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Grr. See, this is the crap that just pisses me off and irritates me to no end.

THEY DON’T WANT ANYONE TO READ AND UNDERSTAND THIS.

Americans are prevented from being able to engage in informed debate and decision making because the DAMNED legalese and doublespeak our legislators engage in completely and totally obfuscates the salient point of the legislation.

Here are two examples from HR3200. I know this is long, but it illustrates the point: they don't WANT us to be able to understand this crap.

I had a discussion with someone who said I had my facts wrong when I stated that you would indeed have to give up your choice of plan and covering doctor with this legislation. So I began reading this part of the bill, and I just want to make sure I have my analysis correct before I see him again...can anyone look at this with a critical eye and let me know if I have my debunking of Obama's debunking correct before I go back for round two?

(Underlined text is the relevant part of the bill, bolded italicized and underlined text are my interpretation...sorry for the difficulty reading, I don't know how to change the color of the text to make distinguish them better)

STANDARDS FOR QUALIFIED HEALTH BENEFITS PLANS

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) GRANDFATHERED HEALTH INSURANCE COV- ERAGEDEFINED.—Subject to the succeeding provisions of this section, for purposes of establishing acceptable cov- erage 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 (Y1 IS THE DAY THE BILL BECOMES LAW) 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 ef- fective date of coverage is on or after the first day of Y1. (THIS MEANS YOU HAVE TO BE ENROLLED IN YOUR PRIVATE PLAN BEFORE THE LEGISLATION BECOMES LAW)

(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 be- fore the first day of Y1. (THIS MEANS THE PRIVATE INSURER CANNOT CHANGE BENEFITS OR PREMIUMS IT OFFERS BEGINNING ON THE DAY THE LEGISLATION BECOMES LAW.)

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. (THIS IS HOW THEY DEAL WITH VARIATION OF PREMIUMS-IT IS CLASSIC DOUBLESPEAK)

(b) GRACE PERIODFOR CURRENT EMPLOYMENT- DHEALTHPLANS.—

(1) GRACEPERIOD.—

(A) IN GENERAL.—The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year pe- riod beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same require- ments as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121. (FIVE YEARS FROM Y1 WHICH IS DEFINED AS THE DATE THE LEGISLATION BECOMES LAW, ALL PLANS WILL HAVE TO OFFER EXACTLY THE SAME BENEFITS AS ALL OTHER PARTICPANTS IN THE "EXCHANGE" TO BE ALLOWED TO EXIST AT ALL. FURTHERMORE, PARTICIPANTS IN THE "EXCHANGE" WILL HAVE TO OFFER THE SAME BENEFITS AS THE TOTALITY OF THE "PUBLIC OPTION" TO BE ALLOWED TO PARTICIPATE IN THE "EXCHANGE". THEY WILL BE FREE TO OFFER MORE BENEFITS, IF THEY WISH, BUT NONE OF THEM WILL, SINCE THEY ARE GOING TO BE "COMPETING" AGAINST A PUBLIC OPTION THAT IS GOING TO OFFER THE SAME THING AT A FAR CHEAPER RATE.)

HERE IS EXAMPLE #2:

I was trying to figure out what is going to happen with physician compensation because I heard from a physician that all specialties, brain surgeons and dermatologists, will be paid the same. So, I tried to look through it, and in the process stumbled across how they plan to reduce both payment AND availability of imaging resources (such as CT, MR, etc.)

This is pissing me off, and really, it is beginning to make me burn. Look at how this thing is written. I copied the section below right out of the document. Look further down for my explanation if you are interested.

*************************************** *************************************** SEC. 1147. PAYMENT FOR IMAGING SERVICES.
10 (a) ADJUSTMENT IN PRACTICE EXPENSE TO RE11
FLECT HIGHER PRESUMED UTILIZATION.—Section 1848 2 of the Social Security Act (42 U.S.C. 1395w) is amend13 ed—
14 (1) in subsection (b)(4)—
15 (A) in subparagraph (B), by striking ‘‘sub16
paragraph (A)’’ and inserting ‘‘this paragraph’’;
17 and
18 (B) by adding at the end the following new
19 subparagraph:
20 ‘‘(C) ADJUSTMENT IN PRACTICE EXPENSE
21 TO REFLECT HIGHER PRESUMED UTILIZA22
TION.—In computing the number of practice
23 expense relative value units under subsection
24 (c)(2)(C)(ii) with respect to advanced diagnostic
25 imaging services (as defined in section
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•HR 3200 IH
1 1834(e)(1)(B)), the Secretary shall adjust such
2 number of units so it reflects a 75 percent
3 (rather than 50 percent) presumed rate of utili4
zation of imaging equipment.’’; and
5 (2) in subsection (c)(2)(B)(v)(II), by inserting
6 ‘‘AND OTHER PROVISIONS’’ after ‘‘OPD PAYMENT
7 CAP’’.
8 (b) ADJUSTMENT IN TECHNICAL COMPONENT ‘‘DIS9
COUNT’’ ON SINGLE-SESSION IMAGING TO CONSECUTIVE
10 BODY PARTS.—Section 1848(b)(4) of such Act is further
11 amended by adding at the end the following new subpara12
graph:
13 ‘‘(D) ADJUSTMENT IN TECHNICAL COMPO14
NENT DISCOUNT ON SINGLE-SESSION IMAGING
15 INVOLVING CONSECUTIVE BODY PARTS.—The
16 Secretary shall increase the reduction in ex17
penditures attributable to the multiple proce18
dure payment reduction applicable to the tech19
nical component for imaging under the final
20 rule published by the Secretary in the Federal
21 Register on November 21, 2005 (part 405 of
22 title 42, Code of Federal Regulations) from 25
23 percent to 50 percent.’’.
24 (c) EFFECTIVE DATE.—Except as otherwise pro25
vided, this section, and the amendments made by this sec-
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275 •HR 3200 IH
1 tion, shall apply to services furnished on or after January
2 1,
*************************************** ***************************************

The following two paragraphs below show what the BULL$HIT above boils down to in normal english, and what it actually MEANS. This just steams me.

“SEC. 1147. PAYMENT FOR IMAGING SERVICES. ADJUSTMENT IN PRACTICE EXPENSE TO REFLECT HIGHER PRESUMED UTILIZATION In computing the number of practice expense relative value units under subsection the Secretary shall adjust such number of units so it reflects a 75 percent (rather than 50 percent) presumed rate of utilization of imaging equipment.”

(I am no expert on this, but downloading a Powerpoint Presentation, and looking around at various critiques of the way practice expense is calculated, INCREASING the presumed rate of utilization drives DOWN the amount of money you get paid. I am a genius. I assumed that, but figured I better check it out...) END RESULT: LESS MONEY FOR IMAGING, FEWER SERVICES OFFERED.

“Section 1848 ADJUSTMENT IN TECHNICAL COMPONENT DISCOUNT ON SINGLE-SESSION IMAGING INVOLVING CONSECUTIVE BODY PARTS. The Secretary shall increase the reduction in expenditures attributable to the multiple procedure payment reduction applicable to the technical component for imaging from 25 percent to 50 percent.”

(What this means is that from now on, if you do a CT of the Abdomen AND a CT of the pelvis without moving the patient, you now get paid 50% less rather than 25% less. This is huge, and just one example of how they are going to cut billions of dollars a year in costs. The scumbags will say with a straight face that they aren’t rationing, but if you don’t get paid for the service, you either don’t do the service, or you go broke) END RESULT: LESS MONEY FOR IMAGING, FEWER SERVICES OFFERED.

According to the Association of American Physicians and Surgeons (at this link: http://www.aapsonline.org/ this is an organization that advocates for physicians, not like the AMA which is advocating for liberalism) these sections above up to a reduction of 4.3 billion dollars a year in money to be paid for imaging. If someone interprets that some different way, please let me know...but if you bring in 45 million more people and reduce the money you pay...gee whiz, what is the end result?

Now, I wasn’t born yesterday, and I know why they are doing this, but this is our healthcare we are talking about, and they have deliberately tried to bury as much of it in incomprehensible legalese as they can get it. It made me madder and madder as I tried to go through it.

THEY DON’T WANT ANYONE TO READ AND UNDERSTAND THIS.