Eunice Kennedy Shriver and Edward M. Kennedy, sister and brother, died 14 days apart – she at the age of 88, he at the age of 77. In a family plagued by more than its share of early deaths, they lived, in the words of country-and-western singer Moe Bandy, till they were too old to die young.
For the 13 years I lived in Massachusetts, Ted Kennedy was my senator. John F. Kennedy had been my first political hero, but when Ted was elected to the Senate in 1962, I thought he was too young for the job. I never met him personally, but have him linked indelibly to a moment of high excitement in my life. That was the first landing by a human on the moon.
In the student lounge of a dormitory in Boulder, Colorado, I watched spellbound with a roomful of fellow scientists as Neil Armstrong stepped onto the moon that Sunday evening of July 20, 1969. About 40 hours earlier, the tragic accident that led to Mary Jo Kopechne’s death in Kennedy’s car had occurred on Chappaquiddick Island. The lowest point in Kennedy’s life had coincided with one of the greatest feats in human history, and the attention span of the nation was torn between the two events.
A tragedy of that magnitude could have ruined a lesser person, and questionable behavior was still to come in his private life, but Ted Kennedy would in time become a worthy public servant. Working tirelessly and effectively as a legislator for improvements in education, the work place, and especially health care, he would live long enough to outlast his youth and honor the office he held.
My contact with Eunice, though brief, was more direct and personal. My wife and I worked for three years at the Eunice Kennedy Shriver Center for Mental Retardation in Waltham, Massachusetts – one of many centers around the country partially endowed with funds from the Kennedy family.
One day Eunice stopped by the Center to see what her money had bought, and to chat with the scientists who were trying to learn more about the causes and cures for mental retardation – by then the mission to which she had become devoted. That she had taken the time to come talk to us and thank us for our work was a gesture of kindness we'll always remember.
Her husband, Sargent Shriver, had founded the Peace Corps and run for Vice-President. He had taken time out from his busy schedule to come with her. Between the two of them, they had already accomplished more than many presidents, and that was 30 years ago.
All of us have flaws, if not as big as Ted Kennedy’s worst ones. And all of us have great potential, if seldom matching the accomplishments of Eunice and Sargent, or of Ted at his best.
But here’s the difference. Most of us manage to trumpet our achievements in public, while keeping our flaws cloaked in private. The Kennedys never had that luxury. We know how they failed in excruciating detail, but we know they succeeded in making the world a better place as well. Each of us can now decide which of their legacies we will remember, and how we will keep the hopes they nurtured alive.
Sunday, August 30, 2009
Friday, August 28, 2009
My Kingdom for a Dunkin' Donuts
A few months ago I submitted three essays in the competition by the El Paso Times to find a new local columnist. I never heard back from them (historically, the El Paso Times has had difficulty finding my name and number in the phone book). Since they have recently announced not one, but four winners, I can safely assume I didn't make the cut. What follows is the first of my three non-winning entries.
I’m a person of habit. For years I would stop at the Subway shop on N. Mesa and Cincinnati for a sandwich on my way home from work at UTEP on Friday nights, then stop at the Dunkin’ Donuts across the street on my way in for a half day of work at my office on Saturday mornings.
One Saturday a couple of years ago, I drove up to the Dunkin’ Donuts to be greeted with the tragic news that it had gone out of business. A few months later the site was leveled, and a couple of months after that a sign appeared announcing that a new branch bank would soon be coming to the site for my convenience.
I don’t know about you, but a bank hasn’t brought me a sense of convenience, ever. When ATMs were finally introduced into El Paso a decade after I had first encountered them in my former home in Massachusetts, I was momentarily relieved to note the arrival of the modern age in the Borderland; but escalating fees and hidden charges quickly dampened my enthusiasm.
Then, when I watched my 401(k) lose a third of its value last year in the collapse of the creative financial instruments that bankers had devised to enrich themselves, I found myself much more than inconvenienced.
The news that my treasured Dunkin’ Donuts was being replaced by yet another bank, enlarging the string of banks that are thicker than thieves from the downtown skyscrapers to the edges of the city in all directions, was an ugly insult added to a bad injury.
New construction is now complete at N. Mesa and Cincinnati. A building apparently geared for retail, built in the Bhutanese architectural style that appears to be a mandatory marketing device in the vicinity of UTEP, now stands where someone used to arrive at 5:00 in the morning to make the donuts. But I note that the bank sign has disappeared. Perhaps the bank has been devoured by the recession it helped create. Or maybe it’s just a cruel joke – a Trojan bank hidden in the belly of the Bhutanese beast, waiting to erupt when the economy revives.
This isn’t personal. While I can’t claim that some of my best friends are bankers, I can say that I have a cordial acquaintance with one or two of them. And the one who talked me out of paying off my mortgage last year with my investment account when it was worth half again more than it is today, is a nice enough guy. But a convenience, he isn’t.
For the time being, the Subway at the corner of Mesa and Cincinnati survives, and I continue to patronize it while I can. Since my retirement, I no longer work on Saturday mornings, and eating fewer donuts is probably better for my cholesterol. But right now, I firmly believe the world would be a better place if there were more Dunkin’ Donuts and fewer banks.
I’m a person of habit. For years I would stop at the Subway shop on N. Mesa and Cincinnati for a sandwich on my way home from work at UTEP on Friday nights, then stop at the Dunkin’ Donuts across the street on my way in for a half day of work at my office on Saturday mornings.
One Saturday a couple of years ago, I drove up to the Dunkin’ Donuts to be greeted with the tragic news that it had gone out of business. A few months later the site was leveled, and a couple of months after that a sign appeared announcing that a new branch bank would soon be coming to the site for my convenience.
I don’t know about you, but a bank hasn’t brought me a sense of convenience, ever. When ATMs were finally introduced into El Paso a decade after I had first encountered them in my former home in Massachusetts, I was momentarily relieved to note the arrival of the modern age in the Borderland; but escalating fees and hidden charges quickly dampened my enthusiasm.
Then, when I watched my 401(k) lose a third of its value last year in the collapse of the creative financial instruments that bankers had devised to enrich themselves, I found myself much more than inconvenienced.
The news that my treasured Dunkin’ Donuts was being replaced by yet another bank, enlarging the string of banks that are thicker than thieves from the downtown skyscrapers to the edges of the city in all directions, was an ugly insult added to a bad injury.
New construction is now complete at N. Mesa and Cincinnati. A building apparently geared for retail, built in the Bhutanese architectural style that appears to be a mandatory marketing device in the vicinity of UTEP, now stands where someone used to arrive at 5:00 in the morning to make the donuts. But I note that the bank sign has disappeared. Perhaps the bank has been devoured by the recession it helped create. Or maybe it’s just a cruel joke – a Trojan bank hidden in the belly of the Bhutanese beast, waiting to erupt when the economy revives.
This isn’t personal. While I can’t claim that some of my best friends are bankers, I can say that I have a cordial acquaintance with one or two of them. And the one who talked me out of paying off my mortgage last year with my investment account when it was worth half again more than it is today, is a nice enough guy. But a convenience, he isn’t.
For the time being, the Subway at the corner of Mesa and Cincinnati survives, and I continue to patronize it while I can. Since my retirement, I no longer work on Saturday mornings, and eating fewer donuts is probably better for my cholesterol. But right now, I firmly believe the world would be a better place if there were more Dunkin’ Donuts and fewer banks.
Monday, August 24, 2009
Questions I would ask if I were there
I wasn’t able to attend Congressman Reye’s Town Hall Meeting on health care reform at the Ray Pearson Forum last week-end. I don’t know how many, if any, of the following questions got asked and answered. I hope that these are among the points that he will address at the meetings that I understand are upcoming:
QUESTIONS ABOUT THE DRAFT FORM OF HB3200 ON HEALTH CARE REFORM
Is there anything in the proposed legislation that would force someone with health insurance to give up their current policies?
Medicare and Veterans’ Health Insurance account for close to 40% of all health insurance. Those are public plans. Do you hear widespread complaints from your constituents about those government-financed programs?
Private health insurance premiums have doubled in the past five years. Have medicare premiums risen that much?
Do public plans like Medicare deny coverage on the basis of pre-existing conditions?
Given the fact that seniors are overwhelmingly satisfied with Medicare, why can’t we just expand that program to anyone who wants to buy into it? Wouldn’t allowing younger people to participate in it make the program more solvent, since they would consume less health care for the same amount of premium payments over a longer period of time than seniors?
We spend roughly twice as much on health care as other industrialized nations. Why is that, and is the quality of our health care that much better?
Health care costs are rising three times faster than wages. What measures in the proposed legislation are designed to rein in these rapidly rising costs?
If Medicare, or any other public option were made available, would people be required to buy into the public plan?
Are there measures in the proposed legislation to make insurance more portable, so that if I lose my job I won’t automatically lose my insurance?
While it’s true that wealthy foreigners sometimes come to the US for treatment by specialists, at which our country excels, do you know of anyone clamoring to drop their health insurance under the French, German, British, or Canadian systems in favor of buying private health insurance in this country? (I don’t! Whatever complaints foreigners have about their systems, I’ve never had a single one tell me they wish they lived under the American system of health care.)
Is there anything in the pending legislation that would restrict anyone’s access to treatment, or “ration” health care?
Enabling doctors to own the labs that conduct the tests they order, or the hospitals in which they do their surgery, would appear to be a conflict of interest. Does the proposed legislation deal with that problem, as one step toward controlling costs?
Is there anything in the pending legislation that necessarily would force private insurers out of the market?
Does the proposed legislation have any provisions for tort reform, to reduce the incentive to practice wasteful defensive medicine? If not, why not?
QUESTIONS ABOUT THE DRAFT FORM OF HB3200 ON HEALTH CARE REFORM
Is there anything in the proposed legislation that would force someone with health insurance to give up their current policies?
Medicare and Veterans’ Health Insurance account for close to 40% of all health insurance. Those are public plans. Do you hear widespread complaints from your constituents about those government-financed programs?
Private health insurance premiums have doubled in the past five years. Have medicare premiums risen that much?
Do public plans like Medicare deny coverage on the basis of pre-existing conditions?
Given the fact that seniors are overwhelmingly satisfied with Medicare, why can’t we just expand that program to anyone who wants to buy into it? Wouldn’t allowing younger people to participate in it make the program more solvent, since they would consume less health care for the same amount of premium payments over a longer period of time than seniors?
We spend roughly twice as much on health care as other industrialized nations. Why is that, and is the quality of our health care that much better?
Health care costs are rising three times faster than wages. What measures in the proposed legislation are designed to rein in these rapidly rising costs?
If Medicare, or any other public option were made available, would people be required to buy into the public plan?
Are there measures in the proposed legislation to make insurance more portable, so that if I lose my job I won’t automatically lose my insurance?
While it’s true that wealthy foreigners sometimes come to the US for treatment by specialists, at which our country excels, do you know of anyone clamoring to drop their health insurance under the French, German, British, or Canadian systems in favor of buying private health insurance in this country? (I don’t! Whatever complaints foreigners have about their systems, I’ve never had a single one tell me they wish they lived under the American system of health care.)
Is there anything in the pending legislation that would restrict anyone’s access to treatment, or “ration” health care?
Enabling doctors to own the labs that conduct the tests they order, or the hospitals in which they do their surgery, would appear to be a conflict of interest. Does the proposed legislation deal with that problem, as one step toward controlling costs?
Is there anything in the pending legislation that necessarily would force private insurers out of the market?
Does the proposed legislation have any provisions for tort reform, to reduce the incentive to practice wasteful defensive medicine? If not, why not?
Sunday, August 23, 2009
What's in a "sliver?"
Much ado has been made by the Talking Heads about President Obama’s statement that the Public Option is just a “sliver” of the overall health care reform bill. The usual over-interpretation of this remark is that the President is backtracking from his support of the public option.
Not necessarily. The ignition system is just a sliver of a car’s electrical network, but without it, the car won’t start. The flaps are just a sliver of an airplane’s wing, but without them the plane can’t take off or land.
The public option is a “sliver” of the whole bill in the sense that it is only one component, and one small part, proportionately, of the overall legislation. That doesn’t mean it isn’t important; and to say that it’s just one of many components is not equivalent to denying that it’s essential.
What the White House truly believes may be another matter. I continue to view the President’s strategy as both cautious and cagey. Remember that this is a man who frequently quotes Martin Luther King’s observation that “the arc of history is long.” He has more patience than we do. He knows that a few words here, a negotiating point there, might be just enough to get a very controversial piece of legislation passed. So he’s not going to be dragged into drawing lines in the sand prematurely.
Whether the President will eventually draw those lines, if he has to, remains to be seen. While he is obviously hoping for the best, I earnestly hope he is preparing for the worst, which means the time may come when he says , “The chance for bipartisan action has passed, the time to vote is now, and so, to all the Democrats who control both the House and Senate, Are you with us, or against us?”
Until that time arrives, those of us who strongly feel the public option is a critical piece of health care reform need to keep the pressure on to have it included. But it’s o.k. to say that it’s just one part of a larger piece of important legislation.
Not necessarily. The ignition system is just a sliver of a car’s electrical network, but without it, the car won’t start. The flaps are just a sliver of an airplane’s wing, but without them the plane can’t take off or land.
The public option is a “sliver” of the whole bill in the sense that it is only one component, and one small part, proportionately, of the overall legislation. That doesn’t mean it isn’t important; and to say that it’s just one of many components is not equivalent to denying that it’s essential.
What the White House truly believes may be another matter. I continue to view the President’s strategy as both cautious and cagey. Remember that this is a man who frequently quotes Martin Luther King’s observation that “the arc of history is long.” He has more patience than we do. He knows that a few words here, a negotiating point there, might be just enough to get a very controversial piece of legislation passed. So he’s not going to be dragged into drawing lines in the sand prematurely.
Whether the President will eventually draw those lines, if he has to, remains to be seen. While he is obviously hoping for the best, I earnestly hope he is preparing for the worst, which means the time may come when he says , “The chance for bipartisan action has passed, the time to vote is now, and so, to all the Democrats who control both the House and Senate, Are you with us, or against us?”
Until that time arrives, those of us who strongly feel the public option is a critical piece of health care reform need to keep the pressure on to have it included. But it’s o.k. to say that it’s just one part of a larger piece of important legislation.
Monday, August 17, 2009
Moving On
The backlash has finally begun to set in against the yellers and screamers and rude interrupters of town hall meetings and hearings intended to inform the public about health care reform. They overplayed their hand and are paying the price in resentment from the majority of the people who want their elected officials to be able to answer their real concerns without being shouted down. Op-ed writers and bloggers across the land have blasted the assault on the democratic process that these bullying tactics have represented (Click here for my commentary on the issue).
The media seem finally to be tiring of having the circus instead of the substance be the story. Today’s headlines proclaim that now the issue is the public option. That’s progress. On the other hand, reports that President Obama may be weakening in his resolve for the public option is not good news.
My take on it is not that pessimistic, just yet. Recall that I have argued previously in this space that the Senate Finance Committee is the rate limiting step. If that committee can report out a bill of any sort, it will have to be combined with the one from the Senate HELP Committee, then that hybrid will need to be reconciled with HB3200, around which all the sound and fury has swirled. Of a total of five committees with jurisdiction, four have emphatically included the public option. So once the bills get to reconciliation, chances are moderately good that the public option will survive.
A generous interpretation of the signal from the White House is that the President is simply doing everything he can to keep those 2 or 3 Republican senators on board long enough to get the bill out of the Finance Committee. If, in spite of the President’s conciliatory tone and the will of 4 out of 5 Congressional Committees, the public plan isn’t a part of the legislation that reaches the floor, that will be the time to draw the line in the sand. I remain convinced that the Republicans will reap the whirlwind if they try to filibuster health care reform to death. In the meantime, we can help by continuing to insist on inclusion of the public plan, to counter the massive effort by the health insurance lobby that desperately wants to kill it.
I previously predicted that August was going to test our will, and so it has. The propaganda has been intense and the process unnerving. But the first assault has been beaten back. Now we need to take heart and keep moving on. If our President has the courage to make good on his promise of Change, and the Democratic majority in both houses of Congress has the will, the votes should be there to get this done – with a public option.
The media seem finally to be tiring of having the circus instead of the substance be the story. Today’s headlines proclaim that now the issue is the public option. That’s progress. On the other hand, reports that President Obama may be weakening in his resolve for the public option is not good news.
My take on it is not that pessimistic, just yet. Recall that I have argued previously in this space that the Senate Finance Committee is the rate limiting step. If that committee can report out a bill of any sort, it will have to be combined with the one from the Senate HELP Committee, then that hybrid will need to be reconciled with HB3200, around which all the sound and fury has swirled. Of a total of five committees with jurisdiction, four have emphatically included the public option. So once the bills get to reconciliation, chances are moderately good that the public option will survive.
A generous interpretation of the signal from the White House is that the President is simply doing everything he can to keep those 2 or 3 Republican senators on board long enough to get the bill out of the Finance Committee. If, in spite of the President’s conciliatory tone and the will of 4 out of 5 Congressional Committees, the public plan isn’t a part of the legislation that reaches the floor, that will be the time to draw the line in the sand. I remain convinced that the Republicans will reap the whirlwind if they try to filibuster health care reform to death. In the meantime, we can help by continuing to insist on inclusion of the public plan, to counter the massive effort by the health insurance lobby that desperately wants to kill it.
I previously predicted that August was going to test our will, and so it has. The propaganda has been intense and the process unnerving. But the first assault has been beaten back. Now we need to take heart and keep moving on. If our President has the courage to make good on his promise of Change, and the Democratic majority in both houses of Congress has the will, the votes should be there to get this done – with a public option.
Saturday, August 8, 2009
Truth v. fiction: a line-by-line analysis of lies about the House health care reform bill
Among the multitude of lies and distortions about plans to reform our broken health care system now abroad in the land is a widely-disseminated document that purports to show the evils of H.B.3200, the tri-committee bill in the House to overhaul health care. If you find anyone left in the country who wants to have a rational debate about health care, a good place to start is with the truth about what the bill actually says. Toward that end, I have analyzed the line-by-line critique and made corrective notes after each allegation. These are too lengthy and technical to be used as talking points, but hopefully will provide anyone with an open mind toward health care reform with helpful background information.
Note that this document was based on a draft form of the bill only. The final version has not yet gone to the House floor for a vote. Also bear in mind that two Senate bills will have to be voted on, which differ somewhat from this one as well. My comments are in italics
Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!
Sec 102 beginning on p.16 says that you can keep the plan you have as long as your insurer does not change the rules, like raising the premium on your risk category. It also allows you to add dependents to your existing program if you want to. It says nothing about your having to take a similar plan, and makes no reference whatever to a government option.
Page 22: Mandates audits of all employers that self-insure!
Sec 113(b) is continued on p.22. It directs that a study be conducted on the nature of employers and businesses that buy coverage as opposed to those who don’t (self-insurers). The study will collect data on the number of employees, the solvency of the companies, etc, and compare private insurance with self-insurance plans. The purpose of this is to deal with the concern that the new reform regulations might drive some employers (especially smaller ones) to try to self-insure themselves – a move that often leaves their employees underinsured. In short, its purpose is to detect and correct any negative effects of the reform package, not to penalize those who self-insure.
Page 29: Admission: your health care will be rationed!
Sec 122(c) is continued on p.29. There it lists the maximum co-payments that individuals ($5,000) or families ($10,000) would be required to make per year under any plan. It also prohibits co-payment charges for wellness and preventive medical care. It therefore is a limit on a person’s financial liability, not a limitation on their care.
Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
Sec. 123, beginning on p.30, establishes a “Health Benefits Advisory Committee”. This committee will be made up of a wide range of health care providers, insurers, and consumers. Their role is to recommend what standards of care must be covered by all plans, private or public. The purpose of this provision is to take decisions about health care that require professional judgments and consumer preferences out of the political process. In this respect, it is intended to serve much as the Securities and Exchange Commission does in regulating the stock market, and the Federal Reserve does in regulating banking practices. All objective observers of our current system agree that one of its greatest weaknesses is the lack of minimal standards for what private insurers must cover, or, for that matter, how the great variation in Medicare and Medicaid reimbursements across the country is determined. There is nothing in this section that says the Committee “will decide what treatments and benefits you get”—it will only make recommendations on what insurance plans must cover. Note that under the present plan, the consumer is at the mercy of whatever their provider decides to cover.
Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice.. None.
The role of the Health Choices Commissioner is to (1) enact and enforce standards that all insurance plans have to meet, as opposed to the current system where each plan can arbitrarily decide who and what it will cover; (2) establish the health insurance exchange so that consumers have greater choice of plans; and (3) determine the eligibility requirements for receiving subsidized health insurance. In subsequent amendments to the bill, the eligibility for subsidies has been scaled back somewhat, to reduce the ultimate cost of the program. There is nothing on p.42 or anywhere else in Sec. 142 that says the Commissioner “will decide health benefits for you.”
Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
Sec. 152, beginning on p.50, prohibits discrimination on the basis of anything (like race, ethnicity, gender, family status, etc.) that doesn’t relate specifically to medical condition. It says nothing about free health care services. Furthermore, Sec. 246 on p.143 explicitly prohibits the participation of undocumented aliens: “Nothing in this subtitle shall allow Federal payments . . . on behalf of individuals who are not lawfully present in the United States.”
Page 58: Every person will be issued a National ID Healthcard.
Sec. 1183A calls for the collection of data on financial eligibility for assistance, “which may include utilization of a machine-readable health plan beneficiary identification card” (p.58). This is part of the effort to move toward electronic data-processing for all patients. Medicare and social security recipients already have identification cards, and must present them to receive benefits. All drivers must carry a driver’s license with a photo and other personal information on it. Travel to a foreign country requires a passport that contains a photograph and personal information. Many other examples could be given to show that a health care identification card, if it is enacted, would hardly be unusual. But this section does not mandate a national i.d. card.
Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
No. Paragraph (C) on p.59 only enables patients to make their co-pays or receive their rebates by electronic transfer, just as many of us receive Social Security payments and tax refunds now. Nothing in this section gives government “access to all individual bank accounts.”
Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (example: SEIU, UAW and ACORN)
No they will not. Sec. 164 starting on p.65 establishes a reinsurance program for those who retire after age 55 but prior to their eligibility for Social Security. It doesn’t mention anything about unions, community organizers, or any of the examples. The word “ACORN” does not occur anywhere in the bill.
Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
True. All plans must meet minimum requirements that do not abuse the insured. Overcharging, denial of claims, denial of applicants for alleged or real pre-existing conditions, and other abuses by private health care insurers are among the litany of problems motivating this legislation.
Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
No. What Sec. 203(b) says on p.84 is that any private health insurer who participates in the Healthcare Exchange must offer the Basic Plan of minimal coverage. Private insurers are free to offer enhanced plans and any other features they like, including any that would make them more attractive than a public plan, as long as they provide the Basic Plan of coverage. If they can compete better outside the Healthcare Exchange, they are free to do so.
Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
Nothing on p.91 refers to aliens, illegal or otherwise. Some older citizens of foreign birth feel more comfortable talking about sensitive matters such as health issues in their most proficient language. Also, private insurers, as well as the rare unscrupulous health care provider, may take advantage of patients less proficient in English by getting them to approve documents and procedures that they don’t fully understand. This provision is intended to guard against such abuses.
Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
Sec. 205 beginning on p.95 specifies only that outreach, particularly to vulnerable populations (like children and the mentally ill) be made “. . . through means such as the mail, by telephone, electronically, and in person.” It makes no mention of ACORN or Americorps. This is another gratuitous reference to ACORN for purely inflammatory reasons, with no basis in fact.
Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
No. What this section says is that persons eligible for Medicaid who do not choose a plan from the Health Care Exchange, will automatically be enrolled in Medicaid. Should they choose to purchase their own private insurance plan, they are free to do so.
Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
All this section says is that the decision of the HHS Secretary with regard to payments to health care providers from the Public Plan are not subject to judicial review. Private insurers are free to charge whatever they want, and health care providers are free not to treat patients insured by the Public Plan. If this provision were not enacted, private insurers would immediately sue the government (taxpayer) to force higher insurance rates and limit benefits to levels that are profitable to them but not necessarily beneficial to patients.
Page 127: The AMA sold doctors out: the government will set wages.
Sec. 125 only specifies on p.127 that doctors who treat patients under the public plan will be reimbursed according to rates negotiated between physicians and the government. Physicians are free to charge whatever they want to those insured under private plans, or paying fees-for-service.
Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
What this section actually says is that employers who provide insurance must enroll their employees in the plan that is least expensive for the employee. There is no requirement that this be the Public Plan, though the tacit assumption of this particular “criticism” is that the Public Plan will be the most economical. Bringing down the cost of health insurance is a major purpose of the legislation, and is the main reason that the health insurance industry is so opposed to it.
Page 146: Employers MUST pay healthcare bills for part-time employees AND their families.
If the employer is required to provide health insurance (small employers are excluded), they must provide the same benefits to part-time employees, in proportion to the extent of their part-time employment only. There is no reference to paying for the healthcare of the employee’s family.
Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll.
Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
These are payments made by employers who choose not to provide any health insurance, not just the public option, to their employees. They can avoid this payment if they provide their employees with any plan, private or public, that ensures the baseline level of health care.
Page 167: Any individual who doesn't have acceptable healthcare (according to the government) will be taxed 2.5% of income.
The requirement that everyone have health insurance, or pay a tax surcharge in lieu of insurance, is based on the principle of fairness. Under our current system, the health care of the uninsured is paid for by a hidden tax of about $1,100 a year that those of us who have insurance pay in higher premiums, and by direct taxes that everyone else pays to hospital districts, counties, and other taxing entities that have to take care of the uninsured. It is only fair that everyone take part in paying for health care. They can do it either by having health insurance, or by paying into a pool that covers expenses for the uninsured.
Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
Non-resident aliens are exempt from the penalty tax because they are not required to purchase or have health insurance (though they may choose to do so). But they are also not eligible for the subsidies that low-income citizens will receive to help pay for their health insurance.
Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
No; this is a gross exaggeration. Sec. 431 on p.195 says only that income tax records, of the type we all routinely have to provide in determining eligibility for everything from scholarships for our kids to Social Security benefits, must be provided to help determine the level of subsidies for which an individual should be eligible. Clearly, proof of income is a reasonable requirement in determining how much help a person needs to meet the requirement for health care coverage – otherwise, the invitation to fraud is obvious. No financial records need to be provided if no subsidies are given; and the bill refers only to income and tax records, not to all financial records, and not to personal records.
Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that.
The context of the statement on p.203 makes it clear that the imposed tax will not be counted as a tax for purposes of making a mathematical calculation in another section.
Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."
The wording of paragraph (c) on p.239 is admittedly byzantine, but a careful reading of it reveals that this section has nothing to do with reducing services. Its purpose is to modernize the reimbursement calculations for physicians, to encourage them to provide better health care for Medicaid patients.
Page 241: Doctors: no matter what specialty you have, you'll all be paid the same (thanks, AMA!)
This section says nothing about paying doctors. It simply specifies that the procedures a doctor performs will be categorized by the procedure, not by the doctor’s specialty. If a surgeon were to run a blood test, they would be reimbursed for running a blood test, not for taking out your appendix.
Page 253: Government sets value of doctors' time, their professional judgment, etc.
Subsection (L) on p.253 simply says that the Secretary of HHS can set up a process for evaluating the value of different procedures for purposes of fairly reimbursing doctors. Under the present system, health insurance companies make that determination in their own interests, and not necessarily in a fair and equitable manner.
Page 265: Government mandates and controls productivity for private healthcare industries.
This section doesn’t mandate or control anything. It simply sets up a mechanism for incorporating how changes in the productivity of health care delivery affect Medicare reimbursements. Maximizing productivity is a hallmark in the private sector, and an essential element of bringing down health care costs.
Page 268: Government regulates rental and purchase of power-driven wheelchairs.
This is a technical clarification of what equipment can be reimbursed under already existing law. It doesn’t introduce any new regulations.
Page 272: Cancer patients:Kiss your ass goodbye!... welcome to the wonderful world of rationing!
Sec. 1145 starting on p.272 empowers the Secretary of HHS to adjust payments to cancer hospitals that are charging more than other hospitals delivering comparable care. It is a protection against fraud, abuse, and price-gouging of patients at their most vulnerable time. Nothing in this section even approaches a discussion of “rationing”, which is obviously a buzz word intended to inflame the discussion and distort the actual meaning and intent of a provision intended to protect both the patient and taxpayer.
Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
Private for-profit hospitals make money by keeping their beds filled. With an excess of private hospital beds in many cities, the incentive to keep patients hospitalized unnecessarily is strong. Sec. 1151 beginning on p.280 provides a mechanism for limiting the ability of hospitals to charge patients for excessive and unnecessary hospital stays. Recognizing their tattered reputation over this issue, the American Hospital Association actually lobbied for this provision in testimony before Congress.
Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
For the reasons indicated above, paragraph (C) on p.298 lists readmissions to hospitals as one of several factors that should be studied in considering reimbursements. It does not mandate anything or penalize anyone.
Page 317: Doctors: you are now prohibited from owning and investing in healthcare companies!
The practice of referring patients to a health care facility (or service) which is owned in part by the doctor making the referral is an obvious conflict of interest with great opportunity for abuse at least, and fraud at worst. It is one of the practices that has greatly escalated the cost of health care, especially in smaller communities where physicians are often invested in local real estate and health care services. This section addresses that form of abuse. It does not prevent the investment by doctors in healthcare companies or facilities that does not create a conflict of interest that favors the investor at the expense of the patient and taxpayer.
Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
No, it does not prohibit hospital expansion. It only regulates the investment in hospitals by doctors who stand to gain by admitting their patients to those hospitals. This is a cost-control and anti-trust measure, aimed at protecting the patient from excessive charges.
Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.
There is no mention of ACORN or any other specific community group anywhere in the bill. nor does it provide for “paying off” anyone. This is another gratuitous attempt to demonize the meaning of community input (which could be from anyone) and to inflame the discussion.
Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
Outcome-based measures have nothing to do with “rationing,” and nowhere is either the word or anything that could be construed as rationing even mentioned. Furthermore, the outcomes-based measures are to be used in evaluating the effectiveness specifically of Medicare Advantage Plans, which siphon off millions of taxpayer dollars to private for-profit insurance companies. Medicare Advantage payments to private insurers are a major contributer to the upward spiral in Medicare costs. The illogical reference to “rationing” is obviously a further attempt to inflame the discussion and play on the fears of the public.
Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
Yes, the government can disqualify those Medicare Advantage Plans which are not complying with the rules required to keep them eligible for the massive federal subsidies they receive. This is another effort to eliminate the waste of taxpayer money. There is no mention of HMOs on p.341.
Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals. << Does this apply to any of you???
This section merely clarifies the open enrollment period for certain types of special needs patients. It makes no restrictions on their enrollment within the period for open enrollment.
Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
Augmenting traditional healthcare through healthcare by phone is a useful and effective way to lower healthcare costs. This section establishes a committee of physicians and other health care professionals outside the federal government to advise the Secretary on matters pertaining to telehealth. It doesn’t add anything to government bureaucracy, which in any event, is much less extensive and abusive than the bureaucracy in private health insurance companies.
Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
Sec. 1233, beginning on p.424 and extending over several pages, provides that patients can receive optional consultations concerning their right to determine what life-sustaining efforts should be used if they become incapacitated, including the right to expend every effort to keep them alive under all circumstances. It also provides that consultations be given to patients concerning the advantages of designating powers of attorney and planning how their financial affairs will be handled upon their death. The so-called “order” for end-of-life treatment (such as a living will) is something the patient orders, not the government. Most people feel that making end-of-life preparations is wise. This section provides that a qualified professional can be reimbursed for helping them do so.
Page 430: Government will decide what level of treatments you may have at end-of-life.
This is blatantly false. Only the patient (or their legally-designated power of attorney) can make such a decision. The relevant passage states an appropriate order is one which, “. . . effectively communicates the individual’s preferences regarding life sustaining treatment. . .”
Page 469: Community-based Home Medical Services: more payoffs for ACORN..
Page 472: Payments to Community-based organizations: more payoffs for ACORN.
More gratuitous falsehoods. There is no mention of ACORN or of payoffs to anyone.
Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
Yes, marriage and family therapy will be covered. To say that the government will therefore be intervening in your marriage is like saying the surgeon who removes your inflamed appendix is interfering with your digestive system.
Page 494: Government will cover mental health services: defining, creating and rationing those services.
The bill expands coverage for mental health services, and defines what will be covered, as all private health insurance plans which cover mental health do. There is no mention of rationing. The use of this term is, again, a gratuitous distraction aimed at feeding fear.
Note that this document was based on a draft form of the bill only. The final version has not yet gone to the House floor for a vote. Also bear in mind that two Senate bills will have to be voted on, which differ somewhat from this one as well. My comments are in italics
Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!
Sec 102 beginning on p.16 says that you can keep the plan you have as long as your insurer does not change the rules, like raising the premium on your risk category. It also allows you to add dependents to your existing program if you want to. It says nothing about your having to take a similar plan, and makes no reference whatever to a government option.
Page 22: Mandates audits of all employers that self-insure!
Sec 113(b) is continued on p.22. It directs that a study be conducted on the nature of employers and businesses that buy coverage as opposed to those who don’t (self-insurers). The study will collect data on the number of employees, the solvency of the companies, etc, and compare private insurance with self-insurance plans. The purpose of this is to deal with the concern that the new reform regulations might drive some employers (especially smaller ones) to try to self-insure themselves – a move that often leaves their employees underinsured. In short, its purpose is to detect and correct any negative effects of the reform package, not to penalize those who self-insure.
Page 29: Admission: your health care will be rationed!
Sec 122(c) is continued on p.29. There it lists the maximum co-payments that individuals ($5,000) or families ($10,000) would be required to make per year under any plan. It also prohibits co-payment charges for wellness and preventive medical care. It therefore is a limit on a person’s financial liability, not a limitation on their care.
Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
Sec. 123, beginning on p.30, establishes a “Health Benefits Advisory Committee”. This committee will be made up of a wide range of health care providers, insurers, and consumers. Their role is to recommend what standards of care must be covered by all plans, private or public. The purpose of this provision is to take decisions about health care that require professional judgments and consumer preferences out of the political process. In this respect, it is intended to serve much as the Securities and Exchange Commission does in regulating the stock market, and the Federal Reserve does in regulating banking practices. All objective observers of our current system agree that one of its greatest weaknesses is the lack of minimal standards for what private insurers must cover, or, for that matter, how the great variation in Medicare and Medicaid reimbursements across the country is determined. There is nothing in this section that says the Committee “will decide what treatments and benefits you get”—it will only make recommendations on what insurance plans must cover. Note that under the present plan, the consumer is at the mercy of whatever their provider decides to cover.
Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice.. None.
The role of the Health Choices Commissioner is to (1) enact and enforce standards that all insurance plans have to meet, as opposed to the current system where each plan can arbitrarily decide who and what it will cover; (2) establish the health insurance exchange so that consumers have greater choice of plans; and (3) determine the eligibility requirements for receiving subsidized health insurance. In subsequent amendments to the bill, the eligibility for subsidies has been scaled back somewhat, to reduce the ultimate cost of the program. There is nothing on p.42 or anywhere else in Sec. 142 that says the Commissioner “will decide health benefits for you.”
Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
Sec. 152, beginning on p.50, prohibits discrimination on the basis of anything (like race, ethnicity, gender, family status, etc.) that doesn’t relate specifically to medical condition. It says nothing about free health care services. Furthermore, Sec. 246 on p.143 explicitly prohibits the participation of undocumented aliens: “Nothing in this subtitle shall allow Federal payments . . . on behalf of individuals who are not lawfully present in the United States.”
Page 58: Every person will be issued a National ID Healthcard.
Sec. 1183A calls for the collection of data on financial eligibility for assistance, “which may include utilization of a machine-readable health plan beneficiary identification card” (p.58). This is part of the effort to move toward electronic data-processing for all patients. Medicare and social security recipients already have identification cards, and must present them to receive benefits. All drivers must carry a driver’s license with a photo and other personal information on it. Travel to a foreign country requires a passport that contains a photograph and personal information. Many other examples could be given to show that a health care identification card, if it is enacted, would hardly be unusual. But this section does not mandate a national i.d. card.
Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
No. Paragraph (C) on p.59 only enables patients to make their co-pays or receive their rebates by electronic transfer, just as many of us receive Social Security payments and tax refunds now. Nothing in this section gives government “access to all individual bank accounts.”
Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (example: SEIU, UAW and ACORN)
No they will not. Sec. 164 starting on p.65 establishes a reinsurance program for those who retire after age 55 but prior to their eligibility for Social Security. It doesn’t mention anything about unions, community organizers, or any of the examples. The word “ACORN” does not occur anywhere in the bill.
Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
True. All plans must meet minimum requirements that do not abuse the insured. Overcharging, denial of claims, denial of applicants for alleged or real pre-existing conditions, and other abuses by private health care insurers are among the litany of problems motivating this legislation.
Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
No. What Sec. 203(b) says on p.84 is that any private health insurer who participates in the Healthcare Exchange must offer the Basic Plan of minimal coverage. Private insurers are free to offer enhanced plans and any other features they like, including any that would make them more attractive than a public plan, as long as they provide the Basic Plan of coverage. If they can compete better outside the Healthcare Exchange, they are free to do so.
Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
Nothing on p.91 refers to aliens, illegal or otherwise. Some older citizens of foreign birth feel more comfortable talking about sensitive matters such as health issues in their most proficient language. Also, private insurers, as well as the rare unscrupulous health care provider, may take advantage of patients less proficient in English by getting them to approve documents and procedures that they don’t fully understand. This provision is intended to guard against such abuses.
Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
Sec. 205 beginning on p.95 specifies only that outreach, particularly to vulnerable populations (like children and the mentally ill) be made “. . . through means such as the mail, by telephone, electronically, and in person.” It makes no mention of ACORN or Americorps. This is another gratuitous reference to ACORN for purely inflammatory reasons, with no basis in fact.
Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
No. What this section says is that persons eligible for Medicaid who do not choose a plan from the Health Care Exchange, will automatically be enrolled in Medicaid. Should they choose to purchase their own private insurance plan, they are free to do so.
Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.
All this section says is that the decision of the HHS Secretary with regard to payments to health care providers from the Public Plan are not subject to judicial review. Private insurers are free to charge whatever they want, and health care providers are free not to treat patients insured by the Public Plan. If this provision were not enacted, private insurers would immediately sue the government (taxpayer) to force higher insurance rates and limit benefits to levels that are profitable to them but not necessarily beneficial to patients.
Page 127: The AMA sold doctors out: the government will set wages.
Sec. 125 only specifies on p.127 that doctors who treat patients under the public plan will be reimbursed according to rates negotiated between physicians and the government. Physicians are free to charge whatever they want to those insured under private plans, or paying fees-for-service.
Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
What this section actually says is that employers who provide insurance must enroll their employees in the plan that is least expensive for the employee. There is no requirement that this be the Public Plan, though the tacit assumption of this particular “criticism” is that the Public Plan will be the most economical. Bringing down the cost of health insurance is a major purpose of the legislation, and is the main reason that the health insurance industry is so opposed to it.
Page 146: Employers MUST pay healthcare bills for part-time employees AND their families.
If the employer is required to provide health insurance (small employers are excluded), they must provide the same benefits to part-time employees, in proportion to the extent of their part-time employment only. There is no reference to paying for the healthcare of the employee’s family.
Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll.
Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
These are payments made by employers who choose not to provide any health insurance, not just the public option, to their employees. They can avoid this payment if they provide their employees with any plan, private or public, that ensures the baseline level of health care.
Page 167: Any individual who doesn't have acceptable healthcare (according to the government) will be taxed 2.5% of income.
The requirement that everyone have health insurance, or pay a tax surcharge in lieu of insurance, is based on the principle of fairness. Under our current system, the health care of the uninsured is paid for by a hidden tax of about $1,100 a year that those of us who have insurance pay in higher premiums, and by direct taxes that everyone else pays to hospital districts, counties, and other taxing entities that have to take care of the uninsured. It is only fair that everyone take part in paying for health care. They can do it either by having health insurance, or by paying into a pool that covers expenses for the uninsured.
Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
Non-resident aliens are exempt from the penalty tax because they are not required to purchase or have health insurance (though they may choose to do so). But they are also not eligible for the subsidies that low-income citizens will receive to help pay for their health insurance.
Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
No; this is a gross exaggeration. Sec. 431 on p.195 says only that income tax records, of the type we all routinely have to provide in determining eligibility for everything from scholarships for our kids to Social Security benefits, must be provided to help determine the level of subsidies for which an individual should be eligible. Clearly, proof of income is a reasonable requirement in determining how much help a person needs to meet the requirement for health care coverage – otherwise, the invitation to fraud is obvious. No financial records need to be provided if no subsidies are given; and the bill refers only to income and tax records, not to all financial records, and not to personal records.
Page 203: "The tax imposed under this section shall not be treated as tax." Yes, it really says that.
The context of the statement on p.203 makes it clear that the imposed tax will not be counted as a tax for purposes of making a mathematical calculation in another section.
Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."
The wording of paragraph (c) on p.239 is admittedly byzantine, but a careful reading of it reveals that this section has nothing to do with reducing services. Its purpose is to modernize the reimbursement calculations for physicians, to encourage them to provide better health care for Medicaid patients.
Page 241: Doctors: no matter what specialty you have, you'll all be paid the same (thanks, AMA!)
This section says nothing about paying doctors. It simply specifies that the procedures a doctor performs will be categorized by the procedure, not by the doctor’s specialty. If a surgeon were to run a blood test, they would be reimbursed for running a blood test, not for taking out your appendix.
Page 253: Government sets value of doctors' time, their professional judgment, etc.
Subsection (L) on p.253 simply says that the Secretary of HHS can set up a process for evaluating the value of different procedures for purposes of fairly reimbursing doctors. Under the present system, health insurance companies make that determination in their own interests, and not necessarily in a fair and equitable manner.
Page 265: Government mandates and controls productivity for private healthcare industries.
This section doesn’t mandate or control anything. It simply sets up a mechanism for incorporating how changes in the productivity of health care delivery affect Medicare reimbursements. Maximizing productivity is a hallmark in the private sector, and an essential element of bringing down health care costs.
Page 268: Government regulates rental and purchase of power-driven wheelchairs.
This is a technical clarification of what equipment can be reimbursed under already existing law. It doesn’t introduce any new regulations.
Page 272: Cancer patients:Kiss your ass goodbye!... welcome to the wonderful world of rationing!
Sec. 1145 starting on p.272 empowers the Secretary of HHS to adjust payments to cancer hospitals that are charging more than other hospitals delivering comparable care. It is a protection against fraud, abuse, and price-gouging of patients at their most vulnerable time. Nothing in this section even approaches a discussion of “rationing”, which is obviously a buzz word intended to inflame the discussion and distort the actual meaning and intent of a provision intended to protect both the patient and taxpayer.
Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
Private for-profit hospitals make money by keeping their beds filled. With an excess of private hospital beds in many cities, the incentive to keep patients hospitalized unnecessarily is strong. Sec. 1151 beginning on p.280 provides a mechanism for limiting the ability of hospitals to charge patients for excessive and unnecessary hospital stays. Recognizing their tattered reputation over this issue, the American Hospital Association actually lobbied for this provision in testimony before Congress.
Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
For the reasons indicated above, paragraph (C) on p.298 lists readmissions to hospitals as one of several factors that should be studied in considering reimbursements. It does not mandate anything or penalize anyone.
Page 317: Doctors: you are now prohibited from owning and investing in healthcare companies!
The practice of referring patients to a health care facility (or service) which is owned in part by the doctor making the referral is an obvious conflict of interest with great opportunity for abuse at least, and fraud at worst. It is one of the practices that has greatly escalated the cost of health care, especially in smaller communities where physicians are often invested in local real estate and health care services. This section addresses that form of abuse. It does not prevent the investment by doctors in healthcare companies or facilities that does not create a conflict of interest that favors the investor at the expense of the patient and taxpayer.
Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
No, it does not prohibit hospital expansion. It only regulates the investment in hospitals by doctors who stand to gain by admitting their patients to those hospitals. This is a cost-control and anti-trust measure, aimed at protecting the patient from excessive charges.
Page 321: Hospital expansion hinges on "community" input: in other words, yet another payoff for ACORN.
There is no mention of ACORN or any other specific community group anywhere in the bill. nor does it provide for “paying off” anyone. This is another gratuitous attempt to demonize the meaning of community input (which could be from anyone) and to inflame the discussion.
Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
Outcome-based measures have nothing to do with “rationing,” and nowhere is either the word or anything that could be construed as rationing even mentioned. Furthermore, the outcomes-based measures are to be used in evaluating the effectiveness specifically of Medicare Advantage Plans, which siphon off millions of taxpayer dollars to private for-profit insurance companies. Medicare Advantage payments to private insurers are a major contributer to the upward spiral in Medicare costs. The illogical reference to “rationing” is obviously a further attempt to inflame the discussion and play on the fears of the public.
Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
Yes, the government can disqualify those Medicare Advantage Plans which are not complying with the rules required to keep them eligible for the massive federal subsidies they receive. This is another effort to eliminate the waste of taxpayer money. There is no mention of HMOs on p.341.
Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals. << Does this apply to any of you???
This section merely clarifies the open enrollment period for certain types of special needs patients. It makes no restrictions on their enrollment within the period for open enrollment.
Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
Augmenting traditional healthcare through healthcare by phone is a useful and effective way to lower healthcare costs. This section establishes a committee of physicians and other health care professionals outside the federal government to advise the Secretary on matters pertaining to telehealth. It doesn’t add anything to government bureaucracy, which in any event, is much less extensive and abusive than the bureaucracy in private health insurance companies.
Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
Sec. 1233, beginning on p.424 and extending over several pages, provides that patients can receive optional consultations concerning their right to determine what life-sustaining efforts should be used if they become incapacitated, including the right to expend every effort to keep them alive under all circumstances. It also provides that consultations be given to patients concerning the advantages of designating powers of attorney and planning how their financial affairs will be handled upon their death. The so-called “order” for end-of-life treatment (such as a living will) is something the patient orders, not the government. Most people feel that making end-of-life preparations is wise. This section provides that a qualified professional can be reimbursed for helping them do so.
Page 430: Government will decide what level of treatments you may have at end-of-life.
This is blatantly false. Only the patient (or their legally-designated power of attorney) can make such a decision. The relevant passage states an appropriate order is one which, “. . . effectively communicates the individual’s preferences regarding life sustaining treatment. . .”
Page 469: Community-based Home Medical Services: more payoffs for ACORN..
Page 472: Payments to Community-based organizations: more payoffs for ACORN.
More gratuitous falsehoods. There is no mention of ACORN or of payoffs to anyone.
Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
Yes, marriage and family therapy will be covered. To say that the government will therefore be intervening in your marriage is like saying the surgeon who removes your inflamed appendix is interfering with your digestive system.
Page 494: Government will cover mental health services: defining, creating and rationing those services.
The bill expands coverage for mental health services, and defines what will be covered, as all private health insurance plans which cover mental health do. There is no mention of rationing. The use of this term is, again, a gratuitous distraction aimed at feeding fear.
Sunday, August 2, 2009
It could be worse; health care reformers take heart
Congress has adjourned for the August recess without voting for health care reform. While this is disappointing, it could be worse.
In its final act before the recess, the House Energy and Commerce Committee passed a bill (save for a few straggling amendments to be considered in September) by a vote of 31-28. Every Republican on the Committee, who the previous day had passed up the opportunity to do away with government-funded Medicare, voted against the bill.
This was the third and final committee with jurisdiction in the House to vote out a bill, leaving only the Senate’s Finance Committee to report out its version. That hasn’t happened because the chairman, Max Baucus (D-MT) is still trying to get three Republican senators to join the effort. He may not succeed, but I see the continuing effort to do so as good, because even one or two Republicans who will support health care reform will lessen the chances of a filibuster in the Senate.
Not that a filibuster will be the end of the world. If opponents of health care reform are that eager to kill it, and think they can survive the wrath of an electorate that overwhelmingly supports reform, let them try. We’ll just have to hope that our allies in Congress have the spine to stand up to them and call their bluff. Our need for reform has become so desperate, that it might be worth shutting the government down to get it done.
Unless you were watching the Energy and Commerce Committee deliberations on Friday, which I was (I know; I need to get a life), you may have missed an important bit of news. When Anthony Weiner (D-NY) introduced an amendment to replace the bill under consideration with a single-payer option (“Medicare for all”), Chairman Waxman informed him that Speaker Pelosi has agreed to allow the single payer option to be offered on the floor of the House after the break. That is very good news, because it means that those who support the elegant logic, simplicity, and superiority of a single-payer system will get to have that possibility debated and voted on before the nation as a whole.
The single-payer plan will probably not prevail. But it gives us something to galvanize around during August and forces the issue onto the table. By having the “extreme” option of a single payer as a possibility, the chances of getting a more progressive bill that provides real reform, even if it isn’t perfect, will be improved.
In the meantime, batten down the hatches – the media blitz in August is going to be intense. Expect all the lies, distortions, and fear-mongering that the money of the health insurance industry can buy. Better yet, just go on vacation; then come back in September refreshed and ready to blitz the media and our representatives with encouragement to say Yes We Can to real health care reform at long last.
In its final act before the recess, the House Energy and Commerce Committee passed a bill (save for a few straggling amendments to be considered in September) by a vote of 31-28. Every Republican on the Committee, who the previous day had passed up the opportunity to do away with government-funded Medicare, voted against the bill.
This was the third and final committee with jurisdiction in the House to vote out a bill, leaving only the Senate’s Finance Committee to report out its version. That hasn’t happened because the chairman, Max Baucus (D-MT) is still trying to get three Republican senators to join the effort. He may not succeed, but I see the continuing effort to do so as good, because even one or two Republicans who will support health care reform will lessen the chances of a filibuster in the Senate.
Not that a filibuster will be the end of the world. If opponents of health care reform are that eager to kill it, and think they can survive the wrath of an electorate that overwhelmingly supports reform, let them try. We’ll just have to hope that our allies in Congress have the spine to stand up to them and call their bluff. Our need for reform has become so desperate, that it might be worth shutting the government down to get it done.
Unless you were watching the Energy and Commerce Committee deliberations on Friday, which I was (I know; I need to get a life), you may have missed an important bit of news. When Anthony Weiner (D-NY) introduced an amendment to replace the bill under consideration with a single-payer option (“Medicare for all”), Chairman Waxman informed him that Speaker Pelosi has agreed to allow the single payer option to be offered on the floor of the House after the break. That is very good news, because it means that those who support the elegant logic, simplicity, and superiority of a single-payer system will get to have that possibility debated and voted on before the nation as a whole.
The single-payer plan will probably not prevail. But it gives us something to galvanize around during August and forces the issue onto the table. By having the “extreme” option of a single payer as a possibility, the chances of getting a more progressive bill that provides real reform, even if it isn’t perfect, will be improved.
In the meantime, batten down the hatches – the media blitz in August is going to be intense. Expect all the lies, distortions, and fear-mongering that the money of the health insurance industry can buy. Better yet, just go on vacation; then come back in September refreshed and ready to blitz the media and our representatives with encouragement to say Yes We Can to real health care reform at long last.
Subscribe to:
Posts (Atom)
