Obama lied about AARP Supporting Obamacare...and more

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I'm not in love with universal health care, unless private insurance offers affordable insurance and good policies, also I don't know about how universal health care will works in America.

Americans can change the way in many years later so we never know.

Just so you know - the situation is not going to be largely resolved with affordable insurance and good policies.

Americans need to work on their own well-being themselves by having a proper diet and exercise..... and curb their smoking and coach potato lifestyle. and Americans need to stop being a sue-sue-sue-sue idiots so that doctors can pay less for their malpractice insurance so that doctors can charge less for patients.
 
Jiro, do you support new regulation to remove the caps (limited) and need cover on pre-existing for private insurance?
 
Jiro, do you support new regulation to remove the caps (limited) and need cover on pre-existing for private insurance?

yes. this pre-existing policy is ridiculous and dumb.
 
curious. more negative than positive? but how?

50 million uninsured vs 250 millions insured.... hmmm...... :hmm:

First: I forget to add uninsured comments in all of my previous posts, not just Medicard/Medicaid and Private insurers.

Second: I believe that I posted in several threads what I saw on TV over several Healthcare Town Hall that many who oppose Obama´s healthcare reform, prefer Medicare over private health insurance.

Third: I did not post the numbers or poll to here but offer you my suggestion to read their comments of their experience as uninsured, private insurers and Medicare comments, that´s all.

Fourth: If numbers is matter to you than look their own experience then is your prerogative.
 
Obama attacks insurance premiums

Obama attacks insurance premiums

US President Barack Obama has stepped up his drive for healthcare reform, attacking excessive premiums charged by insurance companies.

Speaking in Colorado, Mr Obama said that under his plan companies would not be allowed to charge exorbitant fees nor place arbitrary limits on coverage.

Mr Obama is making a series of "town-hall" speeches to back his campaign.

Extending coverage to the millions of Americans who lack health insurance is Mr Obama's top priority for 2009.

His reform plan is currently under debate in the US Congress.

Some 46 million people in America currently do not have health insurance, and rising healthcare costs are a major contributing factor to America's spiralling budget deficit.

'No silver bullet'

Mr Obama said insurance companies had to be held accountable for practices that had led to premiums nearly doubling for the average American family over the past few years.


HEALTHCARE IN THE US

46 million uninsured, 25 million under-insured
Healthcare costs represent 16% of GDP, almost twice OECD average
Reform plans would require all Americans to get insurance
Some propose public insurance option to compete with private insurers

He said: "We're going to ban arbitrary caps on benefits. We'll place limits on how much you can charge on out-of-pocket expenses. No-one in America should go broke because they get sick."

Mr Obama admitted there was "no perfect painless silver bullet out there that solves every problem, gives everybody healthcare for free".

But he said he had "a lot of really smart people around me who've been working on this for months now".

Mr Obama also accused his political opponents of using scare tactics in their campaign against the reform.

He added: "I need you to stand for hope. I need you to knock on doors. I need you to spread the word. Because we are going to get this done this year."

There remains serious disagreement in the US about how to go about reforming the healthcare system.

Democrats in the House of Representatives have reportedly reached a deal on a bill that would mandate all Americans to take out health insurance, with subsidies for the less well-off paid for by a tax on families earning over $350,000 a year.

But in the Senate negotiations have stalled, with moderate senators expressing opposition to both the tax and the public plan proposed by the House.

Both chambers need to agree on a bill before it can become law.

BBC NEWS | Americas | Obama attacks insurance premiums
 
Obama attacks insurance premiums

US President Barack Obama has stepped up his drive for healthcare reform, attacking excessive premiums charged by insurance companies.

Speaking in Colorado, Mr Obama said that under his plan companies would not be allowed to charge exorbitant fees nor place arbitrary limits on coverage.

Mr Obama is making a series of "town-hall" speeches to back his campaign.

Extending coverage to the millions of Americans who lack health insurance is Mr Obama's top priority for 2009.

His reform plan is currently under debate in the US Congress.

Some 46 million people in America currently do not have health insurance, and rising healthcare costs are a major contributing factor to America's spiralling budget deficit.

'No silver bullet'

Mr Obama said insurance companies had to be held accountable for practices that had led to premiums nearly doubling for the average American family over the past few years.


HEALTHCARE IN THE US

46 million uninsured, 25 million under-insured
Healthcare costs represent 16% of GDP, almost twice OECD average
Reform plans would require all Americans to get insurance
Some propose public insurance option to compete with private insurers

He said: "We're going to ban arbitrary caps on benefits. We'll place limits on how much you can charge on out-of-pocket expenses. No-one in America should go broke because they get sick."

Mr Obama admitted there was "no perfect painless silver bullet out there that solves every problem, gives everybody healthcare for free".

But he said he had "a lot of really smart people around me who've been working on this for months now".

Mr Obama also accused his political opponents of using scare tactics in their campaign against the reform.

He added: "I need you to stand for hope. I need you to knock on doors. I need you to spread the word. Because we are going to get this done this year."

There remains serious disagreement in the US about how to go about reforming the healthcare system.

Democrats in the House of Representatives have reportedly reached a deal on a bill that would mandate all Americans to take out health insurance, with subsidies for the less well-off paid for by a tax on families earning over $350,000 a year.

But in the Senate negotiations have stalled, with moderate senators expressing opposition to both the tax and the public plan proposed by the House.

Both chambers need to agree on a bill before it can become law.

BBC NEWS | Americas | Obama attacks insurance premiums

In bold, I don't agree about all Americans are require to get insurance, it sounds like fascist to me because there's some Americans don't want insurance for some reason, even some rich people don't want insurance because able to afford a expensive health care.

It would be more complicated for illegal immigrants either because they don't understand about insurance but rather go to emergency room.

I'm favor into individual's choice.
 
correct me if I'm wrong - all employees are automatically added to their employer's healthcare plan.
That is not correct.

Some employers don't offer health care plans to employees.

Some employers offer their employees to opt out. For example, one spouse may have a health plan for the whole family, so the other spouse doesn't need one at his or her job.

Those employers who do offer health care plans often offer more than one kind, so the employee has to make the choice and sign up for that plan.
 
From Post #15

I typed in purple the sections that were left out that actually provided the true meaning and intent of the bill right onto the word document in the place it applied to that post. I then used that information to correct the interpretations made in the post that were saying that the bill stated something that wasn’t true or was misleading.

From post #15
Better read the bill, Shel, since you are so high-minded in support of choices and employer insurance.

Look for bold "re-evaluation of passages" as a summary explaination found in HR 3200, ‘‘America’s Affordable Health Choices Act of 2009,” to explain what each section was about.

Quote:

1. WILL THE PLAN RATION MEDICAL CARE?

This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:
(p) Adjustment to Hospital Payments for Excess Readmissions:

(1) IN GENERAL- with respect to payment for discharges from a applicable hospital (as defined in paragraph(5)(C) occurring during a fiscal year beginning on or after October 1, 2011, in order to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital under subsection (d) or section 1814(b)(3), as the case may be

‘(ii) EXCLUSION OF CERTAIN READMISSIONS.—For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.

(B) EXPANSION OF APPLICABLE CONDITIONS- Beginning with the year 2013, the Secretary shall expand the applicable conditions beyond the 3 conditions for which measures have been endorsed as described in subparagraph (A)(ii)(1) as of the date of enactment of this subsection to the additional 4 conditions that have been so identified by the Medicare Payment Advisory Committee in its report to Congress in June 2007 and to other conditions and procedures which may include an all condition measure of readmissions, as determined appropriate by the Secretary. In expanding such applicable conditions, the Secretary shall seek the endorsement described in subparagraph (A)(ii)(1) but may apply such measures without an endorsement.





and, under “Definitions”:

‘‘(A) APPLICABLE CONDITION.—The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary . . .

and:

‘‘(E) READMISSION.—The term ‘readmission’ means, in the case of an individual who is discharged from an applicable hospital, the admission of the individual to the same or another applicable hospital within a time period specified by the Secretary from the date of such discharge. Insofar as the discharge relates to an applicable condition for which there is an endorsed measure described in subparagraph (a)(ii)(1), such time period shall be consistent with the time period specified for such measure.

and:


(5) DEFINITIONS FOR THE PURPOSE OF THIS SUBSECTION

(1) readmissions that are defined in subparagraph (A)(ii)(1)

(ii) measures of such readmissions

(1) have been endorsed by the entity with a contract under Section 1890(A); and


(iii) such endorsements have appropriate exclusions that are unrelated to prior discharge (such as planned readmission or transfer to another applicable hospital)
‘‘(6) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of— . . .

(C) the measures of readmissions . . .

(7) MONITORING INNAPPROPRIATE CHANGES IN ADMISSIONS PRACTICES-the secretary shall monitor the activities of applicable hospitals to determine is such hospitals have taken steps to avoid patients at risk in order to reduce the likelihood of increased readmissions for applicable conditions. If the Secretary determines that such a hospital has taken such a step, after notice to the hospital and opportunity for the hospital to undertake action to alleviate such steps, the Secretary may impose an appropriate sanction.

(E) Use of additional payments- funding under this paragraph shall be used by targeted hospitals for transitional care activities designed to redress the patient non-compliance issues that result in higher than normal readmission rates, such as one or more of the following:

(i) Providing care coordination services to assist in transitions from the targeted hospital to other settings

(ii) Hiring transliterators and interpreters

(iii) Increase services offered by transition plans

(iv) Insuring that individuals receive a summary of care and medication orders upon discharge

(v) Developing a quality improvement plan to assess and remedy preventable readmission rates

(vi) Assigning discharged individuals to a medical home

(vii) Doing other activities as determined appropriate by the Secretary

EVALUATION OF THE PASSAGES:

1. This section amends the Social Security Act

But affects Social Security Retirement, Disability, and SSI in no way.

2. The government has the power to determine what constitutes an “applicable [medical] condition.”

That is determined by the Medicare Advisory Panel, and it is expanded to include additions in this bill. And is used in the context of reporting and monitoring as a way to increase the type of services available to patients, and raise the quality and effectiveness of care following discharge.

3. The government has the power to determine who is allowed readmission into a hospital.

Incorrect interpretation. The government does NOT have the power to determine who is allowed readmission to the hospital. What this section provides for is a way to identify those target hospitals that are discharging patients without providing follow up services that will insure that they will not need to be readmitted. It also provides for punishment of those hospitals that are not providing appropriate patient follow up following discharge, and sets forth a plan for those hospitals to improve their services to patients.

4. This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.


Completely incorrect. See paragraph (ii) under EXCLUSIONS that has been added from the reform bill document. Applicable conditions that meet the criteria, but are actually below minimum numbers will not be counted in the reports on readmissions. It is about record keeping and reporting, not determining patient care.
5. This is government rationing, pure, simple, and straight up.

Again, incorrect. This is not about restricting or rationing care, but about actually increasing level of care and availability post discharge service, as well as accountability for hospitals. This section in no way limits or rations care.

6. There can be no judicial review of decisions made here. The Secretary is above the courts.


Why would you need a judicial review? This section expands care. This section targets hospitals that are providing substandard post discharge care for its patients. That benefits the patient.
7. The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.

Absolutely false.



2. Will the plan punish Americans who try to opt out?

What the bill says, pages 167-168, section 401, TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE:

‘‘(a) TAX IMPOSED.—In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of—

(b) Limitations

(1) tax limited to average premium (and that collected tax will be used to provide health care coverage for that individual)
(A) IN GENERAL-The tax imposed under subsection (A) with respect to any taxpayer shall not exceed the applicable national average premium for such taxable year.

(C) EXCEPTIONS

(1) DEPENDENTS-subsection (a) shall not apply to any individual for any taxable year if a deduction is allowable under Section 151 with respect to such individual to another taxpayer for any taxable year beginning in the sane calendar year as such taxable year.

(5) RELIGIOUS CONSCIOUS OBJECTION

(A) Subsection (A) shall not apply to any individual(and for any qualifying child residing with such individual) for any period if such individual has in effect an exemption which certifies that such individual is a member of a recognized religious sect or division therein described in section 1402(g)(1) and an adherent if established tenets or teachings of such sect or division as described in such section.

(2) ACCEPTABLE COVERAGE- For the purposes of this section the terms “acceptable coverage” means any of the following:

(A) Qualified Health Benefits Plan Coverage

(B) Grandfathered Health Insurance Coverage; Under Grandfathered Employment Based Plan

(C) Medicare

(D) Medicaid

(E) Members of Armed Forces and Dependents (Including Tricare)

(F) VA

(G) Other coverage
 
From Post #15 continued...

(1) the taxpayer’s modified adjusted gross income for the taxable year, over

(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer. . . .”

EVALUATION OF THE PASSAGE:

1. This section amends the Internal Revenue Code.

2. Anyone caught without acceptable coverage and not in the government plan will pay a special tax.
They will be assessed a tax that is in the amount of the average premium that will be used to pay for their health coverage. It is not a penalty tax, and it is not in excess of the cost of enrolling them in a health care plan.
3. The IRS will be a major enforcement mechanism for the plan.

No, they will not. The IRS does not make the decision to assess the tax. That decision is made by the Dept. of Health and Human Services when it becomes known that an individual has failed to provide health insurance for themselves and/or their family. The amount assessed does not go into the IRS coffers. It goes to provide insurance coverage for that individual.



3. what constitutes “acceptable” coverage?

Here is what the bill says, pages 26-30, 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 . . .

(1) Provides payment for the items and services in accordance with such benefit standards, consistent with subsection (c)

(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 . . .

(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 . . .

(5) Prescription drugs.

(6) Rehabilitative and habilitative services.

(7) Mental health and substance use disorder services.

(8) Preventive services . . .

(9) Maternity care.

(10) Well baby and well child care . . .

(2) limits cost sharing for such covered health care items and services in accordance with benefit standards, consistent with subsection (c)

(3) does not impose any 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 the Office of the Actuary of the Centers for Medicare and Medicaid Services, to the average prevailing employer sponsored coverage.

(c) REQUIREMENTS RELATING TO COST-SHARING AND MINIMUM ACTUARIAL VALUE . . .

(1) No cost sharing for preventive services (these are covered 100% for the life of the insured)

(2) Annual limitation-cost sharing (co-pay, in current insurance company terms) incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in paragraph B

(B) $5000 individual; $10,0000 family


(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).


EVALUATION OF THE PASSAGES:

1. The bill defines “acceptable coverage” and leaves no room for choice in this regard.

“Acceptable coverage” covers comprehensive medical services. It places no lifetime limit on the amount the insurance company will pay for these covered services. However, insurance companies currently have a lifetime max they will pay for any given service, meaning that, even though you may have coverage for that service, if you have reached your max allowable, the insurance company will deny your claim. This section places safeguards to prevent that being done. In other words, it guarantees that you will never be excluded from benefits paid on any covered service. That is a benefit to the individual. Why would you choose to not receive benefits for a covered medical service?

2. By setting a minimum 70% actuarial value of benefits, the bill makes health plans in which individuals pay for routine services, but carry insurance only for catastrophic events, (such as Health Savings Accounts) illegal.


No, it does not make them illegal. And here are a few facts regarding Health Savings Accounts (HSAs): Illness is unpredictable. You cannot accurately budget for an unpredictable illness. You cannot determine if you will contract a serious disease in 6 months, in 2 years, or in 20 years. Being unable to predict such, you cannot insure that you will have sufficient funds in an HSA at any given point to cover that medical care. The result is that end up in the same position as the millions of uninsured in this country are already in. This bill seeks to prevent that happening, because public responsibility for the costs of care for the uninsured is the factor most responsible for the rising costs of health care.


Pressure to save in an HAS can prevent people from receiving preventive care---the most effective and proven way to avoid serious disease and reduce medical costs.


If you withdraw funds from an HAS before you turn 65, you have to pay taxes on it plus a 10% penalty. Money can only be used for medical expenses.


HSA’s are not a viable option for those over 65 or anyone with a chronic illness.


To qualify for an HAS, you have to be less than 65 years of age, and already be enrolled in an insurance plan with as high deductible. Therefore, this is not an option for the majority of American workers covered under an employee sponsored health care plan.


Additionally, this bill places a cap on the amount that any individual or family will pay in 1 year for co-pays. When the individual or family reaches that cap, all services are paid for 100%. That is exactly the opposite of the way insurance companies cap out under our current system. Under our current system, you must meet your deductible before benefits kick in. Then, once the cap established for benefit pay-out on an individual or a family is reached, the insurance company refused to cover any medical costs for the remainder of that year. This section actually provides for greater access to services with less financial burden on the insured.



4. Will the PLAN destroy private health insurance?

Here is what it requires, for businesses with payrolls greater than $400,000 per year. (The bill uses “contribution” to refer to mandatory payments to the government plan.) Pages 149-150, SEC. 313, EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE

(a) IN GENERAL.—A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution—

(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and

(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.

(The bill then includes a sliding scale of payments for business with less than $400,000 in annual payroll.)

The Bill also reserves, for the government, the power to determine an acceptable benefits plan: page 24, SEC. 115. ENSURING ADEQUACY OF PROVIDER NETWORKS.


And making sure that providers are able to handle the number of patients in their area is a negative how?


5 (a) IN GENERAL.—A qualified health benefits plan that uses a provider network for items and services shall meet such standards respecting provider networks as the Commissioner may establish to assure the adequacy of such networks in ensuring enrollee access to such items and services and transparency in the cost-sharing differentials between in-network coverage and out-of-network coverage.
 
From post #15 continued..

EVALUATION OF THE PASSAGES:

1. The bill does not prohibit a person from buying private insurance.

2. Small businesses—with say 8-10 employees—will either have to provide insurance to federal standards, or pay an 8% payroll tax. Business costs for health care are higher than this, especially considering administrative costs. Any competitive business that tries to stay with a private plan will face a payroll disadvantage against competitors who go with the government “option.”


Incorrect. The percentage goes down as the amount of the business’ payroll goes down. Percentage is decided based on the amount of the payroll of any given business. That 8% is the percentage for businesses who have a payroll totally $400,000 and more a year.


3. The pressure for business owners to terminate the private plans will be enormous.

It is a possibility that employers will drop private plans and opt for a Health Exchange Plan to save overhead costs. However, that has been happening for the past 30 years, as the vast majority of employers have switched from comprehensive care under their employee benefit package to an HMO or a PPO. The rationale behind that was to lower costs of providing benefits to employees. The difference there, and in this bill, is that HMOs and PPOs restrict care and increase individual cost, and the reform provisions will increase availability of care and decrease individual cost.


4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.

They will not lose insurance coverage. They will be covered under whatever plan their employer provides. And, if a plan under the Health Exchange Option, they will have more coverage for less money. How is that a negative for the individual? Remember, the purpose of reform is to increase availability of care and reduce costs for the individual. It is not to put more money into the pockets of already wealthy private insurers.

5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.


Again, completely incorrect. There is nothing contained herein that indicates that to be true what so ever.

6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.

Again, completely untrue. In fact, it is quite the opposite. More choice, less cost for the individual.

5. Does the plan TAX successful Americans more THAN OTHERS?


Here is what the bill says, pages 197-198, SEC. 441. SURCHARGE ON HIGH INCOME INDIVIDUALS

‘‘SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.

‘‘(a) GENERAL RULE.—In the case of a taxpayer other than a corporation, there is hereby imposed (in addition to any other tax imposed by this subtitle) a tax equal to—

‘‘(1) 1 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $350,000 but does not exceed $500,000,

‘‘(2) 1.5 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $500,000 but does not exceed $1,000,000, and

‘‘(3) 5.4 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $1,000,000.

(b) Taxpayers not making a joint return: in the case of any taxpayer other than a taxpayer making a joint return under section 6013 or a surviving spouse shall be applied by substituting for each of the dollar amounts therein:

(1) 50% of the dollar amount so in effect the case of a married individual filing a separate return and

(2) 80% of the dollar amount so in effect in any other case



EVALUATION OF THE PASSAGE:

1. This bill amends the Internal Revenue Code.

2. Tax surcharges are levied on those with the highest incomes.


Which means that Obama is keeping his promise not to raise taxes on anyone making less that a quarter million dollars a year. GOBAMA!!!


3. The plan manipulates the tax code to redistribute their wealth.


No, it doesn’t. It doesn’t manipulate the tax code at all. Nor is it a redistribution of wealth. It is increasing the taxes of those who have, for years, paid less than their fair share as a result of tax breaks afforded them. Unless you make over a quarter million dollars a year, this does not affect you. Raise your hands, ADers…how many of you make a quarter of a million dollars a year?

4. Successful business owners will bear the highest cost of this plan.

Let’s qualify that: successful business owners who have a net income of over a quarter million dollars a year (that’s take home, folks!) and have a payroll for employees that exceeds $400,000 a year will pay the highest cost. Let’s see…a business owner who has a take home profit of $15,000 and a payroll of $12,000 pays less than a business owner to takes home a half mil and has a $400,000 payroll. Makes sense to me.


6. Does THE PLAN ALLOW THE GOVERNMENT TO set FEES FOR SERVICES?

What it says, page 124, Sec. 223, PAYMENT RATES FOR ITEMS AND SERVICES:

(1) IN GENERAL-The Secretary shall establish payment rates for the public health insurance option for services and health care providers consistent with this section and may change payment rates in accordance with Section 224.


(2) INITIAL PAYMENT RULES- In general, except as provided un subparagraph (B) and subsection (6), during y1, y2, and y3 the Secretary shall base the payment rates under this section for services and providers described in paragraph (1) on payment rates for similar services and providers under Parts A and B of Medicare.

(B) EXCEPTIONS

(i) Practitioners’ SERVICES-payment rates for practitioners’ services otherwise established under the fee schedule under section 1848 of the Social Security Act shall be applied without regard to the provisions under subsection (7) of such section and the update under section (d)(4) under such section for a year applied under this paragraph shall not be less than 1%
.
(d) CONSTRUCTION.—Nothing in this subtitle shall be construed as limiting the Secretary’s authority to correct for payments that are excessive or deficient, taking into account the provisions of section 221(a) and the amounts paid for similar health care providers and services under other Exchange-participating health benefits plans.

(e) CONSTRUCTION.—Nothing in this subtitle shall be construed as affecting the authority of the Secretary to establish payment rates, including payments to provide for the more efficient delivery of services, such as the initiatives provided for under section 224.


(3) FOR NEW SERVICES- the secretary shall modify payment rates described in paragraph (2) in order to accommodate payments for services, such as well-child visits, that are not otherwise covered under Medicare.

EVALUATION OF THE PASSAGES:

1. The government’s authority to set payments is basically unlimited.


Wrong. The Secretary sets fee schedules based on fee schedules already established for like services and procedures. Fee schedules already set are based on the average cost of providing said service and procedure.



But, currently, private insurance companies do have the unlimited authority to set fee schedules that are significantly lower than the cost of the service and procedure.
2. The official will decide what constitutes “excessive,” “deficient,” and “efficient” payments and services.


Wrong. Market and utilization determine that.




7. Will THE PLAN increase the power of government officials to SCRUTINIZE our private affairs?

What it says, pages 195-196, SEC. 431. DISCLOSURES TO CARRY OUT HEALTH INSURANCE EXCHANGE SUBSIDIES.

‘‘(A) IN GENERAL.—The Secretary, upon written request from the Health Choices Commissioner or the head of a State-based health insurance exchange approved for operation under section 208 of the America’s Affordable Health Choices Act of 2009, shall disclose to officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, return information of any taxpayer whose income is relevant in determining any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009. Such return information shall be limited to—

‘‘(i) taxpayer identity information with respect to such taxpayer,

‘‘(ii) the filing status of such taxpayer,

‘‘(iii) the modified adjusted gross income of such taxpayer (as defined in section 59B(e)(5)),

‘‘(iv) the number of dependents of the taxpayer,

‘‘(v) such other information as is prescribed by the Secretary by regulation as might indicate whether the taxpayer is eligible for such affordability credits (and the amount thereof), and

‘‘(vi) the taxable year with respect to which the preceding information relates or, if applicable, the fact that such information is not available.


(B) RESTRICTION ON USE OF DISCLOSED INFORMATION- Return information disclosed under paragraph (A) may be used by officers and employees of Health Choices Administration, or such State based health insurance exchange, as the case may be, only for the purposes of, and to the extent necessary in, establishing and verifying the appropriate amount of any affordability credit described in subtitle (C) of Title II of the American’s Affordable Health Choice Act of 2009 and providing for the repayment of any such credit which was in excess of such appropriate amount.
And, page 145, section 312, EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE:

(3) PROVISION OF INFORMATION.—The employer provides the Health Choices Commissioner, the Secretary of Labor, the Secretary of Health and Human Services, and the Secretary of the Treasury, as applicable, with such information as the Commissioner may require to ascertain compliance with the requirements of this section.

EVALUATION OF THE PASSAGE:


1. This section amends the Internal Revenue Code

2. The bill opens up income tax return information to federal officials.


Federal officials already have access. And the forms will be used just as they are now used to decide if you qualify for Earned Income Credit or Childcare Credit. Now they will be used to determine if you qualify for an Affordability Credit. The only thing new here is that you will now have one more credit available to you at the end of the year.
3. Any stated “limits” to such information are circumvented by item (v), which allows federal officials to decide what information is needed.

What information, not who has access to it. And the information is the information contained on your tax reports, which the Federal Government already has. Last time I checked, the IRS was a Federal Governmental Agency. You aren’t giving them anything they don’t already have.

4. Employers are required to report whatever information the government says it needs to enforce the plan.

Only in so far as it relates to the health coverage being provided to their employees. And employers have to report to the federal government now.




8. Does the plan automatically enroll Americans in the GOVERNMENT plan?

What it says, page 102, Section 205, Outreach and enrollment of Exchange-eligible individuals and employers in Exchange-participating health benefits plan:
(1) OUTREACH- The commissioner shall conduct outreach activities consistent with subsection (C), including thorough use of appropriate entities as described in paragraph (4) of such subsection to inform and educate individuals and employers about the Health Insurance Exchange participating health benefits options. Such outreach shall include outreach specific to vulnerable population, such as children, individuals with disabilities, individuals with mental illness, and individuals with other cognitive impairments.
(3) AUTOMATIC ENROLLMENT OF MEDICAID ELIGIBLE INDIVIDUALS INTO MEDICAID.—The Commissioner shall provide for a process under which an individual who is described in section 202(d)(3) and has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.

(4) MEDICAID ELIGIBLE INDIVIDUALS-The terms “Medicaid eligible individuals” means an individual who is eligible for medical assistance under Medicaid.

And, page 145, section 312:

(4) AUTO-ENROLLMENT OF EMPLOYEES.—The employer provides for auto-enrollment of the employee in accordance with subsection (c).


(C) AUTOMATIC ENROLLMENT FOR EMPLOYER SPONSORED HEALTH BENEFITS

(1) IN GENERAL- the requirement of this subsection with respect to an employer and an employee is that the employer automatically enrolls such employee into the employment based benefits plan for individual coverage under the plan option with the lowest applicable employee premium.

(2) OPT-OUT- In no case may an employer automatically enroll an employee in a plan under paragraph (1) if such employee makes an affirmative election to opt out of such plan or to elect coverage under an employment based health benefits plan offered by such employer. An employer shall provide an employee with a 30-day period to make such an affirmative election before the employer may automatically enroll the employee in such a plan.

(3) NOTICE REQUIREMENTS-

(B) INCLUSION OF SPECIFIC INFORMATION- The written notice under subparagraph (A) must explain an employee’s right to opt out of being automatically enrolled in a plan and in the case that more than 1 level of benefits or employee premium level is offered by the employer involved, the notice must explain which level of benefits and employee premium level the employee will be automatically enrolled in the absence of an affirmative election by the employee
.



EVALUATION OF THE PASSAGES:


1. Do nothing and you are in.


Not quite. Read above. You have 30 days to submit a written notice to opt out to your employer. Should not be a problem for you to accomplish this at some point in a month’s time if you don’t want automatic enrollment.


And what automatic enrollment means for the employee is that they no longer have to wait 3 to 6 months (sometimes a year) before they are eligble for insurance coverage. The insurance can no longer deny you coverage, and they cannot demand that you take a physical exam or fill out books full of paperwork regarding your medical history and the medical history of your parents and sibs. Sounds like a huge improvement over the current system of employer sponsored health benefits.




2. Employers are responsible for automatically enrolling people who still work.


Employers have always been responsible for notifying the insurance carrier that they have an employee eligible for health coverage. What’s the big deal about that?


9. Does THE PLAN exempt federal OFFICIALS from COURT REVIEW?

What it says, page 124, Section 223, PAYMENT RATES FOR ITEMS AND SERVICES:

(f) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review of a payment rate or methodology established under this section or under section 224.

And, page 256, SEC. 1123. PAYMENTS FOR EFFICIENT AREAS.


(A) IN GENERAL-Based upon available data, the Secretaqry shall identify those counties or equivalent areas in the United States in the lowest 5th percentile of utilization based on per capita spending under this and Part A for services provided in the most recent year for which data are available as of the date of the enactment of this subsection, as standardized to eliminate the effect of geographic adjustments in payment rates.

‘‘(C) LIMITATION ON REVIEW.—There shall be no administrative or judicial review under section 1869, 1878, or otherwise, respecting—

‘‘(i) the identification of a county or other area under subparagraph (A); or

‘‘(ii) the assignment of a postal ZIP Code to a county or other area under subparagraph (B).


EVALUATION OF THE PASSAGES:


1. Sec. 1123 amends the Social Security Act, to allow the Secretary to identify areas of the country that underutilize the government’s plan “based on per capita spending.”

2. Parts of the plan are set above the review of the courts


What the above section actually provides for is the identification of impoverished and underserved areas. It sets up incentives for providers of health care services to practice in impoverished and underserved areas, thus increasing availability of care to the poorest and most disadvantaged.






So, Kokonut, perhaps it is you that needs to read the entire bill instead of just copying and pasting someone else’s opinion and out of context information intended to distort the actual provisions of the bill.
 
Shelby, let me remind you that Kokonut is regurigating everything he reads from right wing websites and never bother to read the entire text.

For example, death panel was never mentioned or even remotely close to it. The passage was about paying for procedures that deal with end of life situations and that is a COMMON procedure and something that ALL people should have... to avoid the Terri Schiavo-like incidents.

So much for their ignorance.
 
Democratic senator: Public health insurance option dead

WASHINGTON (CNN) -- A key Senate negotiator said Sunday that President Obama should drop his push for a government-funded public health insurance option because the Senate will never pass it.

Democratic Sen. Kent Conrad of North Dakota said it was futile to continue to "chase that rabbit" due to the lack of 60 Senate votes needed to overcome a filibuster.

"The fact of the matter is there are not the votes in the United States Senate for a public option. There never have been," Conrad said on "Fox News Sunday."

His comment signaled a shift in the health care debate, with Obama and senior advisers softening their support for a public option by saying final form of the legislation is less important than the principle of affordable coverage available to all.

At a town hall meeting Saturday in Colorado, Obama said the public option is just one of many issues critical to successfully overhauling the ailing health care system.

"All I'm saying is ... that the public option, whether we have it or we don't have it, is not the entirety of health care reform. This is just one sliver of it," the president said.

Asked Sunday if Obama would accept a bill lacking a public option, White House spokesman Robert Gibbs said the president insists on more competition in the health insurance marketplace to offer consumers better choices.

"The bottom line ... is: Do individuals looking for health insurance in the private market have choice and competition?" Gibbs said on the CBS program "Face the Nation." "If we have that, the president will be satisfied."

Health and Human Services Secretary Kathleen Sebelius echoed Gibbs, telling CNN's "State of the Union" on Sunday that a final health care bill will include competitive choices for consumers in one form or another.

"There will be a competitor to private insurers," she said. "You don't turn over the whole new marketplace to private insurance companies and trust them to do the right thing. We need some choices and we need some competition."

Opponents of overhauling the health care system argue the Democratic proposals under consideration by Congress go too far and will lead to a government takeover of the health care system.

"We have the best health care system in the world," Republican Sen. Richard Shelby of Alabama told "Fox News Sunday." "We need to expand it. We do not need to destroy it."

At issue is how to provide coverage for an estimated 46 million uninsured people while reversing a climb in health care costs.

Democratic proposals passed so far by House and Senate committees include a public insurance option, mandates for people to be insured and employers to provide coverage, and an end to insurance companies refusing to cover pre-existing conditions.

Most Republicans oppose the public option and requirements for employers to provide coverage. They also call for limits on medical malpractice lawsuits -- something Democrats generally don't favor. However, the two parties generally agree on a number of provisions contained in the Democratic bills, including increased efficiency in Medicare and Medicaid and focusing on preventive health programs.

Conrad is one of six Senate Finance Committee members -- three Democrats and three Republicans -- who are negotiating a compromise health care bill that would be the only bipartisan proposal so far.

Instead of a public option, the negotiators are considering a plan proposed by Conrad to create nonprofit health insurance cooperatives that could negotiate coverage as a collective for their members.

Conrad said such cooperatives would provide the competition sought by Obama and Democratic leaders to force private insurers to hold down costs and improve practices. The government would put up initial funding to provide required reserves but would have no other role, he said.

"It's not a public plan at all in terms of government running it," Conrad said.

Shelby called the cooperative idea a "step in the right direction" and "a far cry" from other proposals, adding that Obama and Democratic leaders have "read the tea leaves" from town hall meetings around the country.

However, Democratic Rep. Eddie Bernice Johnson of Texas told CNN it would be "very, very difficult" to support a bill that lacked a public health insurance option.

"Without the public option, we'll have the same number of people uninsured," Johnson said in a "State of the Union" interview. "If the insurance companies wanted to insure these people now, they'd be insured."

She added that "an option that would give the private insurance companies a little competition" is "the only way" to be sure that insurance is available to low-income people and people without employer-provided coverage.

Meanwhile, leaders of organizations representing America's doctors and senior citizens defended the proposed health care overhaul that their groups had opposed in past years.

Dr. J. James Rohack, president of the American Medical Association, and John Rother of AARP -- formerly the American Association of Retired Persons -- told "Fox News Sunday" a comprehensive overhaul sought by Democrats was necessary.

"There are some moving parts that if you just do one and don't do the other, you're going to have unintended consequences," said Rohack, head of the nation's largest doctors' advocacy group.

Rother, executive vice president of policy and strategy for the largest senior citizens' advocacy group, said properly addressing excessive health care costs and waste requires addressing both health insurance coverage and how health care treatment is delivered.

Both men rejected accusations that a health care overhaul would bring rationing of health treatment based on bureaucratic measures such as cost and economic productivity of patients.

"There's a myth that rationing doesn't occur right now," Rohack said, noting that some companies currently deny coverage for pregnancy as a pre-existing condition.

"That's why this bill is so important," Rohack said. "It gets rid of rationing happening right now" and leaves decisions to patients and doctors.

Rohack also condemned claims by some Republicans that a provision in one House bill would lead to so-called "death panels" encouraging euthanasia of senior citizens.

"That's absolutely wrong, it's a falsehood," he said, adding that the provision was intended to provide government support for consultations between patients and their doctors.

Spreading of the "death panel" rumor by some conservative commentators and some Republican politicians prompted emotional opposition at town hall meetings across the country. Senate negotiators on a compromise bill say they have dropped the provision from their proposal due to potential misinterpretation of the intent.

Democratic senator: Public health insurance option dead - CNN.com
 
Liebling, what are you doing in next when US is unable to adopt universal health care or social insurance due lacks of support in congress?
 
Democratic senator: Public health insurance option dead

...

"Most Republicans oppose the public option and requirements for employers to provide coverage. They also call for limits on medical malpractice lawsuits -- something Democrats generally don't favor. However, the two parties generally agree on a number of provisions contained in the Democratic bills, including increased efficiency in Medicare and Medicaid and focusing on preventive health programs.

...

Democratic senator: Public health insurance option dead - CNN.com

At the least, both parties could agree...
 
That is not correct.

Some employers don't offer health care plans to employees.

Some employers offer their employees to opt out. For example, one spouse may have a health plan for the whole family, so the other spouse doesn't need one at his or her job.

Those employers who do offer health care plans often offer more than one kind, so the employee has to make the choice and sign up for that plan.

That is correct. When I was a mail clerk at a freight company, I had to wait 90 days to for insurance to kick in.
 
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