Posted on 08/11/2009 7:00:47 PM PDT by caper gal 1
Edited on 08/12/2009 3:14:21 PM PDT by Admin Moderator. [history]
There are special interest groups trying to block progress on health care reform by using myths and scare tactics. Like the notion that health care reform would ration your care, hurt Medicare or be a government takeover. Actually, these are false statements.
All of the health care reform plans currently being debated in Congress would ensure that you and your doctor are the ones making decisions about your health. The majority of working Americans will continue to receive their health care through their employer. In addition, health care reform will strengthen Medicare by eliminating billions of dollars in waste while lowering prescription drug prices.
Throughout the debate on how to fix what's broken about our health care system, AARP pledges to help you cut through the noise and find the facts about what health care reform means for you and your family. When we see special interests using scare tactics, we'll make sure you're given the facts so you can make informed decisions about health care reform.
The following are some of the most common myths being spread about health care reform and the facts that prove them wrong – click here to watch a video by AARP on the myths and facts of reform.
Fact: Health care reform will preserve the employer-based health care system, meaning an estimated 200 million Americans will continue to get their coverage through their employers.
Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called "public plan" option would seek to give American consumers another choice if they can't find affordable, quality coverage in the private insurance market. The goal of the "public plan" is to give consumers the best value for their money and force greater competition among insurance plans for our business.
Fact: Every proposal that Congress is considering would allow people to choose their own doctors and hospitals.
Bottom Line: Health care reform isn't about a government takeover. It's about guaranteeing all Americans a choice of health care plans they can afford.
Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care.
Fact: Health care reform will NOT give the government the power to make life or death decisions for anyone regardless of their age. Those decisions will be made by an individual, their doctor and their family.
Fact: Health care reform will help ensure doctors are paid fairly so they will continue to treat Medicare patients.
Bottom Line: Health reform isn't about rationing; it's about giving people the peace of mind of knowing that they will be able to keep their doctors and that they will always have a choice of affordable health plans.
Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.
Fact: Health care reform will lower prescription drug costs for people in the Medicare Part D coverage gap or "doughnut hole" so they can get better afford the drugs they need.
Fact: Health care reform will protect seniors' access to their doctors and reduce the cost of preventive services so patients stay healthier.
Fact: Health care reform will reduce costly, preventable hospital readmissions, saving patients and Medicare money.
Fact: Rather than weaken Medicare, health care reform will strengthen the financial status of the Medicare program.
Bottom Line: For people in Medicare, health care reform is about lowering prescription drug costs for people in the "doughnut hole", keeping the doctor of your choice, improving the quality of care, and eliminating billions in waste that is causing poor care and medical errors.
Fact: The President and Congress have committed to producing legislation that will be paid for so it won't saddle our children and grandchildren with debt.
Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years.
Fact: If we do nothing to fix health care, the share of your income spent on health care will nearly double in the next seven years.
Bottom Line: When one in three Americans say someone in their family skipped pills, postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; when government spending on health programs rises so rapidly that it jeopardizes other priorities; and when employers struggle to pay for the costs of health care, the fact is, we can't afford not to fix health care.
Fact: Health care reform will NOT give the government the power to make life-and-death decisions for anyone regardless of their age. Those decisions will be made by individuals, their doctor and their family.
Fact: No one, including the government or your insurance company, will be given power to make life-and-death decisions for you.
Bottom Line: Health care reform isn't about putting the government in charge of difficult end of life decisions. It's about giving individuals and families the option to talk with their doctors in advance about difficult choices every family faces when loved ones near the end of their lives.
$#*& you, AARP.
These people are either complete idiots or unable to read.
Thank God he is that old. Thank you for posting this information.
It is way past time for him to be turned in
at a local recycling center. I wish his parents were still around to do it....but he probably sent them on well before they reached his current age.
My mother was a member of AARP wehn she was killed in an accident. AARP was given notification of her death in the documentation accompanying the routine claims on her AARP insurnce.
Soon afterwards, AARP was sending notifications to my deceased mother that her AARP membership was about to expire and reminded her that she needed to pay her membership dues. AARP was contacted my mail and by telephone innumerable times and reminded them of her death and the documentation already in their offices. Despite reassurances to the contrary, AARP continued frequent mailings requesting immediate membership renewal.
Once the due date for expiration of membership arrived, AARP began a campaign of billing my deceased mother for the dues owed when AARP took it upon their own authority to renew her membership for her after her death. When my deceased mother failed to send in the payments for the membership they renewed for her, they began to send her dunning notices and threatened to report her to a credit reporting agency. Then notices were received from credit reporting agencies claiming a debt owed. Throughout this entire episode, AARP was frequently contacted by telephone, letter, notated billing statements, and notated overdue notices and reminded that she was deceased and AARP had promised to cease the harassment.
Not to be deterred by mere death, AARP finally responded by sending my mother a new membership card without receiving payment of the demanded membership dues. Shortly afterwards, AARP was prominently quoted by the Mainstream News Media (MSM) as being the most important voice for elderly Americans because of its largest membership rolls. Hearing those AARP claims, I could not help wondering how many more captive dead Americans they had as participating members of AARP voicing their political support of AARP and its political agenda besides my own mother?
Apparently AARP thinks old people are dumb. It’s not that I think all those things are myths or are true, but I think the problems with the current legislation....
There are better alternatives and dems aren’t atleast willing to address those. If they would give this all time and consideration, I’m sure there’d be a much better bill available; and while I’m sure conservative wouldn’t find it all appealing...atleast he could say this is a multi-stragetic plan...not some bs to shove down all our throats.
No more AARP for me.
They are only saying this because they have been bought.
I love special interest groups, if they coincide with freedom.
The NRA is a prime example of a special interest group that backs our constitutional freedoms.
AARP is a special interest group that's prime business is to get their members the most money....damn the constitution, steal it from whoever you can.
Yes Virginia there is a difference.....
The Health Care Bill: What HR 3200, ‘‘America’s Affordable Health Choices Act of 2009,” Says
John David Lewis
August 6, 2009
What does the bill, HR 3200, short-titled ‘‘America’s Affordable Health Choices Act of 2009,” actually say about major health care issues? I here pose a few questions in no particular order, citing relevant passages and offering a brief evaluation after each set of passages.
This bill is 1017 pages long. It is knee-deep in legalese and references to other federal regulations and laws. I have only touched pieces of the bill here. For instance, I have not considered the establishment of (1) “Health Choices Commissio0ner” (Section 141); (2) a “Health Insurance Exchange,” (Section 201), basically a government run insurance scheme to coordinate all insurance activity; (3) a Public Health Insurance Option (Section 221); and similar provisions.
This is the evaluation of someone who is neither a physician nor a legal professional. I am citizen, concerned about this bill’s effects on my freedom as an American. I would rather have used my time in other ways—but this is too important to ignore.
We may answer one question up front: How will the government will pay for all this? Higher taxes, more borrowing, printing money, cutting payments, or rationing services—there are no other options. We will all pay for this, enrolled in the government “option” or not.
(All bold type within the text of the bill is added for emphasis.)
1. 1. WILL THE PLAN RATION MEDICAL CARE?
This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:
‘(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.
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.
and:
‘‘(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 . . .
EVALUATION OF THE PASSAGES:
1. This section amends the Social Security Act
2. The government has the power to determine what constitutes an “applicable [medical] condition.”
3. The government has the power to determine who is allowed readmission into a hospital.
4. This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.
5. This is government rationing, pure, simple, and straight up.
6. There can be no judicial review of decisions made here. The Secretary is above the courts.
7. The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.
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—
(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.
3. The IRS will be a major enforcement mechanism for the plan.
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 . . .
(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 . . .
(c) REQUIREMENTS RELATING TO COST-SHARING AND MINIMUM ACTUARIAL VALUE . . .
(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.
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.
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.
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.
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.”
3. The pressure for business owners to terminate the private plans will be enormous.
4. With employers ending plans, millions of Americans will lose their private coverage, and fewer companies will offer it.
5. The Commissioner (meaning, always, the bureaucrats) will determine whether a particular network of physicians, hospitals and insurance is acceptable.
6. With private insurance starved, many people enrolled in the government “option” will have no place else to go.
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.
EVALUATION OF THE PASSAGE:
1. This bill amends the Internal Revenue Code.
2. Tax surcharges are levied on those with the highest incomes.
3. The plan manipulates the tax code to redistribute their wealth.
4. Successful business owners will bear the highest cost of this plan.
6. 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:
(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.
EVALUATION OF THE PASSAGES:
The government’s authority to set payments is basically unlimited.
The official will decide what constitutes “excessive,” “deficient,” and “efficient” payments and services.
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.
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.
3. Any stated “limits” to such information are circumvented by item (v), which allows federal officials to decide what information is needed.
4. Employers are required to report whatever information the government says it needs to enforce the plan.
8. 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:
(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.
And, page 145, section 312:
(4) AUTOENROLLMENT OF EMPLOYEES.—The employer provides for autoenrollment of the employee in accordance with subsection (c).
EVALUATION OF THE PASSAGES:
1. Do nothing and you are in.
2. Employers are responsible for automatically enrolling people who still work.
9. 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.
‘‘(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.
The AARP cannot make promises for the government.
It has no say in making those health care decisions.
Why should I believe them?
I put AARP right down there with ACLU. Bunch of whackos.
Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called “public plan” option would seek to give American consumers another choice if they can’t find affordable, quality coverage in the private insurance market. The goal of the “public plan” is to give consumers the best value for their money and force greater competition among insurance plans for our business.
but, but, but on page 16 it says something totally different...like grandfathered and after Y1 you get govt. enrollment. No choices, no changes....etc.
Ping
Notice that the supporters of the bill NEVER actually point to the bill text itself.
We CAN point to exact quotes in the bill which DO validate the “myths”.
Interesting textbook on the shelf: “Must we mean what we say?”
Fact: Health care reform will preserve the employer-based health care system, meaning an estimated 200 million Americans will continue to get their coverage through their employers.
REALITY CHECK: According to the 2008 Kaiser Family Foundation Employer Benefit Survey, health insurance costs employers on average 11 percent of payroll. Employers can dump their employees on the public "health insurance exchange" and pay an 8 percent "contribution." You do the math.
Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called "public plan" option would seek to give American consumers another choice if they can't find affordable, quality coverage in the private insurance market. The goal of the "public plan" is to give consumers the best value for their money and force greater competition among insurance plans for our business.
REALITY CHECK: People participating in the "Health Insurance Exchange" will be liable for 100% of the cost of the premium. That works out to over $13,000 per year for family coverage for a HMO, according to the report cited above. Those families (not individuals) making more than 400% over the poverty line would not be eligible for any type of Affordable Premium Credit and would be liable for 100% of the $13000 premium. Even with the credit, the only people who would end up paying less than now are those whose salaries are 250% over the poverty line or less.
Fact: Every proposal that Congress is considering would allow people to choose their own doctors and hospitals.
REALITY CHECK: Every proposal that Congress is considering assumes that private insurance companies to participate in the Health Insurance Exchange. That much is true. HOWEVER, whether or not people get to keep their doctors and hospitals is dependent upon whether or not the doctor or hospital will be a participating provider in the Exchange plan that the person selects. Not all doctors accept Blue Cross. Not all hospitals accept Definity. There is nothing in the bill mandating that doctors or hospitals participate in all plans on the Health Insurance Exchange.
Bottom Line: Health care reform isn't about a government takeover. It's about guaranteeing all Americans a choice of health care plans they can afford.
REALITY CHECK: The government will mandate minimum levels of acceptable coverage for an insurance plan to be a "Qualified Health Benefit Plan (QHBP)." If an insurance plan is not listed as a QHBP, it doesn't meet the requirements of providing insurance coverage according to this bill. On the other hand, the government owned and operated "public option" will set an upper bound for coverage on the Health Insurance Exchange. If a privately owned plan wishes to be able to compete on this Exchange, it will have to control its costs to be competitive with this governemnt "public option" -- the only way to do that is to limit coverage to approximately the same as the "public option" and to limit reimbursements to doctors and hospitals to approximately the same level as the "public option."
While that is not EXACTLY a government takeover, the same as a single payer Canada-type plan, it has the same exact effect.
Does anybody want me to continue debunking this piece of propaganda?
I just got off the phone with an AARP representative. I told them I was cancelling my membership, my wife was cancelling hers, and several other family members would be cancelling theirs. The rep asked why, and I told her it was because AARP is endorsing the DeathScare Bill. She didn’t even deny it, just said “OK” in a smarmy voice.
AARP will also tell you that there are hundreds of billions in the Social Security “trust funds”
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