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 (MCW) 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,