CMS indicates that it is again considering compensating physicians for discussions and advice with patients concerning end of life decisions. The American Medical Association requested consideration of the issue last fall.
In holding with the minority liberal wing of the court that the Affordable Care Act is constitutional as a tax, Justice Roberts seems to have concluded that the wholesale sinking of the Act by the Supreme Court was “a bridge too far” for the conservative majority which stopped the vote recount in Florida before it was completed, effectively anointing George W. Bush President of the United States on legal grounds not used before or since. That of course brought us 2 middle east wars on a credit card that we are just beginning to pay and the worst financial crash since the Great Depression.
With the continuing devolution of U.S. health care into at least a three tiered class structure, we are left with a number of questions as to why the U.S. with all of its wealth and power is so far down the list of top health care systems. It may perhaps be related to the growing transformation of the U.S. into “bananarepublichood,” where the growing gross disparity in income here leads to lack of access to care by large segments of the the population which adversely effects our overall averages in quality markers such as life expectancy and infant mortality. When you have a combination of the best and the worst features of a health care system your average necessarily drops precipitously.
Much to the disappointment of social security plaintiff lawyers in West Virginia, Chief Judge Charlie Andrus has resigned as Chief of the Social Security Administration Judges in Huntington, West Virginia. Judge Andrus leaves behind and unblemished record of finding for the claimant in each of 729 cases he heard in the first six months of fiscal 2011. The national average for most judges is about 60% of awards in the cases they review. Perhaps it is just luck of the draw. Perhaps there is a Robin Hood element at play here. There are about 1500 administrative law judges in the Social Security System. Interestingly, there are a number of outliers both for and against claimants that seem to be distortions of the system. While there is some natural tendency not to intrude on the judicial integrity of the judges charged with operating the system, it would seem that extreme deviations from the norm in decisions either pro or con to the claimant are worth a review to determine whether more than unbiased judicial evaluation is going on. The integrity of the system is dependent upon the perception and reality of impartiality in the system. It is not the prerogative of administrative law judges to either play Santa or Grinch in the system but to fairly and equitably adjudicate the claims of the parties.