See the Sun on the Jay Leno Tonight Show - click here
A New Way Insurers are
Shifting Costs to the Sick
By charging higher prices for generic drugs that treat certain illness, health insurers may be violating
the spirit of the Affordable Care Act, which bans discrimination against those with pre-existing conditions.
by Charles Ornstein
From Our Washington News Bureau, ProPublica, Sep. 17, 2014, 11 a.m
→ Health insurance companies are no longer allowed to turn away patients because of their pre-existing conditions or charge them more because of those conditions. But some health policy experts say insurers may be doing so in a more subtle way: by
forcing people with a variety of illnesses - including Parkinson's disease, diabetes and epilepsy - to pay more for their drugs.
Insurers have long tried to steer their members away from more expensive brand name drugs, labeling them as "non-preferred" and charging higher co-payments. But according to an editorial published Wednesday in the American Journal of Managed Care, several prominent health plans have taken it a step further, applying that same concept even to generic drugs.
The Affordable Care Act bans insurance companies from discriminating against patients with health problems, but that hasn't stopped them from seeking new and creative ways to shift costs to consumers. In the process, the plans effectively may be rendering a variety of ailments "non-preferred," according to the editorial.
"It is sometimes argued that patients should have 'skin in the game' to motivate them to become more prudent consumers," the editorial says. "One must ask, however, what sort of consumer behavior is encouraged when all generic medicines for particular diseases are 'non-preferred' and subject to higher co-pays."
I recently wrote about the confusion I faced with my infant son's generic asthma and allergy medication, which switched cost tiers from one month to the next. Until then, I hadn't known that my plan charged two different prices for generic drugs. If your health insurer does not use such a structure, odds are that it will before long.
The editorial comes several months after two advocacy groups filed a complaint with the Office of Civil Rights of the United States Department of Health and Human Services claiming that several Florida health plans sold in the Affordable Care Act marketplace discriminated against H.I.V. patients by charging them more for drugs.
Specifically, the complaint contended that the plans placed all of their H.I.V. medications, including generics, in their highest of five cost tiers, meaning that patients had to pay 40 percent of the cost after paying a deductible. The complaint is pending. ()
Proino Breakfast Club of Largo
My friend Lenny (84 years old) eats at all the restaurants in the Tampa Bay area. He raved about this restaurant in Largo, so I decided to check it out. Like the name says, it's a breakfast joint that lingers open through lunch. I ordered the three egg Number 9 from the menu. It looked so good I photographed it.
I was waited on by MacKenzie, a lovely lady who kept the coffee cup full and gave me lots of attention. I didn't even have to drop Lenny's name to get the VIP treatment. [Lenny has charmed the waitresses everywhere in the greater Clearwater area].
Now for the chow. Two generous links of saussage, two strips of bacon, two pieces of ham, eggs cooked right, slice of watermelon, a chunk of pineapple and a boatload of homefries.
The meal came to just under ten bucks, including the coffee and the meal. The service was so good I splurged on the tip.
Pic: Stan Kosharsky
Clean and shiney, full of joy and attractive aromas, the place just can't be beat.
The long and short of it is this restaurant gets 5 Suns, our highest rating.
Story by Stan Kosharsky, Sun Food Critic
Address: 201 W Bay Dr, Largo, FL 33770
From Our Washington News Bureau
Campus Sexual Assault: What Are Colleges Doing Wrong?
We’ve rounded up cases and coverage that show the persistence of sexual violence at colleges.
by Abbie Nehring, ProPublica, July 29, 2014, 2:54 p.m.
Update July 29: We have updated this article to include
the responses universities gave to the stories.
So how are colleges failing to protect students from sexual assault? We sorted through the reporting to highlight a few cases that show the system's greatest shortcomings.
When Football Goes on Trial
Lizzy Seeberg committed suicide ten days after reporting to Notre Dame campus police that she had been sexually assaulted by a Fighting Irish linebacker. As news of the allegations spread, Seeberg was threatened by the player's teammates. "Don't do anything you would regret," one texted her. "Messing with Notre Dame football is a bad idea."
The campus authorities didn't interview the accused player until 15 days after receiving Seeberg's statement, five days after she committed suicide. The police declined to bring charges and Notre Dame declined to discuss the case when it was first reported.
Since 2010, there have been investigations into rape and sexual assault by football players at the University of Missouri, Baylor College, the US Naval Academy, University of Texas, Vanderbilt, Appalachian State, and numerous others.
And officials have frequently faced scrutiny for their response. When a freshman at Florida State University reported that star quarterback Jameis Winston had raped her, the case was kept under wraps until TMZ broke the news. The New York Times later detailed how authorities failed to promptly investigate even though records show that the athletic department knew about it less than a month after the victim came forward. The university declined to speak to the Times about the case, citing privacy laws.
Hidalgo In Clearwater
The Clearwater Sun is focusing on the surging development of local businesses owned locally. The first segment of the report deals with business proprietors from the State of Hidalgo in Mexico. Mexicans from Hidalgo constitute the vast majority of the population from south of the border who live here.
Andres "Andy" de Hildago owns a small grocery on N. Jefferson Street, just northeast of the intersection of Missouri Avenue and Gulf to Bay. His closest competitor is Save-A-Lot, a food store headquartered in St. Louis, Missouri.
When asked about the sucess of his small bodega, Andy replied, "My wife and I can not have children, so I have the time to pour into the shop to make it the best for my customers. I stock the shelves with fresh vegtables, exotic beer, cowboy boots, and I keep long hours to accomodate those with cooking needs after the corporate stores have closed for the day.
"There is a big parking lot behind the shop and we have drive -through space in the front which allows quick in and out access."
A Sun study of the little shop of wonders compared Andy's place to the corporate stores, Save-a-Lot, Publix (Corporate offices in Lakeland, Atlanta, Miami and Jacksonville) and Wal-Mart, headquartered in Arizona. Andy's prices were often in excess of 300% lower than Publix. The waiting time compared to Wal--Mart was 3-15 times faster, depending on the time of day. Subjective analysis of the quality-to-value ratio of Andy's products to Save-a-Lot resulted in the determination that the food tastes better from Andy's shop.
The staff is fluent in English and Anglos are welcome. The bodega is located at 27 N. Jefferson. Be exotic! Buy local!! -Tiki Parrot
There are two Sandboxes of note. One is the local St. Petersburg College student online newspaper. The other is a news forum for American armed forces men and women (and their families and friends) in connection with duty in Iraq and Afghanistan. Both are good reads.
The armed forces Sandbox is hosted by writer, director, actor, producer and Pulitzer Prize winning cartoonist Gary Trudeau.
To see the military news blog, click here.
RUSSIAN PIANIST PLAYS AT BON APPETIT AND HOUSE CONCERT
Concert Review by Eden Vaning
It was an afternoon of Musical Magic as Kathy Roberts, (the well loved pianist from the Bon Appetit), opened her home to friends and music lovers for a special Soiree to honor a very special guest artist from Russia, concert pianist Andre Shumilov, who enthralled the attendees with a bouquet of musical gemstones including Etudes by Chopin and works by Debussy, Tchaikovsky, and Rachmaninoff.
Andre Shumilov exhibited amazing command of the piano keyboard, being equally at home with pyrotechnic runs, awesome leaps, and anything else the music demanded of him. He captured the hearts of his audience with his flawlessly beautiful lyrical, Romantic style. In a setting resplendent with a candelabra gracing the grand piano, one couldn’t help but sit back and just let his music “sing” to you!
Interaction between the audience and performer is what a Musical Soiree is all about. In such a personal setting, the audience was thrilled to hear the stories and inspirations behind the pieces as related by the performer.
Finally the audience was treated to a selection of Mr. Shumilov's compositions. You could hear his imagination pour forth as he contrasted “growling” lower piano sounds with feather-like, breath-taking higher moments, as the music spun out the stories of the melodies.
Attending an intimate musical event like this, a person realizes just how lucky one is to be “in the moment” of this experience. Indeed, it is magical. To be with an artist of this caliber, trained across the world in the Moscow Conservatory of Music, and to be able to experience the depth of humanity that is deep inside our souls, we are shown that we can, all of us, no matter who or where we are, share the beauty of aesthetics, and be lifted into a higher state.
Perhaps Classical music, which has survived for centuries despite all the strife, stress and pain rampant in this world, will again take its place to bring people together in peace and love. _______________________________________________________________________________________________________
Two secretaries in a doctor’s office have pleaded guilty and a pharmacy owner faces charges
in a scam that Medicare allowed to thrive for more than two years.
[From our Washington News Bureau:]
ProPublica, July 11, 2014, 7:59 a.m.
The fraud scheme began to unravel last fall, with the discovery of a misdirected stack of bogus prescriptions — and a suspicious spike in Medicare drug spending tied to a doctor in Key Biscayne, Fla.
Now it's led to two guilty pleas, as well as an ongoing criminal case against a pharmacy owner.
Last year, ProPublica chronicled how lax oversight had led to rampant waste and fraud in Medicare's prescription drug program, known as Part D. As part of that series, we wrote about Dr. Carmen Ortiz-Butcher, a kidney specialist whose Part D prescriptions soared from $282,000 in 2010 to $4 million the following year. The value of her prescriptions rose to nearly $5 million in 2012, the most recent year available.
But no one in Medicare bothered to ask her about the seemingly huge change in her practice, Ortiz-Butcher's attorney said. She stumbled across a sign of trouble last September, after asking a staffer to mail a fanny pack to her brother. But instead of receiving the pack, he received a package of prescriptions purportedly signed by the doctor, lawyer Robert Mayer said last year. Ortiz-Butcher immediately alerted authorities.
Since then, investigators have uncovered a web of interrelated scams that, together, cost the federal government up to $7 million, documents show. (Go to Health Page)
How Many Die From Medical Mistakes In U.S. Hospitals?
From our Washington News Bureau, Propublica, Story By Marshall Allen, Photo Illustration by Tiki Parrot
It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse.
In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.
In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.
Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says. -
Kickbacks for Docs
Propublica story - click here for more
The purpose of a tatoo is to send a message. Whether a message is effective or not depends on the interpretation. To the left is Tiffany, whose Zombie is ripping the skin apart in an effort to leave the beauty's body. The pale gentlemen to the right has an olio of tat art, which gives a multi-purpose communication, with straight forward purpose. Sun photographer Tiki Parrot captured both pictures. He created the humorous title art for the female tat, but drew a blank for the man.
Phillie Feds Think Bumper Sticker Is Real
Arrest Musician and Her Banjo
Emily Yates, who claims to have put her life on the line for her country in Iraq, is shown in a video with her banjo in the Independence Hall park. The clip shows a federal park policeman asking her words to the effect, "So you refuse to leave?" Ms. Yate's reply is to the effect, "Tell me why I have to go and I'll leave."
This is followed by the banjo player being grabbed by the arresting officers. The instrument is banged hard against a park bench. As Ms. Yates protests her innocence, an officer tells her to "Stop Kicking." The instrument and Ms. Yates continue to chafe the bench top rail as she tries to pull her hand free. An officer is shown applying an offensive martial-arts move to the woman's left shoulder. Ms. Yates releases three screeching painful sounding screams for help as the officer re-administers the martial arts offensive pressure to the shoulder two more times.
Clearwater Sun publisher Charles Perry has claimed responsibility for the arrest.
"It's my fault. I had that bumper-sticker on my car for years. 'Play a banjo, go to jail.' I though everyone knew it was a joke.
"In my opinion two things went wrong here," Mr. Perrry continued. "First, the feds over-reacted. It's like the federal beach on Cape Cod. Nude sunbathing is against the law. A woman gets caught sunbathing naked. They don't run her in. She gets a $75 ticket.
"Second, Miss Yates, doesn't know the law. There is a crime in this country called 'Contempt of Cop.' - You won't find it on the books, but it exists. - She was grandstanding for the camera. The video starts with a lot of cops responding. Something happened earlier which you don't see. Here three doses of pain were administered and an instrument was abused.
"The point to remember in this age of video is reality T.V. is not to be used to bait the cops. In fact, I would debate that reality TV is not even an aesthetic art form." But don't use the camera in an effort to create a situation." - Link to Video - Kody Moe
DON'T THROW AWAY THAT JUNK MAIL!!!!
NOAA, the National Oceanic and Atmospheric Administration is sending a survey to random families in Clearwater. Doesn't take long to answer. There're questions about the weather (that's a NOAA weather station orbiting the Earth in the photo to the left) and questions about how you experience the world's oceans.
And if you're lucky enough to get one of the random surveys, you'll find TWO CRISP ONE DOLLAR BILLS inside.
NOAA is the government agency made famous in a series of books by Clive Cussler in which a swashbuckling employee, Dirk Pitt, collects rare cars, planes and a bathtub. The author writes himself in the series as a minor character. Mr. Cussler actually owns many of Dirk Pitt's rare autos, including this Maybach Zeppelin. Photo by Späth Chr
Jessica Montilla, a local occupational therapy student, was lucky enough to open the NOAA junk mail. "I could not believe the cash drifting onto the floor." Asked what she was going to do with the Washingtons, Miss Montilla said, "My mom filled out the survey, so she kept the bucks." - Kody Moe
The Whistle Stop
A Showcase For Musical Talent
The Whistle Stop outdoor cafe showcases a multitude of musical talent including Steve Grant, left, a guitar-player - singer whose song list features a rich mix of classic rock, alternating with great country sounds.
Every Wednesday features an appearance by the house band, The Back Porch Players, a virtual incubator of local talent.
Thursday night is open mike and provides a glimpse of the evolving musical talent from the Pinellas area.
One recent act was Rebecca Zapen, a hot looking violinist who plays hot music to crowds enchanted by her magical charm. Rebecca's song "Colorado" was selected for The Alternate Root's 'Women Only' sampler. (Click here to listen to the sampler: Alternate Root's 'Women Only' Sampler).
915 Main St, Safety Harbor,
LISA INSERRA TAPPED TO TEACH
VIDEO PRODUCTION CLASS AT
ST. PETE COLLEGE
Lisa Inserra, a video producer of top end videos for corporate executives for Cox Media (affiliated with Valuepak), is the new professor of digital media at the Seminole campus.
The teacher, who has a masters degree in film and television production from an academy of art and design in Savannah, is known for requiring students to engage in hands-on production. In fact, her class produced a short news interview segment using three television cameras, and professional sound equipment.
In addition to teaching Studio Production and Direction, she also teaches Survey of Digital Video. Tony Cerano, who transferred to St. Petersburg College from a local for profit arts school praised her teaching ability. "All we did was write essays about three point lighting. Professor Inserra had us do actually three point lighting in the school's television studio. It's nice being in a real video instruction program."
by Kathy Baird and Tiki Parrot. Professor Eric Hulsizer in SPC studio:
on the War on Poverty!?
Sorties From Faux News Rep. & Clearwater Lawmen
Tucker Carlson, son of an heir to Swanson Foods and an ambassador, graduate of Trinity College, and Fox News talent speaks out on the evils of “cheap student loans.” Mr. Carlson was raised in an affluent seaside community and is well familiar with the need for a labor market.
The quote was recently featured on the Doonesbury comic strip page of Slate E-zine in a segment entitled “Say What?”
Don’t Sit-on-the-Curb Law
Clearwater’s criminalization of sitting on curbs and sidewalks, adopted by the City Council last year, is being enforced. The law applies to the beach area, the downtown and the “gateway” area, which extends from Cleveland Street along Gulf-to-Bay Boulevard to Highland Avenue.
The law bans bottoms on curbs adjacent to private property as well. The use of personal chairs is also a violation subject to charges.
Local resident John Baltimore criticized the law:
“It’s just designed to cover up the problem, to hide the poor. Build them some housing instead!”
ACE Complete Auto Repair= John M. Everett IV - 1021 Park Street - Clearwater, FL 33756 - 727-441-8737
"I was totally black in the back. These guys fixed my lights and did it quickly and reasonably." - Jessica Montilla
This power trio is no relation to the local publishing company, but they do have a great smokin' sound!
Their most recent gig was on Nix, a small moon of Pluto, in an open-air cafe. It's the kind of place where they sweep up the eyestalks at the end of the night.
Moons of Pluto Studios
Violetta Flipperdoodle Dash is The World's Longest Dog
A rock opera. For more information contact Kathy Baird, email@example.com
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Call a Pro to Teach You.
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