Sen. Wyden says his plan will be the one

In a meeting with some directors of the Pima County Medical Society in May, Senator Ron Wyden (D-OR) said that his “health care reform” plan was the one with the best chance of passage. It is the first bipartisan bill in 60 years. The Democrats like it, he said, because it covers everyone, and the Republicans like it because there is a role for the private sector. In addition, the Congressional Budget Office (CBO) has scored it as budget neutral.

Since the introduction of the Healthy Americans Act in 2007, Wyden has “built the largest bipartisan coalition of Senators supporting a comprehensive health reform proposal since the days of Harry Truman,” according to his website.

He claims that “tough cost containment measures” would save $1.48 trillion over 10 years and return surpluses to the Treasury within 2 years. The cost of the bill would be $0.8 trillion per year, according to an analysis by Conservatives for Patients’ Rights, which has prepared a concise summary of the various proposals.

“Insurance company profits would come from keeping their customers healthy,” Wyden asserts.

Group coverage, the Federal Employee Health Benefits Program (FEHBP), Medicaid (except for its wrap-around and long term care functions), and the State Children’s Health Insurance Program (SCHIP) would be phased out.

Key features:

New bureaucracies: These include State Health Help Agencies (HHAs), with a federal fallback plan should states refuse to create them; an advisory committee to report annually on modifications of benefits, etc.; some mechanism to “adjust” the Medicare Part B premium based on whether or not each individual “participates in certain healthy behaviors”; other agencies to calculate payments, monitor individual behavior, set standards as for chronic disease management, check compliance with standards, monitor loss ratios and outcomes of chronic-care management, etc.

Individual mandate. All adults must buy a government-approved Healthy Americans Private Insurance Plan (HAPI) and constantly report on compliance, at every interaction with federal, state, and local government, including at voter registration, motor vehicle departments, or other checkpoints, as well as when filing tax forms. This applies to all legal residents, including non-citizens, although not to illegal aliens.

Penalties. The penalty includes the average monthly premium, plus 15%, for all “uncovered” months. Penalties are not subject to discharge by bankruptcy. This means that the HHA, which receives the penalties, takes precedence over other creditors.

Insurance mandates. Guaranteed issue, community rating, coverage of “wellness” without copayments, annual physicals, a required “health home” (gatekeeper), mental health parity, and reconstructive surgery post mastectomy are all mandatory. Each HAPI plan “shall” make available supplemental coverage for abortion, unless affiliated with a religious institution.

Progressive taxation equivalent. Premium subsidies are phased out incrementally up to 400% of poverty. This means that working harder and earning more is punished by higher mandated health insurance “premiums” (which are the functional equivalent of taxes). People will constantly be reporting on their income status.

School-based clinics. Care must be provided at no cost, or on a reimbursable basis, by school-based clinics, which must provide, “at a minimum,” mental health services, and use electronic medical records by 2012.

Job killer. Every employer “shall pay an employer shared responsibility payment,” which increases for each additional employee in excess of 50. Employers must deduct the individual shared responsibility payment from wages “as and when paid.” This amount is not allowed as a deduction from the employer’s taxable income.

Savings. To offset the costs, Medicare and 90% of Medicaid disproportionate share (DSH) payments are to be “recaptured.” Tax exclusions for health benefits will be limited (sections 661-666). According to section 801, “private insurance companies will be forced to hold down costs and will slow the rate of growth because they are required to offer standardized Healthy Americans Private Insurance plans.” It is also easy to see that prevention, management, reporting, determining best practices, behavior modification, etc., will lead to massive savings even before sickness (or treatment thereof) is completely eliminated.

“Americans want affordable, guaranteed private health coverage that makes them healthier and can never be taken away,” the Act states as a congressional finding.

Additional information:

20 thoughts on “Sen. Wyden says his plan will be the one

  1. Pingback: H.R. 3200 | The Doctor Is In

  2. Translated into practice, this is a terrifying scenario. No one is really rewarded. All are punished (the temporarily able-bodied punished less).
    No real carrots for anyone, only the prospect of avoiding bigger sticks.
    No real choices. Only selection from a narrow range of externally imposed options. Who will be attracted to the job of “gatekeeper”?

  3. I am not impressed. This S.391 bill is another attempt for the government to take health care over completely; it is not hidden at all. The provisions are examples of explicit government coercion.

    -New bureaucracies – paid for by? coercion of private citizens
    -Individual mandate – coercion of private citizens
    -Penalties – government coercion of private citizens
    -Insurance mandates – more government of private businessmen
    -Progressive taxation equivalent – more taxation (coercion)
    -School-based clinics – more coercion
    -Job killer – government coercion of employers
    -Savings – translated: rationing

    Yes, this is a lovely plan: government thugs stealing your money, forcing your will, limiting your choices. Americans must say NO to this!

    If we do not fight for political freedom in medicine — Capitalism — we have nothing to fight for, no cause, no real goal, no purpose. The fight for Capitalism in politics is the fight for freedom of choice in medicine.

    Mark A. Hurt, MD

  4. This bill is a government take over of medical care. it is not what the American people want!

  5. Agree with Dr. Hurt.

    This is another govt takeover with loss of individual freedoms and a job killer all in the name of budgetary constraints.

    If republicans vote for this, they will go down in elections along with the democrats.

    Steve Horvitz, D.O.

  6. Appears that private healthcare is being co-opted, and the most vulnerable in our society, our seniors, will be very low on this doctor’s ‘hierarchy of needs’. The plan seems to include much control by the government, with little mention of any freedom to pursue options for treatment. In sum: a sly, bait-and-switch version of the House plan; presented for public consumtion by someone with medical credentials. It simply doesn’t pass the ‘sniff test’.

  7. We need to emphasize that this is not an argument of cost/profit, access, or even of quality of care but one of Liberty and Freedom.

    We have a situation where Congress and the President believe that one man has a “Right” to another man’s labor, made even worse by the fact that the laborer has little or no say in how they provide the labor or the fees they can charge.

    It is quite ironic that the first “Person of color” to be elected President is attempting to reinstate slavery.

    Brad Vilims, M.D., D.A.B.P.M.

  8. Bipartisan is when the RINOS go along with the Democrats and say “yassa boss!” Any Republican that votes for this or any other Democrat sponsored federal plan better enjoy his time in Washington DC – it will be short.

  9. I did not see mention made of tort reform in this proposal. Did I miss something important?

  10. Oust any Rep. who votes for these dictates!

    The Health-Care ‘Wedge’ Fix (Laffer,WSJ Opinion 8/5/09)
    of patient power does work well. Not only the > 8 M Americans
    with Health Savings Accounts (dumped in present plan of Congress)
    but my patients, many uninsured, are happy with the availability,
    thrift and quality of paying (much less) at the time of care.

    Weekly, I see many patients who regret care like Congress plans.
    Examples: HMO, ER or Medicaid clinic treated negative X-rays with
    just cough syrup, but careful exam finds rales, indicating antibiotic
    for early pneumonia. Patients with back pain get pain pills
    and a work excuse when my careful deep palpation often reveals
    tender spots, curable like shoulder bursitis.

    I confirm Laffer’s “Fix” many times daily: patient power, not regulation,
    reduces costs while improving quality. It is a worthy corollary
    to the famous Laffer documentation that lower taxes bring more revenue.

  11. This is another example of the mentality of today’s politicians. All of us — doctors, patients, young, old — should tell all these big government twerps: No – No – NO!!! None of your plans are acceptable. Just back off. Give us back our freedom! We want the government OUT of medicine — and pretty much everything else. The answer to what ails medicine, the economy, our country is: Capitalism — period.

  12. The use of “Health Insurance” as a mechanism for paying for medical services adds tremendously to the cost, whether the insurer is a private or a government entity. Furthermore, the use of “insurance” as a payment mechanism impairs the patient-doctor relationship. The angrily disruptive controversy now so prevalent stems from the widespread delusion that “insurance” is the only proper way to provide medical services. I hold my concept fundamental and irrefutable. I may be the only human left on earth who believes and understands this, but I challenge anyone to prove me wrong!

  13. Concur with Dr. Karotkin. Unfortunately there are rules which prohibit one from entering into contracts with patients if one is to receive Federal reimbursement monies. Govt is already into our system but wants total control. Doctors need to make themselves heard LOUDLY! If you can speak or write please DO so—our patients are rapidly catching on to the govt plan for tyranny.

  14. Wyden is an arrogant little lawyer who has been pretending to be a health expert for years. He was instrumental in the Pap smear debacle that was impossible for labs to put into practice. No mention of tort reform in his bill. It’s as bad as Obama’s.

  15. Pingback: A Sham ‘Compromise’ Health Care Bill Waiting in the Wings « Romanticpoet’s Weblog

  16. Pingback: » A sham ‘compromise’ health care bill waiting in the wings Where liberty dwells, there is my country…

  17. Pingback: Bear Creek Ledger » Here’s the RINO Healthcare Bill - S. 391 Healthy Americans Act (HHA)

  18. Pingback: Beware ‘Healthy Americans Act,’ or ‘Wyden-Bennett’ – the Most Dangerous Health Care Bill Ever « Right Sided American Kafir

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