Let's discuss what's in the Health Care Bill

I have not read through the entire post cause the way these bills are set up it might as well be in wingdings cause i cant understand any of it. I am not employed and I plan on paying for my health care out of my own pocket with money from other sources. How will this affect those that do not have any type of health insurance and use their own money to pay for health care? Will i not be able to pay cash for health care and be forced to pay for some government insurance in order to see a doctor or dentist? I have numerous health problems but I have never had the insurance or the money to be seen and find out what the problems are caused by or what they are. I also need extensive dentist work done. How will this affect me?

I pretty much want to know the same as the above poster, if you don't have insurance, if you are not well, and are min wage or unemployed, what does this plan do for you, or not do?

reply to post by tasim


if you are not working, it seems that you will be placed into the medicaid type program.

For dental and or vision, you have to qualify for the Premium-Plus type plan from the government according to this bill.

And that is only if it is offered in your area.

Thread is only 9 pages long, you really should try to read the sections we have gone over & if you don't understand it at all, then look at the quote opening the post and the conclusion after the relevant portion of the bill to see if we think that the quote was correct or not

I've only read up to page 5, but so far, this thread is one of the best threads I've seen on ATS in a long time (minus the occasional OT post by random people).

What the several people contributing to the research have done has been a lifesaver for me. I have tried to read the bill, but my eyes start to cross from all of the mumbo-jumbo after only a few sentences. I want to give all of you a BIG hug and Thank You from the bottom of my Heart!

To truly reform health care where it is responsible and accountable to the people would be to return the authority to the States. A Federal (foreign, globalist) owned and operated health care system is not in 'your' interest. It is rather a means of population reduction and further 'control' of the American 'folk'.

They are attempting to rush this through for reason though not as the word implies. Reason itself is absent, tyranny is omniprescent?

Are you slave or sovereign?

You are to live with the result regardless.

You have a Choice.

I've read through this from beginning to end. It seems to me that this legislation moves what is prescribed by my doctor and insurance company and redefines it to having a central committee prescribe allowable procedures and allowable coverage. The government designed exchange policy will cover what the government is willing to subsidize, as prescribed by the central committee. Costly procedures can just be eliminated at will.

It just seems to me that it takes the liberty a doctor may have in treating a patient away.I just see a future where congress can trim procedures to just save money.

It seems to me the free enterprise health care is more efficient and effective than a system controlled by congress and the President. I envision the government cost cutting the quality away to nothing eventually. You'll have health insurance, but God knows what will be covered.

Originally posted by Gateway
reply to post by redhatty

 

Good work!

I would love for the Liberals to come here and debate, what's being proposed rather than continue with moronic threads such as the "Rise of Right wing extreme groups" or "why idiots oppose health care reform" these types of threads only resort to ad hominem attacks, and do not CHALLENGE WHAT WE SAY.

You guys WANT to talk about it. Do it in this THREAD!!

[edit on 8-8-2009 by Gateway]

While I don't like some t hings I've read here, I believe this is the result of health care out of control, and of course, greed.

PG 260 Line 1125 Fed Government will adjust Medicare Payment Localities for California based on Census. ACORN?

SEC. 1125. ADJUSTMENT TO MEDICARE PAYMENT LOCALITIES.
(a) IN GENERAL.—Section 1848(e) of the Social Security Act (42 U.S.C.1395w–4(e)) is amended by adding at the end the following new paragraph:
(6) TRANSITION TO USE OF MSAS AS FEE SCHEDULE AREAS IN CALIFORNIA.—
(A) IN GENERAL.—
(i) REVISION.—Subject to clause (ii) and notwithstanding the previous provisions of this subsection, for services furnished on or after January 1, 2011, the Secretary shall revise the fee schedule areas used for payment under this section applicable to the State of California using the Metropolitan Statistical Area (MSA) iterative Geographic Adjustment Factor methodology as follows:
(I) The Secretary shall configure the physician fee schedule areas using the Core-Based Statistical Areas-Metropolitan Statistical Areas (each in this paragraph referred to as an ‘MSA’), as defined by the Director of the Office of Management and Budget, as the basis for the fee schedule areas. The Secretary shall employ an iterative process to transition fee schedule areas. First, the Secretary shall list all MSAs within the State by Geographic Adjustment Factor described in paragraph (2) (in this paragraph referred to as a ‘GAF’) in descending order. In the first iteration, the Secretary shall compare the GAF of the highest cost MSA in the State to the weighted-average GAF of the group of remaining MSAs in the State. If the ratio of the GAF of the highest cost MSA to the weighted-average GAF of the rest of State is 1.05 or greater then the highest cost MSA becomes a separate fee schedule area.
(II) In the next iteration, the Secretary shall compare the MSA of the second-highest GAF to the weighted-average GAF of the group of remaining MSAs. If the ratio of the second-highest MSA’s GAF to the weighted-average of the remaining lower cost MSAs is 1.05 or greater, the second-highest MSA becomes a separate fee schedule area. The iterative process continues until the ratio of the GAF of the highest-cost remaining MSA to the weighted-average of the remaining lower-cost MSAs is less than 1.05, and the remaining group of lower cost MSAs form a single fee schedule area, If two MSAs have identical GAFs, they shall be combined in the iterative comparison.

This claim appears to be true. They are basing the fee schedules on statistical areas and those statistics will have to come from the census since I don't see them going out and creating thier own statistics for it.

I hunted down the relevant section of the SSA:

Section 1828(e)(2):

(2) Computation of geographic adjustment factor.—For purposes of subsection (b)(1)(C), for all physicians' services for each fee schedule area the Secretary shall establish a geographic adjustment factor equal to the sum of the geographic cost-of-practice adjustment factor (specified in paragraph (3)), the geographic malpractice adjustment factor (specified in paragraph (4)), and the geographic physician work adjustment factor (specified in paragraph (5)) for the service and the area.

This is apparently already done for Medicaid, but I'm still not sure why California is being singled out in the health care bill.

PG 265 Line 1131 Government mandates & controls productivity for private HealthCare industries.

SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.
(a) OUTPATIENT HOSPITALS.—
(1) IN GENERAL.—The first sentence of section 1833(t)(3)(C)(iv) of the Social Security Act (42 U.S.C. 1395l(t)(3)(C)(iv)) is amended—
(A) by inserting ‘‘(which is subject to the productivity adjustment described in subclause (II) of such section)’’ after ‘‘1886(b)(3)(B)(iii)’’; and
(B) by inserting ‘‘(but not below 0)’’ after ‘‘reduced’’.
(2) EFFECTIVE DATE.—The amendments made by paragraph (1) shall apply to increase factors for services furnished in years beginning with 2010.
(b) AMBULANCE SERVICES.—Section 1834(l)(3)(B) of such Act (42 U.S.C. 1395m(l)(3)(B))) is amended by inserting before the period at the end the following: ‘‘and, in the case of years beginning with 2010, subject to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II)’’.
(c) AMBULATORY SURGICAL CENTER SERVICES.—Section 1833(i)(2)(D) of such Act (42 U.S.C. 1395l(i)(2)(D)) is amended—
(1) by redesignating clause (v) as clause (vi); and
(2) by inserting after clause (iv) the following new clause: (v) In implementing the system described in clause (i), for services furnished during 2010 or any subsequent year, to the extent that an annual percentage change factor applies, such factor shall be subject to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II).’’.
(d) LABORATORY SERVICES.—Section 1833(h)(2)(A) of such Act (42 U.S.C. 1395l(h)(2)(A)) is amended—
(1) in clause (i), by striking ‘‘for each of years 2009 through 2013’’ and inserting ‘‘for 2009’’; and
(2) clause (ii)—
(A) by striking ‘‘and’’ at the end of subclause (III);
(B) by striking the period at the end of subclause (IV) and inserting ‘‘; and’’; and
(C) by adding at the end the following new subclause:
(V) the annual adjustment in the fee schedules determined under clause (i) for years beginning with 2010 shall be subject to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II).’’.

This claim is true as far as productivity being adjusted, but it really isn't changing much. The text above is simply adding to the SSA and changing some of the wording, so these are things that are already happening.

PG 268 Line 1141 Fed Government regulates rental & purchase of power driven wheelchairs.

SEC. 1141. RENTAL AND PURCHASE OF POWER-DRIVEN WHEELCHAIRS.
(a) IN GENERAL.—Section 1834(a)(7)(A)(iii) of the Social Security Act (42 U.S.C. 1395m(a)(7)(A)(iii)) is amended—
(1) in the heading, by inserting ‘‘CERTAIN COMPLEX REHABILITATIVE’’ after ‘‘OPTION FOR’’; and
(2) by striking ‘‘power-driven wheelchair’’ and inserting ‘‘complex rehabilitative power-driven wheelchair recognized by the Secretary as classified within group 3 or higher’’.

The following is the relevant section of the SSA.

SSA Section 1834(a)(7)(A)(iii)

(7) Payment for other items of durable medical equipment.—
(A) Payment.—In the case of an item of durable medical equipment not described in paragraphs (2) through (6), the following rules shall apply:
(i) Rental.—
(I) In general.—Except as provided in clause (iii), payment for the item shall be made on a monthly basis for the rental of the item during the period of medical need (but payments under this clause may not extend over a period of continuous use (as determined by the Secretary) of longer than 13 months).
(II) Payment amount.—Subject to subparagraph (B), the amount recognized for the item, for each of the first 3 months of such period, is 10 percent of the purchase price recognized under paragraph (8) with respect to the item, and, for each of the remaining months of such period, is 7.5 percent of such purchase price.
(ii) Ownership after rental.—On the first day that begins after the 13th continuous month during which payment is made for the rental of an item under clause (i), the supplier of the item shall transfer title to the item to the individual.
(iii) Purchase agreement option for power-driven wheelchairs.—In the case of a power-driven wheelchair, at the time the supplier furnishes the item, the supplier shall offer the individual the option to purchase the item, and payment for such item shall be made on a lump-sum basis if the individual exercises such option.

Once again the claim is true, but this is already going on and I'm fairly certain this only applies to those on medicaid.

The content you've provided and proposed for us to view is slanted. Please take out all the !!!!! and all of the summarizing of lines someone has done and list the data as it was written.

It's laughable that you want to have an intelligent conversation about the health care reform bill but then spoon feed someone's doom and gloom theories about the bill.

Show me the facts, not a list of conclusions from someone's interpretation of what's actually written in the bill and then we can have some intelligent conversation.

PG 265 Line 1131 Government mandates & controls productivity for private HealthCare industries.

PART 2—MARKET BASKET UPDATES
2 SEC. 1131. INCORPORATING PRODUCTIVITY IMPROVE3
MENTS INTO MARKET BASKET UPDATES
4 THAT DO NOT ALREADY INCORPORATE SUCH
5 IMPROVEMENTS.
6 (a) OUTPATIENT HOSPITALS.—
7 (1) IN GENERAL.—The first sentence of section
8 1833(t)(3)(C)(iv) of the Social Security Act (42
9 U.S.C. 1395l(t)(3)(C)(iv)) is amended—
10 (A) by inserting ‘‘(which is subject to the
11 productivity adjustment described in subclause
12 (II) of such section)’’ after
13 ‘‘1886(b)(3)(B)(iii)’’; and
14 (B) by inserting ‘‘(but not below 0)’’ after
15 ‘‘reduced’’.
16 (2) EFFECTIVE DATE.—The amendments made
17 by paragraph (1) shall apply to increase factors for
18 services furnished in years beginning with 2010.
19 (b) AMBULANCE SERVICES.—Section 1834(l)(3)(B)
20 of such Act (42 U.S.C. 1395m(l)(3)(B))) is amended by
21 inserting before the period at the end the following: ‘‘and,
22 in the case of years beginning with 2010, subject to the
23 productivity adjustment described in section
24 1886(b)(3)(B)(iii)(II)’’.

1 (c) AMBULATORY SURGICAL CENTER SERVICES.—
2 Section 1833(i)(2)(D) of such Act (42 U.S.C.
3 1395l(i)(2)(D)) is amended—
4 (1) by redesignating clause (v) as clause (vi);
5 and
6 (2) by inserting after clause (iv) the following
7 new clause:
8 ‘‘(v) In implementing the system described in clause
9 (i), for services furnished during 2010 or any subsequent
10 year, to the extent that an annual percentage change fac11
tor applies, such factor shall be subject to the productivity
12 adjustment described in section 1886(b)(3)(B)(iii)(II).’’.
13 (d) LABORATORY SERVICES.—Section
14 1833(h)(2)(A)) of such Act (42 U.S.C. 1395l(h)(2)(A)) is
15 amended—
16 (1) in clause (i), by striking ‘‘for each of years
17 2009 through 2013’’ and inserting ‘‘for 2009’’; and
18 (2) clause (ii)—
19 (A) by striking ‘‘and’’ at the end of sub20
clause (III);
21 (B) by striking the period at the end of
22 subclause (IV) and inserting ‘‘; and’’; and
23 (C) by adding at the end the following new
24 subclause:

1 ‘‘(V) the annual adjustment in the fee schedules
2 determined under clause (i) for years beginning with
3 2010 shall be subject to the productivity adjustment
4 described in section 1886(b)(3)(B)(iii)(II).’’.
5 (e) CERTAIN DURABLE MEDICAL EQUIPMENT.—Sec6
tion 1834(a)(14) of such Act (42 U.S.C. 1395m(a)(14))
7 is amended—
8 (1) in subparagraph (K), by inserting before
9 the semicolon at the end the following: ‘‘, subject to
10 the productivity adjustment described in section
11 1886(b)(3)(B)(iii)(II)’’;
12 (2) in subparagraph (L)(i), by inserting after
13 ‘‘June 2013,’’ the following: ‘‘subject to the produc14
tivity adjustment described in section
15 1886(b)(3)(B)(iii)(II),’’;
16 (3) in subparagraph (L)(ii), by inserting after
17 ‘‘June 2013’’ the following: ‘‘, subject to the produc18
tivity adjustment described in section
19 1886(b)(3)(B)(iii)(II)’’; and
20 (4) in subparagraph (M), by inserting before
21 the period at the end the following: ‘‘, subject to the
22 productivity adjustment described in section
23 1886(b)(3)(B)(iii)(II)’’.

So I had to pull up The Social Security Act (42
U.S.C. 1395l(t)(3)(C)(iv))

This whole section deals with Payment of Benefits,
so yes it does specify what service providers (of ALL Kinds) will be payed.

And yest they do mention productivity adjustments, but for the life of me I cannot find the relevant section in 42 USC

PG 272 Line 1145 TREATMENT OF CERTAIN CANCER HOSPITALS – Cancer patients – welcome to rationing!

4 SEC. 1145. TREATMENT OF CERTAIN CANCER HOSPITALS.
5 Section 1833(t) of the Social Security Act (42 U.S.C.
6 1395l(t)) is amended by adding at the end the following
7 new paragraph:
8 ‘‘(18) AUTHORIZATION OF ADJUSTMENT FOR
9 CANCER HOSPITALS.—
10 ‘‘(A) STUDY.—The Secretary shall conduct
11 a study to determine if, under the system under
12 this subsection, costs incurred by hospitals de13
scribed in section 1886(d)(1)(B)(v) with respect
14 to ambulatory payment classification groups ex15
ceed those costs incurred by other hospitals fur16
nishing services under this subsection (as deter17
mined appropriate by the Secretary).
18 ‘‘(B) AUTHORIZATION OF ADJUSTMENT.—
19 Insofar as the Secretary determines under sub20
paragraph (A) that costs incurred by hospitals
21 described in section 1886(d)(1)(B)(v) exceed
22 those costs incurred by other hospitals fur23
nishing services under this subsection, the Sec24
retary shall provide for an appropriate adjust25
ment under paragraph (2)(E) to reflect those
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00272 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC
July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2)
273
1 higher costs effective for services furnished on
2 or after January 1, 2011.’’.

I may be reading this wrong, but to me it seems it's saying that hosptials and clinics that do cancer treatment will be
audited to make sure that the costs are the same as any hospital who also treats, but doesn't specialize in, Cancer.

I do not see anything that can be interpreted as rationing

[edit on 8/9/09 by redhatty]

reply to post by brianmg5


The content being provided is directly from the bill itself, so I'm not sure how you figure it's slanted. If you think that something that's been covered so far was covered with bias you're more than welcome to post your own interpretation of the relevant sections.

I joined this research project to be as unbiased as possible and have pointed out several false claims myself. If that doesn't show a lack of bias I don't know what does.

I have a question, could be a dumb one though....

In Section 246 where it says no "undocumented" alien will recieve federal care.

Can you be considered documented and still be in the country illegally? How does the government actually define this?

edited : double post

[edit on 9-8-2009 by drock905]

Claim:

Pg 735 lines 16-25 For law enforcement purposes, the Secretary of Health & Human Services will give Attorney General access to ALL data

What it says:

16 ‘‘(d) ACCESS TO INFORMATION NECESSARY TO IDEN
17 TIFY FRAUD, WASTE, AND ABUSE.—For purposes of law
18 enforcement activity, and to the extent consistent with ap
19 plicable disclosure, privacy, and security laws, including
20 the Health Insurance Portability and Accountability Act
21 of 1996 and the Privacy Act of 1974, and subject to any
22 information systems security requirements enacted by law
23 or otherwise required by the Secretary, the Attorney Gen
24 eral shall have access, facilitation by the Inspector General
25 of the Department of Health and Human Services, to
1 claims and payment data relating to titles XVIII and XIX,
2 in consultation with the Centers for Medicare & Medicaid
3 Services or the owner of such data.’’.

This claim is true. Based off the other sections of the bill the government takes control of the insurance policies as we have seen in past sections. Since the gov will be deciding who can offer insurance plans, the AG will have access to all data.

reply to post by julzz


There are patient advocates services all over. Try looking into one of them perhaps? Don't know where you are but my wife (an RN) deals with this alot. And she uses them to direct much of what she deals with.

Hope that helps some,

Mike

PG 270 Line 1144 Government Mandates that all private ambulatory surgical centers submit cost data & other data

Page 270 Section 1144:

SEC. 1144. REQUIRE AMBULATORY SURGICAL CENTERS (ASCS) TO SUBMIT COST DATA AND OTHER DATA.
(a) COST REPORTING.—
(1) IN GENERAL.—Section 1833(i) of the Social Security Act (42 U.S.C. 1395l(i)) is amended by adding at the end the following new paragraph: (8) The Secretary shall require, as a condition of the agreement described in section 1832(a)(2)(F)(i), the submission of such cost report as the Secretary may specify, taking into account the requirements for such reports under section 1815 in the case of a hospital.’’.

This one is undeniably true. It says it right there in the section title.

PG 276 Line 3-20 Oxygen Equipment & Supply Companies - Government MANDATES you will provide supplies NO MATTER where individual is.

Page 276 Lines 3-

‘‘(iii) CONTINUATION OF SUPPLY.—In the case of a supplier furnishing such equipment to an individual under this subsection as of the 27th month of the 36 months described in clause (i), the supplier furnishing such equipment as of such month shall continue to furnish such equipment to such individual (either directly or though arrangements with other suppliers of such equipment) during any subsequent period of medical need for the remainder of the reasonable useful lifetime of the equipment, as determined by the Secretary, regardless of the location of the individual, unless another supplier has accepted responsibility for continuing to furnish such equipment during the remainderof such period.’’.

The claim is true but misleading. Suppliers will have to continue providing supplies regardless of where the individual is unless another supplier takes over, but they won't have to start providing them to someone new regardless of where they are.

PG 287 Line 14-25 PROOF that Government will ration HealthCare by mandating waiting periods for readmission.

Page 287 Lines 14-25:

(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)(I), such time period (such as 30 days) shall be consistent with the time period specified for such measure.

Subparagraph (A):

(A) APPLICABLE CONDITION.—The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary among conditions and procedures for which—
(i) readmissions (as defined in subparagraph (E)) that represent conditions or procedures that are high volume or high expenditures under this title (or other criteria specified by the Secretary); and
(ii) measures of such readmissions—
(I) have been endorsed by the entity with a contract under section 1890(a); and
(II) such endorsed measures have appropriate exclusions for readmissions that are unrelated to the prior discharge (such as a planned readmission or transfer to another applicable hospital).

I'm honestly not sure what to call this one. It mentions waiting periods for re-admission, but implies that that only applies to certain conditions. It all depends on what the Secretary considers high volume and/or high expenditure conditions and procedures. The wording is too vague for me to decide how true this one is.

Originally posted by brianmg5
The content you've provided and proposed for us to view is slanted. Please take out all the !!!!! and all of the summarizing of lines someone has done and list the data as it was written.

It's laughable that you want to have an intelligent conversation about the health care reform bill but then spoon feed someone's doom and gloom theories about the bill.

Show me the facts, not a list of conclusions from someone's interpretation of what's actually written in the bill and then we can have some intelligent conversation.

I will be the first to admit that I am against this bill. But, in order to be against it "intelligently" I have to read it. I am doing this project to learn, and as much as I hate to admit, there are some sections here that I have refuted. And if I can refute something in this bill, then you can be darn sure it's being as unbiased as possible.
Any sections you feel are issues, please point them out. We are all doing our best to JUST relay the information and provide the TRUTH.

PG 298 Line 9-11 Drs, treat a patient during initial admission that results in a readmission - Government will penalize you.

(B) developing measures of rates of read8
mission for individuals treated by physicians;
9 (C) applying a payment reduction for phy10
sicians who treat the patient during the initial
11 admission that results in a readmission; and
12 (D) methods for attributing payments or
13 payment reductions to the appropriate physi14
cian or physicians.
15

True. If an MD re-admits you the doctor will receive a payment reduction.
This is double-edged though. This might mean longer hospital stays because the MD won't want to get dinged because of a readmission issue.
-personal note, I think it's still ok to trust your doctor. . . -