The Mornin' Mail is published every weekday except major holidays
Tuesday, December 8, 2009 Volume XVIII, Number 119

did ya know?


Did Ya Know?...The First United Methodist Church, 7 & Main will hold their annual Holiday Breakfast and cookie walk on Sat. Dec. 12. 8 a.m. to noon. All you can eat breakfast $4 per person.

Did Ya Know?... There will be a Red Cross blood drive at the Nazarene Church , 2000 Grand, from 11:30 a.m. until 6 p.m. Thursday December 10.

today's laugh

One Christmas, mom decreed that she was no longer going to remind her children of their thank-you note duties.

As a result, their grandmother never received acknowledgments of the generous checks she had given.

The next year things were different, however.

"The children came over in person to thank me," the grandparent told a friend triumphantly.

"How wonderful!" the friend exclaimed. "What do you think caused the change in behavior?"

"Oh, that’s easy," the grandmother replied. "This year I didn’t sign the checks."

St. Nicholas is the main Claus. His wife is a relative Claus. His children are dependent Clauses. Their Dutch uncle is a restrictive Claus. As a group, they’re all renoun Clauses. Santa’s elves are subordinate Clauses.

A Chronological Record of Events as they have Transpired in the City and County since our last Issue.

Stamps Must Be Cut.

Revenue Inspector P. J. Ostergard today received official notice from the Treasury department of the new ruling in regard to the cancellation of revenue stamps. All stamps of over ten cents value must be cut three times with a knife or other sharp instrument, so as to completely destroy it. The circular is signed by Lyman J. Gage, and is intended to prevent further swindling by washing the cancellation marks out of the stamps of larger denominations. The ruling is already in effect.

Two New Cases Near Joplin.

Joplin is not getting rid of smallpox as successfully as Carthage did. Two new cases were discovered in a family names Flowers at Villa Heights near that town on Saturday. The father and one child are afflicted. The house was quarantined and a guard stationed in front of it.

  Today's Feature

Parking Vote Set For Tonight.

The City Council is scheduled to hear the second reading, and vote, this evening on the proposed temporary ordinance that would remove the two-hour parking restriction from the downtown area. The proposal would eliminate the restriction during the months of January and February. If enacted, the ordinance would have to be revisited by the Council to make it permenant.

During the last Council and previous Committee meetings, four members have spoke against lifting the restriction. Three members of the Public Safety Committee in Committee meeting to recommend the ordinance to the full Council. Committee Chair Bill Welch voted against the recommendation in Committee, but stated in the last Council meeting he would vote for the proposal when it came up in second reading.

This proposal is coming before the Council as an ordinance and as such requires six votes to be enacted.

The City Council meets every second and fourth Tuesday of the month in City Hall at 7:30 p.m.


What Health Care Reform Means for: Medicaid Recipients

by Sabrina Shankman and Olga Pierce, ProPublica

Sarah Goodwin, 25

Location: Harvey’s Lake, Pa. Health Care Status: Medicaid recipient Household Income: $0, but she has a Social Security application pending

When Sarah Goodwin, 25, was diagnosed with Chronic Fatigue Syndrome, she was a senior in college in Maine. After running out of savings to cover her health costs, and unable to work because of her condition, Goodwin went on Medicaid.

Her story:

Sarah Goodwin, who has chronic fatigue syndrome and a slew of immune deficiencies, relies on Medicaid for health coverage.

Medicaid serves low-income and disabled individuals, with the federal government paying for about 60 percent of the program (with a temporary boost of that percentage included in the stimulus bill) and states paying for the rest. Goodwin has experienced firsthand the wide leeway that states are given in determining who is eligible and what services are covered.

In Maine, Goodwin was able to get only temporary Medicaid, which meant she was constantly reapplying, and having to fight to get the medications she needed. Two years later, she has moved from Maine to Pennsylvania, where she says she’s had a better experience. "The Medicaid people here are really helpful," she says.

Most of the Medicaid-covered services that Goodwin uses are free, with some doctors charging a $3 co-pay.

"I’m really happy with the Medicaid that I have right now, and I would hope that it would stay the same," she says.

For those, like Goodwin, who have chronic conditions, Medicaid can be a lifeline.

"If I ever miraculously get better, I’m still going to be uninsurable," she says.

What changes would mean for her:

Goodwin has seen the two sides of Medicaid: first in Maine, where the program didn’t meet her needs, then in Pennsylvania, where it did. Some states offer coverage for children from families with incomes as high as three times the federal poverty line. Other states cut off eligibility at 100 percent of the poverty line. Some states cover childless adults, some don’t. Physical therapy may be covered with a $1 co-payment – or not at all. This variability among states is one of the major complaints about Medicaid, and is one that the Senate and House health care bills attempt to remedy.

Both the Senate and House bills would require all states to have the same income cutoff for Medicaid.

The Senate bill would expand Medicaid to cover those with incomes up to 133 percent of the federal poverty line (about $14,000 for a single person) starting in 2014, while the House bill would expand it to 150 percent, or about $16,000, a year earlier. The Congressional Budget Office estimates that both bills would result in as many as 15 million new Medicaid enrollees by 2019.

Both bills would make low-income adults, like Goodwin, eligible for Medicaid coverage, even if they don’t have children. Currently, only 15 states offer such coverage — which the states pay for on their own. And many of those states have closed their programs to new enrollees because of funding concerns.

To address disparities among states in benefits for childless adults, both bills would define a minimum benefits package, which would include mental health services. The House bill goes one step further, requiring that beneficiaries be offered preventive services and vaccines with no co-payment.

The biggest difference between the House and Senate bills regards another disparity among states that can have a big effect on how easy it is to get care. Medicaid as a whole tends to pay less than other insurers for health services – and in some states a lot less. This means it may be difficult to find doctors willing to accept Medicaid patients.

To avoid this, the House bill would incrementally increase Medicaid payments for primary care to the higher rates paid by the Medicare program. The Senate bill has no such increase.

Medicaid is already notoriously expensive, accounting for about one-fifth of all state spending. Critics of the expansion have argued that expanding the program is an unfunded mandate that would break states’ already strained budgets.

Under both bills, the federal government would pay a higher share of the cost of new Medicaid enrollees than it pays for people in the program now.

In the House bill, the federal government would pay the full cost of coverage for new enrollees until 2015, when the percentage that Washington covers would be set at about 90 percent.

The Senate bill would pay the full cost of new enrollees for the years 2014 to 2016, then gradually adjust the share that Washington pays. From 2019 onward, the federal government would pay 32.3 percentage points more of the cost of each new enrollee. (This would be about 90 percent on average, but with considerable variation from state to state.)

There’s a catch though: States that already offer coverage to adults beyond federal requirements would get less federal help in the years before 2019. Not surprisingly, these states aren’t happy about this, arguing that they are being penalized for their efforts to cover more uninsured residents.

Though the changes would not be cheap for states or the federal government, for Goodwin, they would likely mean easier access to a bolstered Medicaid program.

Just Jake Talkin'

Sometimes a new perspective can point to fresh ideas.

I was chattin’ with a business owner on the Square over the weekend and it brought to light somethin’ I was aware of but hadn’t been brought up. The parkin’ enforcement office as an ambassador of sorts.

This business person said there are stories related by customers from out of town that they frequently use the parkin’ guy to get directions or other information pertainin’ to the City. He is the City public relations department in mamy instances.

Now in the background I heard the moans of those who have encountered tourist that were mad about gettin’ a ticket.

The Council decides tonight.

This is some fact, but mostly,

Just Jake Talkin’.

Sponsored by Carthage Printing Weekly Columns

To Your Good Health

By Paul G. Donohue, M.D.

Fibroids Can Cause Anemia in Women

DEAR DR. DONOHUE: I am 42 and have an anemia. My doctor thinks it results from my menstrual bleeding, which is quite heavy. I have been taking iron pills, but I am still anemic. The doctor says I should have my fibroids removed, and that will stop the excessive bleeding. I have no other symptoms -- no pain. Will you explain what fibroids are? They aren’t cancer, are they? -- E.B.

ANSWER: Fibroids are not cancer. They’re growths of the uterine muscle. The uterus is mostly muscle, with an inner lining designed to nourish a fertilized egg. Quite often, fibroids don’t cause any problems. Large ones can lead to heavy menstrual bleeding, which, in turn, gives rise to an anemia. They also can put pressure on the adjacent urinary bladder and bring on the need to urinate frequently. Sometimes they produce pelvic discomfort, and they might be involved with infertility.

About two-thirds of women in their 40s have one or more fibroids. What causes them is still a matter of speculation. Female hormones make them grow. That’s why menopause, with its drop in hormone production, usually shrinks fibroids. They also run in families, so there is a gene influence.

The best treatment for fibroids depends on their location in the uterus and their size. Sometimes removal is achieved with instruments introduced into the uterus through the vagina -- no skin incision. Recovery from this procedure is fast. Laparoscopic surgery -- surgery done with a scope and instruments inserted through small incisions -- is another technique that permits quick recuperation. At times, the entire uterus has to be removed.

A newer and popular treatment is uterine artery embolization. Here a slender, pliable tube is threaded from a surface artery to the artery that supplies the fibroid with blood. When the tube arrives at that artery, the doctor releases tiny pellets that promote the formation of a clot (embolus). Without nourishment, the fibroid shrinks and is eventually shed.

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