BREAKING NEWS: Appeals court rules part of President Obama’s health care law unconsti

[saveliberty]

“We have to pass the (health care) bill so you can find out what is in it”.

“Unemployment benefits are creating jobs faster than practically any other program”

“Every week we don’t pass a Stimulus package, 500 million Americans lose their jobs.”

- Nancy Pelosi at work,,,

 

[BoycottTheday]

The best thing that could have been done about health care would have been tort reform imho.

 

[Intense]

At least one version of it did provide access to Individual Saving Accounts.

I did. And there's nothing in the link or the legislative text posted to support that assertion. Which is because it was never true, even for that older bill (which, again, isn't the Affordable Care Act).

They are permanent waivers until 2014 when a government plan, which we were told was not in the works, will kick in.

There is no "government plan." You're confusing the concept of an Exchange with a public health insurance plan.

I did. And there's nothing in the link or the legislative text posted to support that assertion. Which is because it was never true, even for that older bill (which, again, isn't the Affordable Care Act).


I did not make it up Greenbeard. The Link affirms everything you denied was in it. It is a dead issue now, because it is not in the current Bill, true you pointed that out correctly. You have the Link and the article, in which the language is plain.
Correcting the Record on ObamaCare's Access to Individuals' Bank Accounts

 

[Intense]

These exemptions were given mostly to employers and unions with group plans that did not meet the minimum requirement. Increasing coverage of group plans, usually means replacing the whole plan often with a different company. Typically large group plans are covered by a yearly or longer contract.

And if I am not mistaken they are not permanent exemptions. I believe they expire after a few years. Not 100% positive on that, but I thought I read that somewhere and I'm simply not willing to look it up tonight.

Immie

Yes, they one year exemptions and can be renewed each year till 2024.

That's another vein for Campaign Financing, right?

 

[Greenbeard]

Look at the statements of Donald Berwick and that is exactly what he is talking about.

We could even look at some of his papers.

The 100,000 lives campaign: setting a goal and a deadline for improving health care quality
What Practices Will Most Improve Safety?
On the trail of quality and safety in health care
The Business Case For Quality: Case Studies And An Analysis
Measuring Physicians' Quality and Performance
The Triple Aim: Care, Health, And Cost

Wow, interesting to see one of the country's foremost experts on quality improvement and patient safety write so much about quality improvement and patient safety.

The simple fact that there had to be waivers and exemptions immediately after the bill was passed should have been enough to tell us that it is a piece of crap bill.

Do you think if annual limits in health plans weren't being phased out it would be a good piece of legislation?

I did not make it up Greenbeard. The Link affirms everything you denied was in it.

No, it doesn't. That's my point. The argument, poorly formulated as it is, seems to be based on two things:

1) The electronic standards are to, among other things, "enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility" and "enable, where feasible, near real-time adjudication of claims ...". Judging by the use of bold in the article, that second one is particularly important (as is use of the word "individual").

2) The second part seems to be the real crux of it:

In fact, this is so clearly defined in the bill, that on page 64, the language for "operating rules" (which regulate the "using and processing [of] transactions") is changed in a related section to add the phrase "on behalf of an individual." Combine the two, and you have the government paying for services on behalf of an individual from the individual's account.​

The author has clearly drawn a conclusion, yet it makes no sense and doesn't follow from anything else that has been laid down. "The government" hasn't even entered in the equation (beyond Medicare adhering to the same standards as everyone else when it pays claims), as this is about electronic communications between private insurers and private providers. Nor has any individual's bank account. The text references private insurers making payments on behalf of individuals, which I take it is supposed to be the scary, offending piece of the puzzle--except that's what private insurers do. They pay all or part of the clam for you.

I can't really grasp how this is supposed to be contorted into the government (not mentioned in the text) accessing your bank account (not mentioned in the text), but I don't think that's a failing on my part--that article is really just argument by innuendo. There's no there there.

Let me give you a very simple example of what these standards would have been for. A few months ago, I had some dental work done. As I was leaving, the admin person estimated what my share of the costs would be and I paid it. Several weeks later I received a letter from my insurer in the mail showing the value of the claim submitted by the dentist's office and the portion that had been reimbursed by the insurer. Lo and behold the difference (my share) was actually smaller than what I had paid on the day of the visit. Which means I then had to wait a few more weeks to get a check from the dentist's office correcting the overpayment.

Now, in the 21st century it's entirely possible for that process to take place in closer to 6 minutes than six weeks, avoiding the initial overcharge of the consumer (me) in the first place. That requires the information systems of my provider and my insurance company to speak to each other real time.

What would they be communicating about in my case?

Well, first my dentist's admin people wouldn't give me an--ultimately incorrect--estimate of my share of the costs, they would communicate with the insurer in real time and tell me exactly what I personally owe ("enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service"). That eliminates the annoying initial overcharge and the wait-for-the-reimbursement-check-to-come-in-the-mail delay.

Of course, stepping back a bit, I might have needed to verify that my insurer would pay for part of the dental work I got and that my dentist is or still is in my insurer's network ("enable the real-time (or near real-time) determination of [...] whether the individual is eligible for a specific service with a specific physician at a specific facility"). If I needed that done, it would be great to have it verified in real-time on-site.

But now the work is all done, the admin folks have charged me the correct amount (which I still pay for out of my account). However, it still remains for my insurer to pay my dentist its share, which could take a few weeks. Now, as an individual, I don't care so much about this part because it's between the dentist and the insurer but they sure care about it. Imagine if they resolved it over the course of a few minutes instead of over the course of a few weeks of exchanging paper related to the insurance claim ("enable, where feasible, near real-time adjudication of claims ...").

Of course, in my case I did care about this because my financial responsibility for those services wasn't determined in real-time and thus wasn't calculated correctly--thus I had to wait for the insurer-provider reimbursement process to occur, and then I had to wait for additional time beyond that to get my money back from the provider. Granted this is a somewhat trivial example that pales in comparison to equivalent situations in which someone is receiving actual medical care (no offense, dentists!). But I hope it gets the point across.

Allowing this real time communication between insurers and providers to allow things like the real-time calculation of my portion of the tab and the amount the insurer will be charged (yes, on behalf of me, the individual) requires uniform standards for the information and financial transfers, in large part to make sure my information is protected. But none of this involves anyone, including the government, going into your bank account. Do you see what these standards are for?

 

[SFC Ollie]

As I think back in time it seems as though there was never a sentence in this piece of crap legislation that our Mr Greenjeans didn't love. In fact he was an expert on this legislation before it even passed congress. Seems as though he knew more about it than any of the congress critters........

Just thinking out loud...................................

 

[Foxfyre]

As I think back in time it seems as though there was never a sentence in this piece of crap legislation that our Mr Greenjeans didn't love. In fact he was an expert on this legislation before it even passed congress. Seems as though he knew more about it than any of the congress critters........

Just thinking out loud...................................

I'm gonna go out on a limb and say that neither "Mr. Greenjeans" nor any o the congress critters have ever read the entire bill and not one could competently recite all the key points in it, let alone the little nuances and traps and obscured meanings and intent that will be surfacing for years to come if the legislation is not reversed. You can cram a lot of smoke and mirrors and legalese into 2200 pages.

 

[boedicca]

ObamaCare raises the costs of health care as a ratio of GDP - this is widely acknowledged in DC now that the bill is available to read and analyze.

As it was sold on the basis of "bending the cost curve down", it no longer meets the "fake but accurate" pretense of its promoters.

Better to kill it off now.

 

[dblack]

I'm gonna go out on a limb and say that neither "Mr. Greenjeans" nor any o the congress critters have ever read the entire bill and not one could competently recite all the key points in it, let alone the little nuances and traps and obscured meanings and intent that will be surfacing for years to come if the legislation is not reversed. You can cram a lot of smoke and mirrors and legalese into 2200 pages.

And the biggest gotchas are yet to come, given that most of the key decisions have been deferred. The whole thing will be a lobbyist smorgasbord.

 

[Foxfyre]

I'm gonna go out on a limb and say that neither "Mr. Greenjeans" nor any o the congress critters have ever read the entire bill and not one could competently recite all the key points in it, let alone the little nuances and traps and obscured meanings and intent that will be surfacing for years to come if the legislation is not reversed. You can cram a lot of smoke and mirrors and legalese into 2200 pages.

And the biggest gotchas are yet to come, given that most of the key decisions have been deferred. The whole thing will be a lobbyist smorgasbord.

The lobbyists don't worry me anywhere near as much as the bureaucrats do. It will be they who write the rules and regulations to implement and enforce legislation so vague they will have an almost free hand doing so. And you can be sure, if a pro-Obamacare Preident and/or Congress is in power, those rules and regs will put us as close to 100% socialized medicine as they can get.

 

[Flopper]

It's hard to believe that the American style of healthcare will continue into the 21st century. Currently there are 62 million people on Medicaid. Add to that another 30 million that don't qualify for Medicaid but can not afford insurance and you have nearly 1 in 3 people who can not get healthcare without government assistance. Think the recession has helped bring down the rising healthcare cost, think again. USAToday reported healthcare cost rose 9% in 2010. If the healthcare cost increases we have seen in the first decade of the century continue, healthcare cost, will triple in the next 20 years with or without Obamacare.

There is no question that healthcare will have to be rationed. The question is how is to be rationed?

Report: Health care costs to rise 9% in 2010 - USATODAY.com

 

[SFC Ollie]

It's hard to believe that the American style of healthcare will continue into the 21st century. Currently there are 62 million people on Medicaid. Add to that another 30 million that don't qualify for Medicaid but can not afford insurance and you have nearly 1 in 3 people who can not get healthcare without government assistance. Think the recession has helped bring down the rising healthcare cost, think again. USAToday reported healthcare cost rose 9% in 2010. If the healthcare cost increases we have seen in the first decade of the century continue, healthcare cost, will triple in the next 20 years with or without Obamacare.

There is no question that healthcare will have to be rationed. The question is how is to be rationed?

Report: Health care costs to rise 9% in 2010 - USATODAY.com

First off, according to my Doctor, healthcare is already rationed. Secondly, the entire original Idea of healthcare reform was to make healthcare more affordable. Somewhere along the way that was forgotten in favor of more power, control, and of course if they had their way, taxes.

 

[Intense]

Look at the statements of Donald Berwick and that is exactly what he is talking about.

We could even look at some of his papers.

The 100,000 lives campaign: setting a goal and a deadline for improving health care quality
What Practices Will Most Improve Safety?
On the trail of quality and safety in health care
The Business Case For Quality: Case Studies And An Analysis
Measuring Physicians' Quality and Performance
The Triple Aim: Care, Health, And Cost

Wow, interesting to see one of the country's foremost experts on quality improvement and patient safety write so much about quality improvement and patient safety.

The simple fact that there had to be waivers and exemptions immediately after the bill was passed should have been enough to tell us that it is a piece of crap bill.

Do you think if annual limits in health plans weren't being phased out it would be a good piece of legislation?

I did not make it up Greenbeard. The Link affirms everything you denied was in it.

No, it doesn't. That's my point. The argument, poorly formulated as it is, seems to be based on two things:

1) The electronic standards are to, among other things, "enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility" and "enable, where feasible, near real-time adjudication of claims ...". Judging by the use of bold in the article, that second one is particularly important (as is use of the word "individual").

2) The second part seems to be the real crux of it:

In fact, this is so clearly defined in the bill, that on page 64, the language for "operating rules" (which regulate the "using and processing [of] transactions") is changed in a related section to add the phrase "on behalf of an individual." Combine the two, and you have the government paying for services on behalf of an individual from the individual's account.​

The author has clearly drawn a conclusion, yet it makes no sense and doesn't follow from anything else that has been laid down. "The government" hasn't even entered in the equation (beyond Medicare adhering to the same standards as everyone else when it pays claims), as this is about electronic communications between private insurers and private providers. Nor has any individual's bank account. The text references private insurers making payments on behalf of individuals, which I take it is supposed to be the scary, offending piece of the puzzle--except that's what private insurers do. They pay all or part of the clam for you.

I can't really grasp how this is supposed to be contorted into the government (not mentioned in the text) accessing your bank account (not mentioned in the text), but I don't think that's a failing on my part--that article is really just argument by innuendo. There's no there there.

Let me give you a very simple example of what these standards would have been for. A few months ago, I had some dental work done. As I was leaving, the admin person estimated what my share of the costs would be and I paid it. Several weeks later I received a letter from my insurer in the mail showing the value of the claim submitted by the dentist's office and the portion that had been reimbursed by the insurer. Lo and behold the difference (my share) was actually smaller than what I had paid on the day of the visit. Which means I then had to wait a few more weeks to get a check from the dentist's office correcting the overpayment.

Now, in the 21st century it's entirely possible for that process to take place in closer to 6 minutes than six weeks, avoiding the initial overcharge of the consumer (me) in the first place. That requires the information systems of my provider and my insurance company to speak to each other real time.

What would they be communicating about in my case?

Well, first my dentist's admin people wouldn't give me an--ultimately incorrect--estimate of my share of the costs, they would communicate with the insurer in real time and tell me exactly what I personally owe ("enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service"). That eliminates the annoying initial overcharge and the wait-for-the-reimbursement-check-to-come-in-the-mail delay.

Of course, stepping back a bit, I might have needed to verify that my insurer would pay for part of the dental work I got and that my dentist is or still is in my insurer's network ("enable the real-time (or near real-time) determination of [...] whether the individual is eligible for a specific service with a specific physician at a specific facility"). If I needed that done, it would be great to have it verified in real-time on-site.

But now the work is all done, the admin folks have charged me the correct amount (which I still pay for out of my account). However, it still remains for my insurer to pay my dentist its share, which could take a few weeks. Now, as an individual, I don't care so much about this part because it's between the dentist and the insurer but they sure care about it. Imagine if they resolved it over the course of a few minutes instead of over the course of a few weeks of exchanging paper related to the insurance claim ("enable, where feasible, near real-time adjudication of claims ...").

Of course, in my case I did care about this because my financial responsibility for those services wasn't determined in real-time and thus wasn't calculated correctly--thus I had to wait for the insurer-provider reimbursement process to occur, and then I had to wait for additional time beyond that to get my money back from the provider. Granted this is a somewhat trivial example that pales in comparison to equivalent situations in which someone is receiving actual medical care (no offense, dentists!). But I hope it gets the point across.

Allowing this real time communication between insurers and providers to allow things like the real-time calculation of my portion of the tab and the amount the insurer will be charged (yes, on behalf of me, the individual) requires uniform standards for the information and financial transfers, in large part to make sure my information is protected. But none of this involves anyone, including the government, going into your bank account. Do you see what these standards are for?

I see what was implied, and that is subject to interpretation. It was poorly written, it is not in he current Bill. Regardless of intention it was poorly written. That is how bad things happen. That is how bad People Usurp Power. It is a dead issue.

 

[Intense]

(CNSNews.com) - The Department of Health and Human Services (HHS) announced on Tuesday that it has awarded $28.8 million to 67 community health centers with funds from the Obamacare health reform law.

Of that $28.8 million, "approximately $8.5 million will be used by 25 New Access Point awardees to target services to migrant and seasonal farm workers," Health Resources and Services Administration (HRSA) Spokeswoman Judy Andrews told CNSNews.com. HRSA is a part of HHS.

Andrews said that grant recipients will not check the immigration status of people seeking services.

“Health centers do not, as a matter of routine practice, ask about or collect data on citizenship or other matters not related to the treatment needs of the patients seeking health services at the center,” Andrews said.

Further, the grant recipients are required to serve "all residents" who walk through their doors.

“The Program’s authorizing statute does not affirmatively address immigration status,” said Andrews. “Rather, it simply states that health centers are required to provide primary health care to all residents of the health center's service area without regard for ability to pay.”

These Obamacare disbursements seem to contradict a claim President Obama famously made in a nationally televised speech to a joint session of Congress on Sept. 9, 2009.

“The reforms I'm proposing would not apply to those who are here illegally,” Obama said then.

ObamaCare Watch

 

[Intense]

The Patient Protection and Affordable Care Act (PPACA) is not so much a set of norms to regulate conduct as an authorization to administrators to produce norms to regulate conduct. Implementation of the Act will require many years and literally thousands of administrative regulations that will determine its substantive content and coverage. Under current law, those regulations will be promulgated through so-called informal rulemaking procedures, which offer very limited opportunities for public input. A recently introduced bill, H.R. 1432, proposes that rulemakings under the PPACA be conducted using formal rulemaking procedures that enhance the transparency and accountability of the rulemaking process. The idea deserves serious consideration. While formal rulemaking has largely disappeared from the modern administrative scene, it offers some significant advantages in the right setting, and the PPACA may very well be the right setting.
Formal Rulemaking and Transparency for Obamacare Regulations

 

[saveliberty]

Let's just kill the law and then we can forget it.

 

[Flopper]

It's hard to believe that the American style of healthcare will continue into the 21st century. Currently there are 62 million people on Medicaid. Add to that another 30 million that don't qualify for Medicaid but can not afford insurance and you have nearly 1 in 3 people who can not get healthcare without government assistance. Think the recession has helped bring down the rising healthcare cost, think again. USAToday reported healthcare cost rose 9% in 2010. If the healthcare cost increases we have seen in the first decade of the century continue, healthcare cost, will triple in the next 20 years with or without Obamacare.

There is no question that healthcare will have to be rationed. The question is how is to be rationed?

Report: Health care costs to rise 9% in 2010 - USATODAY.com

First off, according to my Doctor, healthcare is already rationed. Secondly, the entire original Idea of healthcare reform was to make healthcare more affordable. Somewhere along the way that was forgotten in favor of more power, control, and of course if they had their way, taxes.

You are correct on both counts. Healthcare is rationed today. Those who can afford it or those with government assistance have healthcare and those who don't do without. But if healthcare cost continues to rise at 9%, we will need a lot more rationing.

The healthcare law that Obama first introduced was a single payer system. It would have reduced the insurance cost part of healthcare but when the insurance companies were thrown back into the mix, the bill was no longer about affordable healthcare but rather equitable healthcare. IMHO, the next healthcare bill, call it a repeal or Obamacare II, will address cost. I think Obamacare is only the first in a number of healthcare bills we will see over this decade.

 

[saveliberty]

Correct Obamacare never addressed real cost savings in healthcare. Of course, neither will adding everyone to the system.

 

[dblack]

Healthcare is rationed today. Those who can afford it or those with government assistance have healthcare and those who don't do without.

That's the opposite of rationing.

 

[Flopper]

Healthcare is rationed today. Those who can afford it or those with government assistance have healthcare and those who don't do without.

That's the opposite of rationing.

You're correct. I meant that today healthcare is made available to those that can pay or have government assistance. In the future we will have to make healthcare available based on other criteria for example need.