Saturday August 8, 2009, 7:42 am
Thanks Tom.

Saturday August 8, 2009, 8:54 am
You Do Not Have Health Insurance


http://www.truthout.org/080709A?n

The Baseline Scenario: "Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, '69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.'

Since most Americans currently have health insurance, they see reform as a poverty program - something that helps poor people and hurts them.

If that's what you think, then this post is for you. You do not have health insurance.

Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I'll come back to that later.)"




So, thanks to Rep. Anthony Weiner (D-NY), Speaker Pelosi says she will bring a vote to the floor on single-payer after the recess. Are you all ready to make those phone calls and write those letters?


Nancy's contact info..http://speaker.house.gov/contact/

Send our speaker an e-mail of encouragement.

Saturday August 8, 2009, 9:00 am
Great article, Blue - and thanks, Tom -
Those insurance people are many and they have no ethics - we have an uphill battle, don't we?

Saturday August 8, 2009, 9:38 pm
wow agreed and agreed. i am on medicade. i had my rx glass' for 12 years.. i could not afford another pair. i knew it was getting bad, the other day they broke none reparable, first i cried, then went to my soon to be ex. he even made me an appoint. w/ Walmart.this after noon i got the shocks of my life, let me note, NEED glass' to drive and its getting worse as time pass'. heres how the pay for them went=
dr visit=$50.00
average glass'=$105
lenses w/ bifocals= hope you are sitting.... 253.00 that adds up to about 500 dollars. i am still utterly shocked and scared i need my teeth done, medicade says no, they change my meds constantly, last month I finally got one that was really starting to help, well, they took it from me. the replacement does NOT work. My dr. has given me tons of samples and he is fightng them now.. but in the mean time. i sit on a borowed amount of money, that he WILL want asap. and a dr. that really is trying,,,,, i am at my end.. hell I even have my funeral attire set up here, so its one less thing my daughter will have to worry about. I got globe life for the lowest one and pray i do not die.

Sunday August 9, 2009, 6:44 am
Amazing piece Tom - Thank you! So many talking points that those angry protesters - the unpaid ones - should hear. Like this one...
"WENDELL POTTER: The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them, that if you even consider that, you're heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern. "

And this one:
BILL MOYERS: This is the key question for me. Can health reform that includes a public plan actually rid our system of the financial incentive on the part of the insurance industry to provide less for more?

WENDELL POTTER: It will help. It would help. Would it rid it? No, I don't think it would, because of the for-profit structure that is now dominant in this country. But the public plan would do a lot to keep them honest, because it would have to offer a standard benefit plan. It would have to operate more efficiently, as does the Medicare program. It would be structured, I'm certain on a level playing field, so that it wouldn't be unfair advantage to the private insurance companies. But because it could be administered more efficiently, then the private insurers, they would have to operate more efficiently. And that 20 cents in that medical loss ratio we talked about earlier might get narrower. And they don't want that.

This is a must see!!!

Sunday August 9, 2009, 11:53 am
Thank you Tom. Great to hear this from a former "insider"!

Monday August 10, 2009, 2:02 am
I watched this program and all I can say is Thank God for Bill Moyers and thank God I live in Canada!

Monday August 10, 2009, 3:30 am
Thank Tom for the posting but the video would not play for me correctly.

Tuesday August 11, 2009, 7:10 am
From Colette Campbell, the NJ Director of Americans for Prosperity, that should be passed along to anyone and everyone on your e-mail list. It is, in my opinion, the most accurate, objective analysis of the proposed “health care reform” bill now before the House of Representatives.
Please forward this to everyone you know so they are up to date and do not place themselves in the embarrassing position of being proved wrong on this vital issue.


The battle over our health care is reaching new heights. There has been a flood of misinformation via the internet regarding House Bill H.R. 3200, the most prominent of the proposals currently being advanced. While this bill is dangerous, it is essential those of you who are attending Town Hall meetings, calling legislators, getting on talk radio and writing letters to editors have all of the correct facts. The left is already calling criticism of this radical governmentalism of our health care false and nasty. A well educated citizen is the best defense of our liberty we can put forth. I am sending you a comprehensive analysis of one of the more popular lists of claims about the bill prepared by our Americans for Prosperity staff. I know it is long, but please take the time to read this. You can’t afford not to.
(Disclaimer: We are discussing H.R. 3200, the current House proposal, which as of August 6, 2009 has not had the amendments from the three House committee markups included in the text.)
CLAIM: Page 22: Mandates audits of all employers that self-insure!
This is TRUE. A commissioner will coordinate with the Secretary of Health and Human Services to create a report detailing the size, scope and stability of self-insured plans. The goal of this report is to “ensure that the law does not provide incentives for small and Mid-size employers to self-insure.” In other words, this bill will work to eliminate self insurers.
CLAIM: Page 29: Admission: your health care will be rationed!
This is PARTIALLY TRUE. The bill does not outline rationing in this section.
However, what it does do is establish cost sharing limitations. These government imposed limits on benefits paid are the statutory groundwork for what could become Rationing once costs inevitably spiral out of control in a government run system.
CLAIM: Page 30: A government committee will decide what treatments and benefits you get (And, unlike an insurer, there will be no appeals process)
This is TRUE. A health care advisory committee will be established with the intent of Defining “the essential benefits package … including categories of covered treatments, Items and services within benefit classes, and cost-sharing.” This new bureaucracy is Essential if politicians want to impose a mandate Americans to get coverage. Bureaucrats will then decide what qualifies as acceptable coverage to meet that mandate.
CLAIM: Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.
This is PARTIALLY TRUE. This section is an extension of the issue discussed above.
CLAIM: Page 50: All non-US citizens, illegal or not, will be provided with free healthcare
services.
This is FALSE. The referenced section refers to non-discrimination of coverage, which has cost implications, but does not discuss providing coverage to non-citizens.
CLAIM: Page 58: Every person will be issued a National ID Healthcare.
This is FALSE. However, the section in question does pose other problems. We invite you to read and ponder the implications: “Enable the real-time determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card.”
CLAIM: Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
This is TRUE. The bill allows Health and Human Services to “enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance.”
CLAIM: Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (read: SEIU, UAW and ACORN)
This is PARTIALLY TRUE. The bill provides for a reinsurance program for employer based plans. This provision is troubling because it puts taxpayers on the hook for improperly managed private retirement health care systems. As the claim suggests, union retirement plans are some of the most under funded in the country and stand to gain significantly.
CLAIM: Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
This claim is TRUE and undisputed.
CLAIM: Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
This is FALSE. The section merely outlines the limits for the types of plans that will be allowed in the exchange.
CLAIM: Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
This is TRUE. However, plenty of people in this country don’t speak English as their first language but are not illegal aliens.
CLAIM: Page 95: The Government will pay ACORN and Aerators to sign up individuals for Government-run Health Care plan.
This is PARTIALLY TRUE. This section does not talk about ACORN but does outline an outreach program to educate individuals and employers about the government system. However, it is certainly a legitimate concern to consider who the government would contract to conduct this “outreach and education.”
CLAIM: Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
This is TRUE. The commissioner of the health board would be instructed to create a process under which someone that “has not elected to enroll in an Exchange-participating health benefits plan is automatically enrolled under Medicaid.” This is another in a line of bureaucratic programs that will further limit and control an individual’s choice in care.
CLAIM: Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.
This is TRUE. The section clearly states that there “shall be no administrative or judicial review of a payment rate or methodology” used rate-setting decisions. This provision is critical if government wants to be able to use its coercive power against the private insurers.
CLAIM: Page 127: The American Medical Association (AMA) sold doctors out: the government will set wages.
This is PARTIALLY TRUE. This section establishes various levels of participation for physicians, including: preferred, participation non-preferred and other providers. These categories each contain limitations on the level of services government will reimburse for and the level of cost sharing that patients and providers must bear.
CLAIM: Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
This is PARTIALLY TRUE. The bill states that an employer must enroll an employee in the government plan unless the employee specifically opts out and instead “elects coverage under an employment-based health benefits plan offer by such employer.” This is a vehicle through which private insurers will be squeezed from the marketplace. The government-run program will be able to offer lower premiums to the employee who will
be forced to choose between the size of the withholding from his paycheck and the quality of care offered.
CLAIM: Page 149: Any employer with a payroll of $400,000 or more, who does not offer the public option, pays an 8% tax on payroll
This is TRUE and undisputed.
CLAIM: Page 150: Any employer with a payroll of $250,000 – 400,000 who does not offer the public option, pays a 2 to 6% tax on payroll
This is TRUE and undisputed.
CLAIM: Page 167: Any individual who doesn’t’ have acceptable healthcare (according to the government) will be taxed 2.5% of income.
This is TRUE. The bill states “any individual who does not meet the requirements of [the government program] is hereby imposed a tax equal to 2.5 percent … of the taxpayer’s modified adjusted gross income.”
CLAIM: Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
This is TRUE. The bill specifies that the mandates and tax penalties do not apply to individual who is a non-resident alien. However, it does not say Americans will pay for them.
CLAIM: Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
This is TRUE. With regards to determining government-determined “affordability credit,” the Health Choice Administration is empowered to gain access to tax return information or other such information that may be required to determine eligibility.
CLAIM: Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.
This is TRUE. With regards to a calculation of the amount of credit offered in a different
section of the bill, it does say that, the “tax imposed under this section shall not be treated as tax.”
CLAIM: Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
This is PARTIALLY TRUE. The bill does not specifically limit care to seniors.
However, it does seek to contain costs by asserting a new fee schedule for payment. This could have the effect of inducing physicians to limit the choices of seniors to receive certain care that does not fit the new schedule.
CLAIM: Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!)
This is PARTIALLY TRUE. The bill sets up new service categories, and pays according to the category. However, placement of physician classes into the categories and expenditures per service category are established by the Secretary of Health and Human Services.
CLAIM: Page 253: Government sets value of doctors’ time, their professional judgment, etc.
This is TRUE. The government will decide the value of doctor’s “time, mental effort and professional judgment, technical skill and physical effort, and stress due to risk.” The market determination for the importance of these functions is completely eliminated under the public plan.
CLAIM: Page 265: Government mandates and controls productivity for private healthcare industries.
This is FALSE. This provision establishes a best practices and productivity improvement incorporation program.
CLAIM: Page 268: Government regulates rental and purchase of power-driven wheelchairs.
This is TRUE. However, it is a reclassification of an existing regulation and contract standards.
CLAIM: Page 272: Cancer patients: welcome to the wonderful world of rationing!
This is PARTIALLY TRUE. The bill requires a review of cancer hospital payments be undertaken and costs adjusted accordingly. Although this will likely have the effect of lowering reimbursements and thus limitation quality care, the bill does not, in itself, ration care.
CLAIM: Page 280: Hospitals will be penalized for what the government deems preventable readmissions.
This is TRUE. “In order to account for excess readmissions in the hospital, the Secretary shall reduce the payments that would otherwise be made to such hospital.” Once again, this is government asserting its own bureaucratic judgment in the place of doctors and hospitals and punishing those who do not conform.
CLAIM: Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
This is TRUE. This is an extension of the above provision that relates to hospitals, only this time, applying it to physicians. Payment reduction will occur if a physician “sees an individual within the first week after discharge from a hospital or critical access hospital.”
CLAIM: Page 317: Doctors: you are now prohibited for owning and investing in healthcare
companies!
This is PARTIALLY TRUE. This section refers to rural operations and contains a percentage of ownership that doctors are not allowed to exceed. However, physician owned operations are very important in many rural areas and limiting a doctor’s ability to own an operation could severely cripple care.
CLAIM: Page 318: Prohibition on hospital expansion. Hospitals cannot expand without
government approval.
This is TRUE. This section limits the ability of physician-owned facilities to increase “the number of operating rooms, procedure rooms or beds of the hospital at any time after the date of the enactment.”
CLAIM: Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.
This is PARTIALLY TRUE. The section provides an opportunity for community input in the proposed expansion of the facility. However, it does not hinge on community approval.
CLAIM: Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
This is PARTIALLY TRUE. The bill does affect a shift toward a focus on outcome based medicine. This section requires a report to “reflect the outcomes of care experienced by individual enrolled in Medicare Advantage plans.” This type of reporting will lay the groundwork for the limitation of care to those procedures that the government believes produces the best outcome.
CLAIM: Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
This is TRUE. This section is a continuation of the empowerment of Health and Human Services to define what qualifies as adequate coverage.
CLAIM: Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
This is TRUE. The section is entitled “Extension of Authority of Special Needs Plans to Restrict Enrollment.” The section also requires a study into special needs treatment.
CLAIM: Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
This is TRUE. The section expands an existing Telehealth program.
CLAIM: Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
This is TRUE. An end-of-life care consultant program is endorsed and outlined explaining the role of such a consultant and the required actions that much be taken by a consultant.
CLAIM: Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
This is PARTIALLY TRUE. The bill does require that this information be provided. However, it does not contain an estate tax provision.
CLAIM: Page 425: Government provides approved list of end-of-life resources, guiding you in death.
This is TRUE. A list of end-of-life resources available from the government is required to be provided.
CLAIM: Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
This is PARTIALLY TRUE. The bill does not mandate this program, it establishes the parameters under which such a program is offered.
CLAIM: Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
This is PARTIALLY TRUE. The bill contains a section allowing for an individual to leave a medical order with an end-of-life consultant, who will then execute it should the need arise.
CLAIM: Page 430: Government will decide what level of treatments you may have at end-of life.
This is PARTIALLY TRUE. Similar to the above claim, an end-of-life planner will carry out the wishes of the patient, including treatments wanted and not wanted.
CLAIM: Page 469: Community-based Home Medical Services: more payoffs for ACORN.
This is TRUE. Government will reach out to and fund community-based medical homes that provide care and supervision of primary care by doctors. However, there is nothing to suggest ACORN would benefit.
CLAIM: Page 472: Payments to Community-based organizations: more payoffs for ACORN.
This is TRUE. Similar as outlined above.
CLAIM: Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
This is PARTIALLY TRUE. Although the bill strikes coverage for clinical social work, it expands the Social Security Act to include marriage and family therapists. However, it relates to private therapy services.
CLAIM: Page 494: Government will cover mental health services: defining, creating and rationing those services.
This is PARTIALLY TRUE. Similar provision as was provided above for marriage counseling. Of the 47 total claims that were offered from the first 495 pages of the 1018 page bill, Patients First finds:
• 25 to be TRUE
• 18 to be a PARTIALLY TRUE
• 4 to be FALSE
H.R. 3200 is a massive reordering of America’s health care services with a heavy bias toward injecting the government’s judgment in place of doctors, installing bureaucratic control in place of patient discretion and enacting significant tax increases in hopes of stemming the deficit busting costs of the new programs.
The analysis above provides a starting point for the digestion of the complex and onerous provisions in the current House proposal. On balance, I find the provisions examined to be a significant threat to the quality of our country’s health care. But don’t take my word for it, read the sections of the bill outlined above and make your own decision. That’s the best way to fight back against the big government mentality that is attempting to seize the nation.

Saturday September 5, 2009, 5:01 pm
Bill Moyers: "We Should Be Treating Health As A Condition, Not A Commodity"