Government health panels...

Today I was sent a list of controversial points in the health care bill by a good friend of mine and I've decided that instead of reading the entire bill through, I'll just start researching the highly contentious points and writing what I find. Tonight I begin with these.

Claim: The HC Bill mandates the Govt will audit books of all employers that self insure.

This is true in a way. The government will set up a panel to study health care, essentially, and make recommendations based on their findings. One area of research would be to look at the companies that choose to self-insure instead of buying an insurance plan. They want to make sure, first, that any companies aren’t putting their employees at risk. And second, they are looking for holes in the legislation that would provide incentive to self-insure. So it’s not an audit in the IRS sense of the word.

Claim: There will be a government committee that decides what treatments/benefits you receive

I’ll paraphrase section 123 of the bill:
There is a private-public advisory committee of medical and other experts to recommend covered benefits and three type of plan.

The Surgeon General will chair the committee.

The committee has to represent
providers
consumer representatives
employers
labor
health insurance issuers
experts in health care financing and delivery
experts in racial and ethnic disparities
experts in care for those with disabilities
representatives of relevant governmental agencies
at least one practicing physician or other health professional
at least one expert on children’s health

They don’t decide what benefits you receive, they recommend benefits covered by three levels of plan. Someone does that for you now at the insurance companies but the insurance company’s job is to decide what the least they can get away with covering is.

This committee’s job, instead, is to recommend a benefit standard for insurance companies to maintain. Their directive is to make sure insurers are covering basic services for everyone. Basic covered services include:
(1) Hospitalization.
(2) Outpatient hospital and outpatient clinic services, including emergency department services.
(3) Professional services of physicians and other health professionals.
(4) Such services, equipment, and supplies incident to the services of a physician’s or a health professional’s delivery of care in institutional settings, physician offices, patients’ homes or place of residence, or other settings, as appropriate.
(5) Prescription drugs.
(6) Rehabilitative and habilitative services.
(7) Mental health and substance use disorder services.
(8) Preventive services, including those services recommended with a grade of A or B by the Task Force on Clinical Preventive Services and those vaccines recommended for use by the Director of the Centers for Disease Control and Prevention.
(9) Maternity care.
(10) Well baby and well child care and oral health, vision, and hearing services, equipment, and supplies at least for children under 21 years of age.

So yes, there is a committee but they are there to guarantee us coverage, not to deny it. We’re not used to that. All we’ve ever known are companies that profit off of us as a primary directive, not companies that keep us healthy as a primary directive.

That's tonight's piece. More tomorrow. If you have anything you want me to look up, drop a comment on the post.

'Night all