HR3200 : Division B : Day Three : Part Two

Now that we have established that cancer treatment will likely be rationed, special needs patients will be left waiting, doctors will be penalized for readmissions, and “death panels” really were in the original text of the bill, let’s more on.

Before we do, however, let me pass something on to you. I received a few messages from someone who read my earlier post today (part one), and told me that the entire “end of life” section I covered was eerily similar to existing VA policy.

It seems her grandfather, who was 78 years old at the time, was diagnosed with prostate cancer. The Veteran’s Administration told him that he was too close to the end of his life to validate the cost of treatment. He lived another eight years as cancer spread through his body before he passed away. But here’s the kicker.

He did not die from the cancer. He died choking on a tuna fish sandwich because the VA also considered the performance of the Heimlich Maneuver to be a violation of his DNR. I kid you not. If you think the government can handle health care on a nationwide scale, all you have to do is look at the VA to learn otherwise.

Let’s see what other gems H.R. 3200 has in store for us.

Division B, Title II, Subtitle C, Section 1234 begins with the waiver of limited enrollment penalty for TriCare beneficiaries. If you are not familiar with it, TriCare is the health care program which serves active duty service members, National Guard and Reserve members, retirees, their families, survivors, and certain former spouses.

Section 1234 will mandate that qualifying individuals will automatically be enrolled in TriCare.

The Secretary of Defense shall establish a method for identifying individuals described in paragraph (1) and providing notice to them of their eligibility for enrollment during the special enrollment period described in paragraph (2).”.

Now we have the Secretary of Defense deciding who gets medical care, along with the Secretary of Health and Human Services, and the Health Choices Administration “Commissioner”, all of whom are not required to be doctors. Section 1234 also states that rates for TriCare will rise.

Section 1236 will establish “patient decision aids”.

The Secretary of Health and Human Services shall establish a shared decision making demonstration program (in this subsection referred to as the “program”) under the Medicare program using patient decision aids to meet the objective of improving the understanding by Medicare beneficiaries of their medical treatment options, as compared to comparable Medicare beneficiaries who do not participate in a shared decision making process using patient decision aids.

It seems your doctor will not be allowed to discuss your treatment options with you unless he/she uses one of these “shared decision making demonstration programs” to help you learn the best treatment option for you at the time. Shouldn’t the best treatment option be the one that saves your life? I wonder what that flowchart would look like?

Do you have a serious illness? If yes, continue. If no, get out of here before we penalize your doctor for allowing you back in the door so soon.

Is your serious illness life threatening? If yes, continue. If no, then get the hell out of here before we penalize you for wasting our time.

Are you older than 65? If yes, continue. If no, receive the best treatment possible adjusted by the number of productive years you have remaining in your life. Have a nice day.

Hello senior. You have reached the end of the flowchart. Congratulations! Unfortunately, by reaching the end of the flowchart you have also reached the end of your usefulness to society, therefore we cannot justify spending a dime in additional care for your “serious illness”. Please return home where you will receive a nice visit from one of our “advanced care planning consultants”. Oh, and don’t forget to make your appointment to complete your health care proxy.

It may sound far fetched to you, but that’s basically how it’s going to work if this bill passes.

Title III, Section 1301 creates a new “accountable care organization pilot program”. Say that three time fast.

The Secretary shall conduct a pilot program (in this section referred to as the ‘pilot program’) to test different payment incentive models, including (to the extent practicable) the specific payment incentive models described in subsection (c), designed to reduce the growth of expenditures and improve health outcomes in the provision of items and services under this title to applicable beneficiaries (as defined in subsection (d)) by qualifying accountable care organizations (as defined in subsection (b)(1)) in order to—

“(1) promote accountability for a patient population and coordinate items and services under parts A and B;

“(2) encourage investment in infrastructure and redesigned care processes for high quality and efficient service delivery; and

“(3) reward physician practices and other physician organizational models for the provision of high quality and efficient health care services.

Physicians will be rewarded for high quality and efficient health care services, but only if they have not already been penalized for readmitting the patient or not following the government guidelines with the “decision aid” for that patients care.

Remember, everything the government is implementing in this bill will be on the reward/penalty system. If you comply, you will be duly rewarded, if you fail to comply you will be penalized in the form of lower payments and therefore forced to comply if you want to eat.

Section 1302 establishes the “medical home pilot program”. Yes, Medicare covered treatments delivered directly to your front door in the form of medical home services, if you live in a “medical home” anyway.

Subject to subsection (g), the pilot program shall include urban, rural, and underserved areas.

Don’t be surprised, however, if you don’t see a doctor when you answer the door.

Nothing in this section shall be construed as preventing a nurse practitioner from leading a patient centered medical home so long as—

“(i) all the requirements of this section are met; and

“(ii) the nurse practitioner is acting consistently with State law.

I can tell you how well this is going to work.

Our oldest son got sick a while ago. He had a fever, was nauseous, and was feeling just awful. Our pediatrician was out of town, but an “office assistant” (who we didn’t even know was not a nurse), told us how to treat his symptoms because a “bug was going around”. After he did not respond to those treatments and seemed to be getting worse we took him to the emergency room. We made it just in time. He had appendicitis and he would have died had we not arrived when we did. He was in the hospital for a week.

We almost lost our son because we had faith in our doctor’s office. We believed we were getting the proper advice from a properly trained individual. It turns out we were wrong, and our son almost died. The doctor was not penalized, the “office assistant” kept her job, and we found another pediatrician immediately.

I can just imagine how well this “medical home pilot program” is going to work. Puh-leaze! Oh, in case you were wondering,

Chapter 35 of title 44, United States Code shall not apply to this section.

That’s right. Those obtaining services under the “medical home pilot program” will not be afforded the right to privacy. Remember, Chapter 35 of Title 44 of the U.S. Code makes a few assurances, one of which is to,

ensure that the creation, collection, maintenance, use, dissemination, and disposition of information by or for the Federal Government is consistent with applicable laws, including laws relating to—
(A) privacy and confidentiality, including section 552a of title 5;
(B) security of information, including section 11332 of title 40 [1] ; and
(C) access to information, including section 552 of title 5;

Section 1308 amends the Social Security Act to allow for marriage and family therapist services.

Section 1861 of the Social Security Act (42 U.S.C. 1395x), as amended by sections 1235 and 1305, is amended by adding at the end the following new subsection:

“Marriage and Family Therapist Services

“(jjj) (1) The term ‘marriage and family therapist services’ means services performed by a marriage and family therapist (as defined in paragraph (2)) for the diagnosis and treatment of mental illnesses, which the marriage and family therapist is legally authorized to perform under State law (or the State regulatory mechanism provided by State law) of the State in which such services are performed, as would otherwise be covered if furnished by a physician or as incident to a physician’s professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services.

Because universal health care is all about diagnosing the problems within your marriage. Notice they pooled marriage and mental health into the same section? Is this so your health care practitioners who decide you are too close to the end of life can also claim your spouse is mentally impaired when they try to protest their decision? Just thinking out loud.

Section 1308 goes on to define mental health counselor services, by defining the services that will be covered, creating those services, setting the prices of those services, and then, ultimately, rationing those services.

Section 1310 will expand access to vaccines, which if I am not mistaken are available now at most health department locations for a low, nominal price, or even free in some cases.

Moving on to Division B, Title IV, Subtitle A, Section 1401 brings us to comparative effectiveness research.

The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research (in this section referred to as the ‘Center’) to conduct, support, and synthesize research (including research conducted or supported under section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003) with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.

Privately funded medical research has been at the forefront of most major discoveries, yet now, in the age of Obama, the government is going to create their own research facility to see if the “effectiveness, and appropriateness of health care services and procedures” are up to par and identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.

The government controlled post office can’t even deliver my mail reliably but I am supposed to think the same government can perform valid research on a topic they know nothing about? Unless this “Comparative Effectiveness Research Center” is comprised of the best clinical minds our country had to offer, it won’t be worth the paper it was created on.

The “Center” will have the authority to collect data from any government agency or department.

The Center may secure directly from any department or agency of the United States information necessary to enable it to carry out this section. Upon request of the Center, the head of that department or agency shall furnish that information to the Center on an agreed upon schedule.

They will also be authorized to utilize all existing information, both published and unpublished.

In order to carry out its functions, the Center shall—

“(i) utilize existing information, both published and unpublished, where possible, collected and assessed either by its own staff or under other arrangements made in accordance with this section,

“(ii) carry out, or award grants or contracts for, original research and experimentation, where existing information is inadequate, and

“(iii) adopt procedures allowing any interested party to submit information for the use by the Center and Commission under subsection (b) in making reports and recommendations.

So far, I have covered 524 pages of the original 1,018 page House bill. Have you noticed the repeating patterns and the total disregard for the freedoms we enjoy in this country?

This bill will allow the government to keep creating new entities, in the form of administrations, committees, and other administrative (bureaucratic) positions. This bill will allow the government to slowly dissolve our rights as citizens. This bill will allow the government to violate our right to privacy and even one of the amendments to the Constitution.

This bill will allow the government to ration health care where they see fit. This bill will allow the government to ignore current laws regarding paperwork and record keeping. This bill will allow the government to schedule the time frame in which you will die.

But most of all this bill will allow the government to destroy the very fabric of our country by destroying the republic for which we stand and replacing it with a socialist agenda that has proven to fail time and time again.

I’ll pick up tomorrow on page 525, Division B, Title IV, Subtitle B, Nursing Home Transparency.