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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.
(c) SPECIFICATION OF BENEFIT LEVELS FOR PLANS.—
(1) IN GENERAL.—The Commissioner shall establish the following standards consistent with this subsection and title I:
(A) BASIC, ENHANCED, AND PREMIUM PLANS.—Standards for 3 levels of Exchange participating health benefits plans: basic, enhanced, and premium (in this division referred to as a ‘‘basic plan’’, ‘‘enhanced plan’’, and ‘‘premium plan’’, respectively).
(B) PREMIUM-PLUS PLAN BENEFITS.— Standards for additional benefits that may be offered, consistent with this subsection and subtitle C of title I, under a premium plan (such a plan with additional benefits referred to in this division as a ‘‘premium-plus plan’’).
(2) BASIC PLAN.—
(A) IN GENERAL.—A basic plan shall offer the essential benefits package required under title I for a qualified health benefits plan.
(B) TIERED COST-SHARING FOR AFFORDABLE CREDIT ELIGIBLE INDIVIDUALS.—In the case of an affordable credit eligible individual (as defined in section 242(a)(1)) enrolled in an Exchange-participating health benefits plan, the benefits under a basic plan are modified to provide for the reduced cost-sharing for the income tier applicable to the individual under section 244(c).
(3) ENHANCED PLAN.—A enhanced plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(A).
(4) PREMIUM PLAN.—A premium plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(B).
(5) PREMIUM-PLUS PLAN.—A premium-plus plan is a premium plan that also provides additional benefits, such as adult oral health and vision care, approved by the Commissioner. The portion of the premium that is attributable to such additional benefits shall be separately specified.
Originally posted by Hastobemoretolife
So what I gather from this is that, if you get a medical implant they will keep data on the implant to determine how effective it is, etc.
The kicker is though is that they said the records will comply to privacy standards and what not, but this gives them the option for addiction tracking.
Originally posted by mikerussellus
the insurance companies won't PAY for treatment they don't deem necessary.
Where as, with the government plan, they won't TREAT you if they don't deem it necessary.
Originally posted by Hastobemoretolife
reply to post by vox2442
No this does not follow regular medical practice. Current medical practice doesn't require a list of all medical implantable devices with serial numbers and who they are implanted in.
That information is confidential between you and your doctor and is on your medical records. The doctor is the one keeps up with that and just reports the success/failure about the device which does not require any identifiable information.
Then you have to read the other sections of the bill and the section that I listed with additional tracking, you could be flagged and in their "community wellness and prevention section" those people could come around asking how you are doing and the likes.
Originally posted by vox2442
Originally posted by mikerussellus
the insurance companies won't PAY for treatment they don't deem necessary.
Where as, with the government plan, they won't TREAT you if they don't deem it necessary.
So, in both cases, you'd be looking at going to a private clinic and paying out of pocket for your new nose.
That's the thing, right? If the bill mandates that you must receive full coverage for everything upon request, well, then you're into sex changes and boob jobs and all kinds of elective surgery that isn't covered by your current insurance anyway.
Try to see both sides of this.
PG 935 21-22 Government will identify specific goals & objectives for prevention & wellness activities. Control You!!
‘‘(a) IN GENERAL.—The Secretary shall submit to
12 the Congress within one year after the date of the enact
13 ment of this section, and at least every 2 years thereafter,
14 a national strategy that is designed to improve the Na
15 tion’s health through evidence-based clinical and commu
16 nity prevention and wellness activities (in this section re
17 ferred to as ‘prevention and wellness activities’), including
18 core public health infrastructure improvement activities.
‘‘(b) CONTENTS.—The strategy under subsection (a)
20 shall include each of the following:
21 ‘‘(1) Identification of specific national goals and
22 objectives in prevention and wellness activities that
23 take into account appropriate public health measures
24 and standards, including departmental measures and
1 standards (including Healthy People and National
2 Public Health Performance Standards).
3 ‘‘(2) Establishment of national priorities for
4 prevention and wellness, taking into account unmet
5 prevention and wellness needs.
6 ‘‘(3) Establishment of national priorities for re7
search on prevention and wellness, taking into ac
8 count unanswered research questions on prevention
9 and wellness.
10 ‘‘(4) Identification of health disparities in pre
11 vention and wellness.
12 ‘‘(5) A plan for addressing and implementing
13 paragraphs (1) through (4).
14 ‘‘(c) CONSULTATION.—In developing or revising the
15 strategy under subsection (a), the Secretary shall consult
16 with the following:
17 ‘‘(1) The heads of appropriate health agencies
18 and offices in the Department, including the Office
19 of the Surgeon General of the Public Health Service,
20 the Office of Minority Health, and the Office on
21 Women’s Health.
22 ‘‘(2) As appropriate, the heads of other Federal
23 departments and agencies whose programs have a
24 significant impact upon health (as determined by the
25 Secretary).
1 ‘‘(3) As appropriate, nonprofit and for-profit
2 entities.
3 ‘‘(4) The Association of State and Territorial
4 Health Officials and the National Association of
5 County and City Health Officials.
PG 89 Line 6-10 The FAR is not applicable. Government can write contracts any way they want.
(3) FAR NOT APPLICABLE.—The provisions of the Federal Acquisition Regulation shall not apply to contracts between the Commissioner and QHBP offering entities for the offering of Exchange-participating health benefits plans under this title.
FAR Wiki article
The Federal Acquisition Regulation (FAR) is the principal set of rules in the Federal Acquisition Regulation System. This system consists of sets of regulations issued by agencies of the Federal government of the United States to govern what is called the "acquisition process," which is the process through which the government purchases ("acquires") goods and services. That process consists of three phases: (1) need recognition and acquisition planning, (2) contract formation, and (3) contract administration. The FAR System regulates the activities of government personnel in carrying out that process. It does not regulate the purchasing activities of private sector firms, except to the extent that parts of it are incorporated into government solicitations and contracts by reference.