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House Health-Care Bill Would Establish 'Medical Homes' for the Elderly and Disabled
CNSNews.com ^ | July 30, 2009 | Marie Magleby

Posted on 07/30/2009 3:34:15 AM PDT by Man50D

The House health-care reform bill proposes to decrease hospital visits by establishing a “medical home pilot program” for elderly and disabled Americans.

Such a medical home would not require a physician to be on the staff, and therefore could be run solely by nurse practitioners and physician assistants. Medical homes also would practice “evidence-based” medicine, which advocates only the use of medical treatments that are supported by effectiveness research.

But physicians’ groups say the legislation could lead to restrictions on which treatments may be used for certain conditions, despite the fact that some patients might require a unique or unconventional approach. It also may lead to dumping Medicare/Medicaid patients in facilities that are not required to have physicians on staff.

The Center for Medicine in the Public Interest (CMPI) expressed its concerns in a report that explains why statistical evidence does not always reflect reality of effective medicine.

“‘One size fits all’ rarely does,” the report said. “From clothes to shoes to hats, few people find that items carrying that label work with their individual bodies. So why do we entrust the health of our bodies -- one of the most important assets we have -- to a one-size-fits-all mentality?”

According to CMPI and individual physicians, however, this one-size-fits-all mentality is just what congressional health-care reform suggests.

“Unfortunately, policies being advanced under the guise of ‘evidence-based medicine’ (EBM) could do just that,” the CMPI report said. “The idea behind EBM, empowering physicians with sound evidence to incorporate into their treatment decisions for individual patients, is a good one.

“Unfortunately, EBM now is being distorted by government bureaucrats and HMOs in ways that impose top-down, one-size-fits-all restrictions on patients and their healthcare providers.”

Rather than enforcing a formulaic approach to medicine based on statistical and clinical research, CMPI says health-care reform should preserve physicians’ autonomy to use the research in conjunction with their experience and knowledge of the patient.

”It is so critically important for the physician to maintain his or her ability to combine study findings with their expertise and knowledge of the individual in order to make the optimal treatment decisions. Evidence-based medicine in its present, distorted form emphasizes just one aspect of the clinical pie over all the others,” the report found.

Kathryn Serkes of the American Association for Physicians and Surgeons echoed the observation.

“There is no typical patient,” Serkes told CNSNews.com. “Every patient is different from a medical perspective. If we have evidence-based medicine that basically says ‘well, we start at treatment one, which leads you to treatment two, to treatment three to treatment four. In practice, that doesn’t work for the patient. That’s the ‘art’ part of the art and science of medicine. That’s what we still need doctors to do, is to figure out what’s right for the patient.”

In the long run, according to CMPI, evidence-based medicine may not even cut costs as Congress suggests it would.

“Evidence-based medicine may provide transitory savings in the short term, but the same patient who takes the cheapest available statin today may very well be the patient costing you -- the taxpayer, the policymaker, the thought-leader, the sister, the spouse -- big bucks when that patient ends up in the hospital because of improperly treated cardiovascular disease,” .

“The repercussions of choosing short-term thinking over long-term results and cost-based medicine over patient-based are pernicious to both the public purse and the public health,” the CMPI report said.

Provisions for the medical home pilot program are an amendment to the Social Security Act, which governs the administration of Medicare and Medicaid services.

The medical home is an approach to medical practice that “facilitates partnerships” between patients and physicians, according to the proposed bill.

The pilot program targets Medicare beneficiaries who have a high medical “risk score” or who require regular monitoring, advising or treatment. This currently applies to more than 22 million Americans, according to Kaiser Family Foundation statistics.

At least $1.5 billion would be redirected from the Federal Supplementary Medical Insurance Trust Fund to fund the medical homes, “in addition to funds otherwise available,” according to the bill.

The Senate health-care reform bill also includes provisions for medical homes, although to lesser detail than the House bill.

If this portion of the legislation passes through Congress, medical homes will be part of the greater health-care reform experiment known as "the public (health insurance) option."

According to the committee, the provisions for medical homes will make the public option a stronger competitor against private health insurance companies.

“The public health insurance option will be empowered to implement innovative delivery reform initiatives so that it is a nimble purchaser of health care and gets more value for each health care dollar,” the House Committee on Energy and Commerce’s summary says about the bill.

Medical homes are tied to “comparative effectivness research” via something called “evidence-based medicine.”

“It will expand upon the experiments put forth in Medicare and be provided the flexibility to implement value-based purchasing, accountable care organizations, medical homes, and bundled payments. These features will ensure the public option is a leader in efficient delivery of quality care, spurring competition with private plans,” the committee’s summary also said.

A statement by the American College of Emergency Physicians (ACEP) said that the effectiveness of the medical home model should be carefully evaluated before applying the model far and wide.

“There should be more research to demonstrate the benefits and continuing costs associated with implementation of the full (patient-centered medical home) model,” the ACEP statement said.

“Demonstration projects being conducted by the Centers for Medicare & Medicaid Services must be carefully evaluated. There should be proven value in healthcare outcomes for patients and reduced costs to the healthcare system before there is widespread implementation of this model.”

The proposal, meanwhile, specifically allows for facilities to be run by staff who do not possess medical degrees – including nurses and nurse practitioners.


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The socialist universal health care bills proposed in the House and Senate are unconstitutional. No where in Article I Section 8 is the power to regulate health care listed. Let you Congress critters know! Toll free capital switchboard numbers are below.

800-828-0498
877-762-8762
800-517-5696
866-338-1015
866-220-0044
877-851-6437
1 posted on 07/30/2009 3:34:16 AM PDT by Man50D
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To: Man50D

death camps


2 posted on 07/30/2009 3:38:07 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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To: Man50D

PG 59: The federal government accesses your bank accounts for mandatory funds transfers.
PG 65, Sec 164: Creates special, federally-subsidized coverage for Unions and “Community Organizing” groups.
PG 84 Sec 203 HC bill - Dictates the benefits packages of all private health insurance plans.
PG 85, Line 7: Limits what private insurers can offer (rationed care).
PG 91, Lines 4-7: Mandates that health care providers pay for interpreters for illegal immigrants.
Pg 95, Lines 8-18: The mandatory use of ACORN and Americorps for signing up Americans to government insurance.
PG 85, Line 7: Imposes more limits on coverage (rationing).
PG 102, Lines 12-18: Mandates Medicare for all who fit criteria (removes all choice).
PG 124, Lines 24-25: Bans companies from suing the federal government, bans the entire judicial system from hearing any cases on the legitimacy of this blatantly unconstitutional socialist health care takeover (no judicial review allowed whatsoever).
PG 127, Lines 1-16: Instructs doctors/AMA on what salaries they are allowed to make.
PG 145, Line 15-17: Requires all employers to enroll all new employees in the government system (no choice whatsoever).
PG 126, Lines 22-25: Requires employers to independently provide insurance for part-time workers, whether they can afford it or not (no choice).
PG 149, Lines 16-24: Imposes an 8% payroll tax penalty for any employer (making over $400k) who fails to force his employees onto government insurance.
PG 150, Lines 9-13: Employers making between $251k and $400k pay 2-6% penalty.
PG 167, Lines 18-23: Imposes 2.5% income tax penalty on any privately-insured individual who fails to get “adequate” private insurance.
PG 170, Lines 1-3: Stipulates that all non-resident aliens pay nothing (we foot the bill).
PG 195: Federal officers will have full access to every citizen’s most private records.

3 posted on 07/30/2009 3:38:33 AM PDT by Diogenesis ("Those who go below the surface do so at their peril" - Oscar Wilde)
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To: Man50D

Sounds good. Send Granny off to be exterminated as a drag on the collective. It is for the good of the Hive. Yikes these liberals are reminding me of the BORG in Star Trek. “We will assimilate”. Time for escape plans.


4 posted on 07/30/2009 3:39:36 AM PDT by screaminsunshine (!!)
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To: Man50D

These people are scumbags. They are creating the equivalent of Nazi death camps. The American Holocaust is expanding from mass murder of our innocent unborn to the mass murder of the elderly and handicapped.


5 posted on 07/30/2009 3:42:32 AM PDT by Jim Robinson (Follow me on Twitter: http://twitter.com/jimrobfr)
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To: Man50D
“Evidence-based medicine may provide transitory savings in the short term, but the same patient who takes the cheapest available statin today may very well be the patient costing you -- the taxpayer, the policymaker, the thought-leader, the sister, the spouse -- big bucks when that patient ends up in the hospital because of improperly treated cardiovascular disease,”

No, they're not going to cost the taxpayer, because they'll have to do their duty to the State to die.

6 posted on 07/30/2009 3:44:13 AM PDT by thecabal (Destroy Progressivism)
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To: Man50D
[. . .EBM now is being distorted by government bureaucrats and HMOs in ways that impose top-down, one-size-fits-all restrictions on patients and their healthcare providers.”]

This provides the perfect setting to conduct experiments in treating patients with healthcare robots.

7 posted on 07/30/2009 3:46:22 AM PDT by Brad from Tennessee (A politician can't give you anything he hasn't first stolen from you.)
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To: Doogle

8 posted on 07/30/2009 3:47:31 AM PDT by Thrownatbirth (.....Iraq Invasion fan since '91.)
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To: Diogenesis
Not only that, they will use this as a platform to perform abortions. One of ObaMao’s staff members said that a child born is not “Human” until he or she displays “proper social traits”. Which must mean that even after born, a human child can still be “aborted” for the “Greater Good”.

This administration is purely evil. It is as simple as that.

9 posted on 07/30/2009 3:47:58 AM PDT by PSYCHO-FREEP (Give me LIBERTY or give me an M-24A2!)
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To: Man50D

Modern concentration camps..

Complete with Dr Mengler


10 posted on 07/30/2009 3:49:19 AM PDT by Tennessee Nana
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To: Doogle
death camps

I get your inference, but I wonder what will happen to someone (like me) who won't succumb to MANDATORY HEALTH INSURANCE?

It IS possible to live without having taxable income. Not as free or as pleasant as now, but do able.

All this to "insure" (or ensure), but not provide health care, for a small percentage of our population.

Certainly seems contrary to the Hippocratic Oath.

11 posted on 07/30/2009 3:54:59 AM PDT by This_far
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To: Doogle
..unfortunately my bother passed 5 years ago.
He had an operation and was put in a “recovery” facility
three days after the operation. While there he had clothes stolen,bandages that were supposed to be changed daily WERE NOT, a doctor, one of his surgeons, went berserk when he witnessed the poor care he got....
After I was allowed to “break him out”, I got him home to his apartment where HE wanted to be. We both knew what the end results were going to be, but I was determine that he wasn't going to be subjected to shoddy medical care and wind up with more to deal with then the cards he was dealt.
12 posted on 07/30/2009 3:56:20 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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To: Diogenesis

In Communism everything is free. But there isn’t any of it. Case closed.


13 posted on 07/30/2009 3:57:05 AM PDT by screaminsunshine (!!)
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To: Man50D
"Welcome to your new home, senior Americans, REST will set you FREE!"
Image Hosted by ImageShack.us
14 posted on 07/30/2009 3:58:04 AM PDT by mkjessup (0bama is ineligible to serve based on Article II Section 1 of the Constitution. End of Story.)
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To: Jim Robinson
These people are scumbags. They are creating the equivalent of Nazi death camps. The American Holocaust is expanding from mass murder of our innocent unborn to the mass murder of the elderly and handicapped.

I'm sure that the AARP will get the elderly to stop off at the polling places to vote for this and other leftist schemes one last time on their way to these "medical homes." Hey, the dead can't ask for a refund of their annual dues.

Mark

15 posted on 07/30/2009 3:59:38 AM PDT by MarkL (Do I really look like a guy with a plan?)
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To: Doogle

Calling these hellholes “medical homes” is like calling the Nazi concentration camp ovens “warming rooms for the Jews.”


16 posted on 07/30/2009 4:03:46 AM PDT by 1951Boomer
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To: Jim Robinson; Man50D; Tennessee Nana

Actually, they’d create just a bunch of screening sites for the death camps.

The “Patient Centered Medical Home” is the name of a well-meaning scheme to re-create the solo family doctor type of care within big practices. The “team” would be bound by all sorts of protocols and electronic reminders to follow up and follow through, so that a patient is more likely to be followed by the same people, less likely to fall through the cracks or get the run around through unnecessary and redundant tests, sub-specialists, etc.

The problem, in addition to the assumption in Washington that you’re only worth your next donation to the DNC, is that the bill would allow these PCMH’s to be headed by nurse practitioners, not just family docs, internal medicine docs or pediatricians.

They would also probably be lumped in with a local hospital and out patient care group to ‘manage’ the patients’ disease care:
30 day bundling of hospital and post-hospital care.
Bullet points to be met for each disease classification.
Step wise “evidence based” medication and therapy, with little recourse for those of us who don’t fit the protocol or who wish to skip a few steps, even if we can afford to pay out of pocket.

And, yes, 4 States allow “physician assisted death” (which still stinks of suicide and murder, no matter what you call it).

Some docs will probably find ourselves practicing under ground, eventually. And if our experience with Shalala (who threatened to prosecute Medicare patients who dared to pay their own money) is any indication, the patients will have to find a back alley doctor, too.


17 posted on 07/30/2009 4:06:26 AM PDT by hocndoc (http://www.LifeEthics.org (I've got a mustard seed and I'm not afraid to use it.))
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To: This_far
Certainly seems contrary to the Hippocratic Oath.

..an Oath means nothing to an narcissistic socialistic dictator like you witnessed on Jan 20,2009. Many doctors are leaving the often mentioned AMA because of very recent decisions.

18 posted on 07/30/2009 4:08:25 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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To: Tennessee Nana
Modern concentration camps..

Complete with Dr Mengler

The Obama version won't even have a doctor in the house. Only Mengele's assistants will be available. You can guess what level of twisted care that will result in.


19 posted on 07/30/2009 4:11:25 AM PDT by magooey (The Mandate of Heaven resides in the hearts of men)
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To: Doogle
death camps

No.

Obama Death Camps.

20 posted on 07/30/2009 4:14:28 AM PDT by savedbygrace (You are only leading if someone follows. Otherwise, you just wandered off... [Smokin' Joe])
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To: Jim Robinson

There is no difference. This meets the definition of Concentration Camps.


21 posted on 07/30/2009 4:22:18 AM PDT by Bluebird Singing
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To: Doogle

Agree.

A Hypocritical oath, while logical, is too obvious (and self nullifying) isn’t it?

I’ll settle for a large asterisk (for now).

Barry Bonds, Barry 0. *


22 posted on 07/30/2009 4:23:00 AM PDT by This_far
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To: Doogle

“According to the committee, the provisions for medical homes will make the public option a stronger competitor against private health insurance companies.”

Whew! Just stick all the undesirables in camps, and they will stop draining the medical system. Out of sight, out of mind. Everybody happy.


23 posted on 07/30/2009 4:24:26 AM PDT by Bluebird Singing
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To: Doogle

House Health-Care Bill Would Establish ‘Medical Homes’ for the Elderly and Disabled

I didn’t know they still had those trailers they sent to New Orleans.


24 posted on 07/30/2009 4:24:26 AM PDT by chainsaw (If you think health care is expensive now, wait until you see what it costs when it's free! -- P.J..)
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To: Man50D

Not only unconstitutional IMO, but also more proof of the imbalance in the mentality of those proposing, and supporting such Government collective activities. It’s right back to the restricted perspective that for every have there is a have not, because somebody else, or something has taken away by the act of possession from somebody else.

IOW “the Rich” are evil because they possess that which belongs to the poor. They (”the rich”) took away the sum of whatever from the limited pool, therefore others cannot partake of that which is their right to have as well. It’s not fair sayeth the collectivist whom cannot see beyond the zero-sum.

This collectivist health-care crap is based upon that same bullscoot mentality that is the retarded Leftist zero-sum perspective.

Liberalism is a mental disorder. No kidding.


25 posted on 07/30/2009 4:26:16 AM PDT by rockinqsranch (Dems, Libs, Socialists...Call 'em What you Will, They ALL have Fairies Living In Their Trees.)
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To: Man50D

So I guess this means that the elderly and the disabled have no rights to see a real doctor.

How could this be Constitutional?

We have to stop this nightmare.


26 posted on 07/30/2009 4:27:13 AM PDT by dforest (Who is the real Jim Thompson? I am.)
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To: Man50D

“Such a medical home would not require a physician to be on the staff, and therefore could be run solely by nurse practitioners and physician assistants.”

I imagine the staff to patient ratio will be abysmal. Speaking as a nurse who also reads at allnurses.com, I know that the long term care homes are already tragic, and this will not make it better.

It’s also disgusting how nurses have been hypnotized by SEIU plants among them. HYPNOTIZED

Pray for our country.


27 posted on 07/30/2009 4:28:46 AM PDT by Bluebird Singing
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To: chainsaw
I didn’t know they still had those trailers they sent to New Orleans.

they (the gov...)couldn't get most people who lived there FREE to buy them for $1.00...most have been destroyed

28 posted on 07/30/2009 4:31:18 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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To: Man50D
Such a medical home would not require a physician to be on the staff, and therefore could be run solely by nurse practitioners and physician assistants.


29 posted on 07/30/2009 4:31:40 AM PDT by COBOL2Java (Big government more or less guarantees rule by creeps and misfits.)
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To: Man50D
Where in the 1000 plus page bill is this? Exactly what is the language?

I don't doubt that this could be in there, I'd just like to read it myself.

30 posted on 07/30/2009 4:32:45 AM PDT by wtc911 ("How you gonna get back down that hill?")
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To: Man50D
Such a medical home would not require a physician to be on the staff, and therefore could be run solely by nurse practitioners and physician assistants.

But you can bet it will require an "affiliation" with a physician so that there's someone to sue.

31 posted on 07/30/2009 4:34:00 AM PDT by Jim Noble (I hope Sarah will start a 2nd party soon)
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To: Man50D

“There is no typical patient,” Serkes told CNSNews.com. “Every patient is different from a medical perspective. If we have evidence-based medicine that basically says ‘well, we start at treatment one, which leads you to treatment two, to treatment three to treatment four. In practice, that doesn’t work for the patient. That’s the ‘art’ part of the art and science of medicine. That’s what we still need doctors to do, is to figure out what’s right for the patient.”

Heaven help us. Reality is, you will be allowed one doctor, who may misdiagnose you, or not diagnose you at all. The doctors won’t have time to properly care for the patients. All power given to the system and one doctor whose duty is cut costs. There will be no “art” and NO APPEALS.


32 posted on 07/30/2009 4:43:37 AM PDT by Bluebird Singing
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To: Jim Robinson

Yet the same leftists that propose such barbaric treatment of our elderly and disabled citizens fight with every breath to get terrorists out of Gitmo, criminals out of prison, and to keep the dangerous mentally ill on our streets. Not to mention their relentless fight to let millions of illegal aliens stay in our country and millions more to come!

It’s insane!


33 posted on 07/30/2009 4:44:40 AM PDT by penelopesire ("The only CHANGE you will get with the Democrats is the CHANGE left in your pocket")
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To: Man50D

My spouse is a top-ranking hospital administrator. He just received correspondence yesterday that under the anti-christ’s socialist plan, NO ONE can be admitted into a hospital unless or until that person (or guardian) has signed a “directive” for end of life decisions.

I guess that “directive” will put the decision of whether you live or die in the anti-christ’s hands.


34 posted on 07/30/2009 4:45:12 AM PDT by Reagan69 (No Representation without Taxation)
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To: Man50D

I belong to a group who monitors nursing homes and assisted living facilities.

Right now, with the legislation we have, there are abuses, medical malpractice, and a severe shortage of CNAs in these places leading to all sorts of patient abuse.

This pending legislation is an open door to elder abuse and abuse of the disabled.

I’m making some phone calls to the director of my outfit and she will be burning up the phones to other organizations who also monitor care.

This needs to be stopped dead.


35 posted on 07/30/2009 4:45:23 AM PDT by OpusatFR (Those embryos are little humans in progress. Using them for profit is slavery.)
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To: Man50D

I especially like the National Health Service Corps, Training of Medical Residents in Community Based Settings, Scholarships for Disadvantaged Students, Educational Assistance in the Health Professions Regarding Individuals from Disadvantaged Backgrounds, Nursing Workforce Diversity Grants, Diversity and Cultural Competency Programs, Cultural and Linguistic Competency Training - all funded by us with preferences given to underrepresented and disadvantaged groups. See Sec. 2201 - National Health Service Corps.

So, stick old people in community homes (probably not Park Avenue, though) and pay activists to train our future healthcare workers there. What a deal!


36 posted on 07/30/2009 4:46:13 AM PDT by oldmomster
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To: Man50D

37 posted on 07/30/2009 4:47:28 AM PDT by paulycy (Liberal DOUBLE-STANDARDS are HATE crimes.)
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To: Man50D

Waitaminute....Is this idea from the same folks who decided in the late 50’s, that institutionalizing the mentally disabled was inhumane, encouraged the release of people who were incapable of taking care of themselves, who then became the newly named homeless?

Sigh. Liberalism - Saying/Doing whatever suits your purposes on any given day...

*DISCLAIMER - Yes, fully aware here, that some institutions were run in such a way as to be detrimental for their patients,(much like some nursing homes today), and that many of the mentally handicapped can, and do thrive outside of an institutional setting. Just commenting on the tendency of the Left to enact broad sweeping changes that usually result in bigger and better problems, not to mention the throwing out of said baby with the bathwater ; }


38 posted on 07/30/2009 4:48:08 AM PDT by thesearethetimes... ("Courage, is fear that has said its prayers." DorothyBernard)
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To: Reagan69

....

Thank you. I am sitting here trying to remember if I have ever read a more heart-stopping post...

God help us.
Tatt


39 posted on 07/30/2009 4:51:45 AM PDT by thesearethetimes... ("Courage, is fear that has said its prayers." DorothyBernard)
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To: Diogenesis

Do you have a URL or link to the actual bill which you list of items refer to?


40 posted on 07/30/2009 5:02:18 AM PDT by angkor
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To: Doogle

this is what we have to look forward to? this crap?


41 posted on 07/30/2009 5:02:44 AM PDT by MissDairyGoodnessVT ("Economy is the method by which we prepare today to afford the improvements of tomorrow"C.Coolidge)
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To: hocndoc
I have been saying right along that if this goes through we will effectively turn medicine upside down. Abortion will be a right one can exercise on Main Street while cholesterol treatment and Crestor will be only abtainable on the black market in back alley clinics. It is kind of humorous in a way but scary at the same time. Get to know your local LEOs cause you're gonna have to bribe them to stay out of jail for seeing patients in the back alley.

Μολὼν λάβε


42 posted on 07/30/2009 5:02:47 AM PDT by wastoute (translation of tag "Come and get them (bastards)" and the Scout Motto)
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To: thesearethetimes...; CaptainAmiigaf

“Thank you. I am sitting here trying to remember if I have ever read a more heart-stopping post...
God help us.”

This is so scary. G-d willing all of us reading this thread will be elders one day......This has to be stopped!
Young lefties can’t think beyond this afternoon....we all age; they obviously didn’t think in terms of themselves in the future.
This will be ALL of us someday.

Please G-d make the insanity stop! Our health care system may not be perfect but it is the BEST IN THE WORLD! It is not a broken sytem.
Zero et al , stop it....just stop it!


43 posted on 07/30/2009 5:08:41 AM PDT by Mrs. B.S. Roberts
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To: Diogenesis
I have been going through this bill f and documenting some of the things I find. I urge every one to do the same by downloding the entire PDF File, HERE.

Then contact all of your reps and exercise a politcal free fire zone over this monstrosity.

Here are some of the things I have found so far.

Section 113 b-1 Page 22: Mandates an audit of all employers that self-insure to "ensure that the law does not provide incentives for small and mid-size employers to self-insure".

Section 123 Page 30: A government Health Benefits Advisory Committee will recommend what treatments and benefits are available. Once accepted and adopted by the Secretary of Health and Human Services, there is no appeal.

Section 141 & 142 Page 42: Establish a "Health Choices Commissioner" appointed by the Prresident who will establish qualified plan standards for the insured, establish a "Health INsurance Exchange", will administer "Health Insurance Credits" and determin who is eligible, will ensure compliance, conduct audits, administer penalites and remedies.

Section 152 Page 50: All healthcare services will be provided without regard to "personal characteristcs" which is not defined within the document as is understood to include immigration status.

Section 1173A a-2-D Page 58: Calls for a National Health Plan Beneficiary Identification Card for every person and the ability to determine a persons indivual financial responsibility and eligibility prior to, or at the time of service.

Section 1173A a-4-C Page 59: Requires the ability to have electronic funds tranfer from insured account to the federal government automate reconcilliation of health care payment.

Section 164 Page 65: Taxpayers will subsidize a retiree reinsurance health fund up to 10 billion dollars to assist participating employment-based plans (unions, community organizers, etc.) with the cost of providing health benefits to retirees and to eligible spouses, surviving spouses and dependents of such retirees

Section 294 b-7 Page 91: Government mandates culturally and linguistically appropriate communication and health services for all.

Section 205 a-1 Page 95-96: The Government will etsablish an outreach program to inform, educate, and enroll participants, directed at "vulnerable" populations and to be accomplished in person at "community locations", by mail, telephone, or electronically. Tailor made for ACORN and Americorps.

Section 205 C-3-3 Page 102: If you do not enroll in a "National Health Exchange Plan" and are eligible for Medicaid, you will automatically be enrolled in Medicaid. You have no choice in the matter.

Section 223 f Page 124: There will be no administrative or "judicial review" permitted for payment rates established under the National Health Care Plans.

Section 224 b Page 125: The Secretary shall design and implement the payment mechanisms and policies under this section in a manner that — (1) seeks to (B) reduce health disparities (including racial, ethnic and other disparities).

Section 312 a-4, c-2 Page 145-148: An employer MUST auto-enroll employees into a government approved plan, either the public plan or another plan, unless an employee makes an affiormative decision to opt out.

Seaction 312 b-3 Page 146-147: Employers MUST pay pro-rated healthcare contribution for part-time employees AND their families.

Section 313 b-1 Page 150: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll, $350+-400K it is 6%, for over $300+-350K it is 4%, for $250+- 300K it is 2%.

Title IV Amendment to IRS COde Imposes a 2.5% income tax penalty to those individuals opting out, not to exceed what would be the National Average Premium, determined by the Secretary of Health and Welfare.

Section 1233 E & F Page 426-433 Establishes mandatory end-of-life counseling for senior citizens over age 65 every five years, or sooner if bebeficiary becomes ill.

Section 1302 a Page 460-482: Establishes a "Medical Home Pilot Program" for the elderly or "targeted high need beneficiaries" in urban, rural, and served areas. No physician nned be on duty, run by nurse paractitioners and physician assistants. Care for beneficiaries coordinated by a team of individuals at the practice level using "evidence based guidelines" which advocate only the use of medical treatments that are supported by effectiveness research.

44 posted on 07/30/2009 5:10:27 AM PDT by Jeff Head (Freedom is not free...never has been, never will be. (www.dragonsfuryseries.com))
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To: Man50D

Over The Hill To The Poor House
1. Oh how can it be they have driven
Their father so helpless and old
Oh God may their crimes be forgiven
To perish out here in the cold
Chorus:
I’m old I’m helpless and feeble
And the days of my youth have gone by
And it’s over the hill to the poor house
I must wander alone there to die
2. Long years since Mary was taken
My faithful affectionate wife
Since then I’ve been alone and forsaken
The light has died out of my life
Chorus:
3. I gave them the house they were born in
A deed to the farm and more
I gave them the place that they lived on
And now I am turned from its door
4. Oh me on the doorstep up yonder
I’ve set with my babe’s on my knee
No father so happy or fonder
Than I of my little ones three

A slain Rat a day, keeps Obamacare away


45 posted on 07/30/2009 5:11:08 AM PDT by bert (K.E. N.P. +12 . fasl el-khitab)
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To: Man50D
I have been going through this bill and documenting some of the things I find. I urge every one to do the same by downloding the entire PDF File, HERE.

Then contact all of your reps and exercise a politcal free fire zone over this monstrosity.

Here are some of the things I have found so far.

Section 113 b-1 Page 22: Mandates an audit of all employers that self-insure to "ensure that the law does not provide incentives for small and mid-size employers to self-insure".

Section 123 Page 30: A government Health Benefits Advisory Committee will recommend what treatments and benefits are available. Once accepted and adopted by the Secretary of Health and Human Services, there is no appeal.

Section 141 & 142 Page 42: Establish a "Health Choices Commissioner" appointed by the Prresident who will establish qualified plan standards for the insured, establish a "Health INsurance Exchange", will administer "Health Insurance Credits" and determin who is eligible, will ensure compliance, conduct audits, administer penalites and remedies.

Section 152 Page 50: All healthcare services will be provided without regard to "personal characteristcs" which is not defined within the document as is understood to include immigration status.

Section 1173A a-2-D Page 58: Calls for a National Health Plan Beneficiary Identification Card for every person and the ability to determine a persons indivual financial responsibility and eligibility prior to, or at the time of service.

Section 1173A a-4-C Page 59: Requires the ability to have electronic funds tranfer from insured account to the federal government automate reconcilliation of health care payment.

Section 164 Page 65: Taxpayers will subsidize a retiree reinsurance health fund up to 10 billion dollars to assist participating employment-based plans (unions, community organizers, etc.) with the cost of providing health benefits to retirees and to eligible spouses, surviving spouses and dependents of such retirees

Section 294 b-7 Page 91: Government mandates culturally and linguistically appropriate communication and health services for all.

Section 205 a-1 Page 95-96: The Government will etsablish an outreach program to inform, educate, and enroll participants, directed at "vulnerable" populations and to be accomplished in person at "community locations", by mail, telephone, or electronically. Tailor made for ACORN and Americorps.

Section 205 C-3-3 Page 102: If you do not enroll in a "National Health Exchange Plan" and are eligible for Medicaid, you will automatically be enrolled in Medicaid. You have no choice in the matter.

Section 223 f Page 124: There will be no administrative or "judicial review" permitted for payment rates established under the National Health Care Plans.

Section 224 b Page 125: The Secretary shall design and implement the payment mechanisms and policies under this section in a manner that — (1) seeks to (B) reduce health disparities (including racial, ethnic and other disparities).

Section 312 a-4, c-2 Page 145-148: An employer MUST auto-enroll employees into a government approved plan, either the public plan or another plan, unless an employee makes an affiormative decision to opt out.

Seaction 312 b-3 Page 146-147: Employers MUST pay pro-rated healthcare contribution for part-time employees AND their families.

Section 313 b-1 Page 150: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll, $350+-400K it is 6%, for over $300+-350K it is 4%, for $250+- 300K it is 2%.

Title IV Amendment to IRS COde Imposes a 2.5% income tax penalty to those individuals opting out, not to exceed what would be the National Average Premium, determined by the Secretary of Health and Welfare.

Section 1233 E & F Page 426-433 Establishes mandatory end-of-life counseling for senior citizens over age 65 every five years, or sooner if bebeficiary becomes ill.

Section 1302 a Page 460-482: Establishes a "Medical Home Pilot Program" for the elderly or "targeted high need beneficiaries" in urban, rural, and served areas. No physician nned be on duty, run by nurse paractitioners and physician assistants. Care for beneficiaries coordinated by a team of individuals at the practice level using "evidence based guidelines" which advocate only the use of medical treatments that are supported by effectiveness research.

46 posted on 07/30/2009 5:13:28 AM PDT by Jeff Head (Freedom is not free...never has been, never will be. (www.dragonsfuryseries.com))
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To: MissDairyGoodnessVT
this is what we have to look forward to? this crap?

more than that, this is what was able to be dug out, seniors are useless to the "progressive" movement...Soylent Green all over again........ with a twist

47 posted on 07/30/2009 5:15:12 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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To: Doogle

We already have such places and they are pretty effective in care for helpless elderly people.

There is a stage between the hospital and the hospice or grave that requires maintenance attention but little or no hope for recovery. It can last days or weeks or even years.

Such places are extremely depressing and are populated mostly by elderly women who are completely helpless but are alive. In my experience, they get care that is simply not possible were it not for such a facility


48 posted on 07/30/2009 5:18:39 AM PDT by bert (K.E. N.P. +12 . fasl el-khitab)
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To: Man50D

Childless Liberals hit hardest.


49 posted on 07/30/2009 5:21:27 AM PDT by momincombatboots (The last experience of the sinner is the horrible enslavement of the freedom he desired. -C.S. Lewis)
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To: bert
Odumbo’s answer?...take the pill
50 posted on 07/30/2009 5:26:20 AM PDT by Doogle (USAF.68-73..8th TFW Ubon Thailand..never store a threat you should have eliminated))
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