies, regulatory bodies, and teaching hospitals—to repel most challenges to the burgeoning child sex-change industry.

Now, though, the consensus appears to be shifting. European governments have backed away from many of these dubious procedures. In England, the Cass Review has raised grave questions about the scientific evidence behind “gender-affirming care.” In the United States, the public has turned decisively against the use of puberty blockers and gender surgeries on minors, with some state legislatures banning the practice.

I have reported on one of these programs, the pediatric gender clinic at Texas Children’s Hospital. Last year, I published an investigation demonstrating that, though it had promised to shut down its program, Texas Children’s had continued to administer hormone drugs to children as young as 11. Following the story, the state attorney general launched an investigation, and state legislators passed a bill, SB 14, prohibiting all transgender medical interventions on minors.

While these scandals caught the headlines, another story involving the same institution was brewing in the background: medical fraud.

According to a new whistleblower, doctors at Texas Children’s Hospital were willing to falsify medical records and break the law to keep practicing “gender-affirming care.” Caught in the wave of ideological fervor, two of the hospital’s prominent physicians, Richard Ogden Roberts and David Paul, cut corners and, according to the whistleblower, committed Medicaid fraud to secure funds for the hospital’s child sex-change program.

(Texas Children’s Hospital, Roberts, and Paul did not respond to a request for comment.)

This is a story of fanaticism, hubris, and the murky business of transgender medicine. It would have remained hidden, except for the courage of two people inside the hospital, a surgeon named Eithan Haim and a nurse who has now decided to come forward. Both have risked much to alert the public to the barbarism that is occurring at the nation’s largest, and arguably most prestigious, children’s hospital.

Some years ago, Vanessa Sivadge thought she had it made, having just accepted a position as a registered nurse at Texas Children’s Hospital. She had wanted to be a nurse since high school and felt a sense of joy in helping children.

But her feelings toward Texas Children’s didn’t last. Beginning in 2021, Sivadge saw a dramatic rise in the number of “transgender children” treated at the hospital. These patients struggled with various problems: depression, anxiety, addiction, suicide attempts, physical abuse, and discomfort with puberty. But rather than deal with these underlying psychological conditions, Sivadge says, doctors at the hospital would diagnose them with “gender dysphoria” and assign them to a regimen of “gender-affirming care.”

The practice made Sivadge recoil. “In the cardiac clinic, we were taking sick kids and making them better,” she says. “In the transgender clinic, it was the opposite. We were harming these kids.”

Then, the following year, she breathed a sigh of relief. Under pressure from the state attorney general, Ken Paxton, Texas Children’s CEO Mark Wallace said that he was shutting down the child gender clinic. But it wasn’t true. Mere days later, it had secretly reopened for business.

And business was booming. Doctors, including Roberts, Paul, and Kristy Rialon, were managing dozens of pediatric sex-change cases, performing surgeries, blocking puberty, implanting hormone devices, and making specialty referrals. They were motivated not only by ideology, but by hope for prestige: they were saviors of the oppressed, the vanguard of gender medicine.

Sivadge soon had seen enough. She read my investigative report exposing Texas Children’s sex-change program, which relied on testimony from Haim, and reached out to share her own observations.

“I work very closely with this provider, Dr. Richard Roberts. I’ve been in the room with him when he speaks with these patients,” she told me in an interview. “Dr. Roberts is extremely encouraging of their transition and will essentially do whatever he can to make sure that they are happy, at least externally happy. Because I am absolutely certain that they are not internally happy. He is very accommodating. He does whatever they want. Essentially, there is no critical analysis of the process.”

In Sivadge’s view, Roberts and other providers were manipulating patients into accepting “gender-affirming care.” When parents objected, the doctors bulldozed them, she claims. Some families, she believed, feared that the hospital would call Child Protective Services if they dissented.

Then, two months after I spoke with her for that story, Sivadge called me in a panic. The FBI had sent two special agents, Paul Nixon and David McBride, to her home. The agents knocked on the door, asked her about “some of the things that have been going on at [her] work lately,” and then asked to enter her home. She was terrified. (The FBI declined to comment.)

The agents told Sivadge that she was a “person of interest” in an investigation targeting the whistleblower who had exposed the child sex-change program. They told her that the whistleblower had broken federal privacy laws. “They threatened me,” Sivadge said. “They promised they would make life difficult for me if I was trying to protect the leaker. They said I was ‘not safe’ at work and claimed that someone at my workplace had given my name to the FBI.”

The authorities—the FBI, the hospital, and, as Sivadge would later discover, federal prosecutors—were all circling the story. Both the Department of Justice and the hospital leadership were ideologically committed to “transgender medicine.” They had been embarrassed by the investigation that had exposed their actions, and they were looking for revenge.

Things went quiet for a while afterward. Sivadge resumed her work as a nurse, and the FBI did not reappear.

Texas Children’s Hospital continued its sex-change program but focused instead on patients who had reached the legal age of 18. Sivadge saw the same terrible medical regimen being prescribed for these young adults: testosterone for girls, estrogen for boys, and referrals for specialty services. While Roberts and Paul had stopped providing sex-change procedures for minors, the gender clinic still overflowed with “transgender” teens. 

Sivadge’s duties as a nurse included providing medication refills and working with doctors to provide parents with information about treatment plans, scheduling, and diagnostics. She worked with patients’ charts and saw their complex psychological diagnoses and the treatments administered by the doctors.

Then Sivadge noticed discrepancies in the paperwork. After the FBI visit, she followed some of the medical charts for these patients and came to believe that doctors might be violating the law.

As Sivadge learned, Texas law forbade hospitals from billing Medicaid for transgender procedures. The Texas Medicaid Provider Procedures Manual has long stated that “sex change operations” are “not benefits of Texas Medicaid.” In 2021, Texas Medicaid officials told the Kaiser Family Foundation that this prohibition was not limited to genital surgeries but “explicitly excludes coverage of all gender affirming health services.”

Transgender activist organizations and the popular media held this to be common knowledge. As the left-leaning Texas Tribune explained in 2023: “In Texas, Medicaid and the Children’s Health Insurance Program already don’t cover transition-related surgeries and prescription drugs like hormone therapies and puberty blockers.”

When reached for comment, a spokesman for Texas Health and Human Services confirmed that the state Medicaid program has “never covered ‘gender-affirming’ surgery or prescription drugs for the purpose of ‘gender-affirming’ care.”

At Texas Children’s, as she was treating patients, Sivadge carefully scrutinized the treatments related to an alarming number of “transgender” teenagers under the care of Roberts and Paul, who, she came to believe, were unlawfully billing the state Medicaid program.

One patient, whom we’ll call Patient A, began treatment at Texas Children’s in 2022, at the age of 16. Patient A is a biological female who identified as “non-binary” and whose records claimed that she was “male.” This patient began treatment with Roberts, who approved a prescription for testosterone as part of the patient’s “gender-affirming” medical regimen.

During treatment, Roberts explained to Patient A the effects of testosterone, including masculinization and the suppression of fertility, and had her continue with testosterone injections. Roberts carefully monitored the progression of the desired characteristics for gender transition: voice deepening, facial hair, body hair. By the following year, Roberts increased the dosage of testosterone for Patient A, with the associated diagnosis of gender dysphoria.

Another patient, whom we’ll call Patient B, began care at Texas Children’s in 2022, also at the age of 16. Patient B is a biological male who identified as a female and whose records indicated the transgender identity, “female.” He arrived at the gender clinic under the care of Paul, already having begun a prescription of a testosterone blocker and estrogen, which served as a sex-change hormone.

Paul wanted to help Patient B feminize his body to conform to his desired gender identity. Patient B had increased the size of his breasts but was frustrated by the persistence of facial hair. Paul discussed changing the testosterone blocker and increasing the dose of estrogen in order to make progress with feminization. Patient B told Paul that he wanted his breasts to be larger, firmer, and more pressed together, with larger areolas. Paul adjusted Patient B’s estrogen prescription and discussed the possibility of breast implants.

Sivadge noticed another critical piece of information: Patient A and Patient B, like several other “transgender” patients, were enrolled in Texas Children’s Health Plan STAR, a “no-cost Medicaid managed care plan.”

Despite the law, which prohibited billing Medicaid for “gender-affirming care,” it appears that this was a standard practice at Texas Children’s Hospital. As Roberts himself admitted in a 2023 affidavit related to the lawsuit against SB 14, he had several patients in his transgender medicine program “who receive their health coverage through Medicaid.”

According to a legal expert with deep knowledge of Texas Medicaid law, the essential facts are as follows: Patients A and B had coverage through Texas Children’s Plan STAR; the doctors explicitly treated them for the purpose of “gender-affirming care”; and the standard practice would be for the hospital to submit this care for reimbursement through the state Medicaid program. It would be extremely unlikely, according to this expert, for the hospital to forgo this practice and, for example, cover the cost of its “gender-affirming care” program from its own budget.

“Based on the facts we have, the only reasonable conclusion is that Texas Children’s Hospital was using Texas Medicaid funds to pay for ‘gender-affirming care,’ contrary to Texas law,” said the legal expert.

For Sivadge, there was no doubt about what was happening. “The largest children’s hospital in the country is illegally billing Medicaid for transgender procedures,” she said. “It is evident that the hospital continues to believe it is above the law not just by concealing the existence of their transgender medicine program from the public, but by stealing from the federal government.”

During this period, the politics of gender procedures were changing behind the scenes. Federal investigators were busy assembling information. A federal prosecutor, Tina Ansari, threatened the original whistleblower, Haim, with prosecution. And the hospital continued to churn through transgender patients.

Then, earlier this month, the stakes intensified. Three heavily armed federal agents knocked on Haim’s door and gave him a summons. According to the documents, he had been indicted on four felony counts of violating medical privacy laws. If convicted, Haim faces the possibility of ten years in federal prison.

The Justice Department appears to be playing a cat-and-mouse game with those willing to challenge the legitimacy of transgender medicine. As public opinion shifts against “gender-affirming care,” Justice Department officials seem to be pursuing harder methods of ideological enforcement—investigating, threatening, and indicting whistleblowers. If you expose the barbarism that is happening in American gender clinics, the message seems to be, you risk imprisonment.

Sivadge, however, remains undeterred. “My faith and my gut, just knowing right from wrong, compels me,” she says. “I was born for this. I have no doubt this is what I am supposed to do.”

For her, it is personal. She witnessed and unwittingly participated in what she now believes to be, quoting a passage from the Bible, “deeds of evil and darkness.” She considers blowing the whistle a form of redemption, recalling a moment early on, in which Roberts asked her to teach a 16-year-old boy how to inject estrogen into his body to affirm a female identity. Later, Sivadge says, she realized what she had done: she had participated in a lie that would harm this boy.

“I was told to do something I knew was wrong,” she says. “It made me sick that the lie called ‘gender-affirming care’ was being sold to parents and children and creating hugely lucrative profits in secret—and I was part of it.”

Sivadge is not the only one feeling regret. Doctors, families, and political leaders are all starting to question the folly of child sex-change programs. The sense is growing that the public was sold a bill of goods—and that children are being put in grave danger. We have begun the painful process of recognition. The activist euphoria has worn off, the old rationalizations no longer suffice, and the bill has come due.

Texas Children’s Hospital is at the center of this national drama. Both sides—the “gender-affirming” doctors and the whistleblowers opposed to them��face enormous risk, including the loss of medical licenses and time in prison.

Some of those implicated in the scheme might escape with their reputations intact. Others might meet ruin. But a deeper lesson emerges, impervious to the ideological mania and the legal maneuvering that have precipitated this crisis: nature is not easily conquered, and its reckoning cannot be delayed forever.

[onceuponanaromantic]

it's a long story (tell me anyway)

(Written for @flashfictionfridayofficial's prompt FFF226: By Any Other Name. Enjoy!)

Fire licks at her hands where she presses them into the burning hull of the spaceship and curses. Fire twists through the ruins of her jacket, biting at her undershirt as she works through the combustion equations in her head, pulling at the wards to admit her new ward as they spiral rapidly through the atmosphere. She calculates the propulsion through rapidly decreasing oxygen levels and increasing heat, ignoring the light and smoke.

In the last few moments, it takes as she sings to it, using the last of her oxygen. And the darkness takes her.

“Hell of an entrance, Ira.” She wakes to the horrible pungent smell of the healing ward. Herbs and antiseptic make for a terrible combination, but they also make for an efficient combination so she bears with it. “Welcome home.”

A hand pats hers, and she squints at the physician treating her. The rough callouses from scalpel use brush against healing skin. The room spins around her as she tries to see through the haze. “Don’t sit up. The smoke did a number to your lungs and your bloodwork made Healer Kyrie curse all sorts of things when it came in, so I recommend you take their instructions.”

“Rest, Ira.” She doesn’t know what expression her face must be making but it’s enough that Dr Kaiyan laughs. “I know you’re not familiar with the concept but it really will help.”

            “It’s not like Rin is going anywhere.”

            Something beeps in the background. Kaiyan curses.

“I need to go now, but let me know if you need anything and,” she hesitates, “it really is good to see you. I wish it was under better circumstances.”

I love you too, she would have said if she had any voice to say it with, as the door closes.

Let’s talk about a hypothetical situation. Let’s say that you’ve spent years staring at warding because you were never that good at making friends anyway. Let’s say that you tell your older sister, who is also your guardian that there’s a problem. That in twenty years’ time, there’s going to be a problem with the magic because there’s an error in the original flow structure that initially imported magic over from a different world. Say, no one takes either of you seriously because what arrogance, to presume that you knew better than the warders who set up the initial system.

Say it happens in six years instead of twenty. Say the systems begin to crumble, and there’s panic and there’s no solution to be found. Say your sister by this time is a priestess who finds a way out through an ancient book. Say she twists the magic to rely on her soul through an ancient spell that converts a death into eternal sleep. There’s a way to get out from it, true love’s kiss, but it will undo the original spell.

They hadn’t even bothered to call her. It was just a letter, mixed in with bills and advertisements for other conferences and new boba tea shops popping up in different nebulae. Just a letter with a plain font.

-

“Ira.” Her sister’s fiancée gets up from beside where her sister lies sleeping. “They told me you were back.”

“Right, I don’t think they told you the part where I fell out of the sky.”

Ana grins, despite the dried tear tracks and the wrinkles. “Oh, Kaiyan did mention that too. You look different.”

“You look different too.” She looks down at herself, taking in the stains from where she had been working through the theory again, checking her wards.

If nobody was going to take her seriously, well, she was going to come up with a solution anyway. It’s not like she wanted to be an academic full-time in the first place.

All she had wanted was to keep her sister safe. And it turns out she hadn’t even managed that.

(She hid the grief for her selfishness in balls of pain in her throat. She knew she was selfish. She could have come back earlier. She knew she could have, when her sister first told her the thing she had predicted was happening already. She knew. But it had been so nice, to be someone other than Rin’s sister. To change her hair, to change her name and her eyes and pretend it wasn’t running away when she had left. To refuse to answer Rin’s messages, because it was an old life and it wasn’t like Rin could come after her anyway.)

She notices the ring around Ana’s finger. “Congratulations, by the way.”

Ana breaks her gaze. “We’re not married. Just engaged and well, she thought we should have rings. I thought she told you.”

She swallowed past the lump in her throat.

“Have they found an alternate solution to the problem?” She winces at the harsh change in subject.

Ana spreads her hands. “Have at it.”

She turns away, mind already spinning ahead in threads and numbers and calculations. “And Ira? Come have lunch sometime. It’s been a while.”

It takes her twelve days, running around the city and not sleeping or eating except for a great deal of caffeine and the occasional snack bar. But she solves it. She sets the plan she had been working on for the last three years in progress, and she executes it perfectly.

She gets through the final result long enough for it all to click into place, for her to get to the room in the temple her sister sleeps in, for her to see her sister begin to stir.

“Oh good.” She says, and passes out herself.

            She wakes up to yet another argument being carried out over her. They all turn to her as she wakes, and she blearily glares at them.

            “How did you get over the true love requirement?” “Why isn’t there anything collapsing?”

            “Math.” She squints at them and then goes back to sleep.

            The next time she wakes, it’s to Rin and Ana talking quietly over her. Rin is the first to notice her, even though the premature wrinkles twist at the edges of her face

            “You look different.” It’s been a while. I’m sorry.

            “Hello, stranger.” Rin says, “I’ve missed you. What’s your name now?”

[protoslacker]

Both drugs were developed in the 1970s and are a part of the WHO Essential Medicines list. Both can be purchased for $0.01 to $0.06 per pill in low-income countries and about $4 to $6 per pill in high-income countries like the UK and Australia. In the US… well, can you guess where I am going with this? The prices for both drugs have been jacked up to over $400 per pill. This is about a hundred-fold more than than other high-income countries, which in turn is likely several-fold more than the true marginal cost – the price we expect in a truly competitive market.

Rahul Nayak in Bill of Health, blog Petrie Flom Center at Harvard Law. The Rotten U.S. Antiparasitic Drug Market

This post is almost five years old, but I bet things haven't changed much. Civica Rx is mentioned as part of a solution to market problems. I think the problem is more than a "market" problem! Still Civica Rx seems like a good thing.

Not related to the search about deworming medicine, but I was also searching around in re prescribed atypical antipsychotics for children on the Autism spectrum. I went to a blog I used to read before the pincipal died, 1 boring old man. I searched for "rispeidone."

I'm no scientist or doctor, and the fact of the matter is I will keep my mouth shut when it comes to what prompted my search; because of course I am no doctor or scientist. But I was reminded reading some of the posts why that blog was so good. Many of the comentators were physicians, and they didn't all share the skeptical takes that the blog author did. Yet the kind of respectful dialog on that blog really does seem part of what can help to make healthcare better. And it's quite sad how little dialog there is.