Making The Rounds Today -- May 2, 2016

I have no idea where this came from -- I found it in my e-mail this morning; I have no idea whether it's accurate. It sounds like there's a bit of hyperbole but there's probably a bit of truth in this somewhere:

In advance of the G7 summit later this month, member country’s energy ministers are meeting today in Japan and there is an urgent “real” agenda according to a leading U.S. Oil & Gas expert.

Hint - It’s not Paris climate change accord implementation or phasing out of fossil fuels in favor of solar and wind energy.

Energy ministers (US, UK, Japan, Italy, France, Canada, Germany) are urgently meeting to discuss:

• an immediate need for G7 members to ramp up investments in oil and gas production capacity to meet the expected rise in oil and gas demand; (current economics have choked all capital investment – companies struggling to survive)
• how to cope with the “Great Crew Change” as 50% of the oil and gas workforce age out and new tech savvy millennials are needed; (a dwindling group of skilled workers attracted to an industry in turmoil)
• no new technology development. (needed to bring energy industry into modern era)

“Even Saudi Arabia has repeatedly warned that more investment in projects for future oil and gas production is necessary to keep up with future demand, to provide more stability/continuity to global markets. When the supply and demand balance shifts back to reveal an undersupplied global oil market, we will begin to experience dramatic price increases.”

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All's Well That Ends Well

And This Will End Well 

After All, It's RomneyCare, ObamaCare, HillaryCare

From The Boston Globe: arithmetic errors from small rural hospital in Massachusetts will cost the state 10% of its Medicare funding; state loses $160 million.

The background to this story goes back to at least 2013.

This is the story:

• a Medicare rule that says a state’s urban hospitals must be reimbursed for wages paid to doctors and staff at least as much as rural hospitals
• Since Massachusetts has only one rural hospital, Nantucket Cottage sets the floor for wage reimbursements. Typically, rural hospitals have lower wages than urban ones.
• But wages on Nantucket are high because of its remote location and high cost of living. Thus, the rural wage floor established on Nantucket has become a boon for hospitals in the rest of the state.
• Massachusetts, Connecticut, New Hampshire, and Rhode Island are among only nine states that win under the current system, negotiated in part by Senator John Kerry as part of the national health reform law. Massachusetts is by far the largest beneficiary, followed by California, which receives half as much money

Okay. So, even under the "best" of circumstances, Massachusetts wins (Medicare is a zero-sum game).

But now this, in today's story, back to the first link

• Nantucket Cottage, the only rural hospital in Massachusetts has nineteen (19) beds
• someone made a mistake calculating the cost of running that hospital (cost was based on number of employees; number of  hours worked; overtime; etc)
• that resulted in extraordinary reimbursement from Medicare to this little 19-bed hospital
• but by law, all hospitals in a state must be reimbursed no less than that paid to rural hospitals

From the linked story:

Simple math errors at a tiny Massachusetts hospital have created big problems for other hospitals in the state, contributing to a potential $160 million drop in federal Medicare payments over the next year.

A loss that steep — 10 percent of Medicare funding for the hardest-hit hospitals — could force layoffs of 2,000 staff, with cuts concentrated outside Boston, according to estimates by the Massachusetts Council of Community Hospitals. 

The quaint 19-bed Nantucket Cottage Hospital, owned by Partners HealthCare System and considered the state’s only rural hospital, has for years had an outsized impact on hospital finances statewide — but usually for the better.

Under nearly impenetrable hospital payment rules, Medicare must reimburse a state’s urban hospitals for employee wages at least as much as it reimburses its rural hospitals. As a result, Nantucket sets the floor for wage reimbursements at hospitals across the state. And because Nantucket’s wages are high, due to its remote island location and steep cost of living, that has created bonuses for many other Massachusetts hospitals in recent years. [See above.]

Not this year. Consultants hired by Partners made several errors that led to lower wages being reported to Medicare for Nantucket Hospital. They overestimated hours, thereby reducing the hourly rate, and did not include enough higher-paid physician hours and overtime pay.

Those mistakes, combined with another smaller adjustment to Nantucket’s wages, would result in a “steep and extraordinarily serious’’ decline in Medicare payments. [General counsel said “the situation is further complicated by the fact that the [Medicare] deadline for corrections has passed.’’

The rates affect the next fiscal year, beginning in October.

It's hard to believe this was a "mistake." My hunch is that in this election year, this will be resolved in Massachusetts' favor: in the Obama administration there is no such thing as a "deadline" that can't be extended or a "red line" that can't be crossed.

And here it begins:

Partners, the largest hospital and physician network in the state, acknowledges it did not catch the consultants’ mistakes when it submitted the data to Medicare in September.

Spokesman Rich Copp said the organization recognized a problem in mid- to late March and sent corrected numbers April 5 — almost two months after the deadline for corrections.

Regardless, he said, Medicare has a responsibility to use the corrected data. “Any other course of action will hurt hospitals in every corner of the state,’’ Copp said.

Hospitals have enlisted the state’s congressional delegation in their appeal.

I can't make this stuff up.

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How Lutheran Social Services Benefits From Refugee Influx

It costs "an agency" about $500 to complete the paperwork and provide the initial support for an illegal minor, or some such number. I don't recall the exact number that's been reported, but it's much less than what the agency will ultimately get in return for that initial investment. The Obama administration is budgeting almost $20,000 for every new illegal minor. My hunch is that the administration has a different term for "new illegal minor" but that's another story for another time.

To put that $20,000 in perspective, social security recipients get, on average, around $15,000/year. Female spouses who worked fewer years because of child-rearing get significantly less than their male spouses who had no work interruptions over the years. 

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Now, Back To Our Regularly Scheduled Program

Active rigs:

	5/2/2016	05/02/2015	05/02/2014	05/02/2013	05/02/2012
Active Rigs	28	86	186	190	209

RBN Energy: New England gas pipeline update.

More than 3,000 MW of new, natural gas-fired generating capacity is either under construction in New England or will be soon, but some of the gas pipeline projects that would ease long-standing constraints into and through the six-state region have hit rough patches. Kinder Morgan in mid-April suspended plans for its Northeast Energy Direct project, a “greenfield” pipeline across Massachusetts and southern New Hampshire, and a few days later the state of New York denied the co-developers of the already-delayed Constitution Pipeline—a key link between the Marcellus and New England--a needed water quality permit. The fates of some other major projects in the Northeast are uncertain too. Today, we provide an update on pipelines in the land of Yankees and Red Sox.

We’ve written often about gas pipeline constraints to and through New England, a region with less than one-third the area of Texas but nearly 15 million people, the vast majority of whom believe that Fenway Park is heaven on earth.

New England has been adding a lot of new gas-fired generating capacity, but only modest enhancements have been made to the gas pipeline network that serves the region.

In the unusually cold winter of 2013-14, the lack of sufficient pipeline capacity to meet demand during periods of very high demand sent natural gas prices soaring as local distribution companies (LDCs) with firm transportation contracts took most of the gas and owners of many gas-fired power plants either scrambled for deliverable, high-priced gas or switched to firing their units with fuel oil.