Health Bill Scare vs. Health Care Reform

 Health Bill Scare vs. Health Care Reform

Based on an article written by the New York Post I started thinking that now is the time to get serious about health and fitness. Plus pray that I don’t need any major health care in the near future. Here is a detailed summary of the bill by the House Committee on Education and Labor can be read here (four-page .pdf). I am for Health Care Reform because I have been through the ringer with health insurances who don’t want to pay their bills when you need health care. Workers Compensation insurance providers play a lot of games and use Independent Medical Providers whose pockets are lined with dollars simply for denying patients medical care and treatment.

7/14/2009–Introduced.America’s Affordable Health Choices Act of 2009 – Sets forth provisions governing health insurance plans and issuers, including: (1) exempting grandfathered health insurance coverage from requirements of this Act; (2) prohibiting preexisting condition exclusions;…Read the Rest

Official Summary

America’s Affordable Health Choices Act of 2009 – Sets forth provisions governing health insurance plans and issuers, including:

(1) exempting grandfathered health insurance coverage from requirements of this Act;
(2) prohibiting preexisting condition exclusions;
(3) providing for guaranteed coverage to all individuals and employers and automatic renewal of coverage;
(4) prohibiting premium variances, except for reasons of age, area, or family enrollment; and
(5) prohibiting rescission of health insurance coverage without clear and convincing evidence of fraud. Requires qualified health benefits plans to provide essential benefits. Prohibits an essential benefits package from imposing any annual or lifetime coverage limits. Lists required covered services, including hospitalization, prescription drugs, mental health services, preventive services, maternity care, and children’s dental, vision, and hearing services and equipment. Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family. Establishes the Health Choices Administration as an independent agency to be headed by a Health Choices Commissioner. Establishes the Health Insurance Exchange within the Health Choices Administration in order to provide individuals and employers access to health insurance coverage choices, including a public health insurance option. Requires the Commissioner to:
(1) contract with entities to offer health benefit plans through the Exchange to eligible individuals; and
(2) establish a risk-pooling mechanism for Exchange-participating health plans. Provides for an affordability premium credit and an affordability cost-sharing credit for low-income individuals and families participating in the Exchange. Requires employers to offer health benefits coverage to employees and make specified contributions towards such coverage or make contributions to the Exchange for employees obtaining coverage through the Exchange. Exempts businesses with payrolls below $250,000 from such requirement. Amends the Internal Revenue Code to impose a tax on:
(1) an individual without coverage under a health benefits plan; and
(2) an employer that fails to satisfy health coverage participation requirements for an employee. Imposes a surtax on individual modified adjusted gross income exceeding $350,000. Amends title XVIII (Medicare) of the Social Security Act to revise provisions relating to payment, coverage, and access, including to:
(1) reduce payments to hospitals to account for excess readmissions;
(2) limit cost-sharing for Medicare Advantage beneficiaries;
(3) reduce the coverage gap under Medicare Part D (Voluntary Prescription Drug Benefit Program);
(4) provide for increased payment for primary health care services; and
(5) prohibit cost-sharing for covered preventive services. Requires the Secretary of Health and Human Services (HHS) to provide for the development of quality measures for the delivery of health care services in the United States. Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality, financed by a tax on accident and health insurance policies, to conduct and support health care services effectiveness research. Sets forth provisions to reduce health care fraud. Amends title XIX (Medicaid) of the Social Security Act to:
(1) expand Medicaid eligibility for low-income individuals and families;
(2) require coverage of additional preventive services; and
(3) increase payments for primary care services. Sets forth provisions relating to the health workforce, including:
(1) addressing health care workforce needs through loan repayment and training;
(2) establishing the Public Health Workforce Corps;
(3) addressing health care workforce diversity; and
(4) establishing the Advisory Committee on Health Workforce Evaluation and Assessment. Sets forth provisions to:
(1) provide for prevention and wellness activities;
(2) establish the Center for Quality Improvement;
(3) establish the position of the Assistant Secretary for Health Information;
(4) revise the 340B drug discount program (a program limiting the cost of covered outpatient drugs to certain federal grantees);
(5) establish a school-based health care program; and
(6) establish a national medical device registry.

New York Post Article:


The health bills coming out of Congress would put the decisions about your care in the hands of presidential appointees. They’d decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare.

Yet at least two of President Obama’s top health advisers should never be trusted with that power.

Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.

Emanuel bluntly admits that the cuts will not be pain-free. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change,” he wrote last year (Health Affairs Feb. 27, 2008).

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, “as an imperative to do everything for the patient regardless of the cost or effects on others” (Journal of the American Medical Association, June 18, 2008).

Yes, that’s what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.

Emanuel, however, believes that “communitarianism” should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia” (Hastings Center Report, Nov.-Dec. ‘96).

Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.

He explicitly defends discrimination against older patients: “Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years” (Lancet, Jan. 31).

The bills being rushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Knowing how unpopular the cuts will be, the president’s budget director, Peter Orszag, urged Congress this week to delegate its own authority over Medicare to a new, presidentially-appointed bureaucracy that wouldn’t be accountable to the public.

Since Medicare was founded in 1965, seniors’ lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too “enamored with technology” and is determined to reduce access to it.

Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.

Blumenthal has long advocated government health-spending controls, though he concedes they’re “associated with longer waits” and “reduced availability of new and expensive treatments and devices” (New England Journal of Medicine, March 8, 2001). But he calls it “debatable” whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you’ll get a different answer. Delay lowers your chances of survival.)

Obama appointed Blumenthal as national coordinator of health-information technology, a job that involves making sure doctors obey electronically deivered guidelines about what care the government deems appropriate and cost effective.

In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist “embedded clinical decision support” — a euphemism for computers telling doctors what to do.

Americans need to know what the president’s health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: “Hospital rooms in the United States offer more privacy . . . physicians’ offices are typically more conveniently located and have parking nearby and more attractive waiting rooms” (JAMA, June 18, 2008).

No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: “Every favor to a constituency should be linked to support for the health-care reform agenda. If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration’s health-reform effort.”

Do we want a “reform” that empowers people like this to decide for us?

Source: New York Post

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