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Sunday, September 13, 2015

H.R. 3862: Obamacare Amendment

H.R.3862 - Respiratory Care Amendment to Obamacare 115th Congress (2015-2016)

Sponsor: Rep. Ding, Bill  [R-NY-11] (Introduced 03/06/2015)
Committees: House - Ways and Means
Latest Action: 04/23/2015 Referred to the Subcommittee on How to Screw Up Healthcare Even More

Shown Here:
Introduced in House (03/06/2015)

Amendment to Obamacare  - Amends the Patient Protection and Affordable Care Act of 2010 to:
  • Creates many senseless policies to ensure a high procedure count for respiratory therapists; to assure that they can keep their jobs; to keep the U3 unemployment number as high as we can get it so we can assure the president looks good.
  • Authorize the newly created state police to better prepare patients for emergency services in the hospital setting.  
  • Mandate that all patients with lung diseases be clean shaven so it's easier to fit a BiPAP mask over their faces.  
  • Based on studies that show the COPD patients who wear BiPAP at home are less likely to make repeated and costly visits to the emergency room, it is requires that all COPD patients be fitted with, at a minimum, the cheapest BiPAP equipment and be required to wear it between the hours of 10 p.m. and 6 a.m.  Settings will be made up by physician rather than wasting government monies on sleep studies or relying on a respiratory therapist who knows how to actually manage the BiPAP.
  • Requires all physicians to talk to their patients about end of life planning so physicians no longer have to waste their time asking, and respiratory therapists and nurses no longer have to waste valuable time that could be spent watching reruns of Columbo wondering.  
  • Requires that all respiratory therapists prioritize emergency room patients over all other patients, even if the patient in ER was using it as a medical clinic.  
  • Further enforces that all patients who are to be admitted to the hospital must be sick enough to have received three bronchodilator breathing treatments in the emergency room.  
  • Once admitted to the hospital, all respiratory patients or patients who produce or might eventually produce annoying lung sounds (i.e. asthma, pneumonia, heart failure, pulmonary fibrosis, kidney failure, faux pneumonia, phthisis, lung cancer, ETOH, dehydration, Sepsis, DIC, altered mental, over the age of 85, on a ventilator, will be on a ventilator, might need a ventilator, requires BiPAP, smells nasty, is annoying to nurses and doctors, sun downers, etc.) must require at least a minimum of four breathing treatments a day to meet criteria for admission and criteria for 
  • On the other hand, if a patient really does require 3-4 breathing treatments in the emergency room, this certainly does qualify them for admission.  It is, however, essential that these patients be ordered to receive Q4ever breathing treatments. 
  • Initial orders for breathing treatments for children under the age of 10 must include Q2 times 4, Q3, times 4, then Q4-6.  It is also highly recommended that mucomyst and pulmicort be thrown in.
  • No two respiratory medicines can be mixed in the same nebulizer.
  • All nebulizers must be cleaned with normal saline after each use by a respiratory therapist.  Surely there is no evidence this will do any good, but it makes us feel like we are doing something useful
  • Requires that all patients show evidence that they are trying to obtain their ideal body weight, with a three year time frame to obtain it.  Punishment for violators is: 1st offense -- 3 days forced BiPAP with a rate set 6 higher than spontaneous rate; 2nd offense -- one practice intubation and extubation (to be performed after office hours as to not interfere with profitable hours); 3rd offense -- a practice intubation by a first year respiratory therapy student followed by one day on a mechanical ventilator without any sedation and run by a physician who barely passed med school and was trained at the same school that teaches physicians not to oxygenate ALL COPD patients.  
  • The 15 year phase-in of a respiratory therapy bachelor's requirement for all respiratory therapists, because just having an associate's degree does not qualify someone to know more than a physician. Of course a bachelor's degree won't either, but, hey, we like to create laws that don't make sense. Violators will be subject to an increasing workload of stupid doctor orders until retirement (which may be forced, because dogmatic, seasoned therapists know too much and must be stopped from educating the young ones that we are tying to indoctrinate.  
  • Nurses and respiratory therapist must scan a patient's band and the medicine prior to administering a medicine, regardless of how urgent it is needed.  Patient suffering and risk of not administering a medicine is no reason to skip steps and cut corners.  Punishment for violators is spend a week doing nothing but making wrist bands for patients. 
  • Punishment for taking the time to check and see what someone else charted and just copying it is branding with the word "Dipshit!" or "Dingdong!" on forehead.  
  • Respiratory therapists are no longer allowed to write "no change" or "no difference" in the post treatment assessment phase.  The reason for this is because we know (we, as in people who sit in suit coats in Washington) that no doctor would order a breathing treatment unless it had some potential benefit.  "No Effect" is likewise unacceptable in the post treatment charting area.  Punishment for violation will be to read the entire 3,000 pages of the Patient Protection and Affordable Care Act

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