Obamacare Vs. Primary Care Doctors: Medicaid Patients

U.S. Plans Stealth Survey on Access to Doctors


Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers” to pose as patients, call doctors’ offices and request appointments to see how difficult it is for people to get care when they need it.

The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.

Federal officials predict that more than 30 million Americans will gain coverage under the health care law passed last year. “These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem of P.C.P. shortages in the United States,” the Department of Health and Human Services said in a description of the project that it submitted to the White House.

Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.

“I don’t like the idea of the government snooping,” said Dr. Raymond Scalettar, an internist in Washington. “It’s a pernicious practice — Big Brother tactics, which should be opposed.”

According to government documents obtained from Obama administration officials, the mystery shoppers will call medical practices and ask if doctors are accepting new patients and, if so, how long the wait would be. The government is eager to know whether doctors give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.

Dr. George J. Petruncio, a family doctor in Turnersville, N.J., said: “This is not a way to build trust in government. Why should I trust someone who does not correctly identify himself?”

Dr. Stephen C. Albrecht, a family doctor in Olympia, Wash., said: “If federal officials are worried about access to care, they could help us. They don’t have to spy on us.”

Dr. Robert L. Hogue, a family physician in Brownwood, Tex., asked: “Is this a good use of tax money? Probably not. Everybody with a brain knows we do not have enough doctors.”

In response to the drumbeat of criticism, a federal health official said doctors did not need to worry because the data would be kept confidential. “Reports will present aggregate data, and individuals will not be identified,” said the official, who requested anonymity to discuss the plan before its final approval by the White House.

Administration officials said the survey would yield an enormous benefit to the government while imposing an extremely limited burden on doctors.

The new health care law includes several provisions intended to increase the supply of primary care doctors, and officials want to be able to evaluate the effectiveness of those policies.

Federal officials said the initial survey would cost $347,370. Dr. Hogue said the money could be better spent on the training or reimbursement of primary care doctors.

Most doctors accept Medicare patients, who are 65 and older or disabled. But many say they do not regard the government as a reliable business partner because it has repeatedly threatened to cut the fees paid to doctors treating such patients. Congress usually steps in at the last minute to avert such cuts.

In many parts of the country, Medicaid, the program for low-income people, pays so little that many doctors refuse to accept Medicaid patients. This could become a more serious problem in 2014, when the new health law will greatly expand eligibility for Medicaid.

Access to care has been a concern in Massachusetts, which provides coverage under a state program cited by many in Congress as a model for President Obama’s health care overhaul.

In a recent study, the Massachusetts Medical Society found that 53 percent of family physicians and 51 percent of internal medicine physicians were not accepting new patients. When new patients could get appointments, they faced long waits, averaging 36 days to see family doctors and 48 days for internists.

In the mystery shopper survey, administration officials said, a federal contractor will call the offices of 4,185 doctors — 465 in each of nine states: Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas and West Virginia. The doctors will include pediatricians and obstetrician-gynecologists.

The calls are to begin in a few months, with preliminary results from the survey expected next spring.

Each office will be called at least twice — by a person who supposedly has private insurance and by someone who supposedly has public insurance.

Federal officials provided this example of a script for a caller in a managed care plan known as a preferred provider organization, or P.P.O.:

Mystery shopper: “Hi, my name is Alexis Jackson, and I’m calling to schedule the next available appointment with Dr. Michael Krane. I am a new patient with a P.P.O. from Aetna. I just moved to the area and don’t yet have a primary doctor, but I need to be seen as soon as possible.”

Doctor’s office: “What type of problem are you experiencing?”

Mystery shopper: “I’ve had a cough for the last two weeks, and now I’m running a fever. I’ve been coughing up thick greenish mucus that has some blood in it, and I’m a little short of breath.”

In separate interviews, several doctors said that patients with those symptoms should immediately see a doctor because the symptoms could indicate pneumonia, lung cancer or a blood clot in the lungs.

Other mystery shoppers will try to schedule appointments for routine care, like an annual medical examination for an adult or a sports physical for a high school athlete.

To make sure they are not detected, secret shoppers will hide their telephone numbers by blocking caller ID information.

Eleven percent of the doctors will be called a third time. The callers will identify themselves as calling “on behalf of the U.S. Department of Health and Human Services.” They will ask whether the doctors accept private insurance, Medicaid or Medicare, and whether they take “self-pay patients.” The study will note any discrepancies between those answers and the ones given to mystery shoppers.

The administration has signed a contract with the National Opinion Research Center at the University of Chicago to help conduct the survey.

Jennifer Benz, a research scientist at the center, said one purpose of the study was to determine whether the use of mystery shoppers would be a feasible way to track access to primary care in the future.

The government could survey consumers directly, but patients may not accurately recall how long it took to get an appointment, and their estimates could be colored by their satisfaction with the doctor, researchers said.

Sources: Fox News, NY Times, Youtube, Google Maps

Obama Advocates Fair Pay For Doctors...Weekly Address

Sources: Whitehouse.gov, Youtube

Carolinas Medical Center Faces Possible Negligence Lawsuit (Kenneth Jermaine Chapman)

According to North Carolina General Statute Chapter § 122C-55 Mental Health, Developmental Disabilities, and Substance Abuse Act of 1985...

Carolinas Medical Center staff had a Legal Duty to cooperate and warn other coordinating agencies about Kenneth Jermaine Chapman's reports of desiring to harm himself and others, however they INTENTIONALLY didn't.

In addition as illustrated in Columbia Medical Center of Las Colinas v Bush, 122 S.W. 3d 835 (Tex. 2003), "following orders" may not protect Nurses and other Non-Physicians from Liability when committing Negligent acts.

Relying on Vicarious Liability or Direct Corporate Negligence, claims may also be brought against hospitals, clinics, managed care organizations or medical corporations for the mistakes of their employees.

Doesn't this all amount to a clear case of Medical Malpractice and Negligence?

Uh-oh! I believe it does.

I smell a FAT lawsuit with a HUGE settlement for Kenneth Chapman's surviving relatives, especially his Child and Mother.

Ching! Ching!

To Kenneth Jermaine Chapman's surviving relatives I suggest you hire a New York lawyer who is also licensed to practice in North Carolina, than SUE Carolinas Medical Center and Charlotte-Mecklenburg County for Medical Malpractice, Gross Negligence & Racial Discrimination!

Charlotte I guess it doesn't pay to continue practicing Racial Discrimination.

I told you Charlotte-Mecklenburg is an Extremely Racist region with "Leaders" who don't know what the heck they are doing.

Check out the articles below and learn what Licensed Psychiatrists from across the country had to say about how CMC staff bungled Chapman's care.




CMC Psychiatrists Claim More Help Was In order Before Chapman Family Killings


Kenneth Jermaine Chapman should have been hospitalized when he showed up at a local emergency room saying he wanted to kill his wife and displaying obvious signs of mental illness, four psychiatrists told the Observer.

Psychiatrists from around the country say they probably would have hospitalized Chapman - even against his will - if they had been called on to treat him.

Chapman twice sought help at CMC-Randolph, once in February and once on March 16 - the same day he killed his wife and two of his children.

Chapman told CMC Clinicians at the Billingsley Road psychiatric hospital that he had access to firearms and wanted to kill his wife, according to records obtained by the Observer.

He later backed away from his threat, saying he would not hurt his wife, Nateesha. But he also told staff he was hallucinating, had a history of alcohol abuse and depression, and had a volatile relationship with his wife.

Both times, CMC Clinicians released Chapman from the emergency room within hours, giving him prescriptions and instructions to call back for an appointment.

CMC Records show no attempt to hospitalize him.

"There's no question" that Chapman should have been hospitalized, says Dr. Janet Taylor, a New York psychiatrist and former clinical instructor of psychiatry at Harlem Hospital. "He's definitely a danger to himself and others."

Officials at Carolinas Medical Center, which runs the Psychiatric hospital for the county under a $16 million contract, say confidentiality laws prohibit them from discussing Chapman's case.

But hospital officials are reviewing how staff at CMC-Randolph handled Chapman's treatment.

The 33-year-old Fed-Ex package handler ultimately killed himself, two weeks after the initial killings.

Chapman's mother, Ruby Cosby, says she's outraged that her son was allowed to leave the hospital when he needed help.

"I lost my son and granddaughter, and other lives were taken because the hospital was Negligent," she says.

"That Negligence cost a lot of lives. What do you have to do or say before anyone pays attention to you crying out?"

Psychiatrists nationally say the decision about hospitalization hinges on whether they believe a patient is dangerous to himself or others. They use a variety of tools to evaluate the risk - including interviews and observation of the patient, consultation with family, and a review of patient medical and behavioral history.

But doctors say they can't be certain who will turn violent, and the decision is ultimately a judgment call.

Five psychiatrists interviewed by the Observer said they couldn't determine whether Chapman should have been hospitalized because they didn't personally evaluate him.

But four other Psychiatrists, recommended by professional associations and well-known medical schools, agreed they would have hospitalized Chapman, based on a detailed description of his hospital visits.

The Doctors did not review Chapman's medical records. And, to avoid influencing their answers, the Observer didn't mention Chapman's eventual killings until they had offered opinions.

The four Psychiatrists agreed that the toxic combination of risks in Chapman's case - Depression, Alcohol Abuse, Threats of Violence and Access to guns - suggested a need for immediate Intervention.

"If the person is depressed, angry with his wife and wanting to kill her, and has access to firearms, I'd certainly be inclined to hospitalize," said Dr. Bernadette Cullen, director of the Johns Hopkins Community Psychiatry Program.

It's not unusual for patients to threaten suicide, psychiatrists say, but explicit homicidal threats are rare and always get their attention.

Dr. Anil Godbole, chairman of Psychiatry at Chicago's Advocate Illinois Medical Center, says patients threaten homicide two or three times a month at his psychiatric emergency department, which sees about 250 patients monthly.

Godbole, who served on President George W. Bush's Commission on Mental Health, said if a patient like Chapman refused to enter the hospital voluntarily, "I would insist ... if he likes it or doesn't like it."

Growing calls for help

Like other mental health facilities in North Carolina, Charlotte's Psychiatric hospital is under stress. With calls and visits steadily climbing, the hospital's 44-bed adult inpatient unit has been above capacity for more than a year.

It's unclear whether any beds were available on March 16. CMC couldn't provide a daily patient count last week. But the occupancy rate for March overall was 105 percent.

Area Mental Health Director Grayce Crockett won't discuss Chapman's treatment. Her department manages the county's mental health care providers, including CMC-Randolph, although the hospital has its own leadership team.

Crockett says even when all of the hospital beds are filled, patient care isn't compromised. If a patient needs to be admitted, she has said, the hospital can transfer him to the state Psychiatric facility in Morganton.

CMC also can send patients to the psychiatric units of general hospitals.

But experts nationally say psychiatrists may hesitate to order an admission if a hospital's beds are full.

"It undoubtedly casts a shadow on the decision-making," says Dr. William Sledge, medical director of the Yale-New Haven Psychiatric Hospital.

The number of psychiatric beds nationally has declined, experts say, and insurance companies increasingly refuse to cover inpatient care except in the most severe cases.

Chapman first went to CMC-Randolph's emergency room on Feb. 28. During the two-hour evaluation, he told clinicians he had been fighting with his wife and thinking about harming her, records show. It was a "chronically volatile" relationship with "verbal and physical conflicts," a doctor wrote. He was previously treated for depression, and had a history of alcohol abuse.

He also had guns.

But Chapman later told staff he wouldn't hurt anyone. Clinicians sent him home with a prescription for medication to treat anxiety and depression. Those medications probably would have taken effect on Chapman within a few days or weeks, psychiatrists say.

Two weeks later, on the morning of March 16, Chapman again appeared at the emergency room.

He had a shouting match with his wife, and he told staff he wanted to kill her, records show. He also reported seeing "shadows of people every day." But later in the visit, Chapman told a nurse and a doctor he wouldn't harm anyone.

A doctor thought Chapman had a "Depressive Disorder" and increased the dosage of Anti-Anxiety medication, records show.

The hospital released Chapman around 6 a.m.

Later that day, police say, Chapman suffocated his wife and 1-year-old daughter and fatally stabbed his 13-year-old stepdaughter.

He spent the next two weeks living in his south Charlotte home with his two surviving children, ages 10 and 2 - while the bodies of his two dead daughters were locked in a bedroom.

When police came to Chapman's home on March 29, they say he shot at them and then took his own life.

'Recipe for disaster'

Under N.C. law, doctors can involuntarily commit mentally ill patients they judge to be a threat to themselves or others.

Chapman's professed change of heart about killing his wife would have complicated a doctor's decision on whether to hospitalize him, Psychiatrists say.

Dr. Marvin Swartz, interim chair of Duke University's psychiatry department, says he couldn't judge whether Chapman should have been admitted without evaluating him.

But he says Clinicians may have concluded they had adequately addressed Chapman's problems in the emergency room.

"If you feel you've turned it around during that visit, sometimes you have to take that risk," he says, "because you can't admit them all."

But Taylor, the New York psychiatrist, says she puts more weight on a patient's initial statements because later comments can be influenced by fears of being committed.

"People start getting nervous about what's going to happen, and they change their tune," she says.

S.C. psychiatrist Gariane Gunter called Chapman's risk factors "a recipe for disaster." A resident at the University of South Carolina School of Medicine, Gunter says she would not have been persuaded by Chapman's later claims that he wouldn't hurt anyone.

"I don't know what else you need to be really scared for his wife," she says.
"He was reaching out".

It's unclear whether hospital staff made any effort to warn Chapman's wife. But the records show no indication that contact was made.

Several of the Psychiatrists interviewed say Clinicians, often by state law, have a duty to warn the targets of such threats. North Carolina has no such law.

Chapman's parents say they wish the hospital had alerted them about their son's troubles. The hospital failed their family, they say.

"He was reaching out," says Chapman's mother, Ruby Cosby, "and they didn't reach back."

The two surviving children are in the custody of the Charlotte-Mecklenburg Department of Social Services, temporarily placed with relatives until officials assign the kids a permanent home - or possibly separate homes.

Chapman's 10-year-old daughter keeps in touch with her grandparents with a cell phone the Cosbys gave her when she went to New Jersey for her father's funeral.
Chapman's 2-year-old son doesn't yet understand death, says Chapman's stepfather, James Cosby.

"All he knows is that he misses his mother and father."






Kenneth Jermaine Chapman's Death vs Carolinas Medical Center's Racist System


Carolinas Medical Center/ Carolinas Health Care System has been previously sued on numerous occasions by several African-American families for Racist Medical practices leading to premature, medically preventable deaths.

Many of those lawsuits were quietly settled with families of those Black patients who died due to intentional improper care or NEGLIGENCE.

Such lawsuits and bad reputation is the reason why Carolinas Medical Center/ Carolinas Health Care System now exist instead of Charlotte Memorial Hospital, the old CMC.

Thus its safe to say Carolinas Medical Center and Charlotte Memorial Hospital are one in the same.

How do I know this?

I always do my research and I talk to people personally affected by what I post on my Blog.

People will tell me things they might not disclose to the Charlotte Observer because the Charlotte Observer has a history of practicing Biased reporting and Discrimination in its publication of articles.

Kenneth Jermaine Chapman was an African-American Charlotte citizen who recently killed three members of his family and later himself.

Prior to his destructive actions he desperately sought Mental Health Care assistance from Charlotte's Carolinas Medical Center.

In fact he sent out an S.O.S. which was intentionally ignored.

Mr. Chapman clearly, verbally expressed to CMC Staff he had thoughts of hurting others and killing himself.

Did CMC Staff report his thoughts to Charlotte DSS even though they knew this man had minor children in the home?

NO!

They didn't give a darn because Ken Chapman was Black and wasn't an affluent citizen.

Now if Ken Chapman had connections with an Affluent, Politically-connected Black Charlotte citizen, than of course they may have taken Mr. Chapman's situation more seriously, but because he was just a poor Black man they didn't give a darn!

The result?

A Black Man who killed his wife, two of his children and than later himself.

If you think Jennifer Roberts (board chair) and the other Charlotte-Mecklenburg Board of Commissioners are seriously concerned about this matter or seriously concerned about investigating Mr. Chapman's case...DON'T BET ON IT!

If you think Charlotte's weak, scared Black Leaders are going to speak up...DON'T BET ON IT!

The only two Charlotte-Meck. County Commissioners who do really care, Harold Cogdell Jr. & Vilma Leak (both African-Americans) will be blocked from doing anything constructive by Jennifer Roberts (board chair), "Ms. N.C. Corruption" herself.

This tragic incident helps to further demonstrate how Racism is deeply woven into all facets and levels of Charlotte, NC's community, including the Health Care System.

Charlotte's other main Medical Center, Presbyterian Hospital isn't much better.

Its a private facility where Blacks go in but don't come out.

Presbyterian Hospital also has a long history of Black Patients needlessly dying but that's a story for another day.

As I was saying Carolinas Medical Center's staff intentionally did NOT prevent Mr. Chapman's death, nor did they help protect his family however.....

I'll bet Mr. Chapman's surviving relatives receive a huge bill for his so-called "treatment".

In fact thousands upon thousands of African-Americans within the Charlotte-Mecklenburg Region have Carolinas Medical Center Medical Bills on their Credit Reports.

Many of those bills are decades old.

Many of those bills are due to Billing errors from Carolinas Medical Center.

Many of those bills are due to Carolinas Medical Center INTENTIONALLY overbilling Black patients.

How does Carolinas Medical Center skirt Federal Law as it relates to Medical Bills which are older than 7 years old?

Carolinas Medical Center pays Equifax, Experian and Trans Union Credit Reporting agencies to sell those old Medical bill accounts to Debt Collectors, who create new account numbers for those decades old bills and continue screwing up the Credit Ratings for hundreds of thousands of North Carolina's Black citizens.

Is this really Racism you ask??

Yes!

For White Patients treated by Carolinas Medical Center staff everything is handled entirely different.

White Patients who visit Carolinas Medical Center for treatment receive proper care regardless of their situation and...

They aren't intentionally overcharged, neither are their Credit Reports damaged even if they don't possess Medical Insurance because NOT every White patient has Private Medical Insurance, just like there are many Black patients treated at CMC who DO possess Private Medical Insurance.

I'd say its time for the Federal Gov't including the FTC, to take a look at how Carolina Medical Center intentionally provides inadequate treatment to its Black patients, how they consistently & intentionally overbill Black patients and how they are paying big bucks to 3 major Credit Reporting agencies (mainly Equifax) for the sole purpose of selling Medical Bill Accounts which are decades old to Debt Collectors.

Just watch the Levine Family, old Charlotte money and one of Carolinas Medical Center/ Carolinas Health Care System largest contributors, use their big bucks to help defend CMC in any possible lawsuit.

The Levine Family is Charlotte's "Savior".

They often come to Charlotte's aid in a crisis however ONLY after the crisis occurs.

They run Charlotte's so-called Leaders including Jennifer Roberts and Anthony Foxx.

The Levines are most likely indirectly involved in most of Charlotte's Racist activities being carried out however, because they are super rich everyone is afraid of them.

If Ken Chapman were a White Man residing in Charlotte, NC neither he nor his family members would be dead today.

Or at least his family members would be alive today.

Both Carolinas Medical Center/ Carolinas Health Care System, Charlotte DSS and quite possibly the Levine Family are ALL legally Responsible for the Chapman Family's death stemming from total NEGLIGENCE.

If I were related to Mr. Chapman's family I would most definitely SUE and demand a Federal Probe to be conducted.

Sadly enough Kenneth Jermaine Chapman's relatives are probably uneducated or too afraid of Charlotte's Racist, Unfair systems to take legal action.

Charlotte's Racist, Scared Leaders know this which is why nothing will probably change.



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Sources: Carolinas Medical Center, McClatchy Newspapers, WCNC, Wikipedia, Google Maps

Medicare, Medicaid Cuts Hurts Patients, Cost Doctors

With Medicaid Cuts, Doctors & Patients To Drop Out



Carol Y. Vliet’s cancer returned with a fury last summer, the tumors metastasizing to her brain, liver, kidneys and throat.

As she began a punishing regimen of chemotherapy and radiation, Mrs. Vliet found a measure of comfort in her monthly appointments with her primary care physician, Dr. Saed J. Sahouri, who had been monitoring her health for nearly two years.

She was devastated, therefore, when Dr. Sahouri informed her a few months later that he could no longer see her because, like a growing number of doctors, he had stopped taking patients with Medicaid.

Dr. Sahouri said that his reimbursements from Medicaid were so low — often no more than $25 per office visit — that he was losing money every time a patient walked in his exam room.

The final insult, he said, came when Michigan cut those payments by 8 percent last year to help close a gaping budget shortfall.

“My office manager was telling me to do this for a long time, and I resisted,” Dr. Sahouri said. “But after a while you realize that we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition.

Mrs. Vliet, 53, who lives just outside Flint, has yet to find a replacement for Dr. Sahouri. “When you build a relationship, you want to stay with that doctor,” she said recently, her face gaunt from disease, and her head wrapped in a floral bandanna. “You don’t want to go from doctor to doctor to doctor and have strangers looking at you that don’t have a clue who you are.”

The inadequacy of Medicaid payments is severe enough that it has become a rare point of agreement in the health care debate between President Obama and Congressional Republicans. In a letter to Congress after their February health care meeting, Mr. Obama wrote that rates might need to rise if Democrats achieved their goal of extending Medicaid eligibility to 15 million uninsured Americans.

In 2008, Medicaid reimbursements averaged only 72 percent of the rates paid by Medicare, which are themselves typically well below those of commercial insurers, according to the Urban Institute, a research group. At 63 percent, Michigan had the sixth-lowest rate in the country, even before the recent cuts.

In Flint, Dr. Nita M. Kulkarni, an obstetrician, receives $29.42 from Medicaid for a visit that would bill $69.63 from Blue Cross Blue Shield of Michigan. She receives $842.16 from Medicaid for a Caesarean delivery, compared with $1,393.31 from Blue Cross.

If she takes too many Medicaid patients, she said, she cannot afford overhead expenses like staff salaries, the office mortgage and malpractice insurance that will run $42,800 this year. She also said she feared being sued by Medicaid patients because they might be at higher risk for problem pregnancies, because of underlying health problems.

As a result, she takes new Medicaid patients only if they are relatives or friends of existing patients. But her guilt is assuaged somewhat, she said, because her husband, who is also her office mate, Dr. Bobby B. Mukkamala, an ear, nose and throat specialist, is able to take Medicaid. She said he is able to do so because only a modest share of his patients have it.

The states and the federal government share the cost of Medicaid, which saw a record enrollment increase of 3.3 million people last year. The program now benefits 47 million people, primarily children, pregnant women, disabled adults and nursing home residents. It falls to the states to control spending by setting limits on eligibility, benefits and provider payments within broad federal guidelines.

Michigan, like many other states, did just that last year, packaging the 8 percent reimbursement cut with the elimination of dental, vision, podiatry, hearing and chiropractic services for adults.

When Randy C. Smith showed up recently at a Hamilton Community Health Network clinic near Flint, complaining of a throbbing molar, Dr. Miriam L. Parker had to inform him that Medicaid no longer covered the root canal and crown he needed.

A landscaper who has been without work for 15 months, Mr. Smith, 46, said he could not afford the $2,000 cost. “I guess I’ll just take Tylenol or Motrin,” he said before leaving.

This year, Gov. Jennifer M. Granholm, a Democrat, has revived a proposal to impose a 3 percent tax on physician revenues. Without the tax, she has warned, the state may have to reduce payments to health care providers by 11 percent.

In Flint, the birthplace of General Motors, the collapse of automobile manufacturing has melded with the recession to drive unemployment to a staggering 27 percent. About one in four non-elderly residents of Genesee County are uninsured, and one in five depends on Medicaid. The county’s Medicaid rolls have grown by 37 percent since 2001, and the program now pays for half of all childbirths.

But surveys show the share of doctors accepting new Medicaid patients is declining. Waits for an appointment at the city’s federally subsidized health clinic, where most patients have Medicaid, have lengthened to four months from six weeks in 2008. Parents like Rebecca and Jeoffrey Curtis, who had brought their 2-year-old son, Brian, to the clinic, say they have struggled to find a pediatrician.

“I called four or five doctors and asked if they accepted our Medicaid plan,” said Ms. Curtis, a 21-year-old waitress. “It would always be, ‘No, I’m sorry.’ It kind of makes us feel like second-class citizens.”

As physicians limit their Medicaid practices, emergency rooms are seeing more patients who do not need acute care.

At Genesys Regional Medical Center, one of three area hospitals, Medicaid volume is up 14 percent over last year. At Hurley Medical Center, the city’s safety net hospital, Dr. Michael Jaggi detects the difference when advising emergency room patients to seek follow-up treatment.

“We get met with the blank stare of ‘Where do I go from here?’ ” said Dr. Jaggi, the chief of emergency medicine.

New doctors, with their mountains of medical school debt, are fleeing the state because of payment cuts and proposed taxes. Dr. Kiet A. Doan, a surgeon in Flint, said that of 72 residents he had trained at local hospitals only two had stayed in the area, and both are natives.

Access to care can be even more challenging in remote parts of the state. The MidMichigan Medical Center in Clare, about 90 miles northwest of Flint, closed its obstetrics unit last year because Medicaid reimbursements covered only 65 percent of actual costs. Two other hospitals in the region might follow suit, potentially leaving 16 contiguous counties without obstetrics.

Medicaid enrollees in Michigan’s midsection have grown accustomed to long journeys for care. This month, Shannon M. Brown of Winn skipped work to drive her 8-year-old son more than two hours for a five-minute consultation with Dr. Mukkamala. Her pediatrician could not find a specialist any closer who would take Medicaid, she said.

Later this month, she will take the predawn drive again so Dr. Mukkamala can remove her son’s tonsils and adenoids. “He’s going to have to sit in the car for three hours after his surgery,” Mrs. Brown said. “I’m not looking forward to that one.”


Sources: NY Times, Youtube

GOP Is Winning Health Care Summit Debate! Stop Food Stamp Abuse! Undercover Patients

Today I watched Pres. Obama's "Bi-Partisan" Health Care Summit meeting.

After reviewing this televised talkfest, it appears the GOP won.

Barack Obama is a Gifted Orator, however its obvious he can't speak as well without his Teleprompter (prepared remarks).

For once he was actually at a loss for words can you believe it?

When it was time for Dr. Tom Coburn (R) to speak he presented three great Health Care Reform ideas:

1) STOP FOOD STAMP ABUSE by encouraging people who use Food Stamps to purchase Healthy Foods via program Incentives.

Its no secret thousands of citizens who use Food stamps often sell them or waste them buying Candy, Chips, Cake, Ice Cream and Gum for their children versus Fruits/ Vegetables.

Such poor diets cause Childhood Obesity and Diabetes.

Why not hire more DSS Workers and require Food Stamp Users to turn in their receipts each month as to keep tabs on what's actually being purchased?

This will also deter the selling of Food Stamps.

I'm NOT suggesting eliminating Food Stamps in this Recession.

However I do agree with Dr. Coburn that the Food Stamp program needs to be highly monitored nationwide to prevent and STOP FOOD STAMP ABUSE.


2) Address Medicaid/ Medicare Fraud by sending Under Cover Patients to Physicians Offices' as a means of catching Doctors and Hospital Administrators who overbill the Federal Gov't.

This is especially so in states like New York and North Carolina.


3) Dr. Coburn also mentioned rewarding Physicians who provide Quality Patient Care versus Doctors who just keep ordering a bunch of unnecessary tests to make money.


Republican members appeared Studious, Well-Informed and Well-Prepared for this debate versus Democrats who were just repeating empty Political, Harvard rhetoric.

I'm very disappointed.

Its obvious Democrats just want to ram this particular Health Care Bill through regardless of whom it will hurt most financially...American Voters.

Check out the Health Care Summit video below Stay tuned.






Sen. Tom Coburn Discusses Cost Containment At The White House Health Summit


MCCONNELL: Mr. President, since some liberties have been taken here, let me just make a quick observation. Then I'm going to call on Dr. Coburn to make our framing statement on the issue of cost containment.

One thing I think we need to be acutely aware of, ladies and gentlemen, we are here representing the American people. And Harry mentioned several polls. I think it is not irrelevant that the American people, if you average out of all of the polls, are opposed to this bill by 55-37. And we know from a USA Today-Gallup poll out this morning they're opposed to using the reconciliation device, the short-circuit approach that Lamar referred to that would end up with only bipartisan opposition, by 52-39.

Now, I'd like to call on Dr. Tom Coburn who's been a practicing physician for many years, to address the cost-containment issue.

COBURN: Thank you.

Well, Mr. President, thanks for having us do this. I think today's going to be enlightening.

The first thing I would do is put out a caution to us because what I see the Congress doing and what I saw this last year is us actually performing bad medicine. And that is that we get stuck in the idea of treating the symptom rather than treating the disease.

And whether you go to Harvard or whether you go to Thomson Reuters, here's -- there are some facts we know about health care in America. And the facts we know is one out of every three dollars that gets spent doesn't help anybody get well and doesn't prevent anybody from getting sick.

The second thing we know is, from the Congressional Research Service, that most of the mal-drivers (ph) today in health care come from government rules and regulations. The government now directs over 60 percent of the health care in this country. And if throwing money at it and creating new government programs could solve it, we wouldn't be sitting here today because we've done all that. It hadn't worked. So what I thought we ought to do is maybe talk about why does it cost so much, because the thing that keeps people from getting access to care in our country is cost.

You mentioned Malia and Sasha. The fact is, is with young kids going to the E.R., whether they have meningitis or asthma, they're going to get treated in this country. But they may get labeled with a preexisting illness after that. And that's another thing I'd be happy to talk about at a later time.

But the fact is, is we know how to treat acute asthma. What we don't do a good job of is preventing children from getting acute asthma. We don't do the good job of prevention.

So when you break down the costs, what we know is 33 percent of the costs in health care shouldn't be there.

And how do we go about doing that? And what are the components of that cost? And when you look at, when it's studied, if you look at what Malcolm Sparrow from Harvard says, he says 20 percent of the cost of federal government health care is fraud. That's his number.

If you look at Thomson Reuters, when they look at all of this, they say at least 15 percent of government-run health care is fraud.

Well, when you look at the total amount of health care that's government run, you know, you're talking $150 billion a year.

So tomorrow, if we got together and fixed fraud, we could cut health care 7.5 percent tomorrow for people in this country.

So what we ought to do is do the Willie Sutton thing. We ought to go for where the money is.

What's the other area? What we do know -- and I'm guilty of this, Dr. Barrasso's guilty of it, Dr. Boustany is guilty of it -- is a large portion of the tests we order every day aren't for patients. They're for doctors. And the reason they're there is because we are risk averse to the tort system and extortion system that's out there today in health care.

And there are a lot of ways to fix that. But I just went through last night, if you add up what Thomson Reuters, which looked at all the studies that have been done and combined them in, they say between $625 billion and $850 billion a year of health care dollars are wasted.

So it seems to me if cost is the number one thing that's keeping people from getting care, then the efforts of us, as we go after cost, ought to be to go to those areas where the cost is wasted.

And there's a philosophical difference in how we do that. One wants more government-centered approach to that. I would personally prefer a more patient-centered, market-orient approach to that. But nevertheless, there's where we can come together, just on those two areas, where we could cut costs 15 percent tomorrow. And that's for everybody in the country.

What would -- what would happen to access in this country if tomorrow everybody's health care costs went down 15 percent? Access would markedly increase.

So what I would hope we would do is that we would go back and concentrate on the areas that have the biggest pot of gold for us. And the biggest pot of gold is, is we don't incentivize prevention. We don't pay rewards for great management of chronic disease. We have a system throughout the country where we're encouraging lawsuits that aren't productive for the country, and what they actually do is cause the cost of health care to go through the roof.

We also know there's some other real things that we ought to address. There are conflict of interests within the medical field. There's nothing wrong with addressing those and taking those off (ph).

We know that we do not -- we absolutely do not incentivize prevention. And I'm not talking about creating walking paths. I'm talking about paying people who actually do a good job to do prevention.

Talking about changing the school lunch programs where it meets the needs, nutritional needs of Americans. Changing the food stamp program where it incentivize people to eat the right things, not the wrong things. We actually create more diabetes through the food stamp program and the school lunch program than probably any other thing, because we're not feeding a -- offering and incentivizing a great response.

COBURN: So I think if -- I think it's great that we're coming together. But the gold is in where's the cost excesses? And what I would hope we would do is we would look at that and say, How do we come together and actually achieve a reduction in the extortion that goes on in this country in terms of medical malpractice? And there's lots of ways to do that without us mandating states to do that.

How do we do that in terms of creating an elimination of fraud?

You know, when you compare the private sector fraud rates, it's 1 percent compared to Medicare and Medicaid. You know, there's estimates that there's $15 billion worth of fraud in Medicaid a year in New York City alone.

So we haven't attacked that. We haven't gone where the money is. And my hope would be that we would look at where the money is. And if truly it's accurate -- and I don't know many people that will disagree that $1 in $3 doesn't help somebody get well and doesn't prevent it, then we ought to be going for that $1 in $3.

And we ought to do it by not creating a whole bunch of new government programs, but by creating an incentive to reward people. In your new bill you have good fraud programs, but you lack the biggest thing to do. The biggest thing on fraud is to have undercover patients so that people know we're checking on whether or not this is a legitimate bill. And you don't know who's an undercover patient and who's not. And all of a sudden you start changing your attitude of whether or not you're going to milk Medicare or you're going to milk Medicaid.

REID (?): Mr. President, if I could just say, I'm not an expert on much, but I am filibusters. And we've got 40 members of Congress here.

OBAMA: Tom, you made some powerful points. You want to just wrap up real quick?

COBURN: No, I'll just finish with that is $1 out of $3 not helping everybody, we ought to go for where it is.

OBAMA: Well, Tom, I appreciate what you said. I think we're going to have Steny Hoyer go next. I just want to make this quick point: Every good idea that we've heard about reducing fraud and abuse in the Medicare and Medicaid system, we've adopted in our legislation.

So that's an example of where we agree. We want to eliminate fraud and abuse within the government systems.

Let's recognize, though, that those savings in the government systems, which will help taxpayers and allow us to do more, doesn't account for the rising costs in the private marketplace.

Now, the private marketplace, you mentioned the issue of medical malpractice and, you know, frivolous lawsuits. And I -- as you indicated, these are areas where Secretary Sebelius has already begun to try to give states some incentives to do that.

On the prevention side, there's a whole host of provisions inside the legislation that's been passed by the House and Senate, and I think Steny will talk about it.

So we've identified some areas we agree on. And then the question just is does that help the average family in the individual market who potentially can get costs.

But, Steny, why don't you...

COBURN: Let me just respond to one thing. You get cost shifted every penny that gets wasted on Medicare.

OBAMA: Absolutely.

COBURN: And that gets cost shifted to the private sector. So if, in fact, we're wasting...

OBAMA: It would help.

COBURN: ... in the public sector, we're shifting it to the private sector.

OBAMA: You and I agree.


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Sources: MSNBC, Washington Post, Google Maps

GOP's Andy Dulin Saves Senior Citizen Medical Trips, Foxx Votes No

During last night's Charlotte City Council meeting Republican council member Andy Dulin (District 6) boldly spoke up and voted "Yes" to save Charlotte's Special Transportation Service for local Senior Citizens.

Newly elected Democrat Mayor Anthony Foxx voted "No". How disappointing.

Foxx voted no because the new Bus Garage from which to house and operate the Senior Citizen Transportation program, will be somewhat close to his Elite, Posh, Uptown digs.

It will also be located in a section of Charlotte where many of his Straight Ticket Voters reside.

Last year on the campaign trail when Anthony Foxx asked Low Income, Black, Senior Citizen constituents to vote for him they did so without hesitation.

After his election how does Foxx wish to repay them?

By attempting to slash a Necessary program that would assist many of them with receiving continued Medical Care via trips to their Doctors.

Excuse me but I thought Democrats were supposed to be the party in favor of Health Care for Low Income and Middle Class citizens. Did I miss something here?

Foxx claims he wants to prevent City Bus Garages from being placed in Urban Areas.

Please know that's just an excuse he was trying to spin because he wanted to use the money (Stimulus Funds) on another venture like a 1.5 mile Streetcar in the Uptown area. (Where he lives)

Why does Charlotte need a Streetcar that will ONLY travel 1.5 miles when we already have City Buses traveling in the same Uptown direction and when a lot of citizens are leaving Charlotte due to High Unemployment??

How much Fiscal sense does this make?? Even a donkey can see how foolish that idea is.

Why not spend the money on renovating a Bus Garage and expanding Charlotte's Blue Lynx Light Rail line?

Both long term ventures will create Job Growth and improve Charlotte's air quality by getting drivers off the road.

This type of Arrogant, foolishness is why prominent Senators like Evan Bayh are getting out while they can before becoming politically infected with vote buying schemes (like the Charlotte Streetcar).

He sees how Arrogant, Cold-Hearted, Greedy and Selfish many Politicians have become, especially Democrats like Anthony Foxx. (If Foxx isn't cold-hearted or greedy he sure has a funny way of showing it.)

They don't really care about other people unless they are Elites or Wall Street Bankers and....

of course their Political careers. That's it!

Its a sad day when White, Republican Politicians like Andy Dulin have to speak up for Black, Low Income Senior Citizens because Black Leaders refuse to do so.

Beware, beware God is watching and those Politicians will someday receive their just rewards.

People like Evan Bayh and Andy Dulin are going to be Blessed, while people like Anthony Foxx will most definitely reap what they sow.....

Unless they change.

CHANGE!

Isn't that what Pres. Obama and his crew (including Anthony Foxx) promised many voters back in 2008?

Was it a CHANGE for better or worse?

Thank you Andy Dulin and God Bless.

Perhaps Andy Dulin will consider running for Charlotte's Mayor or N.C. Senate (again) in the near future.

Charlotteans need Public Servants like Andy Dulin in the Mayor's seat.

Public Servants elected by the people, to serve ALL people NOT just a few Elite citizens.







Charlotte City Council OKs New Bus Garage


The Charlotte City Council approved a zoning change Monday night that will allow the city's transit system to relocate a bus garage adjacent to a greenway along Little Sugar Creek.

The Charlotte Area Transit System will move offices and a garage for its Special Transportation Service from Statesville Avenue to 3.6 acres east of North Alexander Street. The site is just north of Interstate 277.

CATS' plans had been in limbo since the summer, when council members rejected the transit system's tentative plans for the new $14 million facility. They complained last June that the planned buildings were too ugly and would disrupt the improving Belmont and Villa Heights neighborhoods.

Since then, CATS made a number of changes that helped secure council approval.

The transit system changed the layout of the STS facility, placing the more attractive office building facing the park. It promised to save a 30-foot oak tree and limited the size of the building.

Council approved the change by an 8-3 vote. At-large council members Susan Burgess and Patrick Cannon, who are Democrats, and Republican Edwin Peacock voted against it.

Andy Dulin, a Republican, said he supported the transit system's plans because the green space is on what he called a steep hill, leading to the creek.

"This is not a hill you go with your dog and children and throw a Frisbee," Dulin said. "This (facility) is needed today."

STS carries the elderly and disabled on trips to the doctor or grocery store or other errands. CATS said it needs to expand the buildings that house its buses and vans, and it wants to relocate it adjacent to an existing bus maintenance garage on North Davidson Street. That garage is being improved with roughly $20 million in federal stimulus funds.

By combining the two facilities, CATS expects to save money by sharing staff.

The plans still upset some, however. Jud Little, who owns property in nearby Villa Heights, said the plan is short-sighted.

"Putting industrial uses here makes it more difficult to achieve residential re-investment in areas close by," he said.

Mayor Anthony Foxx, who didn't vote on the zoning change, agreed.

"We continue to put industrial uses into our urban core," said Foxx, who lives nearby in the First Ward. "From that perspective, I would vote no."

The city's zoning committee found the STS buildings would be inconsistent with the city's Belmont Revitalization Plan. But the committee voted to approve the zoning change 5-2, saying it was "in the public interest."

In other action, council members unanimously approved a zoning change that will allow an iconic red, white and blue Volkswagen Bug to remain on top of a building at the intersection of Freedom Drive and West Morehead Street.

The change covers 0.28 acres on the building site.

The building owner wants to convert the building to a restaurant, but that would have meant the Bug had to go. The city has an ordinance against rooftop signs.

The change will allow the Volkswagen to stay, though it can't be an advertisement for a business.


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Sources: McClatchy Newspapers, Charlotte Observer, Charmeck.org, Facebook, Youtube, Google Maps

Charlotte Senior Citizens Get No Respect...Streetcar Blues

Apparently Senior Citizens who reside in Charlotte-Mecklenburg county are worth nothing to local Politicians.

In fact it appears Mayor Anthony Foxx wants to sacrifice them for his little "Streetcar Named Desire" pipe dream.

Actually Foxx's ploy to raise property taxes seems more like a "Mayor McCrory Copycat Dream" (North Carolina's first Light Rail system was established under former Charlotte Mayor Pat McCrory's reign).

The City of Charlotte really has NO need or use for a Streetcar at this time, nevertheless since Foxx and his Democrat Political Hacks don't want to lose any Votes, they insist on spending $500 Million Dollars (mostly Property Taxes) to build it.

Thousands of Charlotteans are Unemployed yet Anthony Foxx wants to use Federal, State and Taxpayer dollars to make himself look good.

Yes I am well aware of the new EPA Air Quality/ Fuel Emission Standards.

However constructing a Streetcar which will only travel 1.5 miles in the Uptown area is NOT going to solve that problem!

Most Intelligent people agree that expanding the Light Rail to U.N.C.C. would be a better use of spending Federal, State and Taxpayer dollars.

It would also help to clean up Charlotte's Air Quality.

Furthermore since it would take longer to continue construction of the Light Rail expansion, this would create more long term Jobs for Unemployed Charlotteans.

Its all Politics folks! Nothing but Arrogance, Politics and Power.

(Sigh) Nevertheless....

It doesn't matter if Foxx cancels Senior Citizen Doctor trips (provided by CATS) which will probably cause the death of many Low Income, Black Senior Citizens due to lack of proper Medical Care.

Even though many of those same Senior Citizens voted Foxx into the Mayor's office.

Even though those same Senior Citizen Doctor trips could be paid via the use of Stimulus Money or other Federal funding.

How is it that Mayor McCrory kept the Senior Citizen Transportation program in place for years and Charlotte NEVER went broke?

Suddenly under Foxx's rule the City of Charlotte can no longer afford it?

Easy!

It doesn't matter because Mayor Anthony Foxx is a Narcissistic, Selfish Snob and HE DOESN'T REALLY GIVE A DARN!

Cutting that much needed program will help fund Foxx's 1.5 mile Streetcar project so that when Key National Democrat Leaders come to visit Charlotte he can stick out chest and brag:
"LOOK WHAT I DID".

Its all Politics folks! Nothing but Arrogance, Politics and Power.

That's okay because people always reap what they sow.

Just take a look at what happened to Corrupt Former Mayor of Baltimore Sheila Dixon who used Gift Cards allocated to help Baltimore's poorest citizens for her own use.

As the old saying goes "The bigger they are, the harder they fall".

Charlotteans take a hard look at Anthony Foxx and Charlotte's Future.

Chicago's Corrupt Politics at its finest folks!

This is another reason why I did NOT vote for Foxx.

Once again you can thank your friendly neighborhood newspaper the Charlotte Observer (community nickname: "Charlotte Disturber") for this bit of loveliness.

Mayor Foxx your Coldhearted, Selfish behavior will eventually cause you to reap what you sow.

I'm praying for you.

One More Thing:

Mayor Foxx and every Charlotte City Council Member who agrees with this foolishness should be voted out of Public Office as soon as possible.

NO MORE STRAIGHT TICKET VOTING!




 




Anthony Foxx & CATS To Cancel Senior Citizen Doctor Trips, Raise Fares



Bus and train riders may pay an extra quarter for a one-way ride starting in July, and the Charlotte Area Transit System is considering service cuts for the elderly and disabled to fill a nearly $2 million budget hole.

In addition, CATS is proposing to cut the historic trolley service through South End. That service uses replica trolley cars on weekends, and is mostly used by tourists and families.

CATS also said Wednesday the possible opening of the light-rail extension to University City could be pushed back past 2019 because the transit system may not have enough money. Three years ago, CATS said the 11-mile extension might open by 2013.

The grim forecast is due to the recession, which has led to consumers' cutting back on spending. That has led to a decline in revenue from the half-cent sales tax for transit, which is an important source of revenue for CATS.

Last year, CATS projected the half-cent sales tax would generate about $270 million less over the next decade than was projected in 2006. Now the transit system estimates the shortfall will grow: $349 million over the next 10 years.

CATS proposes raising its local one-way bus and Lynx Blue Line fare to $1.75 from $1.50.

The transit system last raised fares in 2008 due to high fuel prices. That increase raised the one-way fare from $1.30 to $1.50. In the summer of 2007, CATS raised its one-way local fare from $1.20 to $1.30.

CATS policy is to consider raising fares every two years so customers won't have to face steep increases at once. But if the proposed fare increase for 2010 is approved by the Metropolitan Transit Commission, a one-way fare will have risen 46 percent since 2007.

The cost of monthly and weekly passes will also increase. Overall, the fare increase is expected to generate an extra $2.5 million annually.

Carolyn Flowers, CATS' new chief executive, said Wednesday she'll look at reducing special service for the elderly and the disabled to save money.

CATS is required by the federal government to provide special service for those who live near local bus routes. But CATS has for several years provided rides for people who live outside those areas, and is now considering cutting that service. CATS carried just under 3,400 of those rides last year.

The transit system is also proposing cutting a $1.07 million grant to Mecklenburg's Department of Social Services for giving taxicab rides to the elderly and the disabled to jobs or the grocery store. CATS has said DSS could apply for federal grants to offset the lost funding.

That nonscheduled service is considered critical for its riders, but it's also expensive. Some rides cost the transit system $25.

"We are looking at all of our cost structure," said Flowers, who came to CATS from the Los Angeles transit system. "Our focus is trying to sustain our core service."

In the fall of 2007, as Mecklenburg voters debated whether to keep or repeal the half-cent sales tax, CATS warned that repealing the tax would dramatically impact special service for the elderly and disabled.

If the fare increase and the service cuts are approved by the MTC in April, CATS said it will be able to maintain the same number of regular bus and rail service hours that it offers today.

Some members of the MTC were concerned about raising fares in the midst of a recession.

"I'd like to see other options instead of a fare increase," said Davidson Mayor John Woods, who said CATS should study additional service cuts.

CATS isn't in danger of running an overall deficit.

But the transit system tries to sock away money each year for long-term construction projects such as the light-rail extension and the planned commuter rail line to Lake Norman. CATS believes it will be able to save $20.6 million for this fiscal year, which ends in June. Earlier in the year, CATS projected it would have $22 million this year for capital projects.

Flowers said she doesn't want to shift that capital money for today's operating costs.

"You still want to try to build for the future," Flowers said. "If you start nibbling away at your future, you won't have any revenue set aside for capital projects."

After opening the Lynx Blue Line at the end of 2007, CATS has faced a number of obstacles.

The first came in the summer of 2008, when fuel prices spiked to $4 a gallon for consumers. That led CATS to make an unplanned fare increase.

In the fall of 2008, the local economy began to worsen, CATS struggled with lower half-cent sales tax revenue.

Last March, CATS made $4million in service cuts, including cutting six routes and reducing how frequently light-rail trains arrive at rush hours.

Ridership has also suffered due to lower fuel prices and high unemployment.

Overall transit ridership for CATS is down 10 percent for the first six months of the current fiscal year compared with the same period in 2008.

In fall 2007, CATS said it could begin multiple transit lines over the next two decades, including a light-rail extension, commuter rail, streetcar and either a busway or light-rail down Independence Boulevard.

Though that's still officially the plan, it's likely that CATS will be able to build only one of those projects before it runs out of money.

The city of Charlotte has taken the lead in building a streetcar through central Charlotte. The city is applying for a federal grant to build a 1.5-mile starter line on Trade Street, which will cost $1.5 million annually to operate.

The city has said CATS could help pay for those operating costs. Flowers said Wednesday that's not an option.

"Clearly it won't be CATS," Flowers said. "We aren't budgeting it and we aren't planning to budget it."






City Of Charlotte Requests $25M Grant For Streetcar


Charlotte City Council put the wheels in motion Monday night, voting to request a grant for the streetcar project.

The vote passed 7-4 with council's three Republicans and Democrat Warren Turner voting against the measure.

The $25 million federal grant would go toward a 1.5-mile section from Elizabeth Avenue to the transportation center on Trade Street in uptown.

Charlotte would have to come up with another $12 million to pay for construction. Some have questioned that spending.

"You're not doing your job. You're not looking after the people's money. And you're not looking at the facts that we don't (have) cash to run this thing," said council member Andy Dulin.

The city expects to learn this summer if Charlotte wins the federal grant. Construction would start next year and the streetcar could be running in 2013.



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Sources: McClatchy Newspapers, Charlotte Observer, WCNC, Baltimore Sun, Meck Deck, John Locke Foundation, Charmeck.org, Google Maps