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TOPIC: *HEALTHCARE*: "America’s Affordable Health Choices Act of 2009" *RESEARCH INFO.*


silver

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*HEALTHCARE*: "America’s Affordable Health Choices Act of 2009" *RESEARCH INFO.*
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There are many important aspects of the current proposals to reform health care in America.  In the days to come, I hope to develop more information on the reform efforts, with pros and cons.  I also plan to have Hillary's plan up, for a side-by-side comparison. 

I hope everyone joins in discussing this significant legislative event. 


A summary of the Act is here
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BILLSUMMARY-071409.pdf


The full Act is here (warning, it is over 1,000 pages long!)
http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf


The following link has considerable information that might be helpful.
http://edlabor.house.gov/blog/2009/07/americas-affordable-health-choices-act.shtml



For comparrison and contrast to Obama's plan, here is Hillary's "American Health Choices Plan"  - Click on Image for link to full text of plan
HillaryHealthChoicesPlan.jpg





-- Edited by Xyndau on Wednesday 5th of August 2009 01:48:36 PM

-- Edited by thebword on Tuesday 18th of August 2009 02:28:12 PM

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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Charts - Current State and (proposed) Future State

CURRENT HEALTH CARE SYSTEM: http://www.tnr.com/yourhealthcaresystem.html (Chart prepared by The New Republic)

(Dem-Proposed) FUTURE SYSTEM: http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf (Chart prepared by the GOP)

-- Edited by Sanders on Monday 3rd of August 2009 01:28:35 AM

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Diamond

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Xyndau, You have opened a great topic and on a serious note calling for good discussion. Thanks. 

This is your third item there. (I had some difficulty with the live link)
America’s Affordable Health Choices Act - Committee on Education & Labor
http://edlabor.house.gov/blog/2009/07/americas-affordable-health-choices-act.shtml


I have added some more reference items here and moved down my early analysis further down in the thread.  I hope these summaries are not too biased.

I am now looking at these 4 additional items:

(1) America’s Affordable Health Choices Act Section-by-Section Analysis (AmericanBenefitsCouncil.org 7-14-09) (35 pages)

Senate Finance Committee's Description of Policy Options - two whitepapers   --- Looking at these right now.
(2) Expanding Health Care Coverage:
Proposals to Provide Affordable Coverage to All Americans
(65 pages)
(3) Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs(52 pages)
Prior larger version of 1 and 2:
Senate Finance Committe - Healthcare Reform Whitepaper - final Nov 2008
(Sen.Max Baucus D-Mont)

(4) Comparative table - comparison of House & Senate proposals (AP / LA Times) [included below for ease of use in calibrating new info]

===========================================


Healthcare Law Reform Insights
(healthcarelawreform.com)

House Proposes Significant Tax Increases to Pay for Health Care Reform - by Marcha Pugh

The Facts

Health care reform legislation introduced in the House, the America's Affordable Health Choices Act of 2009, provides key details on financing health system reform. Significant revenue-raising proposals include the following:

  • A surcharge on high-income individuals of 1 percent on adjusted gross income between $350,000 and $500,000 (married filing a joint return), a 1.5 percent surcharge on incomes between $500,000 and $1 million, and a 5.4 percent surcharge on income in excess of $1 million, to raise $543.9 billion over 10 years
  • Corporate and international tax proposals that have narrow application or were widely expected by the business community, or both, including a further delay in the application of worldwide interest allocation rules relevant to U.S.-based multinationals for foreign tax credit purposes, denial of treaty benefits for groups parented by non-treaty country entities, and the long-anticipated codification of the economic substance doctrine applicable to a wide range of taxpayers, to raise $37.2 billion over 10 years

What's at Stake

As the House and Senate seek to pay for health system reform, it is expected that one-third to one-half of the cost of reform will be paid for through increased revenue from the tax code. Certain companies and high-income individuals may see significant increases in their tax liability. The Senate Finance Committee is considering a range of revenue-raising options. If the Senate selects different revenue-raising provisions, then the House and Senate will have to reconcile their differences in Conference, which could make passage of a bill more difficult.

Steps to Consider

  • Watch the Senate Finance Committee, which is working to craft its own revenue raising proposals for health reform. It is expected that the Senate will turn to revenue-raising provisions not included in the House bill.
  • Small businesses should pay close attention to the surcharge proposal because many small businesses report profits on individual tax returns. Some members of the House are clamoring for changes to the surtax prior to House floor action.
  • Thus far, tax writers have indicated that the more controversial corporate and international revenue-raising provisions in the president’s budget will not be considered as part of health care reform, but companies should monitor the situation.


-- Edited by Sanders on Monday 3rd of August 2009 02:56:56 PM

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silver

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This Country Does NOT Need Universal Health Care - Mon at 5:13pm (by a group of students at Texas A&M Univ.)

Source link: ?

Here is a brief list of what we get if Universal Health Care is brought to our nation. Read this and even compare it to the real document which link I provided at the end, you will see that it is all true. No bull is being told. When you read these I want you to think about all of these carefully, even if you want to be selfish minded and think that half of these don't even apply to you, think about other people that you know. Think about how it will affect your friends, your family, your neighbors, everyone around you.

If you want to become a business owner, or are one, you will be greatly affected in multiple ways. If you know any one that has special needs (MY BROTHER), they will be restricted from this plan: i.e. WILL NOT BE COVERED. If you have a bank account, the government will have access to it and be allowed to transfer funds. If you are elderly, the government will be allowed to deny you of medical attention if they believe that it won't have much effect, therefore allowing them to "initiate end of life plans" i.e. allow you to just die.

Go on, please read this and please look at the full plan if you have the time. Universal Health Care IS NOT what this country needs. It defies freedom! Please let anyone you know about all of this. People need to know what is really being stated in this 1017 page Universal Health Care plan. Call or email your congressmen and women and let them know what you think.

Pg. 22: MANDATES the Govt will audit books of ALL EMPLOYERS that self insure!!

Pg. 30 Sec 123: THERE WILL BE A GOVT COMMITTEE that decides what treatments/benefits you receive.

Pg. 29 lines 4-16: YOUR HEALTHCARE IS RATIONED.

Pg. 42: The Health Choices Commissioner will choose your Health care Benefits for you. You have no choice in the decision.

Pg. 50 Section 152: Healthcare will be provided to ALL non US citizens, illegal or otherwise.

Pg. 58: Govt will have real-time access to individual finances & a National ID Healthcard will be issued.

Pg. 59 lines 21-24: Govt will have direct access to your bank accounts for direct funds transfers.

Pg. 65 Sec 164: payoff subsidized plan for retirees and their families in Unions & community orgs (ACORN).

Pg. 72 Lines 8-14: Govt is creating a Healthcare Exchange to bring private healthcare plans under Govt control.

Pg. 84 Sec 203: Govt mandates ALL benefit packages for private Healthcare plans in the Exchange

Pg. 85 Line 7: Specifics for Benefit Levels of Plans = The Government rations Healthcare based on cost benefits to government.

Pg. 91 Lines 4-7: Govt mandates linguistic appropriation services or translation services for illegal aliens.

Pg. 95: Lines 8-18 The Govt will use groups like ACORN & Americorps to sign up individuals for Govt Healthcare plan

Pg. 85 Line 7: Specifics of Benefit Levels for Plans. #AARP members - your Health care WILL be rationed.

Pg. 102 Lines 12-18: Medicaid Eligible Individuals will be automatically enrolled in Medicaid.

Pg. 124 lines 24-25: No company can sue GOVT on price fixing. No "judicial review" allowed against Govt monopoly

Pg. 127 Lines 1-16: Doctors/ AMA - The Govt will dictate what wage you are allowed to make. (Wage limits).

Pg. 145 Line 15-17: An Employer MUST enroll their employees into the public option plan. THEY HAVE NO CHOICE, and neither do the employees.

Pg. 126 Lines 22-25: Employers MUST pay premiums for every employee, part time
employees AND their families as well.

Pg. 149 Lines 16-24: ANY Employer with a payroll of $400,000 will have an 8% tax levied on all payroll.

pg 150 Lines 9-13 Employers with payroll between $251,000 & 400,000 who does
not provide in full, the public option, will have a 6% tax on all payroll
levied.

Pg. 167 Lines 18-23: ANY individual who doesn't have acceptable HC coverage according to Govt mandate, will be taxed at 2.5% of their income for healthcare. So, you will have government healthcare coverage, or you will be punished.

Pg. 170 Lines 1-3:l Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)

Pg. 195: officers & employees of HC Administration (GOVT) will have total and complete access to ALL your personal financial, bank and investment information.

Pg. 203 Line 14-15: "The tax imposed under this section shall not be treated as tax" Yes, it says that.

Pg. 239 Line 14-24: Govt will reduce physician services for Medicaid, Seniors, low income, and poor.

Pg. 241 Line 6-8: Wages for all doctors will be made the same. Specialists like Brain Surgeons will make the same money a General Practitioner makes.

Pg. 253 Line 10-18: Govt sets value of Doctor's time. Govt. decides value of humans.

Pg. 265 Sec 1131: Govt mandates & controls productivity for private HC industries.

Pg. 268 Sec 1141: Fed Govt regulates rental & purchase of power driven wheelchairs

Pg. 272 SEC. 1145: TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!

Pg. 280 Sec 1151: The Govt will penalize hospitals for what Govt deems preventable re-admissions.

Pg. 298 Lines 9-11: Doctors that treat a patient during initial admission will be penalized.

Pg. 317 L 13-20: PROHIBITION on ownership/investment. Government dictates what Doctors can make and how much they can own.

Pg. 317-318 lines 21-25,1-3: PROHIBITION on expansion- Govt mandates hospitals cannot expand without government approval.

Pg. 321 2-13: Hospitals have opportunity to apply for exception BUT community input and approval is required. Can you say ACORN?!!

Pg. 335 L 16-25; Pg. 336-339: Govt mandates establishment of outcome based measures. Rationing

Pg. 341 Lines 3-9: Govt has authority to disqualify Medicare Advance Plans, HMOs, etc. Forcing people into the Govt plan.

Pg. 354 Sec 1177: Govt will RESTRICT enrollment of Special needs persons for care. Can euthanasia be far behind for "undesirables"?

Pg. 379 Sec 119:1 Govt creates more bureaucracy - Telehealth Advisory Committee. Can you say HC by phone?

Pg. 425 Lines 4-12: Govt mandates Advance Care Planning Consultation. Egthanasia and Doctor-Assisted Suicide.

Pg. 425 Lines 17-19: Govt will instruct & consult regarding living wills, and assume power of attorney of all enrollees. Mandatory!

Pg. 425 Lines 22-25, 426 Lines 1-3: Govt provides approved list of end of life resources, guiding you in death decisions to end your life.

Pg. 427 Lines 15-24: Govt mandates program to mandatory end of life programs. The Govt will mandate how your life ends.

Pg. 429 Lines 1-9: An "advance care planning consultant" will be used frequently as a patient's health deteriorates

Pg 429 Lines 10-12: "advance care consultation" may include an ORDER to initiate end of life plans. AN ORDER from GOV to terminate a life.

Pg. 429 Lines 13-25: The govt will specify which Doctors can write an end of life order.

Pg. 430 Lines 11-15: The Govt will decide what level of treatment you will have at end of life

Pg. 469: Community Based Home Medical Services=Non profit orgs. Hello, ACORN Medical Services here!!?

Pg. 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORG. 1 monthly payment to a community-based org. Like ACORN?

Pg. 489 Sec 1308: The Govt will cover Marriage & Family therapy. Which means government will now be involved in marriage and family decisions.

Pg. 494-498: Govt will cover Mental Health Services including defining, creating, rationing those services.

The full Health Care bill that sits in the House:  http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.pdf



-- Edited by Sanders on Monday 3rd of August 2009 01:47:47 AM

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Bump.

I moved this to the main room for the time being.

Delete this post.

-- Edited by Sanders on Monday 3rd of August 2009 12:33:47 AM

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RE: Two competing charts (related to Healthcare)
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bump.

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Platinum

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i,ll need to study this more,thanks

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Platinum

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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bump
This post can be deleted. Crunching down the thread.

-- Edited by Sanders on Monday 3rd of August 2009 12:35:55 AM

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silver

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this referred thread has been merged into this thread.

This post can be deleted. Crunching down the thread.

-- Edited by Sanders on Monday 3rd of August 2009 12:49:45 AM

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"America’s Affordable Health Choices Act of 2009"
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Most of the info I have on this already comes from The Confluence and Uppity Woman, links provided below for your convenience. I have already contacted my Congressman, Rick Boucher, and told him I do not support this bill as written for two main reasons, the outrageous cost, and the fact that this bill was poorly written, too complicated and lengthy for anyone to be able to read it and comprehend it, and I have a lot of questions regarding the end of life stipulations that quite frankly I don't think need to be in there. The bill has so many "extras" in it that are not related to providing health care that I consider it pork. My congressman by the way does not support this bill as written, he favors local coops, which has been added from the negotiations with the Blue Dog Dems. The Confluence and PumaPac and Uppity Woman have a lot of info already. The links are below,

The Confluence: http://riverdaughter.wordpress.com/

Uppity Woman: http://uppitywoman08.wordpress.com/

PumaPac: http://uppitywoman08.wordpress.com/

I am adding this which was taken from PumaPac.  It has several points that I have also seen written at The Confluence.

"From theBlack Agenda Report, via the always excellent Violet Sox:

Top Ten Ways To Tell that Obama is NOT Fighting For Health Care For Everybody

by BAR managing editor Bruce A. Dixon

1. Their plan doesn’t cover the uninsured until 2013.
2013 isn’t “day one.” It’s not even after the midterm election. It’s clear after the president’s second term, if he gets one. Congress passed Medicare in 1965 and president Lyndon Johnson rolled out coverage for millions of seniors in eleven months, back in the days before they even had computers.22,000 Americans now perish each year because they can’t get or can’t afford medical care, and this year three quarter million personal bankruptcies will be triggered by unpayable medical bills. Why this president and these Democrats are in such a hurry to pass health care now that doesn’t take effect till two elections down the road doesn’t make sense in any kind of good way.

2. Their “public option” isn’t Medicare, won’t bring costs down and will only cover about 10 million people.
The “public option” was sold to the American people as Medicare-scale plan open to anybody who wants in that would compete with the private insurers and drive their costs downward. But in their haste not to bite the hands that feed them millions in campaign contributions each hear, the president and his party have scaled the public option back from a Medicare-sized 130 million to a maximum of 10 million, too small to put cost pressure in private insurers. Worse still, the president and his party are playing bait-and-witch, not telling the public they have reduced the public option, to nearly nothing.  

This remnant of a public option is not Medicare, as Howard Dean insists, and it will not lead to the sort of everybody-in-nobody-out health care system that most Americans, whenever they are surveyed say they want.

Some Senate and House Democrats want to ditch even the pretense of a “public option” in favor of something they’re calling a private insurance “co-op”, which as near as anybody can tell has the same relationship to an actual cooperative that clean coal has to actual coal.

3. The president and his party have already caved in to the drug companies on reimporting Canadian drugs, on negotiating drug prices downward and on generics.
This explains why Big Pharma, the same people who ran the devastating series of anti-reform “Harry and Louise” ads to spike the Clinton-era drive to fix health care are spending $100 million to run Obama ads using the president’s language about “bipartisan” solutions to health care reform.

4. The president and his party have received more money from private insurers and the for-profit health care industry than even Republicans, with the president alone taking $19 million in the 2008 election cycle alone, more than all his Repubican, Democratic and independent rivals combined.
Democratic senator Max Bacaus got $1.1 million in 2008. Democratic senators Harkin, Landreau and Rockerfeller each got over half a million, and Senator Durbin got just under half a million. Other Democratic senators got a little less. Four Democrats in the House, Rangel, Dinglell, Udall and Hoyer got over half a million apiece in 2008, with other Democrats not far behind.  

Is there any wonder that the insurance companies, like the drug companies are also running “bipartisan health care reform” commercials using the president’s exact language?

5. The president’s plan, and those of Republicans and Democratic blue dogs too, will require families to purchase health insurance policies from private insurers.
This is something the policy wonks call an ‘ros-and-Cons-of-Individual-Mandate">individual mandate”, under which Individuals will be “mandated” to purchase affordable insurance, though companies would not be required to offer it. In Massachusetts, the prototype state for the Obama plan, a family with an income of $33,000 can be required to spend $9,000 in deductibles and out-of-pocket expenses before the insurance company is obligated to pay a dime. As in Massachusetts, public money is used to purchase private insurance for the very poorest citizens. With the revenues of insurance companies on the decline, individual mandate programs are a welcome bailout for the private insurance industry.

6. The president’s plan, and those of Republicans and Democratic blue dogs too, could force you to buy junk insurance.
Think about an insurance policy that costs a lot, but is full of loopholes, exceptions and steep deductibles and co-payments. That’s junk insurance, and for many it’s the only insurance companies offer. Even more pernicious is the widespread practice among insurance companies of “recission” in which claimants are routinely investigated and disqualified in the event that they finally make a claim. Insurance companies admit they do this to half of one percent of policies per year. That means if you hold a health insurance policy twenty years, you don;t have insurance – you have a ninety percent chance of having insurance.

7. The president’s plan, as well as those of Democratic “blue dogs” and Republicans, are to be funded in part with cuts in Medicare and Medicaid.
Private insurance companies have always hated Medicare because it is far more efficient than they are. Medicare’s administrative expenses are under five percent, as compared with the one third of every health care dollar taken by the for-profit insurance companies for their advertising, bad investments, billing and denial machinery, executive salaries and bonuses. Private insurers have, over the years, purchased enough influence in Congress and previous White Houses to restrict Medicare’s payment rates and partially privatize it. But president Obama’s plan, perhaps the most friendly to Medicare and Medicaid, calls for over $300 billion in cuts to the programs that now provide medical care to those with the fewest options, while failing to guarantee that care will come from elsewhere. In Massachusetts right now, hospitals are turning away poor people they used to be able to provide care for because funding that used to go to those institutions is now plowed into the state’s “individual mandate” system.

8. The president, with the cooperation of corporate media and the Republicans is trying to make the argument about himself instead of a discussion on the merits of his policy.
The president and his critics are happy to talk about whether this will be “his Waterloo”, or his Dien Bien Phu, as if that matters more than the 22,000 Americans who die each year from lack of medical care, or the three quarter million who will go bankrupt because of unpayable medical bills. The concentration on whether the president looks good or bad takes up air, ink, and coverage time that might otherwise be spent explaining what is and isn’t in the various proposals, and why.  

If the president were not afraid of his own supporters publicly examining the merits and demerits of his proposals, he would mobilize those 13 million emails and phone numbers collected during the campaign. The reason he has not sone so already is that most of his own supporters favor a Medicare-For-All single payer health care system, HR 676.

9. The president and his party, and the corporate media have spent more time and energy silencing and excluded the advocates of single payer health care, mostly the president’s own supporters, than they have fighting blue dogs and Republicans.
But no matter how diligently the spokespeople for single payer are excluded from media coverage andinvitations to Obama’s policy forums and round tables, no matter how many times the White Housecuts their questions from transcripts and video of public events, the calls, emails and letters keep pouring into Congress and the White House demanding the creation of a publicly funded, everybody-in-nobody-out system, a Medicare-for-All kind of single payer health care plan.

10. Despite the president’s own admission that only a single payer health care system will deliver what Americans want, he and the leaders of his party insist that Medicare For All, HR 676, us utterly off the table.
Before he became a presidential candidate, Barack Obama identified himself as a proponent of a single payer health care system. All we had to do, he told us, was elect a Democratic congress and senate, and a different president. Now that this has been done, he insists that “change” is just not possible, and we have to settle for less. The president continues to admit that only a single payer health care system will cover everybody, but insists that America just can’t handle that much change.  "



-- Edited by jdona on Friday 31st of July 2009 08:48:17 PM

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silver

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Summary of the Bill, highlighting my 'favorite' parts of it:
"SUMMARY AS OF:
7/14/2009--Introduced.

 

America's Affordable Health Choices Act of 2009 - Sets forth provisions governing health insurance plans and issuers, including: (1) exempting grandfathered health insurance coverage from requirements of this Act; (2) prohibiting preexisting condition exclusions; (3) providing for guaranteed coverage to all individuals and employers and automatic renewal of coverage; (4) prohibiting premium variances, except for reasons of age, area, or family enrollment; and (5) prohibiting rescission of health insurance coverage without clear and convincing evidence of fraud.

Requires qualified health benefits plans to provide essential benefits. Prohibits an essential benefits package from imposing any annual or lifetime coverage limits. Lists required covered services, including hospitalization, prescription drugs, mental health services, preventive services, maternity care, and children's dental, vision, and hearing services and equipment. Limits annual out-of-pocket expenses to $5,000 for an individual and $10,000 for a family.

Establishes the Health Choices Administration as an independent agency to be headed by a Health Choices Commissioner. Establishes the Health Insurance Exchange within the Health Choices Administration in order to provide individuals and employers access to health insurance coverage choices, including a public health insurance option. Requires the Commissioner to: (1) contract with entities to offer health benefit plans through the Exchange to eligible individuals; and (2) establish a risk-pooling mechanism for Exchange-participating health plans.

 

Provides for an affordability premium credit and an affordability cost-sharing credit for low-income individuals and families participating in the Exchange.

Requires employers to offer health benefits coverage to employees and make specified contributions towards such coverage or make contributions to the Exchange for employees obtaining coverage through the Exchange. Exempts businesses with payrolls below $250,000 from such requirement.

Amends the Internal Revenue Code to impose a tax on: (1) an individual without coverage under a health benefits plan; and (2) an employer that fails to satisfy health coverage participation requirements for an employee. Imposes a surtax on individual modified adjusted gross income exceeding $350,000.

Amends title XVIII (Medicare) of the Social Security Act to revise provisions relating to payment, coverage, and access, including to: (1) reduce payments to hospitals to account for excess readmissions; (2) limit cost-sharing for Medicare Advantage beneficiaries; (3) reduce the coverage gap under Medicare Part D (Voluntary Prescription Drug Benefit Program); (4) provide for increased payment for primary health care services; and (5) prohibit cost-sharing for covered preventive services.

Requires the Secretary of Health and Human Services (HHS) to provide for the development of quality measures for the delivery of health care services in the United States.

Establishes a Center for Comparative Effectiveness Research within the Agency for Healthcare Research and Quality, financed by a tax on accident and health insurance policies, to conduct and support health care services effectiveness research.

Sets forth provisions to reduce health care fraud.

Amends title XIX (Medicaid) of the Social Security Act to: (1) expand Medicaid eligibility for low-income individuals and families; (2) require coverage of additional preventive services; and (3) increase payments for primary care services.

Sets forth provisions relating to the health workforce, including: (1) addressing health care workforce needs through loan repayment and training; (2) establishing the Public Health Workforce Corps; (3) addressing health care workforce diversity; and (4) establishing the Advisory Committee on Health Workforce Evaluation and Assessment.

Sets forth provisions to: (1) provide for prevention and wellness activities; (2) establish the Center for Quality Improvement; (3) establish the position of the Assistant Secretary for Health Information; (4) revise the 340B drug discount program (a program limiting the cost of covered outpatient drugs to certain federal grantees); (5) establish a school-based health care program; and (6) establish a national medical device registry. "



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gold

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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The main thing I get from this is Section 1233, starting at page 424 the part that throws anyone 65 and older under the bus.

They would just as soon you croak at age 65 to save them money.

And I will be damned if I will go to one of their annual, "Advanced Care Planning Consultations".  They can kiss it.

I wonder what they are going to do when I don't show up, put me in jail?

(merged two thread)


-- Edited by Sanders on Monday 3rd of August 2009 01:07:01 AM

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gold

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Merge note.  This post can be deleted. Crunching down the thread.

-- Edited by Sanders on Monday 3rd of August 2009 12:53:38 AM

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silver

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"America’s Affordable Health Choices Act of 2009"
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I'll go through each highlight here:
"Summary As Of"  - Be careful.  I will never forget that infamous stimulus bill.  All 640+ pages were totally stricken through about 10 pm prior to the next mornngs printing of the bill in preparation of the vote that afternoon.  When those Senators said that they could not possibly have read that bill, they were not lying.  And, the finished bill itself was extremely ambiguous in it's wording.

I'll be back when I am more wide awake.  I had a medical procedure yesterday and then only slept of a couple hours last night.  I am nodding off tonight.


-- Edited by shizzy on Saturday 1st of August 2009 12:50:42 AM

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SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMUNITY-BASED SETTINGS.

Training medical residents? Meaning of “grants” to a medical facility will be based on the majority of the minorities hired and trained (is this reparation?). Hired and trained by “who?” This section shows clearly that health care professionals will eventually be a tier-like progression. Based on government trained, and what government considers “professionals”.

Questions as to whether less specialized professionals will be available, and the community will be treated by a majority of on-the-job substitutes.

SEC. 748. TRAINING OF MEDICAL RESIDENTS IN COMMUNITY-BASED SETTINGS.
`(a) Program- The Secretary shall establish a program for the training of medical residents in community-based settings consisting of awarding grants or contracts under this section.
`(b) Development and Operation of Community-Based Programs- The Secretary shall make grants to, or enter into contracts with, eligible entities--
`(1) to plan and develop a new primary care residency training program, which may include--
`(A) planning and developing curricula;
`(B) recruiting and training residents and faculty; and
`(C) other activities designated to result in accreditation of such a program; or
`(2) to operate or participate in an established primary care residency training program, which may include--
`(A) planning and developing curricula;
`(B) recruitment and training of residents; and
`(C) retention of faculty.
`(c) Eligible Entity- To be eligible to receive a grant or contract under subsection (b), an entity shall--
`(1) be designated as a recipient of payment for the direct costs of medical education under section 1886(k) of the Social Security Act;
`(2) be designated as an approved teaching health center under section 1502(d) of the America's Affordable Health Choices Act of 2009 and continuing to participate in the demonstration project under such section; or
`(3) be an applicant for designation described in paragraph (1) or (2) and have demonstrated to the Secretary appropriate involvement of an accredited teaching hospital to carry out the inpatient responsibilities associated with a primary care residency training program.
`(d) Preferences- In awarding grants and contracts under paragraph (1) or (2) of subsection (b), the Secretary shall give preference to entities that--
`(1) support teaching programs that address the health care needs of vulnerable populations; or
`(2) are a Federally qualified health center (as defined in section 1861(aa)(4) of the Social Security Act) or a rural health clinic (as defined in section 1861(aa)(2) of such Act).
`(e) Additional Preferences for Established Programs- In awarding grants and contracts under subsection (b)(2), the Secretary shall give preference to entities that have a demonstrated record of training--
`(1) a high or significantly improved percentage of health care professionals who provide primary care;
`(2) individuals who are from underrepresented minority groups or disadvantaged backgrounds; or
`(3) individuals who practice in settings having the principal focus of serving underserved areas or populations experiencing health disparities (including serving patients eligible for medical assistance under title XIX of the Social Security Act or for child health assistance under title XXI of such Act or those with special health care needs).
`(f) Period of Awards-
`(1) IN GENERAL- The period of a grant or contract under this section--
`(A) shall not exceed 2 years for awards under subsection (b)(1); and
`(B) shall not exceed 5 years for awards under subsection (b)(2).
`(2) SPECIAL RULES-
`(A) An award of a grant or contract under subsection (b)(1) shall not be renewed.
`(B) The period of a grant or contract awarded to an entity under subsection (b)(2) shall not overlap with the period of any grant or contact awarded to the same entity under subsection (b)(1).
`(g) Report- The Secretary shall submit to the Congress an annual report on the program carried out under this section.
`(h) Definitions- In this section:
`(1) PRIMARY CARE RESIDENCY TRAINING PROGRAM- The term `primary care residency training program' means an approved medical residency training program described in section 1886(h)(5)(A) of the Social Security Act that is--
`(A) in the case of entities seeking awards under subsection (b)(1), actively applying to be accredited by the Accreditation Council for Graduate Medical Education; or
`(B) in the case of entities seeking awards under subsection (b)(2), so accredited.
`(2) HEALTH DISPARITIES- The term `health disparities' has the meaning given the term in section 3171.'.


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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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This whole thing looks awful and more then likely won't pass.  I don't see the Blue Dogs will  go for this.

=====


2010 is coming up very soon.  We need to get on the entire house and the 1/3rd of the Senate that is up for reelection and stay in their faces.  We need to remind them who they work for.


(merged to condense thread)

-- Edited by Sanders on Sunday 2nd of August 2009 11:56:04 PM

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Diamond

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RE: "America’s Affordable Health Choices Act of 2009"
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HMG, unfortunately, all Blue Dogs rollover--eventually.

I was reading this part of HR3200. OMG where the hell are we going to get all this freaking MONEY!! Okay, so the government takes over health care, the training of health care nurses, doctors, ect. Briefly outlined, but not explaining who, where, and how.

SEC. 2235. AUTHORIZATION OF APPROPRIATIONS.
(a) In General- Section 799C, as added by section 2216 of this Act, is amended by adding at the end the following:
`(b) Public Health Workforce- For the purpose of carrying out subpart XII of part D of title III and sections 765, 766, and 768, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:
`(1) $51,000,000 for fiscal year 2010.
`(2) $54,000,000 for fiscal year 2011.
`(3) $57,000,000 for fiscal year 2012.
`(4) $59,000,000 for fiscal year 2013.
`(5) $62,000,000 for fiscal year 2014.
`(6) $65,000,000 for fiscal year 2015.
`(7) $68,000,000 for fiscal year 2016.
`(8) $72,000,000 for fiscal year 2017.
`(9) $75,000,000 for fiscal year 2018.
`(10) $79,000,000 for fiscal year 2019.'.
(b) Existing Authorization of Appropriations- Subpart (a) of section 770 (42 U.S.C. 295e) is amended by striking `2002' and inserting `2019'.

They are getting finance information from the Medicare/Medicade programs.  Which, we all know is broke and inundated with fraud.

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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Why markets can’t cure healthcare (NY Times blog by Krugman 7-25-09) - [brought to our attention by mslas4hillary - also see discussion in a separate thread]

Why markets can’t cure healthcare (7-25-09)
http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/

This is an excellent article that is very nicely grounded and providing a good economists' perspective in layman terms.  Here are the closing paragraphs and some additional perspective..

Excerpts:
This problem is made worse by the fact that actually paying for your health care is a loss from an insurers’ point of view — they actually refer to it as “medical costs.” This means both that insurers try to deny as many claims as possible, and that they try to avoid covering people who are actually likely to need care. Both of these strategies use a lot of resources, which is why private insurance has much higher administrative costs than single-payer systems. And since there’s a widespread sense that our fellow citizens should get the care we need — not everyone agrees, but most do — this means that private insurance basically spends a lot of money on socially destructive activities.

The second thing about health care is that it’s complicated, and you can’t rely on experience or comparison shopping. (“I hear they’ve got a real deal on stents over at St. Mary’s!”) That’s why doctors are supposed to follow an ethical code, why we expect more from them than from bakers or grocery store owners.

You could rely on a health maintenance organization to make the hard choices and do the cost management, and to some extent we do. But HMOs have been highly limited in their ability to achieve cost-effectiveness because people don’t trust them — they’re profit-making institutions, and your treatment is their cost.

Between those two factors, health care just doesn’t work as a standard market story.


I would also add that there is a third factor that supports the same conclusion, which is that the supplier side of the large market is of service providers - both at organizational level (Hospitals, Labs) and at skill level (doctors, RNs) - is not fungible. It is a market with high barriers to entry with good reasons at the organizational level, and questionable reasons on numbers control at the level of control of the number of doctors coming out of colleges.  It takes a long time to become a doctor and to change the "supply" side of doctors.  The Board certifications are at the state level, making it a large oligopoly at the physician level.  While we have the information with which to select doctors and specialists (with luxury of time on our side) we are necessarily entrusting our primary care physician (PCP) with the recommendation -- and our insurance company with the function of managing the cost and being the gatekeeper on services.  While this may be a bitter pill for some, there is really not much better model out there on this except a greater empowerment of the consumer with more information that is more easily available.. and the information economy has been morphing the industry all by itself in this regard.  A table of services and prices set by the government just as they have for Medicare and Medicaid would not provide any relief to the fact that the supply side is highly constrained.


All of this doesn’t necessarily mean that socialized medicine, or even single-payer, is the only way to go. There are a number of successful health-care systems, at least as measured by pretty good care much cheaper than here, and they are quite different from each other. There are, however, no examples of successful health care based on the principles of the free market, for one simple reason: in health care, the free market just doesn’t work. And people who say that the market is the answer are flying in the face of both theory and overwhelming evidence.


Here is my question..
Given the above factors, we have to ask ourselves, what may work?


I believe, SUPPLY SIDE ECONOMICS by actively increasing the number of doctors and nurses may work.. in about 3-5 years, with highly active participation of the government in subsidizing education.

Second key determinant of success is TAKING ADMINISTRATIVE COSTS out of the equation.  The healthcae industry has been working on this very actively for the past 3 years coming towards a consensus on standardized economic processing systems. The established clearinghouses that have been milking the transaction costs have been resisting it, but this is an area that has evolved. A good support to these initiatives would put them on a the "fast track" to reducing administrative costs.  Of course, with that some of the higher skilled resources in the system will also get freed up, contributing to the effort of SUPPLY SIDE ECONOMICS mentioned in the prior paragraph.  The cost reduction side would have to be accompanied by a re-skilling of the current medical billing workforce to care delivery side to prevent brain-drain and to further strengthen the Supply side solution.

There is more thinking needed on other factors.


-- Edited by Sanders on Monday 3rd of August 2009 08:27:13 AM

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"America’s Affordable Health Choices Act of 2009"
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Obama doesn't want you to read the 1000 pages, he wants you to STUPIDLY trust him. He said he wasn't going to have lobbyist in his adminstration, and then he STUPIDLY hired them.

Take a look at the Clunker Junker Program run by his government, how's that working as a give away? Who will be buying the scrape? Obama will STUPIDLY sell them to China, and you can expect pollution to double.

Why are all his experts crunching numbers STUPIDLY. And which rules will apply to me, since I did not vote for Obama, or because he lumps as a birther, and a senior citizen.

STUPIDLY, the Dems will try to go it alone to pass health care. That is why the pressure is on to pass it before recess. As has been said before whatever the government does, it does it POORLY and STUPIDLY.

-- Edited by Building 4112 on Saturday 1st of August 2009 09:10:00 PM

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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merged into comment above
This post can be deleted. Crunching down the thread.



-- Edited by Sanders on Monday 3rd of August 2009 12:36:12 AM

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Platinum

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RE: "America’s Affordable Health Choices Act of 2009"
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I plan on reminding them that if they had been democrats in the first place and stood their ground when Hillary WON with MORE votes than Obama we wouldn't be in such a damned mess right now and they better fix it or they can pack their damned bags!

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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Merge note.  This post can be deleted. Crunching down the thread.

-- Edited by Sanders on Monday 3rd of August 2009 12:05:01 AM

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Merge note.  This post can be deleted. Crunching down the thread.


-- Edited by Sanders on Monday 3rd of August 2009 12:04:39 AM

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House panel OKs healthcare bill, setting stage for fall vote (LA Times 8-1-09)
http://www.latimes.com/news/nationworld/nation/la-na-healthcare-By Janet Hook house1-2009aug01,0,7261961.story

No Republicans on the committee vote for the plan. Democrats will pitch the plan nationally over the August recess.
Reporting from Washington -- President Obama's ambitious plan to overhaul the nation's healthcare system got a major boost when a pivotal House committee passed a compromise bill Friday night, clearing the way for a floor vote this fall.

The bill was approved 31 to 28, with five Democrats and all of the Republicans on the energy and commerce committee voting against it. Despite the defections, enough liberal and conservative Democrats were able to come together to break the deadlock that had stalled the bill for weeks.


"We are a diverse caucus with many points of view," said committee Chairman Henry A. Waxman (D-Beverly Hills). "We've agreed we need to pull together."

To reach agreement, Waxman earlier this week had accepted conservative lawmakers' demands to limit the bill's price tag to $1 trillion over 10 years, exempt more small businesses from the employer-provided insurance mandate, and reduce the number of low-income people who would qualify for subsidized coverage.

But those changes provoked a backlash among liberals. To win them back, Waxman crafted a compromise that would restore low-income subsidies. The committee also added a major provision that would limit the premium increases that insurers could impose, and another that would let the government negotiate pharmaceutical prices under Medicare's prescription drug program -- a goal long sought by liberals as a way to reduce drug costs. (The idea was bitterly opposed by Republicans when the program was established in 2003, as critics questioned whether the government would secure discounts.)


The bill is designed to provide insurance for the 46 million people in the U.S. who now go without it; to curb healthcare costs; and to make it harder for companies to deny coverage or increase premiums.


[snip]


Now Democratic leaders are asking lawmakers to fan out around the country to help Obama sell the plan. They will, among other things, try to counter efforts to portray the bill as a government takeover of medicine and to convince middle-class people that the plan would benefit those who already have insurance.

Every House member was given a card summarizing details of the $1-trillion bill -- including new insurance subsidies for the poor, tax credits for small businesses that provide coverage for their workers, and expanded prescription drug coverage for the elderly.


The legislation also would broaden Medicaid, the federal-state healthcare program, to cover more low-income people. Middle-class workers would receive new subsidies to pay health insurance premiums. And government-sponsored insurance would be available as an alternative to private plans.


[snip]

A key part of the Democrats' strategy, worked out in coordination with the White House, will be to demonize insurance companies for opposing a bill that has been backed by an array of health and consumer groups. Pelosi predicted the industry would conduct a "shock and awe" campaign in the coming weeks to block the bill.

Said Gibbs: "I think many people that believe we need comprehensive healthcare reform think that insurance companies have not lived up to all of their responsibilities -- and that they can do better."


Critics worry that the federally run insurance option would undermine private insurers through cut-rate premiums, putting the health system on a path to being dominated by the government. Republicans on the House panel offered an amendment to drop the public option, but the committee rejected it.


Before approving the bill, however, lawmakers defied Waxman and delivered a major victory for the drug industry by voting to give 12 years of market protection to companies that offer advanced new drugs to combat major diseases like cancer and Parkinson's. Opponents, including the White House, had sought to make generic versions of such drugs available to the public sooner.


The Democrats who opposed the final bill were Reps. John Barrow of Georgia, Rick Boucher of Virginia, Jim Matheson of Utah, Charlie Melancon of Louisiana and Bart Stupak of Michigan.


Energy and commerce is the third and final House committee to have a hand in shaping the healthcare legislation before it goes to the full House. Versions approved by other panels have included a surtax on wealthy people to help pay for the program, and a requirement that most employers provide health insurance for their workers.


Obama had called for action on a healthcare overhaul before the August recess, but Congress is moving more slowly. In the Senate, a key committee has not reached agreement on its version of the bill.


Still, Friday's House committee vote gives a much-needed shot of momentum to the legislation.


During the August recess, House Democratic leaders will tackle the politically tricky task of blending the three committees' versions of the legislation. Unable to count on many Republican votes, leaders will have to produce a bill that commands broad Democratic support, balancing the concerns of conservatives who think the bill costs too much and liberals who think it does not go far enough.


Rep. Anthony Weiner (D-N.Y.) had offered an amendment that would replace the committee's plan with a more comprehensive government health program known as a "single payer" plan -- an alternative modeled after systems like those in Canada and Britain that is strongly supported by liberal activists. Weiner withdrew the amendment after Democratic leaders promised that his measure would be brought before the full House for a vote
.


-- Edited by Sanders on Monday 3rd of August 2009 03:14:50 PM

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Diamond

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The Senate Finance Committee Timeline for Healthcare (SenateAgenda.Wordpress.com 7-31-09)
http://senateagenda.wordpress.com/2009/07/31/new-senate-timetable-for-health-care/

Sen. Baucus has the month of August to complete his negotiations with Senate Republicans.  If not, the Democratic Leadership will step in and order a partisan bill to pass the Finance Committee.  These talks continue only because of Sen. Baucus’s insistence on bipartisan negotiations even as these same negotations have dragged on for months on end.

Does this mean we’ll still be seeing live reports on bi-partisan talks from CNN’s Dana Bash outside Max Baucus’s office when Congress returns in September? Don’t count on it.  Baucus has some time to work out a deal over the August break, but Democratic leaders are unlikely to allow talks with Republicans to drag on into September.

The six negotiators – Democratic Senators Baucus, Conrad, and Bingaman and Republican Senators Snowe, Grassley, and Enzi – will continue to negotiate during the August break through teleconferencing and the like.  We shall see if they can come up with a bill.

UPDATE: Baucus has promised Sept. 15th to be the deadline for these negotiations to end.  This is a week after the Senate comes back from the August recess as the Senate will be back in session on Sept. 8th, the day after Labor Day.

Also, if bipartisan negotiations fail, Reid “likely” plans to use reconciliation to pass the health care bill.  Who are the Democrats who plan to join the Republicans in a filibuster of health care reform because assuming partisan discipline, a party line vote with  60 Democratic Senators is enough to stop a filibuster.



-- Edited by Sanders on Sunday 2nd of August 2009 08:39:47 PM

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Bipartisan Senate Health Talks Face Sept. 15 Deadline
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clearpixel.gifBipartisan Senate Health Talks Face Sept. 15 Deadline (Rollcall 7-31-09)
http://www.rollcall.com/news/37431-1.html?type=printer_friendly

Excerpt:

Jon Selib, Baucus’ chief of staff, laid out Baucus’ strategy in a meeting this week with health care stakeholders.

According to sources who were in the room, Selib said some Republicans were “killing” the health care reform effort for political gain. Selib said the bipartisan talks have yielded agreement on 95 percent of the issues, and that only two or three sticking points remain. Selib made a subtle plea to attendees at the meeting, most of them members of the business community, to urge Republicans to accept the deal, suggesting that it was the best they could hope to get.

Selib also warned the group that pursuing the reconciliation procedural tool might be necessary to get health care enacted this year, and he blamed Republicans for forcing the Democrats to seriously consider using the maneuver. Reconciliation would allow Democrats to pass a health care overhaul with a simple, 51-vote majority.

The meeting occurred before Baucus announced Thursday evening that a health care markup would not occur next week.

Meanwhile, Grassley was still lobbying against setting deadlines for an agreement, saying in a Twitter post that a few extra weeks would not hurt the process. “Little disingenuous for pres obama to say ‘hurry up’ pass healthCare. Wk here wk there makes little differenc considerin startup is 2013,” Grassley tweeted on Friday.

Baucus’ Finance Committee spokesman declined comment.

clearpixel.gifSee what else is on Senate Agenda at present


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Diamond

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***HEALTHCARE***: "America’s Affordable Health Choices Act of 2009" **DISCUSSION**
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How the bills compare (AP / LA Times)
Here’s how some of the elements in the House Democratic healthcare proposals compare with those in the Senate:

lat_logo_inner.gif <--- Click on the image to see a table with 4 axes.

The House Bill and the Senate Bill are compared along 4 axes:  COST, COVERAGE, REQUIREMENTS and PACKAGES


The summary is very simplified high level. It is missing elements of the yet-to-be finalized Senate Finance Committee final output.



-- Edited by Sanders on Monday 3rd of August 2009 08:04:48 PM

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gold

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Must watch MD testifies in front of congress:





Name one efficient  GOV health Program that we have set up? Name one?

Medicaid? Medicare?




Quote from MD in video above:

why are the Emergency rooms loaded down with children that have ear infections because most of them are medicaid eligible already  because we have not over sited and neither have the states in terms of enrolling this people  to where they have a primary care MD.





-- Edited by JamieKuuipo on Sunday 2nd of August 2009 11:36:17 PM

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Senate and House switchboards: 1-877-210-5351 1-800-828-0498
Find the contact forms and fax #'s for your Elected Officials here:
SENATE CONGRESS






-- Edited by JamieKuuipo on Monday 3rd of August 2009 11:48:08 AM

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Diamond

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Our Representatives need our input. Please Dont just flame them; they need sane and sage, self-assured, informed input.  If we don't give them that, we will end up with another TARP-like event.

They work for us. Yes. This time, we have to give them the input necessary to help them work for us.

This domain - healthcare - is complicated. Let's work together to understand the big proposals.


-- Edited by Sanders on Monday 3rd of August 2009 08:28:44 AM

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