Skip to comments.What Does 'Hospitalization' Mean? Under Health Care Bill, Kathleen Sebelius Will Decide
Posted on 10/29/2009 6:37:32 AM PDT by IbJensen
(CNSNews.com) If the Senate approves the health-care package passed by the Senate Finance Committee, Health and Human Services Secretary Kathleen Sebelius will determine the meaning of common medical and health insurance terms such as hospitalization, "physician services," premium, "prescription drug coverage," deductible, and emergency room care.
The provision giving the HHS secretary this power appears on pages 256 and 257 of the Finance Committees gargantuan health-care reform bill, which totals just over 1,500 pages.
The Secretary of Health and Human Services, says the bill, shall, by regulations, provide for the development of standards for the definitions of terms used in health insurance coverage.
The legislation further breaks down the secretarys definition powers into the categories of insurance-related terms and medical terms.
In the insurance-related category, the legislation empowers the HHS secretary to define the words: premium, deductible, co-insurance, co-payment, out-of-pocket limit, preferred provider, non-preferred provider, out-of-network co-payments, UCR (usual, customary and reasonable) fees, excluded services, grievance and appeals."
It leaves the secretary's power wide-open by adding--"and such other terms as the Secretary determines are important to define so that consumers may compare health insurance coverage and understand their benefits.
The list of terms in the medical category reads similarly, giving the government official the authority to define -- hospitalization, hospital outpatient care, emergency room care, physician services, prescription drug coverage, durable medical equipment, home health care, skilled nursing services, rehabilitation services, hospice services, emergency medical transportation, and such other terms as the Secretary determines are important to define so that consumers may compare the medical benefits offered by insurance health insurance and understand the extent of those medical benefits (or exceptions to those benefits).
Devon Herrick, a health economist at the National Center for Policy Analysis, blasted the proposed ceding of powers in an interview with CNSNews.com.
I am very worried about the idea of taking away consumer choice or consumer preferences in the marketplace and replacing those with the Secretary of HHS preferences, Herrick said. Giving the secretary the power to define and regulate all products in the exchange, you essentially remove all consumer choice.
Noting that an HHS committee would likely be established to handle these new responsibilities, Herrick said the board would be the target of lobbyists who would want to make sure that their particular good or service is covered by the mandate.
They are taking the power to basically create the insurance and, really, regulate the insurance that meets their ideas, their needs, Herrick asserted. They want to tell consumers what they must have, and this is just a way to make sure that theres no choice left in the equation.
Dennis Smith, a senior fellow at The Heritage Foundation, a conservative think-tank, also expressed concern.
This entire bill is one big question mark, because youre transferring tremendous power over to the executive branch, Smith told CNSNews.com.
The legislation leaves too many things up to the federal government, he added.
Its the details that matter, Smith said, and those details are going to be shaped by HHS, not by Congress.
This disaster of a Congress has given the King of the Zombies everything he and his communist handlers wanted!
Can we all not see where this Administration is taking us? Instead of us and the doctor we have government designing everything for us.Abortion has set the tone for the government to decide who lives and dies and when.
this morning the Pacifica talking heads were whining about how this healthcare bill is too cheap and under-funded! This whole thing is headed for a train wreck.
How true that is!
How does anybody know what is in the bill if it hasn’t been fully written? They keep floating ideas hoping to find something that the American public wants or that they can get approved before they finalize the bill.
Post the bill so we can all read what freedoms they are trying to take from us.
This whole thing the Liberals are trying to ram into practice is monstrous.
I would take longer and scrutinize in greater detail any assessment of a personal policy than these ‘leaders’ are permitting each other or the country in adoption of THIS plan for which the cost and implementation are almost totally unexplained ... and which will be irreversible, once ‘adopted’!!!
This is really the most lawless and
Lawless and irresponsible behavior on the part of elected officials.
They should be deciding what ‘death panels’ mean....
Newspeak, all of it...
No. Just as the Republicans never have the courage to give the State Department a good flushing when they get in charge, any part of Health and Human Services will remain infested with 'Rats in the upper decision making posts. The next Republican president will appoint a few at the top who will be considered the temporary help by the masses in the department.
In one door on a gurney, out the back door to a hearse.
The new rates for Federal Employees Health Benefit plan that Sebelius and the Obama people helped negotiate just raised our rates almost $50 a month. For eight years they have risen $15 - $20 while we pay more out of pocket but this time it is almost $50 a month with less benefits.
Received the letter this week — last time we had a major hike Clinton was President. What is it with Democrats?
Hope and Change need to hit the trash can instead of people’s pockets. Small raise and higher health insurance costs come January 1st. These clowns now want to take over health insurance for everyone? Give me a break. If FEHB is up to $405 a month, then there is a real problem with Government run healthcare costs that they are not being upfront about.
I heard on the radio this am that they would eliminate “pre-existing conditions”...
Insurance has worked for centuries (maybe not health ins, but ins in general). This is taking away the basis of insurance called “UNDERWRITING”. The insurance company agrees to take on the risk for which the insured pays a premium.
I guess the future of ins companies will be that they can’t make ANY profit at all, because all profit is EVIL.