Helicopter pilot threatened with arrest after flying rescue missions in flood-ravaged NC

 A South Carolina pilot who flew stranded Hurricane Helene victims in flood-ravaged North Carolina to safety claims he was told he would be arrested if he continued the rescue missions.

Jordan Seidhom was flying victims out of the devastation over the weekend when local leaders told him there was a flight restriction on the area and that they would have to arrest him if he continued making flights.

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Jordan and Landon Seidhom flew to the flood-ravaged Lake Lure region of North Carolina to help victims of Hurricane Helene.Jordan Seidhom/Facebook

“There were other victims. As we were flying out leaving the area, we spotted within 300, 400 yards of their location [people] were waving for help as my son and I were leaving,” Seidhom told Queen City News.

After the storm wreaked havoc on the region, leaving hundreds of people stranded as entire roadways washed away, Seidhom read about a family that was stranded without water on a mountain in Banner Elk, a ski town heavily battered by the storm, and knew he had to take action.

“I thought, I have a helicopter, maybe I can help,” he told the outlet.

Seidhom, who once led the Chesterfield County Sheriff’s Office narcotics unit, and his teenage son Landon flew out bottled water and food to the family on Saturday and decided they would set out to find other people in need of help.

The father and son, both volunteer firefighters, flew four victims to safety on Saturday, including two women stranded at the top of a mountain and two vacationers trapped inside their Airbnb.

“They only had one day of supplies, which was gone by Saturday. They didn’t have any food, water, no running water, no power. And we were coming back this direction anyway, so we actually took them to Charlotte-Douglas Airport and they were able to fly home from there,” Seidhom said.

After sleeping in recliners in a pilot lounge at a nearby airport, the father and son went back out on Sunday and found a husband and wife who waved them down from their partially washed-away home.

Only equipped with his small helicopter, Seidhom had his son exit the aircraft to make room for the wife, whom he flew to a group of first responders about three minutes away.

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Seidhom said a local Lake Lure official told him he would be arrested if he continued rescuing victims.Jordan Seidhom/Facebook

“I originally left my son, co-pilot, on the side of the mountain. [The helicopter] was kind of unstable, so I didn’t want to put more weight on the helicopter to lift it back off. So, I left my son with the other victim. And I was just going to take one person down at the time,” Seidhom said.

Seidhom’s plans to return for the other victim and his son were squashed by an unnamed Lake Lure fire official, who allegedly threatened to have him arrested if he continued picking up stranded victims, Seidhom told the outlet.

“I explained to him that I left my son on the side of the mountain, and I left another victim. I was going to go back and bring them, it was already set up for the landing spot and then I would get out of his area. He told me I wasn’t going to go back up the mountain to get them, I was going to leave them there,” he said.

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Seidhom and his son, both volunteer firefighters, returned Sunday to rescue more people.Jordan Seidhom/Facebook

The official, however, held his ground and reiterated his threat to arrest Seidhom if he were to get the other victim and fly him to the first responders, Seidhom claimed.

Defeated, Seidhom returned to retrieve his son and explained what happened to the husband, whom he was forced to leave stranded in his crumbling driveway.

Within half an hour of the confrontation with the fire official, Seidhom said, a temporary flight restriction was enacted over Lake Lure, where he had been trying to save the stranded couple.

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Seidhom says he was forced to abandon a victim after he was threatened with arrest.Jordan Seidhom/Facebook

By the time the restriction was lifted on Monday, Seidhom reloaded his helicopter with food and bottled water and flew back to Lake Lure with the Carolina Emergency Response Team, a volunteer group dispatching pilots where people need to be rescued.

While he is now doing everything he can to help those in need, Seidhom says he believes the Lake Lure fire official’s decision to stop him from picking up victims on Sunday put lives in jeopardy.

“I can only imagine what the people were thinking. You’ve been stranded for 24, 36 hours. No way to speak with anyone. You don’t know what’s going on and you see a lifeline fly over and they keep going. I can only imagine what they were thinking.”

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At least 140 people have been killed in the powerful hurricane.Michael Coffey/Facebook

He added: “If I had to do it over again, I would have stopped and I would have rescued as many people until they decided they were going to arrest me.”

Officials in the town of Lake Lure could not immediately be reached by The Post on Wednesday.

Hurricane Helene slammed into Florida on Thursday as a powerful Category 4 hurricane before tearing a destructive path through the Southeast, causing mass devastation and killing at least 140 people.

President Biden and Vice President Kamala Harris were scheduled to travel on Wednesday to North Carolina, South Carolina and Georgia to assess the wreckage.

https://nypost.com/2024/10/02/us-news/helicopter-pilot-threatened-with-arrest-after-flying-rescue-missions-in-flood-ravaged-nc/

Long-term Care Benefits in Medicare Advantage Plans: Reform Needed

 Five years ago, some analysts and policymakers hoped that allowing Medicare Advantage (MA) plans to offer long-term care (LTC) benefits would be a largely federally financed option for retired and disabled people for such coverage. This would be an alternative to underwritten private long-term care insurance, the unpopular process of spending down assets or questionable methods of eligibility to qualify for Medicaid followed up by uncertain estate recoveries, and politically difficult expansions of public social insurance programs. The result, however, has been quite modest, with MA plans having low penetration, and offering LTC benefits that are small and sometimes poorly coordinated. It is possible that the wide availability of other types of non-health benefits – such as groceries, rent, and transportation – in some MA plans may be crowding out LTC benefits. Additionally, recent and proposed payment cuts to MA plans would further reduce these LTC benefits.

Medicare currently provides some LTC benefits in certain circumstances. In particular, it will pay for up to 100 days of skilled nursing facility care following a three-day or longer inpatient hospital stay if the physician decides it is needed to improve or stabilize an ongoing condition treated during the hospital stay. Also, Medicare will pay for home health services if part-time or intermittent skilled services, like wound care or injections, are needed while homebound. As part of these services, some part-time home health aide care, like bathing and feeding, may be provided up to a combined 8 hours a day for a maximum of 28 hours per week. None of these benefits, however, include long-term custodial or personal care helping with activities of daily living (ADLs) when this is the sole care required.

MA plans allow Medicare beneficiaries to receive benefits from private plans rather than from the traditional fee-for-service (FFS) Medicare program. Through constraints of provider networks and utilization management, MA plans are able to provide required Medicare benefits (mainly physician and hospital care and usually drugs), albeit with a more flexible structure than FFS, as well as additional benefits, with an out-of-pocket spending limit, and sometimes premium rebates. Because Medicare pays private plans a partially predetermined rate that is risk-adjusted for each enrollee rather than a per-service rate, plans should have greater incentives than FFS providers to deliver more efficient care. Now, more than half of Medicare beneficiaries across most of the US are enrolled in over 5600 MA plans offered by 184 organizations; the MA share continues to grow.

Historically, the additional benefits in MA plans were strictly health-related, including dental, hearing, and vision benefits. In 2019, the Centers for Medicare and Medicaid Services broadened the definition to include in-home support services by home health aides, caregiver support, and adult daycare. In 2020, many MA plans were authorized to offer non-health supplemental MA benefits for the chronically ill or low-income, like food, meals, pest control, non-medical transportation, indoor air quality equipment, social club memberships, language classes, rent, utilities, pet care, telephonic spiritual care, hairstyling, and robotic pets. In 2024, more than a quarter of MA plans offered food benefits, but only 15 percent offered in-home support services. The former represents a 20 percent increase from 2023, while the latter experienced a 34 percent decrease.

In-home support services in MA plans include assistance with ADLs, generally available in two to four-hour increments, with a limit on the total number of hours in a given year, typically between 24 and 60 hours. Some MA plans limit these benefits to a post-inpatient-hospital stay. MA plans devoted to dually eligible (to Medicare and Medicaid) beneficiaries have a higher annual limit, generally more than 60 hours, some up to 124 hours, still a quite modest benefit (See ATI Advisory 2023). Moreover, there are concerns that the MA benefits are not well coordinated with those from Medicaid. Some MA plans have liberalized the Medicare skilled nursing facility benefit by not requiring a prior hospital stay.

It is indeed reasonable to include LTC benefits in MA plans to expand upon the basic Medicare coverage. The competition and displacement from extensive and expensive non-health related benefits, however, is not good public policy, given limited public resources to support needed health care at a time of massive and growing federal deficits and debt. Moreover, recent and proposed federal payment cuts to MA plans because of concerns that the risk-adjusted benchmarks are too generous will put further particular pressure on the modest LTC benefits. The menagerie of non-health benefits should be eliminated, and scarce resources devoted to real health coverage. Moreover, the entire Medicare program should be converted to premium support, to maximize its efficiency through competition and allow for focused consumer choice among essential health benefits, including LTC.

Mark J. Warshawsky is a senior fellow at the American Enterprise Institute (AEI), where he focuses on Social Security and retirement issues, pensions, long-term care, disability insurance, and the federal budget.

https://www.realclearhealth.com/articles/2024/10/02/long-term_care_benefits_in_medicare_advantage_plans_1062458.html

What The Left Is Getting Wrong About The GOP’s Health Ideas

ByJohn C. Goodman 

In an interview the other day, J.D. Vance said that Donald Trump will “promote more choice in our health-care system and not have a one-size-fits-all approach that puts a lot of the same people into the same insurance pools.”

In no time at all, left-wing critics pounced.

Trump and Vance would “permit insurance companies to discriminate against people with preexisting conditions,” wrote Jonathan Chait. They would allow insurers to “charge less to the healthy and more (much more) to the sick,” added Josh Barro. “That’s exactly how health insurance worked before Obamacare,” said Paul Krugman.

Yet it is the critics who don’t understand how Obamacare is working and how it needs to be reformed. When insurers are forced to sell to everyone at the same price, they have strong incentives to attract the healthy (on whom they make a profit) and avoid the sick (on whom they incur losses). That is what is happening today.

Obamacare didn’t solve a problem; it merely changed the nature of the problem. In the old days, some chronic patients couldn’t get health insurance. As I show below, today they can get insurance, but they may not be able to get health care.

So, what’s the answer? It begins by recognizing that almost everyone in America today who buys private health insurance is getting a tax subsidy for their purchase. People who get insurance from an employer have that benefit excluded from their taxable income. People who buy in the (Obamacare) exchange are getting tax credits, which are transferred to the insurers along with the buyer’s payment.

Part of the premium we pay is coming out of our pockets, and the rest is picked up by government. Even if our part of the premium is community-rated (that is, the same price regardless of health status), there is no reason why the government’s share has to be restricted in that way.

In an ideal system, the government’s share would vary with health status. The total amount received by the insurer (personal + government payment) would equal the actuarially fair value of the insurance (the expected cost of care). Were this to happen, the healthy and the sick would be equally attractive to the insurers. There would be no incentive for insurers to discriminate based on health condition—either in cost-sharing, benefit design, or choice of provider networks.

If insurers were fully compensated to take on chronic patients, many would specialize and develop lower-cost, higher-quality systems of care. We could have what Harvard professor Regina Herzlinger calls “focused factories,” entities that excel in the treatment of various forms of chronic illness. Far from having everyone in the same risk pool, we could have separate pools for diabetics, heart patients, and those with other chronic conditions.

Some readers may wonder if this idea is practical. Could it actually work?

We are already doing it. What I just described is how the Medicare Advantage program was designed, and it is serving the needs of more than half of all Medicare enrollees. Although originally bipartisan idea, this approach to health care has become increasingly associated with Republicans.

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Medicare Advantage is the only place in the health care system where health plans receive risk-adjusted premiums that reflect the health status of the enrollees. The enrollees pay the same premium, regardless of their health condition. But the government’s additional premium payment makes the total amount the health plan receives equal to the expected cost of the enrollee’s health care. Although not perfect, it is the most sophisticated risk-adjustment system in the world.

Medicare Advantage is also the only place in the health care system where a doctor who discovers a change in a patient’s health condition (say, the detection of cancer) can send that information to the insurer (in this case, Medicare) and receive a higher premium payment for the health plan, reflecting the higher expected cost of care. This means plans are rewarded, not penalized, when they find and treat medical problems.

Finally, Medicare Advantage is the only place in the health care system where insurance plans can specialize. There are special needs plans for diabetes, for patients with respiratory problems, heart problems, cancer care, etc.

Boston University professor Laurence Kotlikoff and I have argued that the Medicare Advantage model is exactly the right way to reform the Obamacare exchanges.

Right now, the individual market is great for the healthy and lousy for the sick. If you have average income and no health problems, the insurance is free (or almost free). But if you have a costly health problem, the out-out-pocket exposure this year is $9,450. For a family it is twice that amount. This is the highest penalty for being sick found anywhere in the health insurance system, and victims have to bear that cost every year.

Compared to employer-sponsored plans, the plans in the exchanges have very narrow networks that often exclude the best doctors and the best medical facilities. And if you go out of network, the plan pays nothing.

With rational risk adjustment, people would not have to be trapped in a one-size-fits-all system. They could go outside the exchange to purchase short-term plans, sharing plans, and other plans not subject to Obamacare regulations. In fact, we could have a fully free market for health insurance, comparable to the markets for other kinds of insurance.

And, although I have referred to government as the risk adjuster, the kind of system I am describing is what probably would have developed privately had the insurance market been allowed to evolve on its own.

What Trump and Vance are talking about doesn’t mean we have to return to the (pre-Obamacare) bad old days. It means we can look forward to a much better future.

https://www.forbes.com/sites/johngoodman/2024/09/24/what-the-left-is-getting-wrong-about-the-gops-health-ideas/