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Thread: Actual Health Care bill.....

  1. #1
    Senior Member TXduckdog's Avatar
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    Default Actual Health Care bill.....

    Here's a section by section, line by line analysis of the proposed healthcare bill. It's unbelievable.

    http://www.lc.org/media/9980/attachm...ama_072909.pdf

    Print it out, read it and pass it around.

    No wonder they tried to ram this through so fast.
    Train the dog, the ribbons will take care of themselves.

  2. #2
    Senior Member YardleyLabs's Avatar
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    I wouldn't vote for the bill being described in the referenced memo either. Fortunately it has little to do with any of the bills being considered in Congress. The operative word in your post is "unbelievable". For example:

    The memo states:

    "Sec. 122, Pg. 29, Lines 4-16 - YOUR HEALTH CARE WILL BE RATIONED!"

    The actual language for section 122 of HR 320 follows:

    "SEC. 122. ESSENTIAL BENEFITS PACKAGE DEFINED.
    • (a) In General- In this division, the term `essential benefits package' means health benefits coverage, consistent with standards adopted under section 124 to ensure the provision of quality health care and financial security, that--
      • (1) provides payment for the items and services described in subsection (b) in accordance with generally accepted standards of medical or other appropriate clinical or professional practice;
      • (2) limits cost-sharing for such covered health care items and services in accordance with such benefit standards, consistent with subsection (c);
      • (3) does not impose any annual or lifetime limit on the coverage of covered health care items and services;
      • (4) complies with section 115(a) (relating to network adequacy); and
      • (5) is equivalent, as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services, to the average prevailing employer-sponsored coverage.
    • (b) Minimum Services To Be Covered- The items and services described in this subsection are the following:
      • (1) Hospitalization.
      • (2) Outpatient hospital and outpatient clinic services, including emergency department services.
      • (3) Professional services of physicians and other health professionals.
      • (4) Such services, equipment, and supplies incident to the services of a physician's or a health professional's delivery of care in institutional settings, physician offices, patients' homes or place of residence, or other settings, as appropriate.
      • (5) Prescription drugs.
      • (6) Rehabilitative and habilitative services.
      • (7) Mental health and substance use disorder services.
      • (8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
      • (9) Maternity care.
      • (10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.
    • (c) Requirements Relating to Cost-sharing and Minimum Actuarial Value-
      • (1) NO COST-SHARING FOR PREVENTIVE SERVICES- There shall be no cost-sharing under the essential benefits package for preventive items and services (as specified under the benefit standards), including well baby and well child care.
      • (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.
      • (3) MINIMUM ACTUARIAL VALUE-
        • (A) IN GENERAL- The cost-sharing under the essential benefits package shall be designed to provide a level of coverage that is designed to provide benefits that are actuarially equivalent to approximately 70 percent of the full actuarial value of the benefits provided under the reference benefits package described in subparagraph (B).
        • (B) REFERENCE BENEFITS PACKAGE DESCRIBED- The reference benefits package described in this subparagraph is the essential benefits package if there were no cost-sharing imposed."
    The bill describes the minimum standards of coverage for a health plan that would qualify as meeting the requirement that everyone purchase insurance. It does not limit what additional benefits might be included in a plan, but it does set a floor. I suspect that if you compare these benefits to the plans you now have, some will find that this proposal is richer but that most will find that this plan is comparable to what you have now and that for some it is more comprehensive. Nothing in the bill prevents more generous plans. In particular, many plans have lower deductibles and coinsurance than the minimum qualified plan standard described in the bill. A legitimate cost question is whether this standard is too rich or if a lesser standard might make more sense at least for now to save money. However, I would be interested to see what language in this section is being interpreted as mandating rationing of care as stated in the memo.

    So far, I have only researched about one third of the comments made in the memo. I haven't found any part that is closer to the truth than this one. The only "Liberty" I see in this piece authored by the "Liberty Counsel" is taking liberties with the truth. Their memo has nothing to do with anything except distortion. If you are actually interested in what is and is not included in the bill, in an easily researched format, the entire text is available on the Library of Congress site at http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200:

    By the way, HR 3200 is being redrafted to reflect the agreements ade with Blue Dog Democrats to reduce costs. The Senate plan is also different from HR 3200. Final language should become clearer in September.

  3. #3
    Senior Member TXduckdog's Avatar
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    Jeff......the source document you are looking at is different from what Liberty used. They used the bill printed in it's entirety by the GPO.

    Here is the source document used by Liberty.

    http://frwebgate.access.gpo.gov/cgi-...3200ih.txt.pdf

    Here is the actual wording for Sec 122; pg 29; lines 4-16:

    (2) ANNUAL LIMITATION.—
    4 (A) ANNUAL LIMITATION.—The cost-shar5
    ing incurred under the essential benefits pack6
    age with respect to an individual (or family) for
    7 a year does not exceed the applicable level spec8
    ified in subparagraph (B).
    9 (B) APPLICABLE LEVEL.—The applicable
    10 level specified in this subparagraph for Y1 is
    11 $5,000 for an individual and $10,000 for a
    12 family. Such levels shall be increased (rounded
    13 to the nearest $100) for each subsequent year
    14 by the annual percentage increase in the Con15
    sumer Price Index (United States city average)
    16 applicable to such year.
    17 (C) USE OF COPAYMENTS.—In establishing
    18 cost-sharing levels for basic, enhanced, and pre19
    mium plans under this subsection, the Sec20
    retary shall, to the maximum extent possible,
    21 use only copayments and not coinsurance.

    Now I will admit....Liberty's info is an "interpretation and projected understanding of the wording", their actual words from the phone call I made to them this morning.

    Perhaps your source document is part of the redraft?

    What would be your interpretation of the subpoints 'Annual Limitations' and for that matter 'Minimum Actuarial Value'?

    Is not the 'Annual Limitations' not referring to a cap on cost sharing? It sure could be interpreted that way.


    So yes, I am actually interested in what "is and is not" introduced in the bill....so lets knock off the editorial comments about "taking liberties with the truth" and "distortion". No need to go into partisan attack mode.

    As the bill stands now....there is a helluva lot of "splainin' " to do.
    Train the dog, the ribbons will take care of themselves.

  4. #4
    Senior Member Buzz's Avatar
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    I don't see how any part of that language could be interpreted as the rationing of healthcare. As Jeff stated, it sets the minimum benefit, or the maximum out of pocket for the insured for the most bargain basement plan.

    quote:
    So yes, I am actually interested in what "is and is not" introduced in the bill....so lets knock off the editorial comments about "taking liberties with the truth" and "distortion". No need to go into partisan attack mode.


    It's hard not to react that way when you see a bunch of scared crapless people raising hell at town meetings around the country because they are purposely being misled on the facts by people that have a greed based interest in seeing things remain the way they are. As someone who part owns and operates a small business, I am more terrified of being priced out of the market for healthcare than anything I've seen proposed so far in Washington. Just for my family, we pay over $10,000/year for a high deductible plan. With the premiums and deductible and coinsurance, last year my family doled out over $17k for healthcare last year. About what it cost me to keep a roof over my head.
    Last edited by Buzz; 08-07-2009 at 10:28 AM.
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  5. #5
    Senior Member Bob Gutermuth's Avatar
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    Yes and the misleading or outright lies are from the pro Osamacare side.
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    Senior Member brandywinelabs's Avatar
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    When I start having to pay $5K each for my wife and I, that would lead to more rationing. I already need surgery on both knees and my back. But I deal with it until it fits the budget. One major expense per year. But with a deductible of $5K. That is a whole lot more deductible per yr than I have to deal with now.....
    Last edited by brandywinelabs; 08-07-2009 at 10:44 AM.
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  7. #7
    Senior Member Buzz's Avatar
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    Quote Originally Posted by brandywinelabs View Post
    When I start having to pay $5K each for my wife and I, that would lead to more rationing. I already need surgery on both knees and my back. But I deal with it until it fits the budget. One major expense per year. but iwth a deductible of $5K. That is a whole lot more than I have to deal with now.....

    But that is the floor for benefits. They are not saying that every plan would have $5k out of pocket per person.
    "For everyone to whom much is given, of him shall much be required." -- Luke 12:48

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  8. #8
    Senior Member Buzz's Avatar
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    Quote Originally Posted by Bob Gutermuth View Post
    Yes and the misleading or outright lies are from the pro Osamacare side.
    For example?...
    "For everyone to whom much is given, of him shall much be required." -- Luke 12:48

    Raven - Moneybird's Black Magic Marker***
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  9. #9
    Senior Member Bob Gutermuth's Avatar
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    The whole package is a lie, why else would they be trying to ram it thru congress so quickly. Remember that congress is fulll of lawyers, and you can tell a lawyer is lying cause his lips are moving.
    Bob Gutermuth
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  10. #10
    Senior Member dnf777's Avatar
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    Quote Originally Posted by Bob Gutermuth View Post
    The whole package is a lie, why else would they be trying to ram it thru congress so quickly. Remember that congress is fulll of lawyers, and you can tell a lawyer is lying cause his lips are moving.
    If ramming something through congress makes it a lie, then the Iraq war must.....oh, never mind.
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