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

Originally posted by 5thElement
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

You OBVIOUSLY didn't read the first post. NO POLITICAL SNIPING.

You are more than welcome to post rebuttals from the page you linked as we actually read this bill & try to decipher it for ourselves

You are NOT welcome to come in & start spewing insults at someone who isn't even here to defend themselves & at anonymous others (twitter users).

If you can't behave in the proper spirit of this thread, then please, just stay out of it.

Thank You.

reply to post by Gateway


Thank You Gateway, feel free to join us in studying & understanding this bill!

Who is (will be) the Healthcare Commissionor?

Is this a czar position, a new government agency head? DO they get elected or appointed? What is his/her staff like?

Seems like an awfull lot of control for just one person.

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

Page 29 Line 3-21:

(2) ANNUAL LIMITATION.—
(A) ANNUAL LIMITATION.—The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B).
(B) APPLICABLE LEVEL.—The applicable level specified in this subparagraph for Y1 is $5,000 for an individual and $10,000 for a family. Such levels shall be increased (rounded to the nearest $100) for each subsequent year by the annual percentage increase in the Consumer Price Index (United States city average) applicable to such year.
(C) USE OF COPAYMENTS.—In establishing cost-sharing levels for basic, enhanced, and premium plans under this subsection, the Secretary shall, to the maximum extent possible, use only copayments and not coinsurance.

This one I'm not sure about. A limitation on cost sharing simply means that you don't have to pay more than the limit, in this case $5k or $10k, per year for medical expenses. So if your single, you won't be expected to pay more than $5k in a single year out of pocket for medical care.

What does concern me there is the language about not using co-insurance.

Page 15 Line 19-25:

(2) INDIVIDUAL AND GROUP HEALTH INSURANCE COVERAGE.—The terms ‘‘individual health insurance coverage’’ and ‘‘group health insurance coverage’’ mean health insurance coverage offered in the individual market or large or small group market, respectively, as defined in section 2791 of the Public Health Service Act.

Edit: fixed external tags again

[edit on 8-8-2009 by Jenna]

reply to post by Jenna


I agree, that sounds more like the "catastrophic cap" that is placed on out of pocket co-pays.

$5K for a single person is pretty high though.

reply to post by redhatty


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


‘‘(C) enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;

That seems pretty straight forward. Although I'm a little unclear on remittance advice. There is really no room for debate on this point. The language,for once, is clear cut. Will the government then, require you to have a checking account? What do the banks say about this? Also, what if you're overdrawn? Do you pay penaties to the government? Will they deny you care until they have access?

I'm sorry if I'm generating more questions than answers while reading this, but it appears that they are leaving too much open for government interpretation.

Though many of your points are good ones, they assume that the person interpreting them has an open mind and all his suppositions are correct.
I have seen this particular list, among others, and those of an opposing view also.
Though I applaud your effort at bringing up the issue, I fear that the use of another persons interpretations are counter-productive.

It would be much more effective to have people READ the actual proposal and come to their own conclusion.
A fair knowledge of "legalese" is required, and those possessing that understanding of terms will immediately find the alligators in waiting. But even those who don't understand legal language can use a dictionary, and I IMPLORE all to do so.
I am of the certain conclusion that those who do so (except for those wanting to live in a fascist dictatorship) will become vocal opponents.

Originally posted by gotrox
Though many of your points are good ones, they assume that the person interpreting them has an open mind and all his suppositions are correct.
I have seen this particular list, among others, and those of an opposing view also.
Though I applaud your effort at bringing up the issue, I fear that the use of another persons interpretations are counter-productive.

I am assuming NOTHING, that is the whole point of the thread, to look at what has been referenced & see if the interpretation given applies or not, to help understand the bill. It is a lot easier to do so with a page and line/sec reference to work from rather than to jump into an over 1000 page bill cold & try to decipher it.

It would be much more effective to have people READ the actual proposal and come to their own conclusion.
A fair knowledge of "legalese" is required, and those possessing that understanding of terms will immediately find the alligators in waiting. But even those who don't understand legal language can use a dictionary, and I IMPLORE all to do so.
I am of the certain conclusion that those who do so (except for those wanting to live in a fascist dictatorship) will become vocal opponents.

See above reply The goal IS to read it for ourselves, and reference pertinent areas already cited.

Yes the legalese is the hardest part & we are trying to decipher it.

Please join in and help us!

Originally posted by redhatty
You OBVIOUSLY didn't read the first post. NO POLITICAL SNIPING.

Yes, I did ...

No political party or view ever mentioned in my post.

Stupidity is actually universal ...

Originally posted by redhatty
You are NOT welcome to come in & start spewing insults at someone who isn't even here to defend themselves & at anonymous others (twitter users).

Who am I to tell you not to spew "insults" at Obama (just an example here), as far as I know, he is never here

Originally posted by redhatty
If you can't behave in the proper spirit of this thread, then please, just stay out of it.

Sorry, but I will call BS when I see it no matter which side it comes from.

Apparently that is not included into "spirit" of your thread, so, yeah, I'm out of here, bye

I find it interesting to note that in this thread the supporters of this bill position has only been an attempt to smear the messenger. When called on it, resorting to preaching to the choir by telling everybody to read it and decide for themselves.

How ironic.

Otherwise the only thing I hear coming from the supporters of this bill is crickets.

[edit on 8-8-2009 by mhc_70]

Originally posted by redhatty

Originally posted by gotrox
Though many of your points are good ones, they assume that the person interpreting them has an open mind and all his suppositions are correct.
I have seen this particular list, among others, and those of an opposing view also.
Though I applaud your effort at bringing up the issue, I fear that the use of another persons interpretations are counter-productive.

I am assuming NOTHING, that is the whole point of the thread, to look at what has been referenced & see if the interpretation given applies or not, to help understand the bill. It is a lot easier to do so with a page and line/sec reference to work from rather than to jump into an over 1000 page bill cold & try to decipher it.

It would be much more effective to have people READ the actual proposal and come to their own conclusion.
A fair knowledge of "legalese" is required, and those possessing that understanding of terms will immediately find the alligators in waiting. But even those who don't understand legal language can use a dictionary, and I IMPLORE all to do so.
I am of the certain conclusion that those who do so (except for those wanting to live in a fascist dictatorship) will become vocal opponents.

See above reply

The goal IS to read it for ourselves, and reference pertinent areas already cited.

Yes the legalese is the hardest part & we are trying to decipher it.

Please join in and help us!

My contention is that by posting the interpretation instead of the actual language, you are opening yourself to be placed firmly in the "denier" or "conspiracy" or "disgruntled righty" camp, along with the person who published the work.
By using another's words to make your point aligns yourself as a follower.
The actual language used in the official version is spooky enough, and bears the weight of fact and not opinion as to interpretation.
Not that I disagree with most of the points, but I took the time to verify them, and might have worded them differently, mayhap, a bit more strongly.

Originally posted by gotrox

My contention is that by posting the interpretation instead of the actual language, you are opening yourself to be placed firmly in the "denier" or "conspiracy" or "disgruntled righty" camp, along with the person who published the work.
By using another's words to make your point aligns yourself as a follower.
The actual language used in the official version is spooky enough, and bears the weight of fact and not opinion as to interpretation.
Not that I disagree with most of the points, but I took the time to verify them, and might have worded them differently, mayhap, a bit more strongly.

Since you took the time to verify them, you should have no problem listing your opinion of the interpetation, which would give your arguement some validity, instead of just your opinion.

Originally posted by gotrox

My contention is that by posting the interpretation instead of the actual language, you are opening yourself to be placed firmly in the "denier" or "conspiracy" or "disgruntled righty" camp, along with the person who published the work.

Those were posted to give a framework, then we're going to the place in the bill that the claims are pointing to and posting the actual bill language. If it confirms the claims, fine, if not, equally fine. If someone wants to toss around labels at us for going through the actual bill to see if the claims have any truth to them, that's their problem.

reply to post by gotrox

It would be much more effective to have people READ the actual proposal and come to their own conclusion.

I disagree. I find the method used, quoting the actual text and then offering comments has helped me understand the quoted text. For example my sleep starved brain originally interpreted the "co -pay" limits of $5000 and $10,000 to mean that was the maximum the Government insurance would pay. Definitely back @$$ward.

Therefore please continue with the analysis. I for one, very much appreciate the work you are doing.

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

Page 42 Section 142

SEC. 142. DUTIES AND AUTHORITY OF COMMISSIONER.
(a) DUTIES.—The Commissioner is responsible for carrying out the following functions under this division:
(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.
(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.
(3) INDIVIDUAL AFFORDABILITY CREDITS.— The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.
(4) ADDITIONAL FUNCTIONS.—Such additional functions as may be specified in this division.
(b) PROMOTING ACCOUNTABILITY.—
(1) IN GENERAL.—The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange.
(2) COMPLIANCE EXAMINATION AND AUDITS.—
(A) IN GENERAL.—The commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected non-compliance.
(B) RECOUPMENT OF COSTS IN CONNECTION WITH EXAMINATION AND AUDITS.—The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations and audit of such QHBP offering entities.
(c) DATA COLLECTION.—The Commissioner shall collect data for purposes of carrying out the Commissioner’s duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health care and may share such data with the Secretary of Health and Human Services.
(d) SANCTIONS AUTHORITY.—
(1) IN GENERAL.—In the case that the Commissioner determines that a QHBP offering entity violates a requirement of this title, the Commissioner may, in coordination with State insurance regulators and the Secretary of Labor, provide, in addition to any other remedies authorized by law, for any of the remedies described in paragraph (2).
(2) REMEDIES.—The remedies described in this paragraph, with respect to a qualified health benefits plan offered by a QHBP offering entity, are—
(A) civil money penalties of not more than the amount that would be applicable under similar circumstances for similar violations under section 1857(g) of the Social Security Act;
(B) suspension of enrollment of individuals under such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Commissioner is satisfied that the basis for such determination has been corrected and is not likely to recur;
(C) in the case of an Exchange-participating health benefits plan, suspension of payment to the entity under the Health Insurance Exchange for individuals enrolled in such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Secretary is satisfied that the basis for such determination has been corrected and is not likely to recur; or
(D) working with State insurance regulators to terminate plans for repeated failure by the offering entity to meet the requirements of this title.

Basically, the commissioner is responsible for establishing the standards (which will be decided on by the committee), establishing and operating a health insurance exchange (what on earth is that?), and the administration of affordability credits (again what on earth is that?).

So this claim is a bit misleading since it's actually the Committee who will be deciding what benefits and treatments are covered and not the Commissioner.

At the risk of being the only one currently online who's still interested in going through this thing with a fine tooth comb.

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

SEC. 152. PROHIBITING DISCRIMINATION IN HEALTH CARE.
(a) IN GENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.

It's actually Section 152, not line. The truth of this claim depends on the definition of "personal characteristics". If it means physical appearance, then the claim is false. If citizenship is included as a personal characteristic, then it's valid.

After running a search on the PDF, I found this on page 143:

SEC. 246. NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS.
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.

For the sake of clarity and understanding I had to run a search for affordability credits as well.

(1) the individual shall be eligible for, in accordance with this subtitle, affordability credits consisting of—
(A) an affordability premium credit under section 243 to be applied against the premium for the Exchange-participating health benefits plan in which the individual is enrolled; and
(B) an affordability cost-sharing credit under section 244 to be applied as a reduction of the cost-sharing otherwise applicable to such plan;

So and affordability credit is basically a credit on what you're charged for your insurance I think. Elsewhere in the bill it says that your eligibility for an affordability credit is based on your tax return, so no I'd imagine people who aren't lawfully present won't be getting those. I can't find any language that specifically states one way or the other whether or not illegal aliens, or nonresident aliens as the bill calls them, will be able to receive health care.

Originally posted by Jenna

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]

Jenna, first let me thank you for the invite.

Secondly, as you quoted from the bill this isn't a "government comittee" in that elected representatives are on the comittee, or even general goverment workers.

You will have the Surgeon General, who although is a political appointment almost was Sanjay Gupta who seems to be a reasonable medical professional.

Then we have 9 members who are not government.

(A) 9 members who are not Federal employees or officers and who are appointed by the President.

Then we have another 9 members who are also not government

(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.

So these members are not government people either. The are private members. However I don't have any data yet on how the Medicare Payment Advisory Commission works.

Finally we have no more than 8 Federal Employees

(C) Such even number of members (not to exceed 8) who are Federal employees and officers, as the President may appoint.

This seems reasonable to me for liasons. Although I'd like to know if they share equal power or where they are placed in the group.

Originally posted by HunkaHunka
Jenna, first let me thank you for the invite.

No problem, the more people looking at this claim by claim the quicker we can get to the truth of what's in here and what's not.

Secondly, as you quoted from the bill this isn't a "government comittee" in that elected representatives are on the comittee, or even general goverment workers.

It isn't a government committee in the sense that it will be made completely of members of the government, but it is a government committee in the sense that the government will be picking and choosing people to be on it. I'd say it's fairly safe to assume that they aren't going to be picking too many people who won't go along with what they want to happen. When you're trying to accomplish something, you don't pick someone who's going to work against you or disagree with you.

This seems reasonable to me for liasons. Although I'd like to know if they share equal power or where they are placed in the group.

I'd like to know that too. Unfortunately, details aren't given in the bill.

i wonder what health care plan him and his fimily are on?