Fuzzy’s Notes: HR 3200, Pages 195-354

I read A Conservative Teacher’s account of his experience at the Birmingham Healthcare Rally with great interest. I wasn’t surprised that the liberals he encountered were launching personal attacks at him, that’s what they do when they don’t have a leg to stand on. It’s so much easier to launch ad hominem attacks than to worry themselves with the actual facts. What rather surprised me was how incredibly unprepared and ill-informed they were; I mean here we have the self-appointed intellectual elite in this country, and they are truly clueless about what this bill says and what it means to this country.

As usual, people are quick to dismiss the fact that BO has said all along he intends to “remake America” and that part of that plan is a single-payer healthcare system for all Americans (not just some, remember? and that’s in the title of the bill, too). He thought it could take up to 20 years to establish well enough to eliminate employer coverage, but Congress, in the form of HR 3200, sets it up over a five-year period.

People dismiss the fact that he was the one who raised the question of “death panels” and healthcare rationing when he stated that moral decisions would need to be made because chronically ill, terminally ill, and elderly people make up 80% of the healthcare costs in this county. What do you think that means except rationing care and someone in Washington deciding if you are worthy of the care you need or if you will be too much of a (to use BO’s term) “burden” on the system.

BO has said that a “panel of medical doctors” will be dictating procedures and which tests aren’t needed. Two things are wrong with this, the bill sets up such a panel (a Committee, it’s called), but only ONE member of that 27 person panel must be healthcare professional. So he is lying through his teeth (or he hasn’t read the bill). The other thing wrong with this is that I don’t want anyone but my doctor deciding what tests I need, or explaining my options to me and letting me decide which I need. I don’t want 27 people in Washington making this decision based on statistics or whether I’m in the right minority group. And how quickly do you really imagine this panel can make these decisions? They are doing so for every single person in this nation; you think they’ll get on your case this week, this year? Think again.

This bizarre notion that the government can somehow provide unlimited, quality care to all people in this country for free (or at any cost, actually) is absurd. I don’t understand why people can’t seem to grasp this. It’s not a difficult problem to figure out. Millions of Americans (and illegal immigrants, remember?) get unlimited, top-quality healthcare from the time they are conceived (I’m assuming prenatal care will be included, since drug abuse treatment is!) to the time they die? Really? There is no possible way that can ever happen: it’s not logistically possible, and it’s not financially possible. But you hear BO promise this every day when he tells you there will be no rationing of healthcare. Of course there will be! What do you think will happen? You’ll get the quality of care you now enjoy for free or next to nothing, that you’ll never be denied care for any reason, ever? That you’ll be able to have the tests you need when you need them? How is that going to happen when BO himself has said testing is one the first things to be rationed, er, closely reviewed so that “unnecessary testing” is eliminated? Guess who decides what is unnecessary, not you, not your doctor, that panel of 27 goons in Washington, only one of whom is a medical professional.

BO promises that this bill will increase competition and “keep the insurance companies honest.” This is also untrue. First of all, the government will dictate what is “acceptable” coverage and only those providers offering “acceptable” coverage will be allowed to do so; the government itself is the only one who can provide the basic plan (the so-called government “option”). Secondly, we also keep hearing how Fed-Ex and UPS are “competition” for the Post Office. But they aren’t. The Post Office is legally the ONLY entity that can deliver first-class mail. Fed-Ex and UPS operate outside that function, delivering mostly packages. They can never (unless the law is changed) deliver first-class mail in this country. No one can. Likewise, this idea that somehow the government will be “competition” for private insurers is a joke. If they are allowed (and yes, the government, in the form of the Commissioner will have the power to ensure they are regulated out of business; indeed, that has long been BO’s goal) to exist at all, they will not be able to offer anything that the government doesn’t expressly allow. If they do not meet whatever the government dictates, the government will “suspend” coverage provided to you by your private insurer (that’s in the first 95 pages). How can they do that? Because they will control ALL health care in this country. Period.

Here’s what the bill says about insurance competition with the government (I covered this in Fuzzy’s Notes; HR 3200, Pages 1-95): the insurance companies will be able to offer supplementary insurance, but they have to offer basic to offer enhanced, etc. That’s what the early pages say, but they come back in Pages 95-194 and say that only the government can offer the basic, enhanced, and premium plans. Not sure what that’s about, but it certainly doesn’t sound the trumpet of choice. I think this means that only when you have basic, enhanced, premium will you be eligible for “premium-plus,” even from the government, and private insurance that would be supplementary to these three policies would fall in the “premium-plus” government category? It could mean that you can get the enhanced plan and that it includes the basic aspects, though, like when we buy cable? I’m not clear on that part, actually. But the end result is the same: The government is essentially the only one who can deliver first-class mail and third-world healthcare. Yay us!

So in addition to all that, and the role of private insurers is still fuzzy (heh!), pages 95-194 leave a loophole for coverage of illegal aliens (I’m no lawyer, but why explicitly exclude illegals from receiving affordability credits if they can’t use the system in the first place?), set up a Health return process that we’ll all have to file each year as we do our taxes, and sets rates for doctors at current Social Security level, while charging these same doctors for doing so! They also write a blank check to the Health Exchange Trust Fund, to be paid via the Treasury; allot who know how much money to 800 hotlines, websites, and “clinics” to explain the system; set up a Special Inspector General Office for five years; sets up a taxing system to penalize all citizens and businesses for NOT using the national health care system, and sets up the state exchanges, of which only one will be available per state.

Is it sounding like Utopia to you? Let’s see what happens in the next hundred or so pages of HR 3200.

1. This section promises to adapt, change, and otherwise break nondisclosure agreements between you and the IRS. The Commissioner or state exchange, including “officers and employees” (pg 195), will have open access to your previously-confidential federal income tax returns. This is a privacy issue, and all those lefties who cried out about Open I. D. better perk up their ears because this is more “Big Brother” than anything George Bush tried to do! Keep in mind, too, that all of your medical records will be fully disclosed to the government, there is no doctor-patient privilege when you deal with the government. If the government gets their foot in the door, that’s that, Jack. It’s done. Look at GM, look at the banking industry in general and AIG in particular. Nothing in your life will be private, not your bank accounts, not your health information, and not your tax information. I haven’t got to the part about the National Health I. D., but you can bet it’s in here somewhere. How else will they track you through the health care system and work with your Health returns? It makes too much sense to use your social security number, so you’ll probably get another, separate national health number. That’s really the only way, if you think about it, that they can ensure that illegals (who obviously don’t have a social security number) can be covered. And make no mistake, they are.

2. Okay, here’s the “surcharge on high income individuals” (pg 197), let’s see how this works and what it reveals. Single, individuals (non-corporation) will be taxed annually at increasing amounts starting at earnings of $350k per year (1%) and going incremental(ly up to those making over $1 million (5.4%) (pg 197-98). These will go up in 2012 so that the 1% becomes 2%, etc. (pg 198).

3. Blah blah all the tax-related gobbeldy-gook that essentially means we’ll all pay a great deal for this plan, except “nonresident aliens,” who won’t be taxed at all (pg 199) and people living overseas who will see some sort of tax reduction (pg 202-03). Blah blah more tax stuff (pg 199-210).

4. Ah! This is more like it, “Medicaid and Medicare Improvements” (pg 215). Well, actually, the Table of Contents for this section runs through page 222, so the actual section itself doesn’t begin until (223). Here we goooooooo! Um, or not. These are (so far) simply amendments and addendums to existing codes and laws, and I don’t have those, so it’s not making much sense out of context. Here’s an example of what I mean:

SEC. 1102. INPATIENT REHABILITATION FACILITY PAY6
MENT UPDATE.
7 (a) IN GENERAL.—Section 1886(j)(3)(C) of the Social Security Act (42 U.S.C.
1395ww(j)(3)(C)) is amended 9 by striking ‘‘and 2009’’ and inserting
‘‘through 2010’’. (pg 224)

I’ll get past all this stuff. Scrolling . . .

5. Okay, I get it now. All of this is designed to pull various other, existing programs, health care providers, and government-run healthcare programs into the single agency. No one can possibly imagine this is being done for any purpose but to centralize and nationalize healthcare. For example, Inpatient Acute Hospitals (pg 224) , Skilled Nursing Facilities (pg 225), Long-term care Hospitals (pg 226), Inpatient Rehab (pg 226), Psychiatric Hospitals (pg 226), and Hospice (pg 228), will be accountable to the central national health agency, at least for purposes of “incorporating market-based updates” to “improve productivity” (pg 224). Outpatient hospitals (pg 265), Ambulance Services (pg 265), Ambulatory Surgical Centers (pg 266), and Laboratory Services (pg 266), as well. So everything gets swept under the national healthcare system that will then mandate improvements to productivity. This is just what it sounds like. And it’s also somewhat amusing that the government is going to give advice on (well, mandate) productivity enhancements. This is the same government that, when customers to the Post Office complained about long waits, took the clocks off the walls! Yep, that solved that. (And sure they denied that was the reason, but we all know what government denials mean. Remember Nixon? Clinton? BO on nationalizing healthcare?)

6. Remember when I asked about how they were going to pay for all the expansions they outline for Medicare? Well, here it is (pg 234+). Hmm, so it sounds like they plan to keep Medicare, but begin reviewing the effects of expansion “not later than 2016” (pg 234). That’s at that magic five year mark, so let’s see what happens . . . . Yep, here it is. Based on the data that they get at that magic five year mark, they will determine whether Medicare is still needed “based on coverage expansion” due to “this Act” (pg 236). Wave “bye” to Medicare as it gets sucked into the national system: there will be an “aggregate” reduction in Medicare funding (pg 237). Ditto Medicaid (pg 235).

7. The next section talks about physicians’ services and fees (pg 238+). A lot of “adjustments” and “revisions” like the one I quoted above. But when we get to page 245, things get interesting again. Here, we have the process by which the government will set the budget for physicians’ services. “Allowed expenditures” in physicians’ services will be determined by taking what was spent in one year and projecting “growth rate” for the next year (pg 245-46). So if there are set “allowed expenditures,” one can only conclude that if they guess wrong on the “growth rate” that there will be rationing of healthcare.

8. Electronic health record established (pg 259). This is in the Medicaid and Medicare section, though, so I’m not sure that it applies to all of us. Yet. Give it five years.

9. Changes the wording of a provision for “power-driven wheelchairs” to read, “complex rehabilitative power-driven wheel chair recognized by the Secretary as classified within group 3 or higher’’ (pg 268). Aw, I hope this doesn’t limit access for seniors to all those power chairs advertised on TV and paid for by Medicare. What’s the point of doing that? How much would that really save? That’s just mean.

10. Eliminates the Medicare Advantage regional plan and moves its funds to the “Federal Supplementary Medical Insurance Trust Fund” (pg 345). I don’t know what the MA regional plan is, but I do know that the feds got more money for their nationalization plan.

It’s 4 a.m., and I’m reading the same paragraph over and over trying to make sense of it:

SEC. 1177. EXTENSION OF AUTHORITY OF SPECIAL NEEDS
4 PLANS TO RESTRICT ENROLLMENT.
5 (a) IN GENERAL.—Section 1859(f)(1) of the Social
6 Security Act (42 U.S.C. 1395w–28(f)(1)) is amended by
7 striking ‘‘January 1, 2011’’ and inserting ‘‘January 1,
8 2013 (or January 1, 2016, in the case of a plan described
9 in section 1177(b)(1) of the America’s Affordable Health
10 Choices Act of 2009)’’ (pg 354)

But I can’t. Sleep now. More later.

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