My Summary on the US House of Representatives’ Health Care Bill
Who has time to read 2000 pages of mumbo-jumbo? I don't - but did anyway, and summarized it for others.
There is so much in this bill that one can’t possibly condense all the details, let alone comment on them. I’ve tried to keep this summary as short and sweet as possible, focusing on the major provisions, which are the most costly and will change the health care system the most.
My comments (editorializing, if you will) are in Italics. I do have some medical training (a degree in Diagnostic Medical Ultrasound), so my comments are coming from that background, as well as my fiscally conservative leanings.
There are some good things to this bill: killing the pre-existing condition bans, letting people appeal insurance co. decisions and a few more, BUT no matter what your political leanings this is a terrible piece of legislation. It was supposed to lower health care costs; instead it WILL raise them substantially. That’s not an opinion - that is a fact, as the summary notes below will show you. It will take trillions of dollars to implement over the next decade, despite the congressional forecasts (lies) you may have heard announced. There are also dozens of studies that are mandated to be undertaken by the Dept. Of Health, Education and Welfare, all to be reported to Congress within 2 or 3 years. The amount of burden this will bestow on HEW is astounding and, it will lead to a massive, costly, and permanent increase in the size of this dept. I feel sorry for the poor sap who gets that Secretary job.
There is also much govt. meddling (into health care companies, manufacturers, and physicians) mandated in the bill, into too many places where it will cause more harm than good, not to mention the endless paperwork. Worst of all, there is no tort reform in the bill!
MY FIRST GRIPE upon reading this 20000-page document: This bill’s Legal wording sucks – lawyers should not be allowed to be Representatives, and this bill is a clear (well, muddy!) example of why that should be so. There is no good reason why this bill could not be pared down and simplified to a 200-page doc.
Let’s move on to the bill itself:
Page 19: It appears that high-risk individuals will get insurance from the govt. for less money than they would otherwise pay. This, of course means that low-risk individuals who work to stay healthy will be underwriting that cost.
Page 20: SANCTIONS: It appears that companies can be penalized by HEW for employees who drop out of their health program for the govt. program, whether it’s the employer’s fault or not.
Page 22: COVERED BENEFITS. — $1500 max. Deductible, and no annual or lifetime limits. That sounds great, but surely means higher costs for insurers, which will be passed along to us end users.
Page 26: Despite the Dems insisting there will be no waiting lists in the health plan, the Sec. Of HEW is authorized to “make such adjustments as are necessary to eliminate deficits in the high-risk insurance pool, including reducing benefits, increasing premiums, or establishing waiting lists.”
Page 27: The HEW is empowered to make (numerous, onerous) regulations on insurance companies (i.e. a uniform definition of medical loss ratio, establish a process for the annual review of increases in premiums, thousands of forms to be filed, etc.)
Page 29-36: Under this section, a qualified “child” has been redefined into a person less than 27 years of age (!!!)
Page 58-61, Very tough to translate this, but it appears that employers will be repaid by HEW for transitioning retirees into another health care plan. Limited to $10 billion.
Page 63: Authorizes “Wellness grants” to employers for up to 50% of “qualified wellness programs” for up to 3 years. No real definition offered, HEW to come up with one, $50,000 limit. No mechanism provided to force those who need it into such a program.
Page 70 –COBRA continuation apparently will be indefinite – wording is truly awful here…
Page 72 - STATE HEALTH ACCESS PROGRAM GRANTS. Money will be made available for state affordable health programs, lots of paperwork required
Page 76-89: ADMINISTRATIVE SIMPLIFICATION. Ha! 13 pages outlining “simplification”.
Pg. 90 - PROTECTIONS AND STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS
Pg. 92 – Current plans are grandfathered in for 5 years, after which they “must meet the same requirements as apply to a qualified health benefits plan under section 201, including the essential benefit package requirement under section 221.
Pg. 96: Sec. 211 prohibits pre-existing conditions exclusions, guarantees renewals
SEC. 213: INSURANCE RATING RULES
Pg. 96 – GENERAL “The Commissioner shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a basic plan, not to be less than $1/month” (!). The amount of work that HEW will undertake to compute this (Pgs. 98-99) is glossed over, and will require substantial new jobs and bureaucracy to accomplish.
SEC. 222: ESSENTIAL BENEFITS PACKAGE DEFINED.
Pg. 105 - MINIMUM SERVICES TO BE COVERED:
(1) Hospitalization (no mention of any length limits)
(2) Outpatient hospital and outpatient clinic
(3) Professional services of physicians and other
(4) Such services, equipment, and supplies incident to the services of a physician’s or a health professional’s delivery of care in institutional settings, physician offices, patients’ homes or place of residence, or other settings, as appropriate.(very vague category, could cover almost anything)
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services, including behavioral health treatments.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.(Notice how they pass the buck here)
(9) Maternity care.
(10) Well-baby and well-child care and oral health, vision, and hearing services, equipment, and supplies for children under 21 years of age (note the changed definition of “child” here)
(11) Durable medical equipment, prosthetics, orthotics and related supplies.
Pg. 111 - Dental care is not included, but the Sec. of HEW will submit to Congress a feasibility report within 1 year.
Pg. 109: ABORTION COVERAGE PROHIBITED AS PART OF MINIMUM BENEFITS PACKAGE.
But health plans can provide optional coverage, and states (Pg. 146) can provide or mandate coverage.
Pg. 111-117: HEALTH BENEFITS ADVISORY COMMITTEE
Committee will have 17 Presidential Appointees and 9 appointed by the Comptroller general. All serve for 3 years. “The Health Benefits Advisory Committee shall recommend initial benefit standards to the Secretary not later than 1 year after the date of the enactment of this Act.” Sec. of HEW reviews their proposal and accepts or declines them.
SEC. 232: REQUIRING FAIR GRIEVANCE AND APPEALS MECHANISMS
Pg. 119-120: Sets up 2 levels of review boards for denied claim appeals BUT “Nothing in this section shall be construed as affecting the availability of judicial review under State law for adverse decisions under subsection 11 or (c), subject to section 251”. State Attorney Generals are also permitted to sue insurance companies (Pg. 146). In other words, there is no tort reform despite the appeals reviews board being set up to help consumers
SEC. 233: REQUIRING INFORMATION TRANSPARENCY AND PLAN DISCLOSURE.
Pg. 119-120: This bill (has the ironic nerve to) require that health insurer’s plans” be provided in plain language. (LOL!)
Pg. 119-120: Commissioner authorized and ordered to harass Insurance companies:
COMPLIANCE EXAMINATION AND AUDITS. — The Commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected noncompliance. The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations. And this will reduce costs?!
Pg. 150-151: Anti-trust exemption removed for insurance companies.
Pg. 153: Provides for higher rates of reimbursement or other incentives for such health care providers to use electronic health records. I thought this was supposed to reduce costs?
Pg. 159: ACCESS TO COVERAGE.
In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance change unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage. This part drones on for 6-7 pages, but says nothing about citizenship being required – covered later.
Pg. 188-189: Newborns are covered indefinitely, but under Medicaid (?) not the new Health Exchange plan: “GENERAL.—In the case of a child born in the United States who at the time of birth is not otherwise covered under acceptable coverage… for the period of time beginning on the date of birth and ending on the date the child otherwise is covered under acceptable coverage”.
Pg. 195: SEC. 307. HEALTH INSURANCE EXCHANGE TRUST FUND. Funds will be obtained from taxes on individuals & employers not obtaining acceptable coverage, and “appropriations to cover government contributions” (namely, taxes!)
Pg. 206: Co-ops. The Commissioner may make grants and loans for the establishment and initial operation of not-for-profit, member–run health insurance cooperatives. There is authorized to be appropriated $5,000,000,000 for the period of fiscal years 2010 through 2014 to provide for grants and loans under this subsection.
Pg. 211: Subtitle B—Public Health Insurance Option
Pg. 213: The Secretary shall collect such data as may be required to establish premiums and payment rates for the public health insurance option and for other purposes under this subtitle, including to improve quality and to reduce racial, ethnic, and other disparities in health and health care (implying that such discrimination exists, without offering any data as proof!)
Pg. 215: Initial funding is $2 billion (LOL< that should last a few days, they claim it will last 90 days)
Pg. 216: NO BAILOUTS.—In no case shall the public health insurance option receive any Federal funds for purposes of insolvency in any manner similar to the manner in which entities receive Federal funding under the Troubled Assets Relief Program of the Secretary of the Treasury (how long do you think this section will last?)
Pg. 217: The Secretary shall negotiate such rates in a manner that results in payment rates that are not lower, in the aggregate, than rates under title XVIII of the Social Security Act. Whatever that amount is!
Pg.222 – Physicians working under the plan will be required to accept whatever the govt. deems is “fair payment”. If you’re looking to discourage people from becoming doctors, this ought to do it.
Pg. 224 - SEC. 329. ENROLLMENT IN PUBLIC HEALTH INSURANCE OPTION IS VOLUNTARY.
This is not in the Senate version of the bill.
Pg. 225-227 Affordable credit options
(An) affordability cost-sharing credit… will be applied as a reduction of the cost of -sharing otherwise such plan; and the Commissioner shall pay the QHBPs affordability credits for all individuals enrolled. Commissioner shall (accept applications and) make a determination as to eligibility of an individual for affordability. The Commissioner shall establish effective methods that ensure that individuals with limited English proficiency are able to apply. (Another benefit for illegal immigrants).
Pg. 228 – Citizenship REQUIREMENT.—No individual shall be an affordable credit eligible individual unless the individual is a citizen or national of the United States or is lawfully present in the United States. However, the next six pages mention nothing about verification required except for a “declaration (!), and even going so far as to prohibiting the Commissioner from “establishing a database of information on citizenship or immigration status”.
Pg. 247: Affordability criteria – unbelievable!
To get affordability credits requires a “modified adjusted gross income below 400 percent of the Federal poverty level for a family of the size involved.” Those with health insurance at work are not eligible. The 2009 poverty level for a single person is $10,830 – multiplied by 4 is $43,320. Factor in that most people’s adjusted gross income is somewhat less than their true gross income, and you have the astonishing definition of somebody who makes no more than $48,000 being partially eligible for “affordability” cost-sharing credits! The poverty level definition rises for each family member too, so that a family of 4 only has to have an AGI of less than $88,200 to qualify for affordability credits. Needless to say, this section alone will cost the govt. billions and billions of dollars to implement. This credit is so generous, that some may want to waive health insurance at work and take a cash payout instead.
Pg. 252 - TABLE OF PREMIUM AND OUT-OF-POCKET LIMITS BASED ON INCOME TIER.
For the first year, affordability credits are gradually scaled back as your AGI increase to 400%.However, even at 350%-400% the out-of-pocket limit is $5000 (only $416/month).
Pg. 268-273 Employer Requirements
Employers are required to pay a minimum of 72.5% (individual) and 65% (family) premiums. Part-time employees are also partially covered under rules not yet devised. Employers can opt out by paying “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” to be “paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund”. Small employers pay less (pg. 276), and pay nothing if payroll for the year is under $500,000. Expect to see companies who have $500,000-$800,000 annual payrolls to downsize to avoid this penalty and the paperwork.
Pg. 278-279. Authorizes studies to examine the hardships this will inflict on employers. Shouldn’t they study this before passing this bill?!
Pg. 281-296 More paperwork, rules, regulations, penalties on employers
Pg. 297-298 TAX IMPOSED on individuals without acceptable health care coverage
Despite what was said on Pg. 224 - SEC. 329: There will be a “TAX IMPOSED on individuals without acceptable health care coverage… equal to 2.5 percent of the excess of the taxpayer’s modified adjusted gross income for the taxable year (which)… shall not exceed the applicable national average premium for such taxable year.
Page 310 - EXCISE TAX WITH RESPECT TO FAILURE TO MEET HEALTH COVERAGE PARTICIPATION REQUIREMENTS.—In the case of any employer who fails to satisfy the health coverage participation requirements, there is hereby imposed for each such employee a tax of $100 for each day.
Pg. 325 - Health flexible spending plans are (limited in) any taxable year to …. $2,500
Pg. 337 SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.
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 5 to 5.4 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $1,000,000. OK, rich guys – incorporate and set up a charitable trust (Pg. 338)!!
Pg. 339 - SEC. 552. EXCISE TAX ON MEDICAL DEVICES. (!!!)
There is hereby imposed on the first taxable sale of any medical device a tax equal to 2.5 percent of the price for which so sold. And HOW will this reduce medical costs?!
Pg. 375: SEC. 1103. INCORPORATING PRODUCTIVITY IMPROVEMENTS
This section features “productivity adjustments” in healthcare. A similar section is on Pages 414-416. This takes up 6 pages - the terminology describing how this will be done is completely incomprehensible. Yeh that should help!
Pg. 424 - SEC. 1144. REQUIRE AMBULATORY SURGICAL CENTERS TO SUBMIT COST DATA AND OTHER DATA. Medical facilities will be required to fill out many more forms, to be developed by Sec. of HEW within 3 years. The Secretary shall provide for periodic auditing of cost reports. More paperwork will not reduce costs or improve healthcare.
Pg. 426-429. Of interest to my friends and fellow students in Radiology/Ultrasound: with respect to advanced diagnostic imaging services (as defined in section 1834(e)(1)(B))furnished on or after January 1, 2011, the Secretary shall adjust such number of units so it reflects a presumed rate of utilization of imaging equipment of 75 percent) & “ICES.—Effective for fee schedules established beginning with 2011, reduced expenditures attributable to the presumed utilization of 75 percent under subsection instead of a presumed utilization of imaging equipment of 50 percent.’’ And “the Secretary shall increase the reduction in expenditures attributable to the multiple procedure payment reduction applicable to the technical component for imaging In other words, payments are cuts to imaging centers, and such centers cannot charge more for imaging another part of the body during the appointment, even though it DOES require more time and work.
Pg. 441-456: ADJUSTMENT TO HOSPITAL PAYMENTS FOR EXCESS READMISSIONS.—
“the Secretary shall reduce the payments that would otherwise be made” to hospitals that have a higher readmission than the 200 “best” hospitals’ readmissions rate. This appears to be an attempt to punish hospitals that (possibly) let patients out too early, and then have to be readmitted. However, this is not always a clear-cut call for hospitals, and 15 pages of obtuse regulations probably will not help them make a decision much easier either.
Pg. 499-507. REVISION OF MEDICARE PAYMENT TO ADDRESS GEOGRAPHIC INEQUITIES.
Finally something that makes sense! Obviously, doctors in NYC should be paid more than those in lower-cost areas like Iowa. This is also covered in Section 1168, on Pg. 532: STUDY REGARDING THE EFFECTS OF CALCULATING MEDICARE ADVANTAGE PAYMENT RATES ON A REGIONAL AVERAGE OF MEDICARE FEE FOR SERVICE RATES.
Pg. 508- 519 describes how differences in the House and Senate health care plans will be ironed out.
It’s as clear as mud.
Pg. 540: ENFORCEMENT AUTHORITY.—The Secretary is authorized, in connection with conducting audits and other activities under subsection (d), to take such actions, including pursuit of financial recoveries, necessary to address deficiencies identified in such audits or other activities.’’ If you like the idea of expanding government powers, and giving unelected officials at the Dept. of HEW the same powers as the IRS, with no mention of due process, well - this clause is for you!
Pg. 571-57 REQUIREMENT FOR MANUFACTURER DISCOUNT AGREEMENT FOR CERTAIN QUALIFYING DRUGS.—
DISCOUNTS.—A discount agreement under this paragraph shall require the manufacturer involved to provide… a discount or qualifying drugs. The amount of the discount …is equal to 50 percent of the amount of the drug-component negotiated price…of the drug under the prescription drug plan or MA–PD plan involved.
This is intended to force drug companies to give individuals the same price break as health plans that buy in large quantities. It sounds very nice, but this ignores the market reality that any consumer knows: buy a ton of stuff at Costco and it costs less than buying one of the products at a regular retail store. The net effect of this will be that drug companies will have to raise their drug prices overall to cover the losses this will create.
Pg. 613-636. More help for immigrants!
The Secretary of Health and Human Services shall conduct a study that examines the extent to which Medicare service providers utilize, offer, or make available language services for beneficiaries who are limited English proficient and ways that Medicare should develop payment systems for language services.
Wow – we’re not only going to bend over backwards and cater to people too lazy to learn English, we will pay them to take English classes?
Pg. 692-693 PRIMARY CARE PAYMENT INCENTIVES.—
In the case of services (furnished on or after January 1, 2011, by a primary care practitioner, There shall also be paid to the practitioner… an amount equal 5 percent (or 10 percent if the practitioner predominately furnishes such services in an area that is designated as a primary care health professional
shortage area. This a good idea – except it will, of course, like everything else in this bill, cost a lot of money
Pg. 697-699 Medicare Covered Preventive Services
The following screenings are covered:
(A) Prostate cancer screening tests
(B) Colorectal cancer screening tests
(C) Diabetes outpatient self-management training services
(D) Screening for glaucoma for certain individuals
(E) Medical nutrition therapy services for certain individuals.
(F) An initial preventive physical examination
(G) Cardiovascular screening blood tests
(H) Diabetes screening tests
(I) Ultrasound screening for abdominal aortic aneurysm for certain individuals
(J) Federally approved and recommended vaccines and their administration
(K) Screening mammography
(L) Screening pap smear and screening pelvic
(M) Bone mass measurement.
(N) Kidney disease education services.
(O) Additional preventive services (what? – no definition needed?!)
This generally a good idea BUT, notice how there is no mention of either”medically necessary” or physician referral in this section. Without there caveats, you can expect too may unneeded screenings to be performed – and once again, this will be very expensive.
PAYMENT AND ELIMINATION OF COST-SHARING.—
15 (1) IN GENERAL.— ‘‘With respect to Medicare covered preventive services, in any case in which the payment rate otherwise provided under this part is computed as a percent of less than 100 percent of an actual charge, fee schedule rate, or other such percentage shall be increased to 100 percent.’’.
This is a bad idea. Any health plan that allows zero co-payments from the patient encourages people to get unneeded tests and services. Even a small co-pay drastically reduces that demand. Again, this well-meaning provision will cost us a LOT of money.
Pg. 704: SEC. 1308. COVERAGE OF MARRIAGE AND FAMILY THERAPIST SERVICES AND MENTAL HEALTH COUNSELOR SERVICES.
Covering psych counseling is absolutely necessary – but marriage counseling?! This is really pushing the definition of health care coverage. It would be nice if we had the money, but considering the rest of this bill we certainly won’t have any extra bucks left over for this luxury!
Pg. 734-761 SEC. 1181 CENTER FOR COMPARATIVE EFFECTIVENESS RESEARCH ESTABLISHED
The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research to conduct, support, and synthesize research with respect to the
outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.
Yet another huge govt. program attempting to do something that could be better done in private industry by health care professionals instead of bureaucrats.
Pg. 762-872. 90 pages of rules, regulations, penalties and fees for nursing homes.
Yes, this will surely result in lower costs at nursing homes, ha-ha!
Pg. 889: SEC. 1128H. FINANCIAL REPORTS ON PHYSICIANS’ FINANCIAL RELATIONSHIPS WITH MFR’ & DISTRIBUTORS OF COVERED DRUGS, DEVICES, BIOLOGICALS, OR MEDICAL SUPPLIES UNDER MEDICARE, MEDICAID, etc.
Physician, Pharmacists, etc. must report gifts, trips, dinners, and even free samples given my drug co’s, mfr’s. etc. Reports must be filed with states and HEW.
Odd requirement pays lip service to ethics – doctors can accept stuff, but must report it all. Probably unenforceable and a waste of time. I don’t know about you, but I like the free samples I get from my doctor!
Pg. 945 - 998: Increased penalties, etc. for fraud, misc. fraud rules & regulations
Pg. 1004: SEC. 1712. TOBACCO CESSATION drugs are now included in Medicare and health plans.
Pg. 1064: SEC. 1726A. REQUIRING COVERAGE OF SERVICES OF OPTOMETRISTS. No details at all.
Pg. 1067: SEC. 1729. PRESERVING MEDICAID COVERAGE FOR YOUTHS UPON RELEASE FROM PUBLIC INSTITUTIONS.
As in “jail”. How considerate!
Pg 1106-1114: SEC. 1745. NURSING FACILITY SUPPLEMENTAL PAYMENT PROGRAM.
Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary of Health and Human Services to carry out this section $6,000,000,000 (that’s 6 billion dollars, over 4 years 2010-2013). Funds appropriated… shall remain available until all eligible dually-certified facilities …have been reimbursed for underpayments under this section during cost reporting periods ending during 2010 through 2013. A $6 billion bonus to nursing homes! Their lobbyists in DC must have done an excellent job.
TITLE VIII—REVENUE-RELATED PROVISIONS
Pg. 1163 - In addition to fees and taxes described previously, $300 million is appropriated for the Health care trust fund through 2012. No mention of how it will actually be funded.
Pg. 1168 – Taxes on existing Insured and Self-Insured Health Plans.
There is hereby imposed on each specified health insurance policy for each policy year a fee equal to the fair share per capita amount (whatever that is) determined (by the Sec. of HEW) under section 9511(c)(1) multiplied by the average number of lives covered under the policy.
LIABILITY FOR FEE.—The fee imposed by sub10 shall be paid by the issuer of the policy.
And passed along, of course, to the person paying for the policy!
Pg. 1218 – SEC. 2003. DEFICIT NEUTRALITY. (No, really, they’re not kidding!)
ESTIMATION OF BUDGETARY IMPACT.—For the purposes of estimating the spending effects of this Act, the authorization of appropriations from the Fund, to the extent amounts in the Fund are derived from the general revenues of the Treasury, shall be treated as new direct spending and attributed to this Act.
Funny, though, how this section is only 3 paragraphs long, and doesn’t explain at all how this bill we be deficit neutral.
Pg. 1268: Hey no democratic bill is complete without some affirmative action assistance, right?
SEC. 2241. SCHOLARSHIPS FOR DISADVANTAGED STUDENTS AND EDUCATIONAL ASSISTANCE IN THE HEALTH PROFESSIONS
‘‘not more than $35,000 (plus, beginning with year 2012, an amount determined by the Secretary on an
annual basis to reflect inflation) of the principal and interest of the educational loans of such individuals.’’
Pg. 1270-1272: ‘‘CULTURAL & LINGUISTIC COMPETENCY TRAINING FOR HEALTH
PROFESSIONALS’’
The Secretary shall establish a cultural and linguistic competency training program for health professionals, including nurse professionals, consisting of awarding grants and contracts under subsection 19 (b). In awarding grants and contracts, the Secretary shall give preference to entities that have a demonstrated record of…Placing health professionals in regions experiencing significant changes in the cultural and linguistic demographics of populations, including communities along the United States-Mexico border.
Let’s bend over backwards for those illegal immigrants. No need to speak English, folks!
Pg. 1286: ‘‘SEC. 3111. PREVENTION AND WELLNESS TRUST.
There is established a Prevention and Wellness Trust. There are authorized to be appropriated to the Trust out of the general fund of the Treasury (about 15.5 billion for the first 5 years).
Outside of the creation of “Task Forces” (Pg. 1291-1304), there is no real mention of what this money will be spent or wasted on. Some will be given in grants to the states (Pg. 1308-1312) for research or wellness programs (again, undefined).
Pg. 1313-1391 Grants for nursing, hospitals, telemedicine, and mental health training programs,
Pg. 1422-1430 GRANTS TO PROMOTE POSITIVE HEALTH BEHAVIORS AND OUTCOMES.
(To) educate, guide, and provide learning opportunities that target behavioral risk factors including physical inactivity, being overweight or obese, tobacco use, alcohol and substance use, injury and violence, risky sexual behavior.
How about we just make these people pay more for insurance?!
Pg. 1431-1433: SEC. 2531. MEDICAL LIABILITY ALTERNATIVES
INCENTIVE PAYMENTS FOR MEDICAL LIABILITY REFORM.—
The Secretary shall make an incentive payment, in an amount determined by the Secretary, to each
State that has an alternative medical liability law in compliance with this section. BUT! :
(B) the law does not limit attorneys’ fees or impose caps on damages.
This is as close as this lameass bill comes to tort reform – this is, of course, no reform at all.
Pg. 1491: 4—PAIN CARE AND MANAGEMENT PROGRAMS
3 SEC. 2561. INSTITUTE OF MEDICINE CONFERENCE ON PAIN.
No later than June 30, 2011, the Sec. of Health & Human Services (will) convene a Conference on Pain.
I do hope they will bring up the agony of reading this frigging bill.
Pg. 1501-1510: SEC. 2571. NATIONAL MEDICAL DEVICE REGISTRY.
The Secretary shall establish a national medical device to facilitate analysis of post market safety
and outcomes data on each covered device.
Yes, tons more paperwork for manufacturers. And, you think this will reduce costs?
Pg. 1510-1519 SEC. 2572. NUTRITION LABELING OF STANDARD MENU ITEMS AT CHAIN RESTAURANTS AND OF ARTICLES OF FOOD SOLD FROM VENDING MACHINES.
Are we micro-managing yet?
Pg. 1562-1605 COMMUNITY LIVING ASSISTANCE SERVICES AND SUPPORTS
The purpose of this title is to establish a national voluntary insurance program for purchasing community
living assistance services and supports.
This drones on a lot, but never states who will pay for this or how, pretty much like the rest of this bill.
Pg. 1618 - 1623 ‘‘SEC. 713. OFFICE OF WOMEN’S HEALTH.
21 ‘‘(a) ESTABLISHMENT.—The Secretary shall establish within the Office of the Administrator of the Health Resources and Services Administration, an office to be known as the Office of Women’s Health.
Is this really necessary? And if so, where is the Office of Men’s Health? This just more bureaucracy, and the money spent would be better spent on something, like, oh maybe women’s health?!
Pg. 1635-1990 DIVISION D—INDIAN HEALTH CARE IMPROVEMENT
The details of this “Division” sound pretty much the same as the rest of the health care bill – I’m not sure why it needs a separate 365-page Indian section. And frankly, I’m shocked, SHOCKED, by the term “Indian” instead of Native American! LOL.
No, thank you, I will not be reading the US Senate version of this bill.
Write your Senators and tell them to vote against this monstrous piece of legislation.
And for those of you who like it: what are you, nuts?!
