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anyone else think this is a bit over complicated:

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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:24 PM
Original message
anyone else think this is a bit over complicated:
Subtitle B—Public Health
6 Insurance Option
7 SEC. 321. ESTABLISHMENT AND ADMINISTRATION OF A
8 PUBLIC HEALTH INSURANCE OPTION AS AN
9 EXCHANGE-QUALIFIED HEALTH BENEFITS
10 PLAN.
11 (a) ESTABLISHMENT.—For years beginning with Y1,
12 the Secretary of Health and Human Services (in this sub13
title referred to as the ‘‘Secretary’’) shall provide for the
14 offering of an Exchange-participating health benefits plan
15 (in this division referred to as the ‘‘public health insurance
16 option’’) that ensures choice, competition, and stability of
17 affordable, high quality coverage throughout the United
18 States in accordance with this subtitle. In designing the
19 option, the Secretary’s primary responsibility is to create
20 a low-cost plan without compromising quality or access to
21 care.
22 (b) OFFERING AS AN EXCHANGE-PARTICIPATING
23 HEALTH BENEFITS PLAN.—
24 (1) EXCLUSIVE TO THE EXCHANGE.—The pub25
lic health insurance option shall only be made avail26
able through the Health Insurance Exchange.
VerDate Nov 24 2008 10:05 Oct 29, 2009 Jkt 000000 PO 00000 Frm 00211 Fmt 6652 Sfmt 6201 C:\TEMP\AHCAA_001.XML HOLCPC
October 29, 2009 (10:05 a.m.)
F:\P11\NHI\TRICOMM\AHCAA_001.XML
f:\VHLC\102909\102909.022.xml (453769|4)
212
1 (2) ENSURING A LEVEL PLAYING FIELD.—Con2
sistent with this subtitle, the public health insurance
3 option shall comply with requirements that are ap4
plicable under this title to an Exchange-participating
5 health benefits plan, including requirements related
6 to benefits, benefit levels, provider networks, notices,
7 consumer protections, and cost-sharing.
8 (3) PROVISION OF BENEFIT LEVELS.—The pub9
lic health insurance option—
10 (A) shall offer basic, enhanced, and pre11
mium plans; and
12 (B) may offer premium-plus plans.



a "health insurance exchange", and basic, enhanced, and premium" plans??

maybe i just don't understand what the fuck i'm reading but, the whole things just seems way over complicated. i mean, if they were going to do a real public option, why not just say "medicare if you want it, the end."?

page after page and my brain just doesn't understand. to me, it's almost like the more there is to this bill the more they leave themselves open for insurance companies to find loopholes.

again, i could be wrong. it just seems kind of ridiculous.

i am still hoping that they get things worked out and everyone would have access to a real public option, but this tiered system just sounds too much like insurance company bullshit to me.

admittedly, i'm no expert, but this whole thing so far doesn't make any rational sense.


:shrug:





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BrklynLiberal Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:25 PM
Response to Original message
1. Convolutedness is intentional.
Edited on Thu Oct-29-09 12:25 PM by BrklynLiberal
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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:36 PM
Response to Reply #1
4. here's another oddball:
Edited on Thu Oct-29-09 12:38 PM by Soylent Brice
pg 216

13 (3) NO BAILOUTS.—In no case shall the public
14 health insurance option receive any Federal funds
15 for purposes of insolvency in any manner similar to
16 the manner in which entities receive Federal funding
17 under the Troubled Assets Relief Program of the
18 Secretary of the Treasury.

wow.

so coporations have more access to taxpayer dollars than an entity designed to provide healthcare to the taxpayers themselves??

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Autumn Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:40 PM
Response to Reply #4
7. It's a matter of priorities.
And these fucking parasites we have elected know what their priorities are.
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mike_c Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:34 PM
Response to Original message
2. contrast with HR 676 medicare for all....
Full text at: http://johnconyers.com/hr676text

The gist of it:

TITLE I—Eligibility and Benefits

SEC. 101. Eligibility and registration.

(a) In general.—All individuals residing in the United States (including any territory of the United States) are covered under the USNHI Program entitling them to a universal, best quality standard of care. Each such individual shall receive a card with a unique number in the mail. An individual’s social security number shall not be used for purposes of registration under this section.

(b) Registration.—Individuals and families shall receive a United States National Health Insurance Card in the mail, after filling out a United States National Health Insurance application form at a health care provider. Such application form shall be no more than 2 pages long.

(c) Presumption.—Individuals who present themselves for covered services from a participating provider shall be presumed to be eligible for benefits under this Act, but shall complete an application for benefits in order to receive a United States National Health Insurance Card and have payment made for such benefits.

SEC. 102. Benefits and portability.

(a) In general.—The health insurance benefits under this Act cover all medically necessary services, including at least the following:

(1) Primary care and prevention.

(2) Inpatient care.

(3) Outpatient care.

(4) Emergency care.

(5) Prescription drugs.

(6) Durable medical equipment.

(7) Long term care.

(8) Mental health services.

(9) The full scope of dental services (other than cosmetic dentistry).

(10) Substance abuse treatment services.

(11) Chiropractic services.

(12) Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).

(13) Hearing services, including coverage of hearing aids.

(b) Portability.—Such benefits are available through any licensed health care clinician anywhere in the United States that is legally qualified to provide the benefits.

(c) No cost-sharing.—No deductibles, copayments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits.

more@link
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sharp_stick Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:34 PM
Response to Original message
3. Legalese
understanding this crap is why people need to spend several years in law school. It's a handy way to make sure nobody else can understand it.

It's also a byproduct of the way we write laws. There are thousands of people involved in the writing of a complex law and everyone of them is going to make damned sure they leave their fingerprints on it. From the elected representative from nowhere KS to the third aide in charge of paperclips to the representative from farout ME.
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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 01:04 PM
Response to Reply #3
11. this thing is making my head spin
Edited on Thu Oct-29-09 01:13 PM by Soylent Brice
it's making it sound like the individual requirements to qualify for the PO would be the same for medicaid.

i could be wrong. that's how it sounds though.

they should have a "spell it out for me" version they release simultaneously.

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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:36 PM
Response to Original message
5. All bills are written this way. Believe it or not, it really does
prevent loopholes. I'm not saying there's none in there, but one of the first things any good lawyer does when looking for a loophole is to find things that AREN'T MENTIONED! Their explaination is "We did it because the law doesn't say we can't!"

All bills are very hard to read because of the legalese in which they are written. There was a Dem on the Senate Finance Committee who said exactly that. "Do you actually believe the avg. person will understand something like this when it's posted online?" I don't remember who it was but I was watching the hearing at the time.
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lunatica Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:46 PM
Response to Reply #5
9. There are a lot of what they call 'average' people who understand
Because as much as they believe that Americans are all stupid they're fucking wrong.
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Are_grits_groceries Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:38 PM
Response to Original message
6. I can catch a glimmer of an idea if I can force myself
to sit and concentrate. I get a headache and agita in about 15 minutes tops of reading.
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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:42 PM
Response to Reply #6
8. members of congress can enroll in public option:
SEC. 330. ENROLLMENT IN PUBLIC HEALTH INSURANCE
2 OPTION BY MEMBERS OF CONGRESS.
3 Notwithstanding any other provision of this Act,
4 Members of Congress may enroll in the public health in5
surance option.

this thing keeps getting weirder and weirder...

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sandnsea Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 12:46 PM
Response to Original message
10. Does the Medicare bill say "medicare if you want it"?
Why do people help kill legislation by buying into the right's stupidity.

Of course legislation is complicated. They're writing laws that have to be implemented and enforced fairly. They have to consider all the unforeseen misinterpretations and attempts to claim the legislation is unConstitutional in some form or other.

People complain about the country being dumbed down, and then turn around and demand it get even dumber.

No Billy Bob, you can't understand the legislation. That's why you elect smart people to go to Washington.
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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Oct-29-09 01:08 PM
Response to Reply #10
12. i'm not asking them to dumb it down, but
have you even looked at this thing yet??

i still can't narrow down the specific requirements for individual enrollment into the PO. it sounds like medicaid-like requirements, but i can't tell.

i'm not asking for it to be dumbed down. but a list of black and white qualifications would have seemed almost common sense. they didn't have a problem with spelling it out when they were explaining that the PO can't receive bailout funds.

that was pretty cut and dry black and white.

why not do the same for individual requirements for eligibility?

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