points to consider - raised by a very credible source

Massachusetts is living under this type of plan now - and yet Kennedy went to the Carolina's to get care.

Printed in The Wall Street Journal, page A15

Dissecting the Kennedy Health Bill

No, you won't be able to keep your insurance if you like it.

By BETSY MCCAUGHEY

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.

Last September Sen. Barack Obama promised that under his health-care proposal "you'll be able to get the same kind of coverage that members of Congress give themselves." On Monday, President Obama repeated that promise in a speech to the American Medical Association. It's not true.

The president is barnstorming the nation, urging swift approval of legislation that is taking shape in Congress. This legislation -- the Affordable Health Choices Act that's being drafted by Sen. Edward Kennedy's staff and the Health, Education, Labor and Pensions Committee -- will push Americans into stingy insurance plans with tight, HMO-style controls. It specifically exempts members of Congress (along with federal employees; the exemptions are in section 3116).

Members of Congress "enjoy the widest selection of health plans in the country," according to the U.S. Office of Personnel Management. They "can choose from among consumer-driven and high deductible plans that offer catastrophic risk protection with higher deductibles, health saving/reimbursable accounts and lower premiums, or fee-for-service (FFS) plans, and their preferred provider organizations (PPO), or health maintenance organizations (HMO)." These choices would be nice for all of us, but they're not in the offing. Instead, if you don't enroll in a "qualified" health plan and submit proof of enrollment to the federal government, you'll be tracked down and fined (sections 3101 and 6055).

For a health plan to count as "qualified," it has to meet all the restrictions listed in the legislation and whatever criteria the Secretary of Health and Human Services imposes after the bill becomes law. You may think you're in a "qualified" plan, but the language suggests that only plans with managed-care controls such as the "medical home" will meet the definition (sections 3101 and 2707).

"Medical home" is this decade's version of HMO-style insurance, according to the Congressional Budget Office, with a primary-care provider to manage your access to costly services such as visits to specialists and diagnostic tests. Medical home providers in "qualified" plans, states the Kennedy bill, will have a "payment structure" based on "incentives" rather than payments for each doctor visit or procedure (section 3101).

These requirements are reminiscent of the unpopular controls HMOs imposed two decades ago that caused public outrage and led to state laws reining in abuses. In December 2008, a Congressional Budget Office report evaluating early drafts of major federal health insurance proposals noted that "medical homes" were likely to resemble the HMO gatekeepers of 20 years ago if cost control is a priority.

That report specifically referred to a payment incentive called the "withhold." When HMOs became dominant in the early 1990s, they would withhold 10% or more of physicians' fees until the end of the year and give it back only to the physicians who met targets for limiting how many referrals to specialists or diagnostic tests their patients used.

The targets were so stringent that, if they were exceeded, what a doctor prescribed for you came out of your doctor's own pocket at the end of the year. This set up a conflict of interest between you and your doctor.

Mr. Obama tried to put a positive spin on such cost controls in his June 13 weekly radio address. He said "if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs." Fair enough -- if you want your doctor paid to police your care and to be financially penalized for that extra test or referral you get.

It is reasonable to require that people who accept a government subsidy for health insurance tolerate cost controls to protect taxpayers. But according to the terms of the Kennedy bill, you must enroll in a "qualified" plan or face a fine, even if you and your employer are paying the entire cost of the plan you already have (section 161).

The president has promised that if you like your plan you can keep it. Mr. Kennedy's bill says that too. It's doubletalk, as the consequences of nonenrollment make clear. How big a fine will you face? The bill doesn't specify or set a limit. It says the fine will be enough to "accomplish the goal of enhancing participation in qualifying coverage" (section 161).

If legislation similar to the Kennedy bill lands on Mr. Obama's desk, he has an obligation to keep his promises to the American people and veto it. And whatever health-insurance law is passed should apply to members of Congress. If it isn't good enough for them, it shouldn't be imposed on the rest of us.

Ms. McCaughey is chairman of the Committee to Reduce Infection Deaths and a former lieutenant governor of New York state.

Printed in The Wall Street Journal, page A15

Budget reconciliation process on Health Care affects your health.

Hopefully the plan for health care in the U.S. will be under bi-partisan craftsmanship. The Budget reconciliation process, if used here, will create a plan that will have almost 1/2 of the population left out of the creation process.

This would not be a good situation for a president who campaigned, in part, on his ability to reach across the isle.

It would not be a good for the population, as if it is fast tracked, the overall concerns of "We, the People" will not be fully heard.

Providers will choose alternative channels, since there is no way to force them to accept more patients and give less care for less money. Those with short memories need only look what happened in MD about 10 years ago, or what is happening in Massachusetts and other states, today.

If we've learned anything at all from the last year of Congress, with the Stimulus Bill and TARP, Congress moving quickly spells major expenses and lack of control for us now, and our future generations.

"We, the People" have an obligation, and a right to be heard, and be involved fully in the process. Do not let Congress adversely affect the quality of life just to "do something".

Those who have followed my posts know the risks we have if we allow "any" system to be put in place. A plan like used in most European nations, Canada, or our own VA or Medicare system will leave us with limited access to providers.

Such a system will have more Doctors retiring, more going to limited "boutique" access practices, and less accepting the public limited access and limited fee system.
Massachusetts's is on the leading edge, with several state mandates, and they are experiencing Doctor shortages, lack of care, and major increases in ER use.

Trends showing increased lack of care, denial of care, limited access to medications, denied coverage are well documented in Medicare recipients, as well as in Universal "one payer" (one controller of health care access) systems.

I, for one, with 5 family members as Medical providers, am scared to turn 65, because I loose coverage levels and access I enjoy now.

Please, follow the process, and remain active in the political agenda. Your health depends on it.

Health May Go On Fast Track

• By ARTHUR D. POSTAL

Published 4/28/2009

Democratic congressional leaders have come out with a 2010 budget resolution conference agreement that includes health reform and estate tax provisions.

Democrats and Republicans have posted separate texts and analyses of the 2010 budget resolution agreement on the Senate Budget Committee website, at http://budget.senate.gov

The conference agreement resolves differences between the Senate version, S. Con. Res. 13, and the House version, H.Con. Res. 85.

Here is a "side by side" comparison posted by the Republican members of the Senate Budget Committee.

Congress has agreed to handle health reform measures through the ordinary legislative process until Oct. 15, officials say. If no legislation passes by that date, Congress may consider health reform through the budget reconciliation process.

Supporters of a bill usually need to get the cooperation of 60 senators to get the bill to the Senate floor. When Congress includes a measure in the budget reconciliation process, supporters need just 51 votes in the Senate.

Robelynn Abadie, president of the Association of Health Insurance Advisors, Falls Church, Va., says she is disappointed that health reform could end up becoming part of the budget reconciliation process but welcomes the decision to let lawmakers try to craft a bipartisan health reform plan through the ordinary legislative process until October:

“A health care bill written entirely by Democrats would almost certainly create a new public health insurance program,” Abadie warned.

Continuing with bipartisan efforts offers the best chance of coming up with “an agreement on health care that will stand the test of time,” says John Greene, a vice president at the National Association of Health Underwriters, Arlington, Va.

“Reconciliation would make it difficult to achieve bipartisan health care reform that addresses the core issues of cost, access, and quality together,” says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, Washington.

Democratic congressional leaders have come out with a 2010 budget resolution conference agreement that includes health reform and estate tax provisions.

Democrats and Republicans have posted separate texts and analyses of the 2010 budget resolution agreement on the Senate Budget Committee website, at http://budget.senate.gov

The conference agreement resolves differences between the Senate version, S. Con. Res. 13, and the House version, H.Con. Res. 85.

Here is a "side by side" comparison posted by the Republican members of the Senate Budget Committee.

Congress has agreed to handle health reform measures through the ordinary legislative process until Oct. 15, officials say. If no legislation passes by that date, Congress may consider health reform through the budget reconciliation process.

Supporters of a bill usually need to get the cooperation of 60 senators to get the bill to the Senate floor. When Congress includes a measure in the budget reconciliation process, supporters need just 51 votes in the Senate.

Robelynn Abadie, president of the Association of Health Insurance Advisors, Falls Church, Va., says she is disappointed that health reform could end up becoming part of the budget reconciliation process but welcomes the decision to let lawmakers try to craft a bipartisan health reform plan through the ordinary legislative process until October:

“A health care bill written entirely by Democrats would almost certainly create a new public health insurance program,” Abadie warned.

Continuing with bipartisan efforts offers the best chance of coming up with “an agreement on health care that will stand the test of time,” says John Greene, a vice president at the National Association of Health Underwriters, Arlington, Va.

“Reconciliation would make it difficult to achieve bipartisan health care reform that addresses the core issues of cost, access, and quality together,” says Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, Washington.

No Earmarks was the Presidential Promise

Let's see if he keeps his word - If not - I expect everyone who voted for him because of that promise to raise all kinds of fuss - because they were fooled again.

from one of my news release sources, Financial E News:

"STIMULUS" BILL PASSES – Under the guise of "stimulus" and a Presidential promise of no earmarks, the House has passed President Obama's "emergency" bill that includes the following. The expectation is that the Senate will remove a number of these appropriations, but time will tell.

• $200 million to rehabilitate the National Mall.
• $276 million to fix the computer systems at the State Department.
• $650 million to repair dilapidated Forest Service facilities.
• $50 million outlay for the National Endowment for the Arts.
• $44 million for repairs at the Agriculture Department headquarters.
• $336 million for sexually transmitted disease efforts.
• $360 million for new child care centers at military bases.
• $1.8 billion to repair National Park Service facilities.
• $276 million to update technology at the State Department.
• $500 million for the Transportation Security Administration to install bomb detectors at airports.
• $1.5 billion for a "carbon-capturing contest."
• $600 million for General Services Administration to replace older vehicles with alternative fuel vehicles.
• $2.5 billion to upgrade low-income housing.
• $400 million for NASA scientists to conduct climate change research.
• $426 million to construct facilities at the Centers for Disease Control and Prevention.
• $4.1 billion for "neighborhood stabilization activities"...groups like ACORN.
• $572 million for the Coast Guard for "acquisition, construction, & improvements."
• $800 million to clean up Superfund sites.
• $150 million for the Coast Guard to repair or remove bridges deemed a hazard to navigation.
• $6.7 billion to renovate and improve energy efficiency at federal buildings.
• $400 million to replace the Social Security Administration's 30-year-old National Computer Center.

One could argue the value to society of any or all of the above. One could also argue that some of them will result in job creation. The question, however, is to what degree in the shorter term this spending package will help the tens of thousands of Americans who have lost their private-sector jobs, including the 100,000 plus just last week.