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Attempt at being a dutiful citizen

August 1, 2009

Some interesting stuff in this health care plan.

On page 21/22:

The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, shall conduct a study of the large group insured and self-insured employer health care markets. Such study shall examine the following … (C) The financial solvency and capital reserve levels of employers that self-insure by employer size. (D) The risk of self-insured employers not being able to pay obligations or otherwise become financially solvent.

The government is going to check the books of private employers that self-insure? Umm …

On page 29, starting on line four:

(A) The cost-sharing incurred under the essential benefits package with respect to an individual (or family) for a year does not exceed the applicable level specified in subparagraph (B). (B) The applicable level specified in this subparagraph for Y1 is $5000 for an individual and $10,000 for a family.

Is that saying that a family only get $10,000 worth of coverage per year? What if you have a baby? What if more than one family member is in a car accident? What if you have a child with down syndrome?

The “goals for financial and administrative transactions” is on pages 57 and 58. They include,

(C) be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications; (D) 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, which may include utilization of a machine-readable health plan beneficiary identification card;”

What happens then? They scan your card, determine that – due to the fact that your son had surgery earlier this year – you don’t have enough health care credit to be treated for this heart attack you’re having right now. Sorry.

I went to Immediate Care a couple weeks ago because I was having an allergic reaction to something, and the hives were spreading. And I don’t think any part of that necessitated the government being able to check my bank account.

Title II, on page 72, starts out,

There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.

That’s almost arrogant, unless I’m reading it wrong. “You’ll have choices, but we know we’re going to destroy privatized health care, so here’s how you switch to our plan?”

That’s as far as I am – ’cause it’s dense and probably deliberately so. If any of this freaks you out, and you’ll like to let your Congressperson know, go here. It will tell you who your Congressperson is and give you a link to email him/her.

And if you’re a politician or a lawyer (or just smarter than me) and I’m mis-interpreting this, please correct me.

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