Tuesday, August 18, 2009

Correcting the Health Care Crazies -- Part 2

A few days ago, I received an email about the House health care bill that included so many inaccuracies and outright lies, that I was compelled to respond. This is the second post in rebuttal to that email. Earlier discussion of the health care debate is here.

Yesterday, I looked at self-insured plans and out-of-pocket maximums. Today's topics are those folks the crazies say will get to dictate your health plan and illegal immigrants.

• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)

I think this is supposed to be scary because it is "the guvmint" whose committee will set guidelines; otherwise, this is no different than what goes on today. Here is the text of the bill:
(1) IN GENERAL.—There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.
Of course, every health insurer already has a panel that "decides what treatments and benefits you get." When you get your benefits book (assuming you already have insurance), there will be a very long section listing which conditions are not covered, which treatments are not allowed, or which procedures will only be partially paid for. Those decisions were made in advance by a committee of doctors, actuaries, and accountants who decide what should and should not be covered.

The bill calls for a committee to make recommendations to those insurers who are part of the health exchange. These recommendations will ensure that those carriers offering coverage through the exchange meet minimum standards of coverage. If you purchase insurance through the exchange and want to have a procedure done that is not covered by the plan you choose, you can pay out of pocket for the procedure...just as you can today.

And because you have the option to buy a private plan through the health care exchange (or through your employer), you will have the option to appeal...just as you do today.

• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.

The "Health Choices Commissioner" is the head of the agency, like the Postmaster General or the Director of FEMA. From the bill:
(a) DUTIES.—The Commissioner is responsible for carrying out the following functions under this division:

(1) QUALIFIED PLAN STANDARDS.—The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.

(2) HEALTH INSURANCE EXCHANGE.—The establishment and operation of a Health Insurance Exchange under subtitle A of title II.

(3) INDIVIDUAL AFFORDABILITY CREDITS.— The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.

(4) ADDITIONAL FUNCTIONS.—Such additional functions as may be specified in this division.
The Commissioner is charged with setting the standards that companies who wish to offer insurance through the exchange must meet. He or she is responsible for administering this exchange of plans. He or she is also coordinates the subsidy paid to people who make less than three-times the federal poverty limit.

You will have a choice. You can choose to keep the plan you have with your employer or not. If not, you can choose from any number of plans in the exchange. If you are not wealthy, your premiums through the exchange may be subsidized. The commissioner runs the plan. He or she does not make any of those decisions for you.

• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.

Oh brother. Let's just go to the bill:
(a) IN GENERAL.—Except as otherwise explicitly permitted by this Act and by subsequent regulations consistent with this Act, all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services.
"Personal characteristics extraneous to the provision of high quality health care" is pretty ambiguous. When I read that, it tells me that participants cannot be discriminated against for any host of reasons--religion, race, gender, age, etc.--but let's assume the Crazies are right and this is a way to sneak illegal immigrants into the bill. Even if we concede the point, this section only allows undocumented immigrants to purchase health care through the exchange.

In order for someone to qualify for "free health care," one would have to be so poor that they would receive a full subsidy for their care (which would not happen because participants who are that poor would get their care through Medicaid, not the exchange). However, illegal immigrants cannot receive subsidy credits. From page 143 of the bill:
Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.
That's about as plain as legislative language gets. "No Federal payment for undocumented aliens." So if there is no Federal payment, there is no free (or subsidized) health care. Period.

Next time: Big Brother wants your checking account.
blog comments powered by Disqus

Post a Comment


No Drumlins Copyright © 2009 Premium Blogger Dashboard Designed by SAER