Tuesday, August 18, 2009

Health Care Reform - HR 3200 review, Part 2

Today continues my review of HR 3200 which is the leading health care reform bill currently in the U.S. House of Representatives. As promised, we look at pages 201-400 today. In my opinion, today's section is troubling because it is an attack on our free market economy. Here's the link to the bill with today's highlights following -
  • P. 241 line 6 thru 8 says that ALL doctors will be paid the same no matter their specialty. This will discourage people from becoming specialists.
  • P. 253 line 10 thru 18 says government will "validate" (a.k.a. audit) doctors time, technical skills, professional judgment, physical effort, and stress in pre-, post-, and inter-service components of their work. Afterwards, government "may" adjust fees. Remember, this is all gonna be done by a 27-member committee with only 1 doctor on it. They won't have a clue.
  • P. 268 says government will regulate rental and purchase of power wheelchairs. I wonder if GM (Government Motors) be producing them.
  • P. 269 thru 270 says home infusion therapy services within Medicare will be evaluated to determine savings if it were reduced or eliminated - a.k.a. rationing.
  • P. 272 lines 4 thru P. 273 line 2 - a study will be done to compare costs of cancer treatments at hospitals that specialize in cancer treatments to costs at those that don't. Costs and fees will be see an "appropriate adjustment." Rationing is not specifically mentioned here. However, the language of this section leaves the door wide open. Don't get cancer if the bill passes.
  • P. 280 line 1 thru P. 289 line 8 says the government will penalize hospitals for what it deems preventable re-admissions. Plus, they cannot appeal the government's decision. Eliminates due process. Then, if a hospital begins turning away individuals that might be high risk for readmission because of this, the hospital be penalized for that, too.
  • continuation of above on P. 298 lines 9 thru 11 says if a doctor treats a patient who is then later readmitted, they are penalized. Does this sound like double jeopardy to anyone but me ??
  • P. 313 line 7 thru P. 318 line 3 says that entities providing medical services must provide the government with ownership information which includes investments and compensation agreements with physician owners. After the bill goes into affect, doctors are forbidden from increasing their ownership share. Furthermore, if a physician within the entity has relatives with ownership shares within that entity, the same information must be disclosed to the government about them, too. The entity must also provide the physicians "unique identification numbers" (not sure what this is but could be SSN). If your physician refers you to a hospital that is owned wholly or in part by doctors, he or she must disclose that to you. ALL of this information must also be disclosed on the public Medicare and Medicaid websites. I believe this will open doctors up to identity theft. Lastly, if a person within the entity or a doctor fail to disclose ANY of this information, they can be fined up to $10,000 per day. Hospitals are also prohibited from expanding.
  • P. 321 line 1 thru P. 325 line 14 provides for exceptions to the rule above that hospitals cannot expand. They can apply (ask the government's permission) to expand once every two years but community input is required (could open the door for more ACORN involvement). If approved, the government will tell them what facilities can be expanded and to what capacity.
  • P. 335 line 16 thru P. 341 line 9 specifically targets Medicare Advantage Plans (MAP) by mandating "outcome-based measures". Current MAPs have better benefits than Medicare alone because the enrollee pays an additional premium for them. This section will enable the government to disqualify MAPs they feel don't meet the outcome-based measures they set. Remember, the government is making the rules. This will enable them to force people onto the public plan.
  • P. 354 line 3 thru P. 355 line 6 - this section is vague but seems to restrict the enrollment of people with special needs after conducting a "study". The word "discrimination" comes to mind.
  • P. 355 line 7 thru P. 358 line 10 - It took 355 pages, but I finally found some good news in the bill !! Medicare Part D enrollees will see a gradual phaseout of the coverage gap or dreaded donut hole.
  • P. 358 line 11 thru P. 363 line 7 requires drug companies to pay "rebates" to the government on the drugs that enrollees in the plan purchase. These rebates primarily target Medicaid, Medicare, and Medicare Advantage Plans. I think you could make a good argument that these "rebates" are more of a tax. Some would argue they're kickbacks. I'll let you decide for yourself. The fact is the drug companies will be required to give more of their profits to the government just to stay in business.
We're done for the day. Got three days to go. Tomorrow, I'll cover the section that has everyone upset about end-of-life care and euthanasia. Wondering if the rumors are true ?? I'll tell you tomorrow.
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