Health Care Options

Possible better solution:
Legislate serious Tort Reform to reduce insurance costs.

Eliminate the Anti-Trust exemption for Insurance Companies. They may be the last entity that has Anti-Trust exemption. This can expose them to Public scrutiny on rate increases and coverage changes. It would also subject insurance to competitive marketing.
Plastic Surgery and Lasik type eye surgery operate in a competitive atmosphere and have rate schedules for procedures that are much lower than other medical procedure schedules.

Move the 10 – 12 million citizen’s that want insurance and can’t afford it to Medicare or Medicaid, where they should be anyway, that’s the purpose of Medicaid.

Remember, it is Federal Law that if you present yourself at an Emergency Room you cannot be refused treatment.

In combination these measures would reduce Medical costs and a review after a reasonable implementation period could show areas for more detailed cost reduction.

Now let’s look at some of the Pork and Central Planning silliness that has been attempted against logic.

Originally proposed by Dingle H. R. 3200 is the Bill under which any other amendments or proposals will be consolidated. There are 55 more amendments to be considered just in the Commerce committee after the August break.

There is a Veterans Health Care Budget Reform Bill, H. R. 1016. That is not the issue at the ‘Townhalls’.

The Senate is working up the Kennedy – Dodd bill.

While there are committee reports floating around and amendments were added H. R. 3200 is the Bill. The real deal will be hammered out in Conference Committee between The House and The Senate.

Saying that ‘it doesn’t matter yet’ is like saying ‘They haven’t even decided what size bullet they are going to shoot us with yet. So don’t worry, be happy’.

(The Education and Labor Committee passed H. R. 3200 on July 17, 2009;
the Ways and Means Committee passed H. R. 3200 on July 17, 2009;
the Energy and Commerce Committee is currently marking up H. R. 3200.)
*Energy & Commerce voted and approved the bill Friday evening 8-14-09.

The actual Section numbers are included from H. R. 3200 if you wish to check yourself. Many references in The Bill are to sections of the US Code (USC). Quotes are from The Bill. Notes following the quotes are my own interpretation of some of the Legalese.

*Let’s start on Pg 16.

“Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1 (Year 1 is projected to be 2013.)”

This means Insurance companies CANNOT write new policies 1 year after this bill goes into effect. Might this put them out of business?

*Sec. 152 – “Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.”

One aspect to consider here is that Citizenship doesn’t have to be proved.
There is talk that this provision will be pulled or changed, but changed to what?

*”…enable the real-time (or near real time) determination of an individual’s financial responsibility at the point of service and,” …

The Commission will have direct access to your Bank Accounts

…”may include utilization of a machine-readable health plan beneficiary identification card;”

Good or bad, here’s your National ID Card.

“…describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions; ”

Routing and account numbers?

*Sec. 164 – “Reinsurance Plan.”
Sounds like a payoff to bailout poorly managed plans run by unions and community organizers like ACORN.

*Sec. 201 – Creates yet another Bureaucratic Department

*Sec. 203 – “The Commissioner shall specify the benefits to be made available under Exchange-participating health benefits plans during each plan year,”

The Commission will decide what is offered in your Healthcare Plan. (After determining what isn’t offered.) The term for this is Rationing.

* Sec. 205 –
“AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO MEDICAID.—The Commissioner shall provide for a process under which an individual who is described in section 202(d)(3) and has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.”

No choice here. Everyone will be insured one way or another or they will be fined. IRS will adjust your return if you don’t have insurance.

* Sec. 223 –
” LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section 224.”

* Sec. 225 –
“The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year…”

The Secretary of HHS will tell Doctors how much they will be paid in salary.

* Sec. 312 –
“An employer meets the requirements of this section with respect to an employee if the following requirements are met:

PROVISION OF INFORMATION.—The employer provides the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable, with such information as the Commissioner may require to ascertain compliance with the requirements of this section.
AUTOENROLLMENT OF EMPLOYEES.—The employer provides for autoenrollment of the employee in accordance with subsection (c).”

Since Insurance Companies will no longer be allowed to write new policies new employees will be automatically enrolled in the ‘Government Option’. Is it really an option if there is no choice?

* Sec. 313 –
“SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers).”
Smaller businesses will be hit with 2 – 6% tax if their payrolls are smaller, down to <$250,000 which won't need to pay this tax. At least they are admitting it is a tax, not a voluntary contribution. Again, what choice?

* Sec. 401.59B
“TITLE IV—AMENDMENTS TO INTERNAL REVENUE CODE OF 1986 Subtitle A—Shared Responsibility PART 1—INDIVIDUAL RESPONSIBILITY SEC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.

TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of
(1) the taxpayer’s modified adjusted gross income for the taxable year, over
(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.

Sec. 401.59B Continued –
“NONRESIDENT ALIENS.—Subsection (a) shall not apply to any individual who is a nonresident alien.”

We pay for them. They only get tax money, they don’t pay income tax.

* Sec. 431 –
“The Secretary, upon written request from the Health Choices Commissioner or the head of a State-based health insurance exchange approved for operation under section 208 of the America’s Affordable Health Choices Act of 2009, shall disclose to officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, return information of any taxpayer whose income is relevant in determining any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009.”

The IRS will provide all relevant information to ‘officers and employees of the Health Choices Administration or such State-based health insurance exchange’. More unelected bureaucrats will have access to your shorts, eh.

* Sec. 441 –
“NOT TREATED AS TAX IMPOSED BY THIS CHAPTER FOR CERTAIN PURPOSES.—The tax imposed under this section shall not be treated as tax imposed by this chapter…”

Yes, this language is actually in the Bill.

* Subtitle B—School-Based Health Clinics (SBHC)

Sec. 2511
Sec. 399Z-1
(iii) the SBHC will provide on-site access during the academic day when school is in session and has an established network of support and access to services with backup health providers when the school or SBHC is closed;

More Bureaucracy to add to the school systems. A Federal Union Employee in every school in the nation.

There is more. Wouldn’t it be nice if our elected officials knew what was in the bills they vote on? We give them money to pay staff, maybe that staff could do more than make coffee.

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