Let's discuss what's in the Health Care Bill

A guy on Twitter, Peter Fleckenstein (twitter.com...), has been reading through the HC Bill and tweeting what he's found. Now I will be the first to admit that some of his comments are over the top, but at least it gives us the direct page & line number to read for ourselves and see how we interpret it.

I openly admit that I do not have much time for the next few days to research each and every thing listed below on my own, so I am calling in for the help of ATS-ers on BOTH sides of the debate to help do the research and point out the truths and falsehoods in the list below.

BE AWARE THIS IS NOT FOR POLITICAL SNIPING AND I WILL ALERT MODS FOR ANYONE WHO POSTS ANY POLITICAL SNIPING OF ANY KIND. THIS IS FOR ACTUAL RESEARCH SO WE CAN ALL UNDERSTAND THE BILL AND HOW IT WILL IMPACT US IF IT IS PASSED.

Thank you for complying with the ground rules Now, here's the list:

PG 22 MANDATES the Government will audit books of ALL EMPLOYERS that self insure!!

PG 24 Line 116 Government effectively sets prices for ALL private health plans.

PG 30 Line 123 THERE WILL BE A Government COMMITTEE that decides what treatments/benefits you get.

PG 37 Line 132 The Government will be reviewing grievances about themselves and will decide on appeals for rejected claims.

PG 29 Line 4-16 YOUR HEALTHCARE IS RATIONED!!! Additionally you can reference PG 15 Line 19-25.

PG 42 The Health Choices Commissioner will choose your HealthCare Benefits for you. You have no choice!

PG 50 Line 152 HealthCare will be provided to ALL non US citizens, illegal or otherwise.

PG 58 Government will have real-time access to individuals’ finances & a National ID HealthCare Card will be issued!

PG 59 Line 21-24 Government will have direct access to your banks accounts for electronic funds transfer!

PG 61 Line 22-24 Congress has no clue what Electronic Medical Records will cost. Asks for estimate.

PG 62 Protection of Data, Government shows they will have database of your personal & financial info.

OK peeps a big one – PG 64 Line 21-25, pg65 Line 1-5 which refers to processing payment transactions by financial institutions

PG 65 Line 164 is a payoff subsidized plan for retirees and their families in Unions & community organizations (ACORN).

PG 72 Line 8-14 Government is creating an HealthCare Exchange to bring private HealthCare plans under Government control.

PG 84 Line 203 Government mandates ALL benefit packages for private. HealthCare plans in the Exchange.

PG 85 Line 7 Specs for of Benefit Levels for Plans = The Government will ration your HealthCare! #AARP members – your Health care Will be rationed.

PG 89 Line 6-10 The FAR is not applicable. Government can write contracts any way they want.

PG 95 Line 8-18 The Government will use groups i.e., ACORN & Americorps to sign up individuals for Government HealthCare plan.

PG 98 Line 8 Americans - You will be paying for others HealthCare while paying for your own.

PG 100 Line 15-19 The Government Will be using ACORN and other community groups to promote & enroll.

PG 102 Line 12-18 Medicaid Eligible Individual will be automatically enrolled in Medicaid. No choice.

PG 109 Line 207 Health Trust Fund. The Government will raise taxes on EVERYONE to fund HealthCare as they see fit. Correction

PG 110 Line 7-12 Employment taxes on ALL employers NOT offering Government HealthCare. No choice.

PG 110 Line 13-18 An excise tax on ALL goods from companies not offering Government HealthCare. ALL Americans pay.

PG 110 Line 19-24 the Treasury can take $$ from Soc Line to pay HealthCare.

PG 111 Line 208 The Federal Government will usurp all State powers in State Based HealthCare Exchange. Violation of 10th Amend.

PG 119 Line 1-3 Establish geographically-adjusted premium rates for public option Can you say ACORN census?

PG 121 Line 223 PAYMENT RATES FOR ITEMS AND SERVICES. Can you say Government price fixing & monopoly?

PG 124 Line 24-25 No company can sue Government on price fixing. No “judicial review” against Government Monopoly.

PG 126 Line 10-15 The Government can make up prices for anything at anytime for any reason.

PG 126 Line 22-25 Employers MUST pay for HealthCare for part time employees AND their families.

PG 127 Line 1-16 Doctors: The Government will tell YOU what you can make.

PG 129 The public option will be subsidized. Credits = your tax dollars. Redistribution of wealth.

PG 130 Line 10-23 Federal Government will subsidize State Medicaid = Even Higher State & Federal taxes for ALL.

PG 145 Line 15-17 An Employer MUST auto enroll employees into public option plan. NO CHOICE.

PG 149 Line 16-24 ANY Employer with payroll 400k & above who does not provide public option pays 8% tax on all payroll.

PG 150 Line 9-13 Biz with payroll btw 251k & 400k who doesn’t provide public option pays 2-6% tax on all payroll.

PG 151 Line 1-3 Aggregate Rules-tax on employers payroll not on public option include payroll of other biz.

PG 167 Line 18-23 ANY individual who doesn’t have acceptable HealthCare according to Government will be taxed 2.5% of inc.

PG 170 Line 1-3 Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)

PG 195 Officers & employees of HealthCare Administration (Government) will have access to ALL Americans financial/personal records.

PG 198 Line 1-3 1.5% ADDITIONAL TAX on peeps who have income of 500k to 1mil. Redistribution of Wealth.

PG 198 Line 4-6 5.4% ADDITIONAL TAX on peeps who have income of $1mil+. Redistribution of Wealth

PG 199 Line 1-4 Surtax rates on raised AGAIN on Americans in 2012.

PG 201 Line 12-19 Government will ignore whatever costs they see fit to show savings. (Cooking the books)

PG 203 Line 14-15 “The tax imposed under this section shall not be treated as tax” Yes, it says that.

PG 202-215 is a Government rewrite of the tax code ensuring more taxes for EVERYONE, Everywhere.

PG 239 Line 14-24 Government will reduce physician services for Medicaid. Seniors, low income, poor affected.

PG 241 Line 6-8 Doctors, doesn’t matter what specialty you have, you’ll all be paid the same.

PG 236 Line 22-25 PG 237 Line 1-3 National rate of uninsured defined by Census. Can you say ACORN corruption?

PG 239 Line 10-12 Medicare DSH payments will be increased. Can you say even higher taxes for all?

PG 238-249 Line 1121 Doctors-Government mandates your growth, costs, value, services, & income. Peeps- Welcome to rationing

PG 253 Line 10-18 Government sets value of Dr’s time, prof judg, etc. Literally value of humans. We’re next.

PG 260 Line 1125 Fed Government will adjust Medicare Payment Localities for California based on Census. ACORN?

PG 265 Line 1131 Government mandates & controls productivity for private HealthCare industries.

PG 268 Line 1141 Fed Government regulates rental & purchase of power driven wheelchairs.

PG 270 Line 1144 Government Mandates that all private ambulatory surgical centers submit cost data & other data

PG 272 Line 1145 TREATMENT OF CERTAIN CANCER HOSPITALS – Cancer patients – welcome to rationing!

PG 276 Line 3-20 Oxygen Equipment & Supply Companies - Government MANDATES you will provide supplies NO MATTER where individual is.

PG 287 Line 14-25 PROOF that Government will ration HealthCare by mandating waiting periods for readmission.

PG 298 Line 9-11 Drs, treat a patient during initial admission that results in a readmission - Government will penalize you.

PG 303 Line 12-25 Post Acute Care Services Data – Government will collect data including personal information as they see fit.

PG 304 Line 17-19 BIG ONE HERE: Expedited Data Collection – More information here

PG 304 Line 17-19 Government does NOT have to protect your private, share with anyone, & is not resp (more on expedited data collection)

PG 306 Line 3-6 The Government can expand the scope & size of Post Acute Program Services anytime & as they see fit.

PG 313 Line 9-14 Government MANDATES Health Services providers will state ownership, invest, & compensation arrangements.

PG 317 Line 13-20 PROHIBITION on ownership/investment. Government tells Drs. what/how much they can own.

PG 317-318 Line 21-25,1-3 PROHIBITION on expansion- Government is mandating hospitals cannot expand.

PG 318-319 Government is mandating how hospitals & physicians conduct business & investments. We’re next!

PG 321 2-13 Hospitals have opportunity to apply for exception BUT community input required. Can you say ACORN?!!

PG 328 Line 1157 Government study disguised. Its a HealthCare workforce study mandated by law for unionization.

Pg335 Line 16-25 PG 336-339 Government mandates estab. of outcome based measures. HealthCare the way they want. Rationing.

PG 341 Line 3-9 Government has authority to disqualify Medicare Adv Plans, HMOs, etc. Forcing peeps in to Government plan.

PG 354 Line 1177 Government will RESTRICT enrollment of Special needs people!

PG 355-369 Line 1181 Government disguises tax on Drug Companies as rebate to Government to subsidize Drugs. We pay in the end.

PG 379 Line 1191 Government creates more bureaucracy – Telehealth Advisory Committee. Can you say HealthCare by phone?

PG 399 If your a subsidy eligible individual under Medicare part D and you don’t enroll, the Government will auto enroll you.

PG 401 Section 1221 Americans will fund Medicare Language & Translation Services Program. Can you say MORE taxes?

PG 404 Lines 12-16 Government exempts itself again from - Chap 35 of title 44, USC including privacy of Americans.

PG 404 Lines 17-19 Government doesn’t know the cost of Language services but states that money is there.

PG 425 Lines 4-12 Government mandates Advance Care Planning Consult. Think Senior Citizens end of life.

PG 425 Lines 17-19 Government will instruct & consult regarding living wills, durable powers of atty. Mandatory!

PG 425 Lines 22-25, 426 Lines 1-3 Government provides approved list of end of life resources, guiding you in death.

Continued in next post....

PG 427 Lines 15-24 Government mandates program for orders for end of life. The Government has a say in how your life ends.

PG 429 Lines 1-9 An “advance care planning consultant” will be used frequently as patients health deteriorates.

PG 429 Lines 10-12 “advance care consultation” may include an ORDER for end of life plans. AN ORDER from Government.

PG 429 Lines 13-25 The Government will specify which Doctors can write an end of life order. Logan’s Run anyone?

PG 430 Lines 11-15 The Government will decide what level of treatment you will have at end of life.

PG 432 Lines 18-21 The Government will publish “quality measures” for individual’s end of life in Federal Register.

PG 434 Section 1234 Military Active, Reservists, Families - If you’re not enrolled in Tricare it is mandated.

PG 434 Section 1234 Military Active, Reservists, Families - Once HealthCare bill is passed your premiums will go up.

PG 438 Section 1236 The Government will develop a patient decision making aid program that you & Dr. WILL use.

PG 443 Lines 7-24 Government at taxpayers expense test out an “Accountable Care Org” program (Government doesn’t have plan.)

PG 444 Lines 1-6 Government’s Accountable Care Program will mandate services & infrastructure thru reward/penalty system.

PG 448 Lines 4-17 Government will set performance targets for ALL Accountable Care Organizations including private.

PG 455 Lines 3-4 Government exempts itself from Chapter 35, Title 44 Paperwork Reduction & Citizens Privacy Protection Act

PG 460 Section 1302 Knock, Knock - It’s the Government and I’m here with the Medical Home Program - YOUR home.

PG 460 Section 1302 The Government WILL provide medical services in your home. Paging Nurse Pelosi!!

PG 464 Lines 17-22 Independent Patient Center Home Medical Services - Drs. don’t have to be at your home just some directed by D

PG 469 Community Based Home Medical Services=Non profit organizations. Hello, ACORN Medical Services here!!?

Page 472 Lines 14-17 PAYMENT TO COMMUNITY-BASED Organization - 1 monthly payment to a community-based organization Like ACORN?

PG 476 19-20 Chapter 35/ title 44, (Privacy of personal records) shall not apply Home Medical Services. ACORN ACCESS

PG 489 Section 1308 The Government will cover Marriage & Family therapy. Which means they will insert Government into your marriage.

PG 494-498 Government will cover Mental Health Services including defining, creating, rationing those services.

PG 502 Section 1181 Center for Comparative Effectiveness Research Established. - Hello Big Brother - Literally.

PG 502 Line 5-18 Government builds the “Center” to conduct, support, & synthesize research to define our HealthCare Services.

PG 503 Line 13-19 Government will build registries and data networks from YOUR electronic medical records.

PG 503 Line 21-25 Government may secure data directly from any department or agency of the US including your data.

PG 504 Line 6-10 The “Center” will collect data both published & unpublished (that means public & your private info)

PG 506 Line 19-21 The Center will recommend policies that would allow for public access of data

PG 518 Line 21-25 The Commission will have input from HealthCare consumer reps - Can you say unions & ACORN?

PG 524 18-22 Comparative Effectiveness Research Trust Fund set up. More taxes for ALL.

PG 525-620 deals with the Government basically taking over nursing homes, ... Read More here

PG 620 Line 1-9 The Government will define, prioritize, and nationalize your Health Care Services.

PG 621 Lines 20-25 Government will define what Quality means in HealthCare. Since when does Government know about quality?

PG 622 Lines 2-9 To pay for the quality Standards Government will transfer $$ from to other Government Trust Funds. More Taxes.

PG 624 “Quality” measures shall be designed to assess outcomes & functional status of patients.

PG 628 Section 1443 Government will give “Multi-Stake Holders” Pre-Rule Making input into Selection of “Quality” Measures.

PG 630 9-24/631 1-9 Those Multi-stake holder groups including Unions & groups like ACORN deciding HealthCare quality.

PG 632 Lines 14-25 The Government may implement any “Quality measure” of HealthCare Services as they see fit.

PG 633 14-25/ 634 1-9 The Secretary may issue non-endorsed “Quality Measures” for Physician Services & Dialysis Services.

PG 635 - 653 Physicians Payments Sunshine Provision - Government wants to shine sunlight on Docs but not Government.

PG 654-659 Public Reporting on Health Care-Associated Infections - Looks okay.

PG 660-671 Doctors in Residency - Government will tell you where your residency will be, thus where you’ll live.

PG 676-686 Government will regulate hospitals in EVERY aspect of residency programs, including teaching hospitals.

PG 686-700 Increased Funding to Fight Waste, Fraud, and Abuse. LMAO!! You mean the Government with an $18 mil website?

PGs 701-704 Section 1619 If your part of HealthCare plan that isn’t in Government HealthCare Exchange but you qualify for Federal aid, no payment.

PG 705-709 SEC. 1128 If Secretary gets complaints (ACORN) on HealthCare provider or supplier, Government can do background check.

PG 711 Lines 8-14 The Secretary has broad powers to deny HealthCare providers/suppliers admittance into HealthCare Exchange.

Pg 719-720 Section 1637 ANY Doctor who orders durable medical equipment or home medical services MUST be enrolled in Medicare.

PG 722 Section 1639 Government MANDATES Doctors must have face-to-face with patient to certify patient for Home Health Services.

PG 724 Lines 16-22 Government reserves right to apply face-to-face certification for patient to ANY other HealthCare service.

PG 724 23-25 PG 725 1-5 The same Government certifications will apply to medicaid & CHIP (your kids)

Pg 735 lines 16-25 For law enforcement purposes, the Secretary of Health & Human Services will give Attorney General access to ALL data.

PG 740-757 Government sets guidelines for subsidizing the uninsured (That’s your tax dollars peeps)

Pg 757-762 Fed Government will shift burden of payments to Disproportionate Share Hospitals (DSH) to States. (Taxes)

Page 763 1-8 No DS/EA hospitals will be paid unless they provide services without regard to national origin

Pg 765 Section 1711 Government will require Preventative Services including vaccines. (Choice?)

Pg 768 Section 1713 Government - Nurse Home Visitation Services (Hello union paybacks)

Pg 769 3-5 Nurse Home Visit Services - “increasing birth intervals between pregnancies.” Government Abortions anyone?

Pg 769 11-14 Nurse Home Visit Services include-economic self-sufficiency, employment advancement, school-readiness.

Pg 769 3-5 Nurse Home Visit Services - “increasing birth intervals between pregnancies.” Government ABORTIONS anyone?

Pg 770 SEC 1714 Federal Government mandates eligibility for State Family Planning Services. Say abortion & State Sovereign.

Pg 789-797 Government will set & mandate drug prices, controlling which drugs will brought to market. Bye innovation

Pgs 797-800 SEC. 1744 PAYMENTS for grad medical education. The government will now control Drs education.

PG 801 Sec 1751 The Government will decide which Health care conditions will be paid. Say RATION!

Pg 810 SEC. 1759. Billing Agents, clearinghouses, etc. required to register. Government takes over private payment system.

Page 820-824 Sec 1801 Government will identify individuals ineligible for subsidies. Will access all personal finances.

Pg 824-829 SEC. 1802. Government Sets up Comparative Effectiveness Research Trust Fund. Another tax black hole.

PG 829-833 Government will impose a fee on ALL private health insurance plans including self insured to pay for Trust Fund!

PG 835 11-13 fees imposed by Government for Trust Fund shall be treated as if they were taxes.

Pg 838-840 Government will design & implement Home Visitation Program for families with young kids & families expecting kids.

PG 844-845 This Home Visitation Program includes Government coming into your house & telling you how to parent!!!

Pg 859 Government will establish a Public Health Fund at a cost of $88,800,000,000. Yes thats Billion.

Pg 865 The Government will MANDATE the establishment of a National Health Service Corps.

PG 865 to 876 The NHS Corps is a program where Drs. perform mandatory HealthCare for 2 years for part loan repayment.

PG 876-892 The Government takes over the education of our Medical students and Drs.

PG 898 The Government will establish a Public Health Workforce Corps. to ensure supply of public health professionals.

PG 898 The Public health workforce corps shall consist of officers of Regular & Reserve Corps of Service.

PG 898 The Public health workforce corps shall consist of civilian employees of the U.S. as Secretary deems.

PG 900 The Public Health Workforce Corps includes veterinarians.

PG 901 The Public Health Workforce Corps WILL include commissioned Regular & Reserve Officers. HealthCare Draft? WTF!

PG 910 The Government will develop, build & run Public Health Training Centers.

PG 913-914 Government starts a HealthCare affirmative action program thru guise of diversity scholarships.

PG 915 SEC. 2251. Government MANDATES Cultural & linguistic competency training for HealthCare professionals.

Pg 932 The Government will establish Preventative & Wellness Trust fund - intial cost of $30,800,000,000-Billion.

PG 935 21-22 Government will identify specific goals & objectives for prevention & wellness activities. Control You!!

PG 936 Government will develop “Healthy People & National Public Health Performance Standards” Tell me what to eat?

PG 942 Lines 22-25 More Government? Offices of Surgeon General -Public Health Services, Minority Health, Women’s Health

PG 950- 980 BIG Government core public health infrastructure includes workforce capacity, lab systems; health information systems, etc

Continued in next post....

PG 993 Government will establish school based health clinics. Your kids wont have a chance.

PG 994 School Based Health Clinic will be integrated into the school environment. Say Government Brainwash!

PG 1001 The Government will establish a National Medical Device Registry. Will you be tracked?

PG 1003 9-11 National Medical Dev Reg ‘‘(iii) other postmarket device surveillance activities” you WILL be tracked.

PG 1018 States give up some of their State Sovereignty.

Okay, let the research begin

The Bill can be found HERE

Edit to add link to bill

[edit on 8/8/09 by redhatty]

I'll start on the bottom of the list and work my way toward the begining. Oh boy

For any interested, here's the link to the bill.

frwebgate.access.gpo.gov...:h3200ih.txt.pdf

rrrrrrrrrrrrrrr, having trouble linking the pdf !!!

Never mind, saw you had the link, -sigh- I should read more carefully. . . .
[edit on 8-8-2009 by mikerussellus]

[edit on 8-8-2009 by mikerussellus]

[edit on 8-8-2009 by mikerussellus]

[edit on 8-8-2009 by mikerussellus]

Thanks Mr Headshot & Mikerussellus

I appreciate the help in picking this thing apart.

reply to post by redhatty


PG 22 MANDATES the Government will audit books of ALL EMPLOYERS that self insure!!

From the bill . . .
(B) The similarities and differences between typical insured and self-insured health plans.
(C) The financial solvency and capital reserve levels of employers that self-insure by employer size.
(D) The risk of self-insured employers not being able to pay obligations or otherwise becoming financially insolvent.

If I am reading this right, the government will determine the risk/benefits based on some standard (not explained in the bill) to determine if an employer can self insure. Question, how can the government determine if it is affordable? Is this going to be linked to determining what an employer can/should pay to an employee? To themselves? If government says you can't do it now, but if you cut your salary by a third, THEN you could, isn't that just another incentive to take the government plan?
There is nothing that I have read in this area that would provide ANY incentive to the business owner to keep their own type of insurance for their employees.




[edit on 8-8-2009 by mikerussellus]

reply to post by mikerussellus



Not later than 18 months after the date of the enactment of this Act, the Commissioner shall submit to Congress and the applicable agencies a report on the study conducted under paragraph (1). Such report shall include any recommendations the Commissioner deems appropriate
to ensure that the law does not provide incentives
VerDate Nov 24 2008 23:22 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00022 Fmt 6652 Sfmt 6201 E:\BILLS\H3200.IH H3200 jlentini on DSKJ8SOYB1PROD with BILLS


I guess I answered my own question. This was found on the bottom of page 22 and goes onto page 23.

This section of page 22 looks rather important as well.

(E) The extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and mid size employers to self-insure
(2) REPORTS.—Not later than 18 months after the date of the enactment of this Act, the Commissioner shall submit to Congress and the applicable agencies a report on the study conducted under paragraph (1). Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and mid-size employers to self-insure or create adverse selection in the risk pools of large group insurers and self-insured employers. Not later than 18 months after the first day of Y1, the Commissioner shall submit to Congress and the applicable agencies an updated report on such study, including updates on such recommendations.

So not only are they going to do a study on every employer who self-insures, they're also going to make sure there aren't any incentives for them to do so.

EDIT: Didn't see that you had posted the rest of it before I did.

[edit on 8-8-2009 by Jenna]

reply to post by mikerussellus


Here's the section in the entirety:

(1) STUDY.—The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a
study of the large group insured and self-insured employer health care markets. Such study shall examine the following:

(A) The types of employers by key characteristics, including size, that purchase insured products versus those that self-insure.
(B) The similarities and differences between typical insured and self-insured health plans.
(C) The financial solvency and capital reserve levels of employers that self-insure by employer size.
(D) The risk of self-insured employers not being able to pay obligations or otherwise becoming financially insolvent.
(E) The extent to which rating rules are likely to cause adverse selection in the large group market or to encourage small and mid size employers to self-insure
(2) REPORTS.—Not later than 18 months after the date of the enactment of this Act, the Commissioner shall submit to Congress and the applicable
agencies a report on the study conducted under paragraph (1). Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and mid-size employers to self-insure or create adverse selection in the risk pools of large group insurers and self-insured employers. Not later than 18 months after the first day of Y1, the Commissioner shall submit to Congress and the applicable agencies an updated report on such study, including updates on such recommendations.

So am I reading that right, they want to make sure that there are NO INCENTIVES for small & mid-sized employers to self-insure their employees???

Can I get a WTF??

ETA: Welcome to the research party Jenna

[edit on 8/8/09 by redhatty]

PG 24 Line 116 Government effectively sets prices for ALL private health plans.


(a) IN GENERAL.—A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP
offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.

Who is the Commissioner? The ratios are defined by him? So this mystery man can make a determination based on, what? If he had a nice meal the night before and was in a good mood? And who is paying for the rebates? Us? More taxes?

Redhatty, the more I read this and try to define it, the more confused I get. Just in the little I've read, so much of this is based on amorphous interpretation and what "The Commissioner" decides, that I feel like I'm trying to put spray paint on a cloud.

I'll continue and try to find something substantial. . . .

reply to post by redhatty


That was the way I read that too, especially since it clearly says they want to make sure there are no incentives for small and mid-sized employers to self-insure. And people wonder why many of us believe that this is a ploy to take away choice.

Thanks for the welcome, by the way!

Originally posted by mikerussellus
Redhatty, the more I read this and try to define it, the more confused I get. Just in the little I've read, so much of this is based on amorphous interpretation and what "The Commissioner" decides, that I feel like I'm trying to put spray paint on a cloud.

I'll continue and try to find something substantial. . . .

I have been having the same issue, it is so undefined in so many places, that it MAY lead to "personal" interpretation by those who are ultimately selected to "run" this program.

This is why I seriously believe that an educated, non-partial research attempt to see what is and isn't in this bill is so very necessary.

Again, thank you for helping!!

reply to post by redhatty


You're welcome. This is an education for me as well.

reply to post by redhatty


Good work!

I would love for the Liberals to come here and debate, what's being proposed rather than continue with moronic threads such as the "Rise of Right wing extreme groups" or "why idiots oppose health care reform" these types of threads only resort to ad hominem attacks, and do not CHALLENGE WHAT WE SAY.

You guys WANT to talk about it. Do it in this THREAD!!

[edit on 8-8-2009 by Gateway]

PG 30 Line 123 THERE WILL BE A Government COMMITTEE that decides what treatments/benefits you get.

SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
12 (a) ESTABLISHMENT.—
13 (1) IN GENERAL.—There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
(2) CHAIR.—The Surgeon General shall be a member and the chair of the Health Benefits Advisory Committee.
(3) MEMBERSHIP.—The Health Benefits Advisory Committee shall be composed of the following members, in addition to the Surgeon General:
(A) 9 members who are not Federal employees or officers and who are appointed by the President.
(B) 9 members who are not Federal employees or officers and who are appointed by the Comptroller General of the United States in a manner similar to the manner in which the Comptroller General appoints members to the Medicare Payment Advisory Commission under section 1805(c) of the Social Security Act.
(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.

So the President will be appointing up to 17 people to this committee and the Comptroller General will be appointing 9.

(b) DUTIES.—
(1) RECOMMENDATIONS ON BENEFIT STANDARDS.—The Health Benefits Advisory Committee shall recommend to the Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) benefit standards (as defined in paragraph (4)), and periodic updates to such standards. In developing such recommendations, the Committee shall take into account innovation in health care and consider how such standards could reduce health disparities.

This committee will be recommending benefit standards.

(4) BENEFIT STANDARDS DEFINED.—In this subtitle, the term ‘‘benefit standards’’ means standards respecting—
(A) the essential benefits package described in section 122, including categories of covered treatments, items and services within benefit classes, and cost-sharing; and
(B) the cost-sharing levels for enhanced plans and premium plans (as provided under section 203(c)) consistent with paragraph (5).

And those standards they recommend will be for the categories of covered treatments, items and services within "benefit classes".

Looks like we can mark this one down as true. The government committee will be deciding what benefits and treatments we can have.


Edit: fixed external tags

[edit on 8-8-2009 by Jenna]

PG 24 Line 116 Government effectively sets prices for ALL private health plans.

It's Sec. 116, not line, but anyway, here is the section:

SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.
(a) IN GENERAL.—A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.
(b) BUILDING ON INTERIM RULES.—In implementing subsection (a), the Commissioner shall build on the definition and methodology developed by the Secretary of Health and Human Services under the amendments made by section 161 for determining how to calculate the medical loss ratio. Such methodology shall be set at the highest level medical loss ratio possible that is designed to ensure adequate participation by QHBP offering entities, competition in the health insurance market in and out of the Health Insurance Exchange, and value for consumers so that their premiums are used for services.

Okay, I really don't understand this one at all, but I have to ask this...

WHAT IS THE "HEALTH INSURANCE EXCHANGE"?????

Is that going to be something like the Climate exchange? Is healthcare something that we will now trade on a market?

I am so confused & it only 25 pages into this monster!

PG 37 Line 132 The Government will be reviewing grievances about themselves and will decide on appeals for rejected claims.

REQUIRING FAIR GRIEVANCE AND APPEALS
MECHANISMS.—A determination made, with respect
to a qualified health benefits plan offered by a
QHBP offering entity, under the external review
process established under this subsection shall be
binding on the plan and the entity.

On first reading, this sounds good. It means that an EXTERNAL board will be established to review issues that may arise.
But if you read carefully, it also says. . .

(1) IN GENERAL.—The Commissioner shall establish an external review process (including procedures for expedited reviews of urgent claims) that
provides for an impartial, independent, and de novo
review of denied claims under this division.

Which means that the Commissioner (again with the commissioner. . . )establishes the "external" review board.

So basically, the government says an outside group will oversee this. But they are going to build, establish the outside board.

-huh?-

You chain-mail believers are awesome ...

I call BS on this one.

Peter Fleckenstein is an idiot, big pharma shill and insanely biased corporate capitalistic butt kisser (he loves to drink Kool-Aid too).

He lacks basic reading and comprehension skills...

Most folks who use twitter probably do as well, lol

Here is more sane view on some stuff he is "trying" to put into "perspective" for the average mindless USA drone:

POLITIFACT

Perhaps it is the lack of sleep (suffering from insomnia) but something occurs to me about one of the alleged provisions which has been vexing me.

In particular, I am talking about the line item which mandates that the self-insured undergo a mandatory audit (paraphrased).

Doesn't that take a whole lot of manpower and government resources to accomplish? I mean, wouldn't the IRS have to hire thousands and thousands of people (or maybe some suitably politically-connected 'private' contractor) to carry all these audits out?

Sounds like an influx of revenue for the IRS..... or am I being too cynical?