The View from Under My Rock

A Sales Tax ON TOP OF a gasoline tax??? Seriously, Marty???

2012-02-04T11:44:00.001-05:00

Marty O'Malley never ceases to amaze me.

Not only is he the biggest wastrel this state has seen since the late William Donald Schaefer, he makes Schaefer look like a piker, and that is pretty hard to do.

Gasoline taxes, which sit at 23 cents/gallon currently (last raised by the said Schaefer in the 1990s), are somewhere in the middle of the list of state gasoline taxes. Several neighboring states have raised theirs since the Bush/Obama recession started. Their normal purpose is to provide funds for new roads, repair of existing roads, and even helping mass transit.

Except, of course, in Maryland. For more than the last decade (including the only Republican governor the state has had in 40 years), administrations have routinely raided the "Transportation Trust Fund" to fill holes in the state's budget, moving them into the General Fund, and going for current expenses. Like the Social Security "Trust Fund," there are plenty of IOUs in both the Transportation Trust Fund and the Chesapeake Bay Foundation Trust Fund that will never be reimbursed. Not that other states haven't borrowed from theirs, but O'Malley has turned it into an art form.

When Marty and his cronies first came into office in 2007, they quickly went on a hiring and spending spree, even depleting the Rainy Day Fund to its lowest level permitted by law. It boggled the mind. He (read WE) paid for huge salary increases for some of his political appointees in high positions, hired a large staff to cater to the Governor's needs, and made sure his buddies got well paid off with state contracts and jobs. One of those includes a cushy job for his father-in-law, the former state Attorney General--a position Joe Curran still holds, and he even retained a chef on staff in the Governor's Mansion 24/7, just in case he gets a little hungry. Tough life, ain't it? RHIP, I guess.

When it was obvious that we were heading into a major recession, he browbeat the General Assembly to raise the sales tax from 5% to 6% along with other tax and fee increases (which he hammered the former governor for doing in the 2006 campaign), this despite the strong opposition from his Comptroller, Peter Franchot.

Comptroller Franchot argued that you don't raise taxes while we're starting to go into a recession. I have a great deal of respect for him because, as a Delegate, he was one of the more liberal members of the House. However, as Comptroller, he has been a fiscal hawk--he gets it. Franchot warned that the revenue estimates from the sales tax increase were not realistic. One year after the sales tax went into effect, Maryland's sales tax revenues dropped by $76 Million.

Maybe good old Marty has never heard of oh, I dunno, DELAWARE ("Home of Tax-Free Shopping") or Pennsylvania and New Jersey, who don't tax sales of clothing and shoes.

There's almost nowhere in this state that is further away from any other state border than 40 miles, a real quick trip when you want to shop for a number of items. People simply shopped in another state. Who'd'a thunk it? Comptroller Franchot did, but his was the voice in the desert.

When Obama came into office and lavishly spread the "stimulus funds," Marty latched onto them like a drunk at last call. Did this mean we used the funds to plan for the future? No, of course not. Time to increase spending, even though we're deep into a recession! When that federal teat dried up, even though he knew it would beforehand, he showed major surprise and began furloughing State workers, making them take scheduled days off as an unpaid long weekend.

After several years, Governor O'Malley finally realizes that there are major traffic problems in the State (can we say DC Beltway Inner Loop from the American Legion Bridge to US 1 in afternoon rush?), but there are no funds to be found in the Transportation Trust Fund to cover them. Rather than transfer funds back into the Trust Fund, he whines that you can't get a $100 Million bridge for just $10 Million, and something must be done.

So, he and his budget wunderkinds get the bright idea that the gas tax needs to be raised 15 cents per gallon over the next 3 years. When that went over like a lead balloon, they changed the proposal to removing the sales tax exemption on gasoline and impose the full 6% sales tax on the entire purchase. What an improvement!!

I'm certainly hoping this is a false flag--a proposal made that's so outlandish that something more reasonable will be enacted.

Although I'm not in favor of doing anything right now with the gas tax, what with the high cost right now, I wouldn't want to see any proposal pass unless it is tied to a Constitutional amendment putting the Transportation Trust Fund and Chesapeake Bay Trust Funds in an Al Gore-style lockbox. We could vote on it this coming fall, and measures have already been introduced into the Assembly to do just that.

The real answer, though, is to cut spending and bring the budget back under control. Comptroller Peter Franchot gets it. Marty O' never will.

I'm Going with Obama on This One!!!

2012-01-25T23:55:00.000-05:00

As all two or three of my regular readers know, I am not one to heap praise on actions proposed by Barack Obama. However, sit down for this one: I strongly support one of his recent proposals!

He recently came out with a cost-savings measure in the federal bureaucracy that I can get behind and rally the populace from the rooftops. (That means it's doomed to failure, but at least he proposed it. I'll give him props for that...)

Somehow, in a discussion about how there were so many offices involved in international trade, and how foreign companies had to run the gauntlet of all of them, spanning several Cabinet departments, he actually said he wanted to combine the offices that did basically the same thing and streamline the process. Yes, he really used the words "combine" and "government agencies" in the same sentence -- and with a positive point of view!

I nearly pulled a Fred Sanford and called for Elizabeth, but, then I got a grip. I needed to examine if my ears were clear enough to understand that I had NOT mis-heard, and that I was not dreaming. I need to search to see exactly when he said it, and I'll work on doing more research to be able to discuss it more fully. And I heard it again on the following newscast. Hmmm...

As I said, I can enthusiastically support him on this (if it ever comes to pass). That doesn't mean he'll get my vote in November -- he won't -- but, at least a stopped clock is right twice a day, and I'll give him a round of applause for the idea.

Just sayin...

The End of "Don't Ask, Don't Tell"

2010-12-18T21:50:00.000-05:00

As of the Senate vote today, it's all over but the shouting.

Sort of.

The US Senate voted today to repeal the military policy of "Don't Ask, Don't Tell" (DADT) that was first passed in 1993 as an upgrade to the former military policy on gay and lesbian personnel. Before that, it was possible to just whisper that Joe X. was a "homo" and the military could start on the procedures to drum him out.

Or not.

Back in the late 70's, I had a roommate who was gay. He was in the military and a flaming queen. He was also the chief steno to the Chairman of the Joint Chiefs of Staff, with the concomitant security clearances, and for which he had just been re-certified. He died a few years later, and the military had to know he was gay, yet, because he was such a good steno, nothing was ever done about it.

Even during the Vietnam War, many men who were trying to avoid the conflict told their draft boards that they "had homosexual thoughts" or were "actively homosexual" and yet the military said, "So what? We still need you -- you're on your way to 'Nam. Have a nice trip."

When I was draft-eligible, in 1973, the war had wound down, and there was not much likelihood that I would face conscription, even though my draft lottery number was 70, and the first 95 were re-classified as 1-A (ready to go). College deferments were no longer available, and, if the military had needed us, we would have been drafted if our number was called.

Amazingly, when Vietnam was over and the US wasn't involved in active military operations, "we don't care" turned into "now, you got our attention." And, this was one of the factors that led to the 1992 Clinton-Gore campaign pledge of allowing open gays and lesbians to serve honorably.

In actual fact, all throughout history, gay men have fought and died along with their heterosexual comrades. Many countries have allowed open gays to serve in their military forces for years.

Needless to say, when Bill Clinton tried to change the policy in 1993, the "fit hit the shan," and the Congress got involved. The compromise that came about was DADT. Someone gay or lesbian could serve, but not be open about it. Essentially, the brass was told "Don't Ask," and the gay personnel were advised, "Don't Tell." The military would no longer go on a witch hunt and try to find out one's sexual orientation, but, if it became an issue, then, the military would, in its discretion, begin the separation proceedings.

Seems that nobody was happy with the results. Most Republicans, by and large, didn't want any change, liberal Democrats wanted a complete reversal of policy, and the affected gays and lesbians still had to be in the closet to stay in the service. Thus, the long battle to repeal DADT.

Things got so stupid that, back during the second Gulf War, there was a shortage of Arabic speakers, so the military offered training to people in Arabic, so that they could help translate television and radio broadcasts, newspapers, and documents seized. That should have greatly helped the war effort.

But, nooooooo....

Some thirty-seven of them were gay or lesbian! So, rather than use the talents of these translators, the military refused to use them. So, we had a shortage of translators, we trained people to be translators, and then we kicked three dozen or more to the curb because of their sexual orientation. Alllllrighty, then.

And just how did that work out for us? Intelligence, shmintelligence.

President Obama won election promising the repeal of DADT, yet, when challenged in the courts, his Administration pleaded for a stay of the court's ruling. Yes, the logic went, the Congress was the one that passed the original legislation, the Congress should be the one to repeal it.

What a concept! It went to the courts because the Congress had not acted.

I have spoken to, and know of, a number of former service personnel, most of whom were not even involved in the field of battle, but were separated because of DADT. They tell me they'd jump at the chance to get back in because they loved the military. Some even had more than a dozen years in and wanted to stay until retirement.

So, what happens now...?

Now that the repeal of DADT has passed, there are some questions that still need to be resolved. The legislation gives the Secretary of Defense the power to "certify" that the military is ready for repeal, but it's not effective until 60 days after that.

In the meantime:

The DOD will have to come up with procedures, training, and regulations regarding how the new law will be implemented. It's assumed this will take months, and will be phased in.
The Secretary of Defense will certify that the military is ready for the changes to be effective.
Sixty days thereafter, buh-byee DADT.

So, now a few more questions arise, among which are:

What happens with investigations currently in the separation pipeline? If the policy is going to be repealed eventually, is there any reason to continue those investigations, especially in light of our budgetary crisis?
Senate Majority Leader Harry Reid (D-NV), with whom I rarely agree, did ask President Obama today to order the military to cease and desist any further investigations from here on out, since the repeal is coming.
What will be done with re-admitting service members who wish to continue their military service after the repeal? Seniority, benefits, whatever else come into play. I'm assuming that will be handled in the DOD review of regulations, training, and so forth.

So, is it "all over but the shouting"? Is the policy now dead?

Until we get more details on implementation, the answer remains: sort of.

Call/E-mail your Senators NOW: NO on Senate Bill 510

2010-11-29T23:28:00.001-05:00

This is sort of last minute, and I'm really sorry I didn't blog about this much earlier, but... the time for action is NOW. The US Senate has scheduled a vote on the amendments to and the final reader of Senate Bill 510, the "Food Safety" Act, for about 9:30 AM Eastern on Tuesday, November 30, 2010. A companion bill has already passed the House, and it would go to a conference committee for final language.

I strongly object to the bill on several fronts, and urge you to contact your Senators, either by phone, or by e-mail ASAP to see if we can't get this thing stopped.

First, if you're like me, you like wandering into a "health food store" and buying various vitamins and supplements that you choose to use for your health. I have taken 3,000 mg or more of Vitamin C per day when I've been sick, and I usually take at least 1,000 mg per day as a maintenance dose.

Under S. 510, you could no longer do that. The bill calls for "harmonization" with the Codex Alimentarius, a set of "standards" set by the UN's Food and Agriculture Office and the World Health Organization. For a fuller discussion, please see:              http://en.wikipedia.org/wiki/Codex_Alimentarius

What should be most disturbing is the following, taken from the Wikipedia article:

It is reported that in 1996 the German delegation put forward a proposal that no herb, vitamin or mineral should be sold for preventive or therapeutic reasons, and that supplements should be reclassified as drugs.^[4] The proposal was agreed, but protests halted its implementation.^[4] The 28th Session of the Codex Alimentarius Commission was subsequently held July 4 - July 9, 2005.^[5] Among the many issues discussed were the "Guidelines for Vitamin and Mineral Food Supplements"^[6], which were adopted during the meeting as new global safety guidelines.^[7]

If you follow the links in the paragraph above for the Vitamin and Food Supplements "recommendations," you'll notice that, for Vitamin C, they suggest 90 mg.as the daily requirement, with a max of 2,000 mg. The paragraph also goes on to say that they are only "suggestions" and that member countries do not have to "impose" them.

Maybe someone should have told that to the European Union, which has legislated such guidelines in their member countries. Any Vitamin C tablets more than 100 mg must be obtained by prescription only.

"Harmonization" with the Codex will allow the FDA to require the same mandates here, and they're champing at the bit to do so. They have tried unsuccessfully for several years. This bill will give them carte blanche to impose it.

Secondly, the bill will allow the introduction of Genetically-Modified Organisms (GMOs) into our food supply. Now, if you want to allow GMO carrots into the market, for example, I have no real problem with that. Just tell me that the carrots are modified, and I'll make the choice whether to buy or not. I'll tell you now, I won't buy them.

However, this bill does not require informing the consumers that the foods they are purchasing are GMOs.

Now, follow the money trail for a moment. What companies are heavily into GMO research and development? How about Monsanto (who also owns the General Nutrition Center [GNC] chain)? How about ConAgra? Archer Daniels Midland? What do they all have in common? They're all Big Agra. And, yes, they're all very well politically connected. Yes, and they lavish their largesse on both the Dems and the Reps.

Finally, I object because the rules that govern calling produce "organic" would be so badly relaxed that almost anything could be called organic, and the consumer loses the freedom to choose again. After all, since many (including me) are willing to pay a slight premium on organic produce, what's to stop anyone from saying that their produce is organic -- even when it's not -- and charging the extra price?

I'm hoping that something happens to extend the time period on the vote, so we can rain messages on our Senators and get them to stop. At the very least, the next Congress should take it up, and we've got time to nip it in the bud there.

For Maryland residents, here are your direct office numbers:

                       Barbara Mikulski                    202.224.4654
                       Benjamin Cardin                     202.224.4524

For any other state, the Capitol Switchboard number is:   202-224-3121. Ask for your Senator's office by name, and you can ask for the direct number as well before they try to connect you.

"Food Safety"? Meh.

Miscellaneous Musings, #2: The US Postal "Service"

2010-11-24T10:15:00.000-05:00

Just recently, the US Postal Service announced they had yet another loss in revenue and might have to think about raising rates. Well, isn't that special?

They cited things, such as increased use of e-mails and online payments, gas prices, the economy, and all sorts of good stuff like that. One thing they forgot to mention was "service."

Many people have anecdotes about dealing with that behemoth, and I'm going to add another. I still haven't figured out what happened, and, by now, I really don't care, as long as the problem is fixed, and that remains to be seen. The ball was dropped, and disappeared into the abyss.

Now, one would think that a change of address would be a simple thing, right? Especially when the Postal Service allows you to do it online. And charges your credit card $1.00 for the "service." You get a lovely confirmation and their message tells you that you should receive your mail at the new address in about 7-10 business days. What could be easier?

As part of their security efforts, they send a letter to your old address saying that someone has requested a change of address and list the named party(ies) that the change affects. This is a good and happy thing, because if you didn't order it, you could still stop it from going through.

I trustingly put my Change-of-Address Order (PS Form 3575) online on September 29, 2010, with an effective date of October 1, 2010. I paid my dollar, got the confirmation, and figured everything would be fine. After all, I'm only moving a few blocks away, it's even in the same zip code, so the same post office would handle everything. What could go wrong? Uh huh.

Now, I'm no slouch at getting mail. I get bills, junk mail, letters, all sorts of crap. I waited for the 7-10 business days. Nothing. I began to get mail at my new address with my new address on it, but, nothing that was addressed to the old. I had other fish to fry at that point, so I didn't make any inquiries. In the interim, I had received two envelopes with the yellow update stickers on them: one junk mail, and the other, from the state.

Now, to the intriguing part. Early in November, I received an Official Change of Address Confirmation Letter from the USPS, telling me that my change would be effective as of November 4, 2010. (Note: more than a month after I filed the request online.) I guess their concept of 7-10 business days differs from mine and the rest of the world's. And I wait.

A week or so later, my former roommate called me and told me he's still getting regular delivery of mail for me. I'm not sure why that's happening, but I figure now is the time to call the Postal Service and find out. I dutifully called the number on the Official Confirmation, and got the local number for my post office. I called and spoke with a very nice woman who said she'd check with the carrier and find out the status of the change.

A couple days later, she calls me back and said that the route carrier has no record of any change of address for me and that I should probably file another. OK, whatever.

But, wait, there's more! Now, how much would you pay? See your dollar stretch!

Remember the security letter that they send to verify the changes? In the stack of mail I picked up from my former roomie, the letter was there, dated October 4, 2010!

So, two days ago, I wandered into my local post office and spoke with a very nice lady who told me I didn't need to fill out another change, it would only confuse the issue.

Then, she gave me some very interesting information. When you file a change of address online, it goes directly to the change of address section in the main computer. However, that information doesn't seem to get passed on to where it really counts: the local post office and the carrier. One hand apparently doesn't know what the other hand is doing. Yet, they still took my dollar!

She suggested that, in the future, I go directly to the post office and file it there so that they have a local record. I hereby pass that on for your information.

I'm not sure they've ever dealt with streamlining their organization, which at one time supposedly had one supervisor for every 8 employees, one manager for every few supervisors, and on up the management food chain. If they haven't, then, that would be a start.

Supporters will say that the cost of postage really hasn't risen, it's merely being adjusted to inflation. That may be partially true, but I don't buy it. I'll bet if they improved their service, they might get a little more business and make the money they need.

I'm just sayin.

Miscellaneous Musings, #1: Westboro Baptist

2010-11-24T00:42:00.007-05:00

I should probably sub-title this post: "Some Days, You Get the Bear; Some Days, the Bear Gets You."

Gotta hand it to the loons at the Westboro Baptist Church, the supposedly "Christian" family cult in Kansas that pickets the funerals of military personnel with signs such as "Thank God for IEDs," "God Hates Dead Soldiers," "God Hates You," and, of course, their standard "God Hates Fags." Why they have that particular bee, and not others as well, in their bonnet is anyone's guess.

Now, I am a strong defender of the First Amendment. I truly believe that, no matter how hateful and vile the messages they spew, they have the right to say it. I have the right not to agree with them, and I certainly don't.

Fred Phelps and his wife, Margie, are both attorneys as well as pastors of their kindred flock. They can choose to parse the English language any way they want, but I think most funerals are and should be private affairs, allowing the friends and family of the deceased time to grieve. The kinds of stunts they pull is, at the very least, a breach of etiquette and boorish behavior.

No matter, these self-righteous blowhards believe in what they're doing, and they spend lots of time and money going around to various funerals to do their shtick. Many states have enacted laws against protesting at a funeral, and the church has been sued over it, and one case from Maryland, Snyder v. Phelps, was just argued at the Supreme Court last month.

I reacted with mild amusement at how our local news radio station reported what happened last weekend. Maybe you didn't hear about the event, at which a van, containing 6 of the faithful, showed up.

Apparently, the folks in Tulsa, OK, were ready. A local motorcycle club got between the protesters and the funeral, and, while they were shouting, the bikers revved their engines to drown them out. I hate when that happens.

But the part that really amused me was how the reporter told about the group going back to its van... and finding all four tires slashed. But the fun was only beginning for their intrepid crew. As they drove away on rims, they tried to find somewhere to replace the tires. Nobody in Tulsa would help them. Guess whoever did eventually help them got a nice sale: 4 tires, 4 rims, and all the trimmings.

I will say categorically that I don't condone willful destruction of personal property.

Ya know, though, sometimes, you spew your hate and filth all over the place and claim you are totally in the right. But that doesn't stop someone who finds you really offensive from reacting a little outside the law.

I'm just sayin.

Access to Healthcare for All Medicare Patients?

2010-03-22T23:00:00.005-04:00

In this post, I suggest that the new healthcare bill will have unintended consequences of reducing the availability of primary care available to Medicare patients once it goes into effect.

The following is text captured from a thread that I participated in shortly after the House vote dealing with the question of access for more Americans under the new healthcare plan. My church friend, XXX, and I have discussed the issue at length over recent months, and we have agreed to disagree agreeably.

The reason I'm quoting the thread is that in a related post coming soon from Under My Rock, entitled "Well, Isn't THAT Special?? Is This Really Debate?," you can see how, apparently, I ruffled someone's feathers and that person's reaction to the following:

======================================

Steve Boone

No, XXX, when your health care is provided by the government and you can't get quick treatment by a primary care doc *because there are too few to go around*, I hope you'll still be as exultant as you are now.

XXX

Your statement does not represent this bill (health care will not be exclusively covered by the government) and is completely unrealistic. You are certain the insurance companies have your back, Steve? They make their money denying claims. No secret there. You favor insurance companies rights to jack your premiums at will? Want to discuss pre-existing conditions or meeting runaway Cobra payments? Leaving the millions of hard working unisured is better than coverage? Mandated access to prevantative care is cruel? This is a quantum leap towards a healthier and well cared for society. I am sorry

you do not see it that way. How do you propose to care for the uninsured.

Steve Boone

XXX, first of all, let me repeat again what I have said to you in the past. YES, there is a need for health care reform in this country, a serious need. However, this is not the way to do it.

I realize you’re one of those people who ignores one little fact time after time: You can no more change the characteristics of The Market than you can stand on the shore and stop the waves. The Market will always do what The Market does.

Screw with The Market and you have “unintended consequences.”

Example? Your buddy, [Maryland Governor Martin O’Malley] Marty O’s brainstorm to raise the sales tax to 6% [in a 2007 Special Session of the General Assembly]. Should bring in more revenue, right? WRONG! The State Comptroller’s Office reported that, a year later, sales tax revenues were DOWN $76 MILLION. People who wouldn’t normally bother going to Delaware to pay 0% sales tax or wanted to buy clothes in Pennsylvania and save 6% sales tax DID so. The hit was hardest on the Eastern Shore. Who’d’a thunk it?

Now, remember what I do for a living. Healthcare billing. Yes, I’m aware that getting insurance companies to pay is a little more difficult nowadays. But Nancy Pelosi promised us that this new bill would increase access to care for all Americans. Bull.

Here’s just one example of where that pesky Market comes in: Medicare reimbursement will be cut by 20%. It’s in the bill, and CMS (Centers for Medicare and Medicaid Services) has suspended all payments since 2/28/10 until the new fee schedules are approved by Congress. This means that if I got $40.00 reimbursement for an office visit, [now] I would then only get $32.00.

If I’m a primary care physician with a geriatric patient population, what’s going to happen? My income is going to dive. I will have 20% less to pay my office space, my staff, my overhead, whatever. I have a couple of choices now. If I’m running a marginal practice, just eking by, I will probably close my doors. I’ll give people 3 months or so and close the practice because I no longer can afford to stay in business. Put that in 1,000 doctors’ situations, and what happens? The access to health care shrinks because there are fewer primary care docs to take care of Medicare patients!

Now, I’m running an OK practice, doing all right. I have a mix of patients, both Medicare and private insurances. The hit will be less on me, but, I may have to do the math and determine I can no longer afford to accept Medicare patients because it isn’t worth the paperwork and hassle and the reimbursement sucks. I send all my Medicare patients a note saying “due to reductions in payments by Medicare, I will no longer accept Medicare after May 1, 2010. Where’s the access to care now for these Medicare patients?

Now, I’m doing fairly well at my practice, I have a lot of well-to-do patients. I’m tired of messing with the insurance companies, I don’t want to deal with any of that any more. I can do the latest fad: tell everyone that I am changing my practice to a boutique operation, and if they pay me a retainer of, say $2,000 a year, I’ll see them whenever they need me, night or day. But, it’s a cash retainer, paid in advance. Again, there goes the number of available doctors!

And this is only a minor part of the bill, dealing with Medicare patients...

======================================

Rising Health Care Costs - Some Reasons

2009-06-27T18:36:00.010-04:00

Part of the "Healthcare Crisis" which has everyone calling for relief is the fact that the cost of medical services keeps rising. It's getting more and more expensive to see even a primary care doctor, and the time we actually see doctors in those visits seems to keep getting shorter and shorter.

For one of the many reasons this is happening, we need to look back in history some 50 years. Back to the "good old days." What's changed since then?

Back in the day, there were insurances, yes. Blue Cross and Blue Shield policies were probably among the most popular at the time. Many plans offered an 80/20 split, where the Blues would pay 80% of the charge, and you'd pay 20% as a co-insurance.

But millions of people didn't have any. They didn't really need it.

You'd go to the doctor, he'd see you for, say, 20 minutes, and charge you $25.00. If you needed penicillin, he'd come through with the pills you needed, charge you a nominal fee for the drug, and you'd be on your way. If he wanted you to take something he didn't have in stock, he'd write a prescription, and you'd take it to the drug store.

If you had no insurance, you'd pay the $25.00 in full and that would be it. If you had the Blues, you'd pay $5.00 and be out the door, with Blue Shield picking up the $20.00. Easy, right?

Well, yeah, basically.

Then along came President Lyndon Johnson, a Democrat, with his Great Society program. They were going to end poverty, fix all the social ills, and a new utopia was going to emerge. Under his administration, the government got involved in a lot of areas where it hadn't before. Enter federal involvement in health care.

Stories abounded how grandma had to eat cat food because she couldn't afford to go to the doctor. (No, I don't think grandma should have to eat cat food, either--that's not what I'm saying!) But, something had to be done about it! So, Congress worked and worked.

The result was Medicare in 1965.

At the start, Medicare acted just like a regular health insurance. They paid 80%, and the patient paid 20%, allowing the patient to have a little more cash available for other expenses. Many doctors accepted Medicare because it was just as good as Blue Shield. Some seniors even picked up Blue Shield or another insurance policy like AARP to pay the 20% co-insurance.

But, sooner or later, with the War in Vietnam in full swing, it became time to save money in the federal budget. So, what happened?

In a cost-cutting move, Medicare began to say:

"We have decided that the office visit you're charging $25 for is really only worth $20, so that's what we're going to allow you to be paid for a Medicare patient in your care. That means we're going to pay you 80% of what we allow, or $16, and you can collect $4 from the patient."

"Oh," the doctor replies, "so what happens to the $5 you don't allow?"

"You have to write it off, of course! You cannot bill the patient for the difference."

Well, now it's time to do a little simple math.

Let's say Dr. Smith needs revenues of $50,000 per year to meet her expenses for office space, office staff, taxes, and to give herself a salary. 20% of her revenues are Medicare patients with that level of service, or $10,000. Medicare revenues are now $8,000, instead of $10,000, a hit of $2,000, or 4% of gross revenues. Maybe that's absorbable, maybe it's not.

Now, let's say Dr. Jones has an older practice, and he serves mostly the elderly. Many of his patients love him and have been with him for years. He still needs that $50,000 in revenues, but fully 50% of his practice is on Medicare. $25,000 in charges turns out to be $20,000 in Medicare allowed charges. He's writing off that $10,000 in revenue, but that doesn't meet his expenses. He's taken a 20% hit in revenue, and cannot make ends meet on that level.

What is going to happen in either case? Something's gotta give to bring the gross revenues back up to the $50,000 level, right? Well, there are five obvious answers. The doctors either have to:

*(1) Raise the prices for office visits for all patients to make up the difference in what Medicare is forcing them to write off, or

*(2) Work longer hours and see more patients to make up the difference, or

*(3) Refuse to take new Medicare patients into the practice, or, worse yet for the patients

*(4) Refuse to take any Medicare patients, forcing them to go to other doctors, or

*(5) Simply close up shop (or, like what's happening now, set a date certain, then refuse all insurances and become a "boutique" doctor, where the patient pays a large retainer to call the doctor 24/7 when needed.)

Well, of course, the most common answer was #1. Raise rates. Maybe Dr. Smith could get by with raising her rates only $5.00 a visit, but that paltry amount wasn't going to get Dr. Jones' budget back in shape. And, guess who gets hit hardest by these increases? Who else--the patient without insurance!

Additionally, every year, Medicare revises its fee schedule--the allowed amount for the coming year for a host of procedure codes.

Is this a simplistic presentation? You bet! But as simplistic as it seems, it's accurate for what has happened.

In the 1970s, inflation ran amok. Inflation was measured by the "market basket." Remember it? The cost of a specific set of products at the supermarket would change month-to-month, and, imagine that, the cost of that basket pretty much always rose. The dollar bought less and less as it fell in value. Guess what happened to all the other prices? Same thing, they had to go up.

Since medical expenses are not in a bubble, they went up, too. And, insurance policies became pretty much an absolute necessity in order to help patients pay for medical care.

Although we haven't had the roaring inflation of the 70s since then, inflation hasn't stopped, it's only moderated a bit here and there. Prices of goods still go up even though inflation is fairly low, especially over the course of 30 years.

Next post: "Managed care" comes on the scene.

Health Care Reform? The Debate Looms. . .

2009-06-26T21:05:00.007-04:00

A brief introduction. . .

For the first few months of this year, I have been a frequent flyer as a consumer of medical care. I was an inpatient with three stays at two different local hospitals as well as an outpatient with a number of different providers, even including urgent care. Additionally, my work as a medical biller has helped me keep my own health care costs more contained. As the debate on healthcare reform nears, it is one in which I have some very definite ideas.

-----------------

Starting off, I want to say that I believe our healthcare mess did not develop overnight, and no "magic bullet" is going to fix it immediately. It's also an issue that cannot be discussed in a single post, so watch this space for new postings in the next few days. There isn't just one factor contributing to it, there are many, and they involve many different groups. In the next few posts, I will name names of those I think have had a hand in bringing the problem about. Some may even surprise you.

I don't have all the answers, and I won't claim to. I do have some ideas that should alleviate some of the crisis aspects, but they're not going to turn this situation around quickly. Nor will any of the "reforms" being discussed at this point in Washington or Annapolis.

All that having been said, welcome! Please, if you see something with which you disagree, post a comment! Likewise, if you see something with which you happen to agree, please feel free to add your comments, too. Lively discussions can be both very informative and helpful in framing an issue. Who knows? Offer a convincing enough argument, and you may get someone else to think differently. Maybe even me.

Some of the questions we'll explore will include:

* Why are health care costs so high?
* Why are health insurance rates so high?
* What about a single-payer insurance system?
* Why are people willing to gamble on no insurance coverage?
* Should people be forced to have health insurance coverage?
* Should we have a national health care system like Britain or Canada?
* Should we develop our own version of a national health care system?
* Why shouldn't the government just go ahead and regulate health care costs?

All right, then. I've already been working on my first "culprit" post, and I should have it done by tomorrow midnight or so. If real inspiration hits, there may be more "culprits" exposed by that time. Watch this space, and let's have a good discussion!

A Personal Cautionary Tale...

2009-02-21T13:16:00.005-05:00

Hello, and sorry for the delay of getting new stuff posted. If you haven't seen much here lately, it's because I haven't been able to do any posting. But, now I'm back! (I think...)

I offer a cautionary tale on many levels. There are no morals to the story here, just a bunch of stuff that happened that may give you something to take with you. If so, wonderful! If not, hey, I tried.

You know when they tell you you should never ask what ELSE can happen, because it's probably better that you didn't know? Take it from me--HEED that advice, and pronto!

DON'T ask.

Don't even THINK about it!

A combination of family emergencies and personal health crises has arisen over the last several weeks that basically took me out of circulation. It's going to be an interesting road back, and I'm going to have some commentary on some things that have happened, but, the bottom line is that I'm trying to get back into some sort of "regular" life pattern, and we'll see where we go from there.

Unbeknownst to us at that time as being somewhat related, I began having mild headaches around the first of the year. They weren't overly bothersome, but I could take an occasional dose of Tylenol (tm) or other non-aspirin product to get over the edge. In short, it was very manageable, and I didn't think any more about it.

In mid-month, my mother ended up being admitted to a hospital in Cumberland with multiple problems. She had been an active, vital eighty-two year old who was still driving on her own, had a bunch of different irons in the fire, and so forth. It was somewhat unexpected.

Not having a full-time job at the time, I was able to go up, stay with my sister, and help manage some things at that end. The headaches, of course, continued, and got a little worse. Still, what would you think? Stress? Duh.

Mom got better that next weekend, and I came home to start a new project. Headaches? Yup, a little worse. I'd been on blood thinners and decided to risk taking NSAIDs like ibuprofen, even though I knew that I probably shouldn't have, but wasn't getting relief with the other stuff any more.

The first night on the new project, Mom slipped away. I was in Cumberland in the wee hours. The headaches, of course, were kicking harder by then.

After a sort of decent night's sleep, we went about making arrangements, looking over the will, all that good stuff, and planned for a Friday funeral. Mom had done a lot of pre-planning, thankfully, and some of the expected expenses had already been covered, especially at the cemetery.

The head kept going.

I spoke for our family at her service and came home later that weekend, ready to go back to my project. The headaches became near crippling. I called my primary care doc's office for an appointment the following day (Wednesday), and they were able to squeeze me in in the afternoon. That Tuesday evening, I remember driving back home, lights bothering me, doing the best I could so I could down some naproxen.

Wednesday, my doctor ordered a brain CT. We tried to get a late afternoon scan, but to no avail. The radiologist's scheduler looked up my insurance and said that I needed a pre-auth. I duly reported it to the doc's office, and they told me they'd get me one the next morning. I did some pre-registration with the radiology office over the phone, and they said they'd be ready once I had the pre-auth to go from there.

My doctor's office called early in the morning, said she had talked with my plan, no auth was needed, but gave me a reference number in case I wanted to give it to the registrar. A 2 PM CT scan was scheduled.

I could still drive, but barely.

A CT scan without contrast turned into one with and without. I was asked to sit in the dressing room for a minute while they read it. Within another minute, the radiologist popped in and asked, "Say, do you like hospital food?"

"Not particularly," I replied, "but I figure that's where this is headed."

"OH yeah. I've spoken to your doctor, he's getting you ready to be admitted to Harbor. He thinks it's OK for you to grab a few things and get over there, they'll be ready for you."

Last couple of points in this tale:

The diagnosis was a subdural hematoma. Surgery was indicated, and fairly quickly. Blood thinners complicated the process because I couldn't have the surgery until I had plasma infusions and my bleeding time normalized. Surgery was done Tuesday. Recovery 4-6 weeks, though, since I'm able to do net stuff right now, I may be able to do some of my project a bit earlier.

So, there it is. I leave the gleaning of any lessons to you, and thanks to all of you for your prayers and support!

A "Throwaway" Poll for You. . .

2009-01-23T13:21:00.003-05:00

I was watching the Inaugural ceremonies this past Tuesday, and actually enjoyed most of the buildup and our new President's Inaugural Address. I'm happy to see some of the things he's done in just the first couple days in office that will start to reverse the damage done by the Bush Administration, and I wish him the best for our nation.

It's amusing that the news media has been taking certain elements of the program and picking them apart, though.

Last night, we found out that the musical number with Yo-Yo Ma and the rest of the gang was (gasp!) pre-recorded. It was still a beautiful selection, very nicely arranged, and performed well. I can understand that, due to the extreme cold, the instruments would probably not have kept in tune and the results could have been disastrous. I'm OK with that.

You gotta hand it to the folks that decided to attend and stand in that weather for a long period of time. I couldn't have done it.

The real amusing thing has been the "controversy" over The Hat, though. Aretha Franklin's grey bow hat with Swarovsky crystals. You couldn't forget it. Not that it wasn't interesting, it was! Not that it didn't go well with the rest of her outfit, it did! But the first words out of my mouth when I saw her come to the podium were, "oh, NO, she DIH-int wear that hat!" My sister, sitting with me, said, "oh yeah, she DID."

Seems that Ms. Franklin has a regular chapeau maker named Luke Soon, with whom she's had a long-term buying relationship. It's actually a combination of two hats that the Queen of Soul saw when she was shopping for her Inaugural duds. Apparently she wanted the bow from one hat and the cap from another combined, which, of course, Mr. Soon was only too happy to do. Ellen Degeneres wore a knockoff (apparently available for $178.00) the next day on her show, and, of course, CNN, Fox, and a few other tv networks had things to say about it.

So, here's the throwaway poll. You can see it in the sidebar. I realize there aren't enough choices to really give a chance to express an opinion, so, please make a comment if you wish as well.

New Stuff? I Need to Apologize

2009-01-23T13:07:00.002-05:00

For all my fans, all three or four of you, I apologize for not having new postings up in the last week or so. There has been a family emergency and I've been out of town, not really having the time or energy to think of new things to post. I fully expect that I may have some new stuff at the beginning of next week, so please check back after January 26 and see if I've done so.

Maybe This Year for Zero-Based Budgeting?

2009-01-14T13:31:00.006-05:00

You gotta pity poor Martin O'Malley and the Two Mikes in Annapolis. Really, you do.

Now that tax increases seem to be off the table, there's some real budget cutting that's got to happen. Call out the usual suspects: we're going to have to cut education, public safety, health services, you name it. It's the typical scare tactics they trot out every time.

Not this year, they won't! It won't fly.

The Governor is already saying that there is likely going to have to be layoffs of state workers. That's a real kick in the teeth for the folks that put him there, just like the furloughs were. Now, there are going to have to be job cuts, too.

Well, there are a couple of things to consider in trying to fix the budget mess. It's not an exhaustive list, by any means, but it's a couple of steps in the right direction.

1) There are phantom employees budgeted in a number of State agencies. A phantom is a worker whose salary is in the budget, but there is no employee doing any work. Let's say that our agency, the Bureau of Obfuscation, budgets 20 employees for the year, but we only really keep 18 filled. With 2 unfilled positions now we have money that *would* go toward salary and benefits if there were employees in those positions.

If each of the spots would pay $30,000, then that's $60,000 in "extra" money we can move around because we know we're not going to fill them in the first place. We don't have to put $37,000 in the budget for project X that we really want because we can take money from "salaries" and move it to X, and we'll still have $23,000 left over! And our Bureau isn't the only one in State government that has them.

Sure, but now the situation is dire enough that, even after you lay off all the phantoms, there will still be real people losing their jobs and benefits.

2) However, there's something even more galling, and both State and Federal departments do this. Our Bureau of Obfuscation got a $10 million appropriation for this year. We spent our money fairly wisely, and we still have our two phantoms, and now our total spending was $9 million. Uh oh!

We need to spend the other $1 mil and do it quickly, before the end of the fiscal year! Why? Because if we don't, those who make the appropriations process will see that we didn't spend all of our money, and they'll think we won't need $10 million or more for next year. I've mentioned this to friends of mine who actually are government employees, and they vouch for the fact it happens all the time.

Now, we go into panic mode and start ordering anything and everything we can. We stack our office supplies room to the ceiling with boxes of paper; grosses of pens, pencils, and highlighters; millions of binder and paper clips and other things. But we've only spent $100,000. What to do? What to do?

Well, we have to go on a spending spree! That office furniture we bought only two years ago is looking kinda rough. Suzie Q down the hall complained that the fabric was frayed on her arm rest. Get her a new ergonomic one, right away! The carpet in our posh lobby from last year has a tiny worn spot in it already, and the copiers we bought three years ago have been worked to death. Or have they? But, if we replace the carpet and buy two new copiers for each floor, we might get close to spending the entire $1 mil left in the budget. We'll get our appropriation for next year, and we can do it all over again!

Oversimplified? Yeah, admittedly. But a lot closer than you'd like to believe.

There's an alternative, though. Sooner or later, the State is going to have to look at it. Could this be the year? Under this Governor?

It's called zero-based budgeting. Instead of looking at what your budget was last year, you start at zero. How much are we going to need for real employees? Add it in. How much are we going to need for office supplies? Add that in. What's our phone bill? Add it in. And so forth.

Now, how much do we need for the programs we actually administer? What are the historic costs we've incurred in administering this program, not what number have we decided to pull out of the air because it sounds cool? Are there inefficiencies we can correct to save even more money?

Do we let our lights burn all night instead of shutting them off when nobody's in the building? Is our HVAC system set so that it doesn't provide the heat or AC to keep the mice nice and comfy at night, but is good for working hours? Do we shut our computers off at night, keeping only the essential servers going?

OK, you want to add $1.5 million in the XYZ program. What does the XYZ program do? How much did we spend last year? Why? How effective was the program, how many people did it help? How will the new money be spent? What is your budget for XYZ? Basically, you justify your expenditure proposal. It could happen.

Let's say your 12 year-old child comes to you and says, "Mom, when we go shopping today, would you give me $20.00?" Your first reaction isn't going to be, "sure, honey, here it is. Enjoy. Buh-bye."

At least that's not what MY mother would have said. (If you would say it, could you adopt me, please???)

No, you're going to ask why the child needs the $20.00, what she intends to buy with it, why she needs the item, and you'll probably have a whole host of other questions.

In this period of budget crisis, and even in good times, we should do no less with government budgets.

What can we do about it? Contact your legislators, both your Senator and your Delegate(s), and let them know you want a different approach to budgeting! You can find out who your folks are by going to the General Assembly website at: http://mlis.state.md.us/ and put your address in the "Find Your Legislator" box.

And, while you're at it, why not drop Gov. O'Malley a little note asking the same thing? http://www.gov.state.md.us/mail/

UH OH! Guess What Happens Wednesday?

2009-01-12T01:48:00.007-05:00

The Maryland General Assembly opens its 90-day Session in Annapolis on Wednesday, January 14, 2009. Although the State is going through some tough economic times right now, various legislative leaders seem to indicate that tax hikes are not likely, but that budget cuts are. (Whew!)

I'm already looking at the synopses of bills that have been pre-filed, and I've got a couple of them that have me scratching my head. Once I see the synopsis, if I have other questions, I'll go into the text of the bill itself.

SJR 1, for example, would have Maryland finally ratify the 17th Amendment to the US Constitution, which provides for the direct election of US Senators. It was ratified on April 8, 1913. (And we need to do this, why?) http://mlis.state.md.us/2009rs/bills/sj/sj0001f.pdf

What will they get into this year? I don't know, but stay tuned! I'll try to report on it as best I can. And I welcome comments!

Just remember, if the 2007 Special Session didn't prove the following quote, nothing will:

"No man's life, liberty or property is safe while the Legislature is in session."

Now, I digress. Do you know who said that? The answer may surprise you!

A lot of people think that it was either Mark Twain or even H. L. Mencken that came up with the saying. In doing research on the net, I wasn't quite satisfied, so I looked for as many references as I could find, and one source seems to have done exhaustive work on it.

The American Dialect Society has a number of citations as to where the quote was first found, and it determined that it was neither Twain, nor Mencken, nor even Ambrose Bierce (1842-1914), a journalist and short-story writer during his lifetime.

The answer? Judge Gideon Tucker. Who? He ruled in favor of a widow in a negligence suit [1 Tucker 248 (NY Surr 1866)] because her attorney did not advise her on the most current law dealing with settling her husband's estate. That's when he uttered the quote.

It seems that Twain somehow got hold of the statement, used it, and Noah Webster apparently credited Twain with it rather than the judge.

If you'd like the citation, drop me an email and I'll send it to you.

Anyway, Wednesday's going to be the first day of many of fun. And, think of it! We'll soon have Governor O'Malley delivering the State of the State Message!

A Poll on The Economy, Just for Fun

2009-01-11T00:26:00.005-05:00

Just how confident are you that President-Elect Obama's economic team will be able to do much of anything with the economy in the next 12 months? Will the Wall Street banker types and the head of the New York Federal Reserve Bank be able to start fixing a badly-broken system in that time?

I thought I'd put up a poll to see what you all had to say about it. You'll see it down on the sidebar, so please take a moment and cast your vote. When it's done, I'll post the results and we can discuss them. I wanted to see if there was a market for occasional polls on this site, because they might be fun to do.

Meanwhile, this post is open for your thoughts about the economy in the next year and what we think or hope will happen with it.

I will admit I haven't taken a real close look at the PE's economic plan yet, especially since he just announced it the other day. What the mainstream media boils it down to and what was actually said can often turn out to be two different things. I prefer going to as close to the source as I can for something like that.

Has anybody looked at your 401(K) or other retirement plans yet? I'll admit, I'm scared to open mine, especially since the company I worked for had lousy choices in the first place. I know that a friend of mine has looked at his 403(B) since the meltdown, and he's down to around $20,000 from $35,000 this past summer.

How's that bailout working out for US?

It appears that our new President is going to have a lot of Bill Clinton's retreads on his team. That could be good or bad news, because, on balance, the Clinton years weren't all that bad economically.

Will that be enough to bring consumer confidence up so that people will start spending again? Will businesses start expanding again? Will the jobless rates go down, even slightly?

Will the opinion-makers in the press and media be able to convince Joe the Sixpack that everything's far rosier than it is? (Remember Josef Goebbels.)

OK, now I'm getting farklempt. I've put a lot of questions out there! Discuss.

Noon on January 20 Can't Come Fast Enough

2009-01-09T21:35:00.008-05:00

Dear Mr. Bush,

The title of this post says it all. Your presidency has been an absolute disaster for just about everybody concerned, and I can't wait until your last moment in office. No, I didn't vote for you in either 2000 or 2004, neither did I vote for your Democratic opponents.

As a Republican, you belied everything that the GOP stood for. If I hadn't decided to leave your party in 1996, I would definitely have hit the road during the early portion of your first term. The "Compassionate Conservative" turned into the "Big Government Socialist Warmonger," ruining just about everything you and your neocon cohorts could get your mitts on.

The assault on civil liberties following 9/11 -- and what DID you know and when DID you know it beforehand? -- by the USA PATRIOT Act and other legislation is reminiscent of the Clinton reaction to the 1995 Murrah Building incident in Oklahoma City. The bottom line is that we've lost a hell of a lot of our civil liberties in the last two administrations.

"No Child Left Behind" was based on a fraudulent program in Texas and has been shown as the mistake it was in the years since its passage. Discipline problems run amok, schools can't take the steps they need to correct these problems for fear of losing federal funds. Teachers don't like it, school systems have to hire extra staff and spend extra money to administer it. And to think that developmentally disabled children who can't even take care of themselves with basic life skills are going to be able to pass Algebra II by a certain age just flies in the face of reality. It needs to be either radically reworked or, better yet, scrapped.

An attack on Afghanistan *might* possibly have been justified on the basis of the Taliban's aid and comfort for al-Qaeda. However, the war in Iraq, which has cost thousands of American lives and countless Iraqis, and spent untold bagazillions of dollars, was absolutely over the top and unjustified. Now, we're in a morass where someone else is going to have to clean up *your* mess.

On the basis of "UN Resolutions" you stubbornly led a coalition into Iraq. I'm sorry, but when are US troops supposed to be used to enforce UN Resolutions? Especially when the UN has NOT requested that they be used?

The US Constitution (remember that old thing?), which you swore "to preserve, protect, and defend" does NOT call for this nation to be the world's policeman. Nor are we to arrogantly tell others how they must live or mandate what system of government we think is best for them. That's what's gotten us into this situation in the first place!

You've consistently grown the government you talked about paring back. New departments, new fiefdoms, new titles, new powers assumed, new regulations.

Your economic policies haven't been much better. Although I did agree with the tax cuts to help stimulate the economy, I did not think your cozy relationships with all the Wall Street crowd was terribly helpful. There were many warning signs that the subprime market was going to bite us in the rear, but your administration ignored them.

Then, when it all went south, Hank Paulson's "solution" was the big bailout in September, making the Sec Treas the "Bailout Czar," with the sole and ultimate authority to decide who got what funds. (And those are his to give, WHY? )

Sure, there's plenty of paper stock at the Bureau of Engraving and Printing. Roll 'em out, don't worry that our dollar may well free-fall.

Last time I checked, a free market didn't guarantee that if you made bad decisions, the government would bail you out. If you made bad decisions, it was your problem to figure out. We haven't had a free market in decades, though.

But I nearly went through the roof when the bailouts occurred. Taking over AIG made us, for the first time, a socialist nation. The government now owns a certain percentage of equity in exchange for funds in a company that immediately sponsored a lavish vacation for its inept executives at a posh spa. Great.

And it didn't stop there! Now the government has equity in a number of banks and other companies that are "too big to fail."

I've suggested that we scrap the "Star Spangled Banner" for "The Internationale." I'm only half kidding.

No, sir, I'm not going to miss you and the rest of your gang. That all this damage could have come in just eight years is astounding. I'll give three cheers that "The Decider" has finally left the building and we'll be through with him. It will be up to the new administration (which, I'll also say in full disclosure I did not vote for) to try to rebuild our foreign relations, our economy, our morale.

I'm looking forward to the "change." It certainly can't be much worse...

Unintended Consequences of MD Slots?

2009-01-09T11:47:00.000-05:00

Back in November 2008, you almost would've forgotten that there was a presidential election going on in this state. Why? After all, at 8:00:01, you *knew* Obama had 10 electoral votes.

Megabucks (and not the multi-state lottery game) were being spent by both sides trying to convince us to either approve or shoot down a Constitutional amendment to permit Video Lottery Terminals (slots) gaming in our dear state.

It's funny how in 2003, when Bob Ehrlich (R) was governor, Mike Busch (D) couldn't see his way to permitting slots in the state. It was a horrible idea, and we didn't need them, and all sorts of evil would befall the state if we were to allow them. And, for 4 years, we didn't get slots.

Fast forward to 2007, now Martin O'Malley (D) is governor, and the economy is starting to go to hell in a handbasket. O'Malley called a Special Session and Speaker Busch jumped right in line saying that, hey, the economy was bad, and slots would now be good.

Comptroller Peter Franchot (D), a slots opponent all along, to his credit, said that he still thought it was a bad idea. I'm not going to rehash all the arguments, the election is over. (Whew!)

However, I gotta tell you, it's not the lottery terminals I had a problem with. It's the METHOD of bringing them to Maryland that stunk. Those who opposed the amendment will be able to point out next year that the slots, which will just possibly be coming online, are not going to live up to the promises made, and may organize to oust the rascals that voted to put the question to the voters. Can I help?

You see, if the Assembly had grown a pair, they could have simply passed a bill authorizing slots and the parlors could be well under construction or even open right now. There really was no need to amend the Constitution to do it. The bill could not have been sent to referendum because, under the Constitution, it is a "revenue bill," and, therefore, not referrable.

I did mention unintended consequences, right? Back in 2002, I was spending an evening at the Charles Town Races and Slots in West Virginia. They had just begun construction on a new garage and expanded gaming floor, and I had the chance to speak to a security guard. He told me that they hoped that MD would pass slots in 2003. Why? Because the WV General Assembly would be ready to consider adding table games in their state. Now that slots are also in Pennsylvania, how soon do you think they can pass it?

Cool! No more 2-1/2 hour drive to Atlantic City to have to deal with their attitude. No more 5 hour flights to Vegas, where western hospitality was a lot of fun, but the jet lag sucks. We may soon go to WV and get it all there!

Full Disclosure: I have gambled in slot parlors in PA, DE, WV, and other states, and will likely also do so in MD. I have no problems if an adult wants to spend some of his entertainment money playing slots. But, in the end, I also voted "AGAINST" the amendment.