Vince Cataldi - Milwaukee
Milwaukee County Executive Scott Walker
Seeking answers to resolve GAMP inefficiency

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Seeking answers to resolve GAMP inefficiency Correspondence
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Seeking answers to resolve GAMP inefficiency

General Assistance Medical Program - Milwaukee
County Executive Scott Walker - GAMP Links - Milw. Wis. - GHAC

County Executive Scott Walker says:

Subject: RE: Town meetings schedules: Regarding the GAMP program - this is a program for the indigent that do not qualify for Medicare or Medicaid and have no other health insurance option. Milwaukee County is not mandated to have the GAMP program, but it was put into place after Doyne Hospital was closed to serve the indigent population.  Milwaukee County sees it as a service to its residents that need health care assistance. again this is not a mandated or required program for Milwaukee County, however, it is a program that is necessary and speaks to the core functions of county government.


Darlene J. Wink - Constituent Services Coordinator
-Milwaukee County Executive Scott Walker - 414-278-4191
dwink@milwcnty.com   ----- 
Forwarded by Darlene Wink/Co Exec/Milwaukee County 
on 08/27/2003 10:39 AM -----

Health Care: in America must become more efficient
 - or people die for waste, and the politics of medicine


 The office of Milwaukee County Executive Scott Walker says: "...again this is not a mandated or required program for Milwaukee County, however, it is a program that is necessary and speaks to the core functions of county government"  Human beings, in the United States of America and, deserve affordable, truly accessible, and honest Healthcare from their communities, an obligation of the community at the local level.

Executive Walker is not Walking as he's Talking, would Ryan still be Trying?
Below is my historical record of my efforts to improve efficiency within GAMP, to free up millions of wasted money, and redirect them to assist the true intended  needy.  

Below you will find 32 e-mail correspondence concerning my grievance with GAMP -- General Assistance Medical Program  Milwaukee. This correspondence begins on June 26 and ends on September 19. Despite my efforts to help them, my inquiries are still virtually unanswered, although somewhat sparingly replied to. It's turning into a bit of a mess, and I am surprised because I only wanted to help them, so I could be helped too. 

I tried to understand the inefficiencies and discrepancies between the records of communication; between GAMP and Dr. Deckard office.. I write to request a formal investigation, only because the Gamp Utilization Department instructed me to do so.

Therefore, I wrote again, and again, and again, and so on; my county executive Scott Walker refuses to respond to me, and continues to treat me like a contagious problem. Please read this series of correspondence below, to understand what is going on.  Thanks for your time.

I was so delighted that DR Deckard agreed to help me as a professional favor and referral from Dr. Dicus, they both gave me a huge favor.  I am embarrassed, insulted, and furious with the way GAMP dealt with Dr. Deckard.  Why should this specialist doctor help me for no money, piles of paper work, and the run-around; why would GAMP treat him like with complete disrespect.  I feel betrayed.

Health and Human Services for Milwaukee County

PAULA A. LUCEY, RN

Paula A. Lucey, RN, Director of Health and Human Services for Milwaukee County, is one of Wisconsin’s leading advocates for urban health and the special health care needs of the poor. In her current position, she helped develop and continues to  implement the General Assistance Medical Program (GAMP) that provides a safety net of medical care to over 25,000 Milwaukee County residents.

 

Medical College of Wisconsin logo

Copyright © 2003 
Medical College of Wisconsin

For Further Information Contact:

Joseph Cooper
JECooper@admin2.chrp.milwcnty.com
414/257-5949
Or
Paula Lucey
palucey@admin2.chrp.milwcnty.com
414/257-5949
Medical College of Wisconsin logo

 Jim McGuigan






Scott Walker

 

Give Health A Chance

Vincent J Cataldi -- Milwaukee, Wisconsin 53202 - USA
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General Assistance Medical Program Milwaukee
County Executive Scott Walker - GAMP Links - Milw. Wis. - GHAC


GAMP - reality, gamp in action
mailto: gamp.milw

 

----- Original Message -----
 

Reduced Health Costs:
you made it possible.
Thank you my friends!

1 Scott Walker
2. Senators Kohl, Feingold , and Gore
3, Froedert and the Medical College
4. Nehring Family Business
5. Wisconsin Governor Doyle
6. Secretary Thompson
Reduce health costs: good for the small-business, the individual, medium and large distributors, health care providers and distributors, and our political leaders who serve with conviction through example to enrich those they serve. It seemed like such a dream, for so long just beyond our grasp, but now we can reach it!

Thank you all for your participation and support, and I thank you and applaud you in advance, for even more contributions towards this effort, which I expect we can finally realize. Individually, I have negotiated with each of you, brief but intense negotiations which quickly lead to a better understanding, and individually we all now realize that slight repositioning of priorities will allow us to achieve what we all want, need, and desire so dearly.

This is the first time I introduce you to each other as my team, a team I chose by following my heart. I believe in you. I know we can do it, I know we can win. Some of you sacrificed by readjusting your schedules and priorities with little advanced warning, some of you accommodated the inconvenience only with personal sacrifice. Some of you paid more than others, even if it was expended political capital, but in some way we all pay the price, and we should rejoice that inevitable victory is just around the corner.

I'll introduce you, not ordered by the personal sacrifices you've made, or even alphabetically; I'll introduce you in order to most easily introduce each of you to each other, all at the same time.

We are compelled to join forces, I insist.


1. County Executive Walker is our backbone toward actualization: he joins the project because I challenge him to convey a grand jury, for only then will my ethics allow me to show him several millions of annual waste within Gamp which is being purposefully hidden from him; his political survival depends on it, or he fails the leadership-quality test for re-election.

2. Senator Kohl and Senator Feingold . from the great state of Wisconsin, and Senator Gore too, as we feel the need to provide highly visible leadership through example, and power within the Federal Congress. Forcing an improved ethics in our Federal system is important to them, to all of us as well. Your ethics are earned, and ones most valuable asset, role model leadership with ethics is critical for the on-going stability of our very culture since only the US can ensure our continuation as a nation able to protect freedom.

3. Froedert and the medical College and their partnership with GE Medical. I am especially proud of this group for several reasons. I remember Jack Welsh well, and loved GE (and GE Med) all my life. I remember dining with him at my home years ago, I was about to enter first grade. We moved to Milwaukee when pop came to run the first of the medical systems - pacemaker - which split off from x-ray at the time.

I look forward to this participation. I also know Jack is looking for meaning activities as a new chapter in his life begins, and I will ask pop to invite his advice.

Froedert and the Medical college hold in trust 600 million of the peoples money directed for poor and elderly, realizing just now that the first proposed allocation of these funds needs an adjustment - serving the community is their passion and contractual obligation.  I am most pleased about this success because I have not told them yet.

4. The Nehhring Family Businesses. A proud member of our community , this shining example of enterprise and job creation brings stubborn determination and vast knowledge. He is too often torn ethically, and pained to inflict health insurance costs on employees.  His decisions should not need to effect his very existence and survival as a viable business. Health costs must be controlled and lowered - and he is a fighter, but his greatest value is down to earth insightful solutions. He is a bottom up problem solver, as am I.


5  Two others in our group deserve special, mention but need no introduction. Governor Doyle of the great state of Wisconsin hasn't enough time to solve all the problems we face all by himself. He is why I assembled our group.

He reached out to help a critically needy stranger because the story, and desperateness of the situation touched his heart. That stranger was me, I love him and I love the courage he has chosen to exercise to dismantle waste demanded by congress to reward the pharmaceutical and insurance lobbies, and assure their power with re-election.

I owe this man, and I respect this Governor, my Governor. I am helping as much as I can, as he labors to help us all with efficiency, and a bit of defiance too, as sometimes it is required to appease his ethics.

Lastly, and ironically HHS Secretary Tommy G Thompson. This is ironic as he spearheaded the earliest reform efforts and served a leadership role drafting the National Governors Association Health Care Reform Policy HR-32.

It is also ironic because he made it possible for my beloved Governor to continue a non-stop tradition of US reform, fighting for efficiency, from Wisconsin. I have never spoken to him, but have recently appealed to him for help, acting from his powerful position to help Milwaukee first, before he comes home to Wisconsin, not to retire, but to start something new. Think of the potential value if his help continues even after he leaves public federal service.


1 Scott Walker
2. Senators Kohl, Feingold , and Gore
3, Froedert and the Medical College
4. Nehring Family Business
5. Wisconsin Governor Doyle
6. Secretary Thompson
7.  I Am


Introduce yourselves, check out the links above to understand negotiated positions. Chat among your selves, fine tune the plan; I will be unable to provide continuous leadership for medical reasons. You must developed a working relationship with each other so we act well as a team, even if I must watch from the side lines at times.

I am so pleased. I see critical mass - this can't fail, unless you all bolt ship. Any one who leaves will be pressured back by the others who still have spirit. No one can be spirited all the time. No one can make the best decision each time, all of us straddle what is right and what is viable. As a team we can overcome individual weaknesses and grow, supporting any dispirited core-group members.

I have enjoyed working with you and look forward to our future and the honest self-pride we will earn.

Sincerely,

Vincent J Cataldi


THE PLAN

Initially define and implement the TGT Audit Standard.  Eventually seek to achieve all terms of the National Governors Association Policies, see www.GiveHealthAChance.org

 
12-21-03
Tommy G. Thompson
Secretary of Health and Human Services
U.S. Department of Health and Human Services
200 Independence Avenue, S. W.
Washington, D.C.20201
Telephone: 202-619-0257
Toll Free: 1-877-696-6775

HHS.Mail@hhs.gov
Vincent J Cataldi
1651 N. Farwell Ave. 
Apartment. #110
Milwaukee, WI.  52302
Home:
414-276-3773
eFax: 262-364-3999
vince@cataldi.us


Dear Mr.  Secretary:

1 - I write to request that you scrutinize and then help us regain control of Milwaukee Health System (MCHS) costs, so our poor county residents have reasonable health-care possibilities.  I believe you can help many if you will: a) re-examine legitimacy of using  Froedtert Hospital and the Medical College of Wisconsin (MCM) to redistribute indigent bound HHS funds, for redistribution, b) analyze and determine a productivity-quotient for GAMP operations – cost-efficiency analysis protocol, c) compel GAMP to honor HIPPA laws and my request to release my patient information, d) help state's achieve increased rights to allow NGA HR-32 goals, and e) establish an upgraded HHS Audit Standard.


Scrutinize federal funds flowing into our MCHS, and use your authority to regain control of this flow. These funds are desperately needed now, yet virtually all these charitable funds are siphoned-dry prematurely; as the mighty Colorado River is sucked dry before reaching its’ destination, Mexico’s Pacific Ocean. Despite lavish federal, state and county funds flowing in, MCHS exhibits no apparent desire to help, even to help desperate medical conditions.  Locally, resources appear primarily to support managing bureaucrats and hospitals high-margin profit centers.

I believe scrutiny will reveal ubiquitous diversion of funds is significant, unnecessary, and defies intent of Congress.  These precious flows of charitable-responsibility are consumed before reaching desperate patients as intended. Congress provides this flow as a critical, common-sense US investment in ourselves, yet locally its’ application routinely sacrifices health for lack of resources. If my situation and experience in Milwaukee is nationally representative, I must contend that to increase health-care efficiency is an increasingly critical National Security Issue.


2 - My experience and health care professionals, including Robert J. Wetzler MD instruct me, and thus I discovered an abhorrently illogical, wasteful, and in-equitable situation which is at best an imprudent use of well-meaning federal funds.  I am one of the growing masses who fell through the crack, into a personal health care crisis; a chilling glacial crevasse from down here.  I earned too much for income assistance, yet too little for disability benefits.  Uninsurable, my only recourse was to become an indigent.  Even then, indigent health care eligibility required a diagnosis first.  I have struggled for more than three years now, to define my critical spinal problem, as I worsen, and likely, my cost to survive increases.  Surgery is urgently recommended, yet my problem is not defined yet.  How can this happen in the richest, most powerful country in the world? 

I attack inequity, waste and ridiculousness.  I fight for efficiency of an accountable, equitable public health sector.  I fight problems I stumble over, to help others behind me, though I do fear possible retribution.  My friends and family believe I may be compromising the long term quality and perhaps length of my life, by rocking the boat too much.  I feel strongly that I must fight however, because I believe I can improve things somewhat; and a small percentage improvement in efficiency will produce huge benefits statistically, actually, immediately, and freely. 

3a - Froedtert Hospital and Medical College of Wisconsin (MCW), as a team, publish booklets of services offered to poor, yet in practice their clinics have not admitted a new patient in three years, ‘look elsewhere’, they told me.  Despite lavish funding flowing from your department, they no longer serve our community despite historic obligations.        Instead they positioned themselves to deny underinsured and uninsured all access to medicine, except their costly ER services.  Froedtert Hospital, serves as a General Electric Medical Systems demo-site, with uniquely high quality CT technology, yet they refuse me access, self-pay.  Froedtert Hospital and MCW recently made a deal with BCBS for 600 million dollars when a court ordered the 'peoples money to be returned because BCBS became for-profit, yet no flow of these funds is allocated for underinsured and uninsured patient care. 

3b - GAMP is completely ineffective for me as well. It took 8 month for acceptance, then six months to get an urgently required diagnostic MRI scan. This approval also required helpful intervention from Governor Doyle  Experienced, effective leadership has left or been pushed aside, and now GAMP behaves without accounting even to duly elected county administrators, I am told  GAMP is equipped with beautiful new desk and lap-top that listens, yet nothing gets done.  Decision makers earn more money if they say no, or don't say yes; so they do nothing and personally profit.  .

Medical professionals ideally would serve a balanced mix of well-insured and uninsured, but this is not happening.  Many doctors won’t tolerate wasted time and abuse from GAMP, while earning nothing too.  Medical professionals, who endure to help indigents, are swamped, so specialize to serve indigents.  These kind doctors some times spend retirement funds, and battle bureaucracies, to provide health care; still they often are thwarted and seriously frustrated. 

4a – Executive Walker wrote me, “Regarding the GAMP program - this is a program for the indigent that do not qualify for Medicare or Medicaid and have no other health insurance option. Milwaukee County is not mandated to have the GAMP program, but it was put into place after Doyne Hospital was closed to serve the indigent population.  Milwaukee County sees it as a service to its residents that need health care assistance.  Again this is not a mandated or required program for Milwaukee County, however, it is a program that is necessary and speaks to the core functions of county government.”  Froedert Hospital and MCW bought Doyne Hospital, and now renege on their obligation to replace its’ specialized patient care.  Does it still make sense to funnel health funds for indigents through this group?

4b&c - I request, as GAMP suggested, an investigation of GAMP accountability concerning me.  Governor Doyle intervened on my behalf, starting a series of 32 emails with GAMP and Executive Walker.  I received no meaningful response.  I asked simple questions, and received only non-answers.  I offered to provide cost-efficiency analysis without charge.  Still, I received no response.  I requested legally my patient records to analyze my GAMP data.  GAMP operations manager, Bridget Murray, denies its’ existence.  HIPAA laws blatantly, repeatedly are ignored.

For summary details concerning my GAMP complaints, please contact Lisa M Simeone, Regional Manager, Health and Human Services - Office for Civil Rights, ref. # 16632.  Complete, continually updated details are also available: www.givehealthachance.org/~gamp.milw/ and www.givehealthachance.org/Vince/. 

 

4d - ‘GiveHealthAChance.org‘, based around the National Governors Association (NGA) HR-32 - Health Care Reform Policy, petitions to mandate 100% reimbursement to states, for all federally mandated medical costs.  Therein also, I petition to increase states rights to improve insurance risk of indigents by commingling the uninsurable into inter-state, and state supported pools.  This will achieve volume-power medical discounts, routine for all but the individual, small businesses, and our poorest.  Without US insurance and pharmaceutical lobbies to battle, our neighbor uses bulk-purchasing so well, now massive ‘US-created legal-drug’ traffic comes back home, from Canada.  Please support NGA and our united governors’ efforts, to achieve the increased efficiencies HR-32 goals provide. 

4e - Current technology allows you significantly to improve accountability and cost-efficiency of health funds spent, using a proven-developed audit process that looks at a hospital bill to access data quality hospitals engineer into a bill, and tests it for reasonability.  Statistically, 90% of hospital bills have an 11% overcharge; some are much worse rising to the level of fraud.  Establish an upgraded HHS Audit Standard to document waste and release a significant flow of funds very quickly, cost free.  Start in Milwaukee, your own back yard; benefits can rapidly spread nation wide, then throughout the private health sector, and other public sectors also. 

5 – County Executive Walker likely is unaware of GAMPs imprudent activities, powerless to influence the MCW and Froedert hospital, and he refuses to acknowledge my appeals; so I ask for your intervening help.  You fought entrenched waste, you sparked a revolutionary evolution of the federal welfare system as Governor of Wisconsin, yet your authority over the Milwaukee County health care system was limited.  Your advantage here is that you know it's a problem, you know its politics, you know its people, you know its victims.  As Secretary of Health and Human Services, you now have power to remedy this national health-security issue, not only here, but everywhere we waste federal dollars.  As a Badger you should want to start here, as a Republican, you have a huge political opportunity. 


Sincerely,

 

Vincent J Cataldi


Vincent J Cataldi Health
Milwaukee, Wisconsin 53202 - USA
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I am now inspired to try to help others too.  I hope this will help, please help me do so.

Health is my only serious concern these days.  I am making my story public to help arouse enough public attention to force change for others.

 

The most important thing in my life these days is my deteriorating health.

I deal with it publicly hopeful I can help many others in similarly ridiculous circumstances.

I owe thanks to a mother daughter team.  They helped me find courage enough to believe that I may be able to help many. 

We crisis-crossed  through time-space with salient timing, needing each other as we met at a moment. 

Emily Willegal - Paisley Woodside

   
This Milwaukee Journal article linked below was such a compliment, the most wonderful thank you I ever got, and it was the day I needed it most, same day I heard my long fought for medical scan results.  It was both my best and worst day.  http://www.jsonline.com/news/metro/feb03/115919.asp?format=print 
 

My favorite Quotes

These three quotes I invented to paraphrase long stories which I routinely used as motivational assistance.  These three each took ten years to condense, and were created ten years apart, taking thirty years to complete the recursive trinity lessons. 

Vincent J Cataldi - October 2006

 

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