18,000+ have perished in Pakistan. A terrible tragedy has occured in the world, we should

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Medical bills are debt. Debt is big business. Do not expect to find any compassion for your problems when you show up without insurance. You'll be lucky just to get care when they flag your chart "No Insurance" or "Self Pay."

If you are uninsured and do not qualify for state or federal assistance because earnings are too high, you are gambling on everything you own or will own in the future, including future earnings.

If you require elective medical care and have time to work out a cash payment deal in writing with the provider, you may be protected. You will require a signed agreement by every provider - hospital, radiology, lab, interpreting physicians, etc. If you fail to meet the provisions of the agreements you sign, the following will apply to this debt as well.

If you receive medical care without a prior agreement on payment, you will be responsible for the debt. After the fact, the providers have no legal reason to allow you to set up a payment plan. If you send a monthly payment anyway without a prior agreement, the only thing you can hope for is when they take you to court a sympathetic judge or arbitrator takes this into account. A voluntary payment sent by you won't stop any legal action and, in fact, may hurt you in the future trying to resolve the debt.

Every state has a set amount of time before a creditor can sue you (depending on the type of debt). For most states, medical debt is 2 years. So, from the date of service you have 2 years of collection agencies to deal with and then they simply take you to court at which point they will take everything you own and sell it at auction, enforce liens against your current and future earnings, and take every potential bit of future income or asset you may have.There has been some legal challenge to this in some states - check with your state attorney general's office to see if any headway has been made in protecting patients with medical debt.

If you think you'll just go bankrupt, think again. Medical debt is rarely discharged now since the rules have changed, especially if you at some point indicated you would be willing to do a payment plan with the providers - this is used against you.

If you think you can maintain your health and nothing will happen, you are dreaming. Make sure off the top that you no longer have a GB, appendix or uterus. You'll just have to ride out all the little things - UTI, flu, sinusitis, and forget about routine maintenance care. The stress alone of knowing you must not become ill or injured is enough to make you sick.

Anyone who tells you not to worry about medical debt while uninsured or underinsured is either ignorant of the facts, living in another dimension, or just plain lying.

I do not admire the Amish in general. I did, when I thought of them in the stereotypical way that many people do. Then I learned about how they treat the women in their society when I watched a story on Dateline recently (and read some other things):

http://www.newhousenews.com/archive/murray112805.html (just go to Goggle and type in Amish puppy mills).

Now I don't think of them as any better or worse than the rest of our society, religious or otherwise. I feel sorry for the women in their closed, oppressive (only to women, of course), patriarchal society, and I wonder if theirs is a "culture" or a cult.

I feel so bad for those little girls that were shot, and maybe it's not appropriate for me to be saying this now, with the recent events, but I hate to see people thinking of the Amish as so wonderful...

Perhaps this doesn't belong on any board here, but I felt I just needed to say something about the very tragic state of medical transcription. I have been an MT for over 40 years, most of which occurred in the clinical setting, but I also worked for 4 years at a very large MTSO.

No one in our wonderful profession is going to get anything changed until en masse. If we don't stick up for ourselves and that means going to governmental officials (those people get sick too and do have medical records!), the media and other well-known sources where the message could potentially be heard world-wide, then we have only ourselves to blame. I know this is a huge undertaking but if we don't like it (and I hear that many don't) then we have to impact it. I would, for one, feel so much better telling my children and grandchildren that I had taken part in a grassroots movement to try and change/impact the manner in which a patient's medical visits were documented rather than leaving millions (ha, ha!) for them to use on fancy cars, trips, etc.

We only have today---some people who died on the bridge or drowned here in Minneapolis last evening will never again get a chance to make any impact ever again!

REMEMBER WHEN THIS STORY BROKE? Finally, somebody is dealing with the issue. Check this out!

VA IT security gaps extend to contractors
06/14/06 -- 04:15 PM
By Mary Mosquera,

Rep. Buyer: Department CIO needs IT security enforcement authority

[b]The Veterans Affairs Department said today that it has been investigating allegations that an offshore medical transcription subcontractor last year threatened to expose 30,000 veterans� electronic health records on the Internet in a payment dispute with a VA contractor. [/b]
The VA assistant inspector general referred to the investigation during questioning in a congressional hearing on VA�s data security environment in the wake of the theft of sensitive data of 26.5 million veterans, active duty military and reserves officers.

The medical transcription incident highlights how gaps in information security also extend to contractors, said Michael Staley, VA�s assistant inspector general for auditing. Some VA medical transcription contractors have used offshore subcontractors in India and Pakistan without VA�s approval and without adequate controls to ensure veterans� health information was secure under the Health Insurance Portability and Accountability Act, according to an audit released today.

�Contracts do not specify criteria for how to protect information,� Staley told the House Veterans Affairs Committee.

Staley enumerated audits of information management security under the Federal Information Security Management Act, the Consolidated Financial Statement and Combined Assessment Program that revealed significant vulnerabilities. These include VA not controlling and monitoring employee access, not restricting users to only the data they need and not terminating accounts of departing employees in a timely manner.

In last year�s FISMA review, the IG provided 16 recommendations, including addressing security vulnerabilities of unauthorized access and misuse of sensitive information and data throughout VA demonstrated during its field testing. All 16 recommendations remain open, he said.

Audits also found instances where out-based employees send veterans� medical information to the VA regional office through unencrypted e-mail; monitoring remote network access and usage does not routinely occur; and off-duty users� access to VA computer systems and sensitive information is not restricted.

�VA has implemented some recommendations for specific locations identified but has not made corrections VA-wide,� he said.

From fiscal years 2000 to 2005, the IG identified IT and security deficiencies in 141, or 78 percent, of 181 Veterans Health Administration facilities reviewed, and 37, or 67 percent, of the 55 Veterans Benefits Administration facilities reviewed.

�We recommended that VA pursue a more centralized approach, apply appropriate resources and establish a clear chain of command and accountability structure to implement and enforce IT internal controls,� Staley said.

The underlying situation is the VA�s department CIO does not have authority to enforce compliance with data security and information management and recommendations from GAO, said Veterans Affairs Committee chairman Steve Buyer (R-Ind.).

Buyer traced problems in security enforcement to a memo dated April 2004 from the general counsel that said the department CIO did not have enforcement authority.

The CIO, undersecretaries who lead VA�s benefits, health and burial administrations, and the VA secretary share responsibility for enforcement, said Gregory Wilshusen, director of information security issues for the Government Accountability Office.

�Information security is a governmentwide problem, and we have talked with OMB about that,� said Linda Koontz, director of GAO�s information management issues.

Buyer expressed frustration that there are no consequences for �recalcitrant� agencies that do not correct problems that GAO has repeatedly highlighted. He cited the Privacy Act, which has been strengthened with consequences.

�If you have a bureaucracy so strong in the department that the secretary or political bodies are unable to act, don�t you think the president or vice president or OMB needs to know that because there are monetary consequences behind that inaction? I�m bothered that GAO doesn�t have the higher authority to which they can turn,� Buyer said after the hearing.

After several more hearings this month, Buyer and his committee will make recommendations or craft legislation. He suggested that Congress consider looking at strengthening FISMA.

�We can even come up with that in our language, but we�re not going to have jurisdiction over that. We�ll have to work with Mr. Davis [House Government Reform Committee chairman Tom Davis (R-Va.)] and his committee. I�d be more than happy to do that,� he said.

If I were the parents, I would most likely be blaming myself; not my friends that I left my 2 year old with and not the person who hit the child on the highway! It would have been my responsbility to either have my 2 year old with me or at least make sure the people I left him with were responsible. As for the driver of that car, what were the driving conditions; apparently it was at night; was it raining; was it foggy; did they even see that little,tiny child; was the child standing or crawling or just lying on the road???????? It sounds horrible but maybe the driver just felt a bump! Maybe the driver didn't even realize he had hit a child! Maybe the driver just thought he ran over a board in the road. I'm one of the few, I guess, who believes the safety of your child lies only within your power. According to some, accidents do happen, but I don't believe in accidents! Accidents, according to the dictionary, are considered to be unforseen incidents.....we as parents, however, must use common sense to try to abate these "unforseen incidents".

Again, I do have greath empathy for the parents, their friends and for the driver of that car. They certainly did not preplan this but maybe a little bit of preplanning would have prevented it. I am sure that little 2 year old will be another beautiful angel in Heaven and that eventually his parents will know he is happy and in a good place.

I wonder if the accounts are seeing a reduction in the price that they are being charged -- that is what I want to know. Went through this when NFTA came into effect with my husband and truck drivers. Also the car industry has gone through this with all the jobs going overseas. Pretty soon the doctors won't have any patients because no one will have insurance or jobs or be able to pay so they will be out of a job. I hope it eventually all backfires on them but I doubt it. I have talked to my local doctors, senators, anyone that will listen about this but no one seems to be worried. Tax bases will go to pot with everyone out of work, no one to pay the government. All we can do is to keep voicing our opinions.

in past years has been on Singulair and Nasonex for them. They have always worked well together in the past to keep him from ending up with an upper respiratory infection and eventually nausea and vomiting from all of the mucus. This year; however, those two drugs do not seem to be doing the trick. I took him to the doctor and they switched him to Flonase and an Azmacort inhaler.

I was just wondering if anyone has any experience with these medications and what type of results you got. I know Flonase is supposed to be wonderful for allergies, but I'm curious about the Azmacort. His nasal congestion does seem to be a little better than yesterday but I have not been able to guage any benefit from the Azmacort yet (I know, it's still early to tell). The doc said that if these meds do not work he will have to start getting allergy shots.

He will be 8 on Sunday. He has been suffering every year (this time of year is horrendous) since he was 3. Just curious to hear any comments and/or suggestions.

On DQS acct, lines stink - on three other programs, same as you 300-400 lph. I hate DQS and proud to tell everyone. 35+ yrs trans. The old selectric typewriters were better, even Mag cards were better.

do you think everything posted on these boards is the gospel truth. No, the admin's would not be so foolish as to sink into that territory...

I have to say, I am sooo glad it's Friday. This week has been just awful; whatever could go wrong, did go wrong; dang you Murphy's Law!!!

CALEDONIA, Mich. (AP) - A couple sat by their daughter's hospital bedside for weeks after an auto accident until she came out of a coma and they realized she was not their daughter after all, but another blond-haired young woman injured in the wreck. Their own daughter, it turned out, was dead and buried.

In a tragic mix-up, one family had been incorrectly told their daughter had died in the April 26 crash in Indiana, and another was erroneously informed their daughter was in a coma.

The two young women - both students at Indiana's Taylor University - looked remarkably alike, and the one in a coma suffered facial swelling, broken bones and cuts and bruises, and was in a neck brace.

The family of Laura VanRyn, 22, disclosed the mix-up Wednesday on a Web log that they had used to record detailed updates on the young woman's recovery.

``Our hearts are aching as we have learned that the young woman we have been taking care of over the past five weeks has not been our dear Laura, but instead a fellow Taylor student of hers, Whitney Cerak,'' the VanRyns said on the blog.

Cerak's grandfather, Emil Frank, said news of his granddaughter's survival was a shock. ``I still can't get over it. It's like a fairy tale,'' he said.

Coroner Ron Mowery, whose office handled the case, apologized for the mistake. He said acquaintances of the students had identified the survivor as VanRyn, but no scientific tests were conducted to verify the IDs.

``This tragedy unfolded like we could never have imagined,'' he said.

The VanRyns said that as the young woman began regaining consciousness at a rehabilitation center in Grand Rapids, Mich., she said things that made them question her identity.

As recently as Monday, the VanRyns reported: ``While certain things seem to be coming back to her, she still has times where she'll say things that don't make much sense.''

The coroner said that VanRyn's boyfriend raised initial questions about her identity. Then her father became suspicious when she referred to him by a pet name he didn't recognize.

``He started asking questions and the process evolved to where she actually came to and suggested who she was and wrote her name,'' Mowery said.

In a statement, the two families said they took their concerns to hospital officials, and dental records confirmed that the injured woman was Whitney Cerak.

``Both families understand how this could have happened,'' said Bruce Rossman, a spokesman for Spectrum Health, which operated the rehab center.

Frank, a retired minister in Portland, Maine, said his granddaughter's parents declined to look at the body before the funeral. ``They wanted to remember her the way she was,'' he said.

An official at Taylor University, an evangelical Christian college in Upland, Ind., about 60 miles northeast of Indianapolis, said the Grant County coroner had notified the school of the error.

``We rejoice with the Ceraks. We grieve with the VanRyns,'' said Taylor spokesman Jim Garringer.

The VanRyns, who are from Caledonia, Mich., said their daughter and Cerak, 18, of Gaylord, Mich., bore an ``uncanny resemblance.''

The coroner described an accident scene strewn with purses and wallets.

``I can't stress enough that we did everything we knew to do under those circumstances, and trusted the same processes and the same policies that we always do,'' Mowery said.

Four Taylor students and an employee were killed when their van was struck by a tractor-trailer that had drifted across a highway median. Those in the van worked for Taylor's dining services and were preparing for a banquet for the inauguration of a new president of the 1,850-student school.

Most of the crash victims had funerals with closed caskets. A month ago, an overflow crowd of more than 1,400 people turned out for what they thought was Cerak's funeral in Gaylord, Mich.

Joe Sereno, associate pastor at Gaylord Evangelical Free Church, said the casket was closed both for visitation and for the funeral.

``We did everything you usually do,'' Sereno said. ``We had a memorial service at the church. The family did a private burial the next day. Everybody thought it was Whitney.''

The VanRyn family used the blog to provide progress reports on the young woman, reporting, example, that her hair was in pigtails or braids, that she managed to feed herself some applesauce, that she played a game of ``Connect Four'' with one of the therapists and did quite well, and that she performed an exercise in which her therapist gave her a word and she had to supply the word's opposite.

Calls to the VanRyns and Ceraks were not immediately returned, and a young man outside the VanRyns' home declined to comment to a reporter. An attorney for 'the Cerak family did not return a call either.

Prosecutors are weighing criminal charges against the truck driver, saying he may having fallen asleep at the wheel.

A memorial service for VanRyn is scheduled Sunday in Grand Rapids.