HR3200 : Division B : Day One : Part One

Today, we begin with Division B, Medicare and Medicaid Improvements. I know we skipped a little bit, but feel free to read pages 204 – 215 which include Sections 442, 451, 452, and 453.

The table of contents for Division B is eight pages long. Yes, eight pages to tell you where everything is for this section alone. It figures that the Medicare/Medicaid section of this bill would take up so much space. Let’s dig in…

Title I, Subtitle A, Part 1, Section 1101 redefines the payments for skilled nursing facilities. Wow, they didn’t waste any time changing the payment structures in Division B. Section 1102 redefines the payments for inpatient rehabilition facilities, and Section 1103 incorporates “productivity improvements into market basket updates that do not already incorporate such improvements” in such places as skilled nursing facilities, long term care facilities, inpatient rehabilitation facilities, and psychiatric hospitals. Reading ruther it looks like they talk an awful lot about productivity improvements throughout a big part of the Medicare/Medicaid industry.

Section 1112 covers payment adjustments in response to coverage expansion. Not only will everyone be insured, but even more people will qualify for Medicare and/or Medicaid.

Not later than January 1, 2016, the Secretary of Health and Human Services shall submit to Congress a report on Medicare DSH taking into account the impact of the health care reforms carried out under division A in reducing the number of uninsured individuals

What do they want? A complete overhaul of health care. When do they want it? Now! When does the Secretary of Health and Human Services have to report on the impact of their “reform”? Not for 7 years. Whoah!

Universal Health Care. What does that mean? To most people, I think it means everyone will have insurance, everyone will be covered. Maybe not.

There is a “significant decrease in the national rate of uninsurance as a result of this Act” if there is a decrease in the national rate of uninsurance (as defined in subparagraph (B)) from 2012 to 2014 that exceeds 8 percentage points

If, after 3 to 5 years from the time this bill passes that there is a decrease of at least 8 percentage points in the national rate of uninsurance, the government will use the word “significant” when they refer to the decrease. The only thing significant about this section is the fact that national health care won’t provide a decrease of 100% of those who are uninsured. What do this have to do with Medicare and Medicaid anyway? Does this mean only poor people and old people won’t have universal health care?

Apparently it doesn’t apply to Medicare at all.

The term “national rate of uninsurance” means, for a year, such rate for the under-65 population for the year as determined and published by the Bureau of the Census in its Current Population Survey in or about September of the succeeding year.

So that whole section about the “significant decrease” only applies to people who are less fortunate / out of work / on the streets / needing assistance / doing without. Yes, it applies only to those people who need coverage in the first place.

Why exactly is the Secretary of Health and Human Services waiting seven years to report on the impact to Congress? Are they phasing it in, or giving it time while they phase out our existing health insurance plans?

Subtitle B, Part 1, Section 1121 amends the Social Security Act in regard to the sustainable growth rate reform, “rebasing” using 2009 for future adjustments, and limiting the rate computation for physician services. Yes, this means they are reformulating the amounts that can be charged and limiting how much physicians can charge for their services.

What happened to the free market? Setting the rates and limiting earnings are all part of the socialist agenda. It would be bad enough if they set rates for different specialties, but they don’t. Every physician, whether they are podiatrists or oncologists will earn the same amount of money.

Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.

Is “rebasing” a lot like “freebasing”? Because whoever wrote this section must have been on something at the time.

I can’t take anymore right now. One thing for sure, antacids better be covered under this plan because we’re all going to need it if this thing passes.

I’ll be back with more later, beginning with Division B, Subtitle B, Part 2, Section 1132 on page 265.