The first is this canard of "universal health care". It doesn't exist. Even countries that claim to have it don't. NHS rations care. France discourages people from seeing doctors. Every nation has a means for limiting the amount of care people receive. Every government that wishes to avoid huge cost overruns looks for ways to restrict what it will pay out in terms of health care--just like every insurance company. Care is never universal, and will never be universal. Passing the buck to the government does not eliminate the basic reality of scarcity.
The second is that "comparative effectiveness research" is not about providing a cheaper plan. It is about deciding what treatments and protocols are "effective"--which is to say which ones are worth the price tag. Those pronouncements are going to be pushed upon all doctors, and the Health Exchanges are, if this legislative abortion passes, going to be empowered to mandate that all insurance companies cover only "effective" treatments and protocols. (The job description of the Health Choices Commissioner is to make your insurance choices for you.)
The third is the notion that anything in the legislation before the Congress has anything to do with making health care less costly. In fact, the CBO's own analyses of the various bills and proposals has been consistent on one thing: they will cost more, not less; they "bend the curve" up, not down.
The one actual cost containment mechanism being proposed is this notion of comparative effectiveness research, which is simply deciding which treatments and protocols GovernmentCare will cover--which means that, at some juncture, GovernmentCare will be telling you that, rather than pay for a particular medicine, or surgery, or other treatment, it's better to just let granny die.
Dear Leader wants you to believe that such a scenario is nonsense, that the mere mention of it is a "scare tactice", and when he says such things he lies through his teeth. "Effective" is an economic consideration when viewed in the aggregate. "Effective" means, in the aggregate, not paying for something despite the patient's desires and the doctor's judgment. That is what "effective" means. That is all that "effective" means.
Why is private insurance better? Because private insurance can be made a competitive market. Granted, Congress has, in the last half century or so, gone out of its way to make health insurance a most non-competitive market, in particular by making health insurance a tax deduction to employers and not to individuals (there is no better way to remove competition than to restrict the customer base). This, however, is easy to alter, if people will stop long enough to think the possibilities through. With more insurance companies offering more insurance products, patients have more options, and that gives them market power to say to insurance companies what manner of coverage best suits them. If we are going to have insurance, further restricting and regulating insurance markets will only result in a system that is even less efficient and less attentive to patient need than the one we have now--and yet all the Anti-Republicans can think of is more regulation, more restriction, more government, all of which adds up to more cost for less actual care.
There are better solutions out there. We can alleviate restrictions on insurance, if we simply must have insurance. We can make insurance an individual and not an employer purchase. We can end the economic madness of "fee for service" compensation, that pays for procedures and not for outcomes. These are things that will directly lower health insurance premiums, make insurance companies more response to patients, and bend the health care cost curve lower for society and for individuals. They are not things the Anti-Republicans wish to even acknowledge as possible solutions; they prefer ideas which have been proven not to work, ideas which have been proven to result in less care, and ideas which have been proven to increase costs rather than curtail them--that is the Anti-Republicans' notion of "reform".
HR3200, Division B, Title IV, Subtitle A
This section enshrines utilitarian approaches to medicine. "Effective" and "appropriate" are of little comfort to a patient being told the medicine they believe will help will not be provided; they are of little comfort to the patient told the surgery that will keep them from being bedridden for the remaining years of their life simply will not be performed.The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research (in this section referred to as the `Center') to conduct, support, and synthesize research (including research conducted or supported under section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003) 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.
Utilitarian medicine is bad medicine. It is the wholesale abdication of the Hippocratic Oath, which oath is the one thing that renders physicians worthy to gamble with people's lives in the manner they do. Utilitarian medicine means, invariably, letting granny die.
After reading it it seems that they do nothing of the sort.
It doesn't even say that they make recommendations for policy ouside of research.
Please examine their powers and duties:
(2) DUTIES- The Center shall--I am not seeing the "tell Granny she has to die" section. Nor am I seeing the part where folks can't get their own insurance to cover w/e perceived gaps in coverage there are.
- `(A) conduct, support, and synthesize research relevant to the comparative effectiveness of the full spectrum of health care items, services and systems, including pharmaceuticals, medical devices, medical and surgical procedures, and other medical interventions;
- `(B) conduct and support systematic reviews of clinical research, including original research conducted subsequent to the date of the enactment of this section;
- `(C) continuously develop rigorous scientific methodologies for conducting comparative effectiveness studies, and use such methodologies appropriately;
- `(D) submit to the Comparative Effectiveness Research Commission, the Secretary, and Congress appropriate relevant reports described in subsection (d)(2); and
- `(E) encourage, as appropriate, the development and use of clinical registries and the development of clinical effectiveness research data networks from electronic health records, post marketing drug and medical device surveillance efforts, and other forms of electronic health data.
- `(3) POWERS-
- `(A) OBTAINING OFFICIAL DATA- The Center may secure directly from any department or agency of the United States information necessary to enable it to carry out this section. Upon request of the Center, the head of that department or agency shall furnish that information to the Center on an agreed upon schedule.
- `(B) DATA COLLECTION- In order to carry out its functions, the Center shall--
- `(i) utilize existing information, both published and unpublished, where possible, collected and assessed either by its own staff or under other arrangements made in accordance with this section,
- `(ii) carry out, or award grants or contracts for, original research and experimentation, where existing information is inadequate, and
- `(iii) adopt procedures allowing any interested party to submit information for the use by the Center and Commission under subsection (b) in making reports and recommendations.
- `(C) ACCESS OF GAO TO INFORMATION- The Comptroller General shall have unrestricted access to all deliberations, records, and nonproprietary data of the Center and Commission under subsection (b), immediately upon request.
- `(D) PERIODIC AUDIT- The Center and Commission under subsection (b) shall be subject to periodic audit by the Comptroller General.
Please point out the relevant language that gives the commission the ability to make decisions about Granny's medical care.
Before ppl decide that I am in favor of something I am not, please recognize that I am just pointing out a lack of evidence.
I may be wrong.
HR3200, Division A, Title II, Subtitle A, Section 203 -- nothing purchased within the Exchange except what the government allows.
HR3200, Division A, Title III, Subtitle A, Section 301 -- punitive tax for people without insurance of 2.5% of Adjusted Gross Income.
Folks won't be able to purchase their own medical treatments because they won't be allowed to purchase anything besides GovernmentCare, will be taxed if they do not purchase GovernmentCare, and because HR3200 bends the cost curve up and not down, this leaves folks with less money to pay for things out of pocket.
Remember, if health care weren't so damned expensive, people would not need health insurance in the first place. Cramming everyone into government designed health insurance plans merely sucks all that disposable income away by not lowering nominal health care costs.
2001-2008: Dissent is the highest form of patriotism.
2009-2016: Dissent is the highest form of racism.
2017-? (Probably): Dissent is the highest form of misogyny.
So I am not so much choosing to overlook it as it doesn't seem to be there.
If you would please, it would help if you could quote actual text from teh bill that supports your assertions.
I may be wrong.
Here is the actual text of that section. Please note the lack of anything that says what you say it says.:SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
- (a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
- (1) LIMITATION ON NEW ENROLLMENT-
- (A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
- (B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.
- (2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
- (3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.
DIVISION A--AFFORDABLE HEALTH CARE CHOICES
SEC. 100. PURPOSE; TABLE OF CONTENTS OF DIVISION; GENERAL DEFINITIONS.
- (3) INSURANCE REFORMS- This division--
- (B) creates a new Health Insurance Exchange, with a public health insurance option alongside private plans;
I may be wrong.