HR3200 : Division C : Day One

Tonight we cover Division C, the last “division” of the monstrosity known as “America’s Affordable Health Choices Act of 2009“.

Division C concentrates on Public Health and Workforce Development. The first thing we learn in this division is that each “amendment” mentioned in this division, unless otherwise specified makes reference to the Public Health Service Act.

Except as otherwise specified, whenever in this division an amendment is expressed in terms of an amendment to a section or other provision, the reference shall be considered to be made to a section or other provision of the Public Health Service Act (42 U.S.C. 201 et seq.)

Section 2002 establishes a fund to be called the “Public Health Investment Fund”. The funding for this “fund” will be set by the following schedule.

There shall be deposited into the Fund—

(i) for fiscal year 2010, $4,600,000,000;

(ii) for fiscal year 2011, $5,600,000,000;

(iii) for fiscal year 2012, $6,900,000,000;

(iv) for fiscal year 2013, $7,800,000,000;

(v) for fiscal year 2014, $9,000,000,000;

(vi) for fiscal year 2015, $9,400,000,000;

(vii) for fiscal year 2016, $10,100,000,000;

(viii) for fiscal year 2017, $10,800,000,000;

(ix) for fiscal year 2018, $11,800,000,000; and

(x) for fiscal year 2019, $12,700,000,000.

That’s a total of $88,700,000,000. That’s $88.7 billion dollars over the next 10 years. Which amounts to just $16 billion more than the cost of covering 0.9% of the population (those treated for HIV, Cancer, and Parkinson’s Disease).

Where do you think the government is going to get an additional $88.7 billion over the course of the next 10 years?

Amounts deposited into the Fund shall be derived from general revenues of the Treasury.

Where do you think general revenues come from? That’s right. Taxes. There ain’t no mincing words about that.

The funds allocated for the “Public Health Investment Fund” will not be subject to the Balanced Budget and Emergency Deficit Control Act. That means the costs for operating this fund may rise and rise with no limit on appropriations at all. Yes, that means your taxes will rise and rise with no limit (until they hit 100%) on your income.

Amounts appropriated under this section, and outlays flowing from such appropriations, shall not be taken into account for purposes of any budget enforcement procedures including allocations under section 302(a) and (b) of the Balanced Budget and Emergency Deficit Control Act and budget resolutions for fiscal years during which appropriations are made from the Fund.

Title I, section 2101 increases funding for community health centers. This actually makes sense since most of the bill up to this point deals with the Public Option, Medicare, and Medicaid. Everyone will be covered by the time the fund is funded to the levels they claim, so community health centers are going to need the money, aren’t they?

Community health centers will be appropriated money out of the Public Health Investment Fund, in the following amounts.

For the purpose of carrying out this section, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) For fiscal year 2010, $1,000,000,000.

“(2) For fiscal year 2011, $1,500,000,000.

“(3) For fiscal year 2012, $2,500,000,000.

“(4) For fiscal year 2013, $3,000,000,000.

“(5) For fiscal year 2014, $4,000,000,000.

“(6) For fiscal year 2015, $4,400,000,000.

“(7) For fiscal year 2016, $4,800,000,000.

“(8) For fiscal year 2017, $5,300,000,000.

“(9) For fiscal year 2018, $5,900,000,000.

“(10) For fiscal year 2019, $6,400,000,000.”.

The total for Community Health Center funding comes to $38,800,000,000, or $38.8 billion. That’s 43.7% of the money allocated for the Public Health Investment Fund.

Title II covers the “Workforce”. Section 2201 mandates the creation of a “National Health Service Corps.

Individuals who receive educational funding through a federal Scholarship Program or the Loan Repayment Program will be required to provide “half-time” clinical practice. No this does mean that the new up and coming doctors will be treating all their patients during the break in the local football game. It means they will be required to offer half-time service (yes, devoting half of their employment time) for two years to fulfill their obligation for the funding services they received from the government.

I wonder what the “government service” interns will be required to wear? With their coats be red in color?

Section 2202 sets the authorization of appropriations and provides for additional funding for the scholarship and loan repayment programs in the following amounts:

“For the purpose of carrying out this subpart, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $254,000,000 for fiscal year 2010.

“(2) $266,000,000 for fiscal year 2011.

“(3) $278,000,000 for fiscal year 2012.

“(4) $292,000,000 for fiscal year 2013.

“(5) $306,000,000 for fiscal year 2014.

“(6) $321,000,000 for fiscal year 2015.

“(7) $337,000,000 for fiscal year 2016.

“(8) $354,000,000 for fiscal year 2017.

“(9) $372,000,000 for fiscal year 2018.

“(10) $391,000,000 for fiscal year 2019.”.

A total of $3,171,000,000. Thats $3.171 billion or 3.6% of the Public Health Investment Fund. So far, we’ve spent $41.971 billion of the $88.7 billion dollar fund.

Section 2212 sets the loan provisions, rate of interest for those loans, and requires the student to practice in such care for 10 years or through the date on which the load is repaid in full, whichever occurs first.

If you take a government loan to become a doctor, you will be required to work “half-time” in clinical practice, as well as practice for at least 10 years or at least as long as you are repaying the loans you received.

to practice in such care for 10 years (including residency training in primary health care) or through the date on which the loan is repaid in full, whichever occurs first.”

The powerful and mighty Secretary of Health and Human Services will be pulling more strings behind that giant green curtain too. In addition to all of the other new responsibilities he/she will hold once this bill becomes law, the Secretary will also be responsible for something else.

The Secretary shall make grants to, or enter into contracts with, eligible entities—

“(A) to plan, develop, operate, or participate in an accredited professional training program, including an accredited residency or internship program, in the field of family medicine, general internal medicine, general pediatrics, or geriatrics for medical students, interns, residents, or practicing physicians;

“(B) to provide financial assistance in the form of traineeships and fellowships to medical students, interns, residents, or practicing physicians, who are participants in any such program, and who plan to specialize or work in family medicine, general internal medicine, general pediatrics, or geriatrics;

“(C) to plan, develop, operate, or participate in an accredited program for the training of physicians who plan to teach in family medicine, general internal medicine, general pediatrics, or geriatrics training programs including in community-based settings;

“(D) to provide financial assistance in the form of traineeships and fellowships to practicing physicians who are participants in any such programs and who plan to teach in a family medicine, general internal medicine, general pediatrics, or geriatrics training program; and

“(E) to plan, develop, operate, or participate in an accredited program for physician assistant education, and for the training of individuals who plan to teach in programs to provide such training.

That’s right. The Secretary will be responsible for creating training programs for new doctors. The Secretary will decide (by entering into a contract with services or corporations of his/her choosing) what doctors will learn, how they will serve their communities, and how the inductees students, will repay their debt for the awesome opportunity to serve their country.

The Secretary will decide which hospitals qualify for these contracts, which programs will serve the best community good, and which students will be allowed to participate in these programs.

This bill isn’t just about the common good where health care is concerned, it’s not about lowering costs or making the system more efficient. It’s about the outright full control of health care, and ultimately our lives, in this country.

The allocation for funding for primary care and dentistry will amount to the following values.

For the purpose of carrying out subpart XI of part D of title III and sections 723, 747, 748, and 749, in addition to any other amounts authorized to be appropriated for such purpose, there is authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $240,000,000 for fiscal year 2010.

“(2) $253,000,000 for fiscal year 2011.

“(3) $265,000,000 for fiscal year 2012.

“(4) $278,000,000 for fiscal year 2013.

“(5) $292,000,000 for fiscal year 2014.

“(6) $307,000,000 for fiscal year 2015.

“(7) $322,000,000 for fiscal year 2016.

“(8) $338,000,000 for fiscal year 2017.

“(9) $355,000,000 for fiscal year 2018.

“(10) $373,000,000 for fiscal year 2019.”.

This amounts to another $3,023,000,000 or $3.023 billion. This brings our total “spent” to $44.994 billion.

In case you were wondering, Section 2221 adds nurses into the same “plan” as doctors where they will be allowed to serve their government as a “repayment” for two years. The funding for this additional program is allocated (like the rest) over the next ten years.

For the purpose of carrying out this title, in addition to any other amounts authorized to be appropriated for such purpose, there are authorized to be appropriated, out of any monies in the Public Health Investment Fund, the following:

“(1) $115,000,000 for fiscal year 2010.

“(2) $122,000,000 for fiscal year 2011.

“(3) $127,000,000 for fiscal year 2012.

“(4) $134,000,000 for fiscal year 2013.

“(5) $140,000,000 for fiscal year 2014.

“(6) $147,000,000 for fiscal year 2015.

“(7) $154,000,000 for fiscal year 2016.

“(8) $162,000,000 for fiscal year 2017.

“(9) $170,000,000 for fiscal year 2018.

“(10) $179,000,000 for fiscal year 2019.”

A total of $1,450,000,000 or $1.45 billion. Our total is now $46.444 billion of the $88.7 billion total set in the fund. Yes, the government actually wants you to believe that they can fund the opening of community health centers (nationwide) and define plus fund the education of doctors as well as nurses for just $46.444 billion. Remember, it’s going to cost $72 billion to treat just 0.9% of the people in our country. When do we talk about covering the remaining 99.1 percent of the people? Is that included in the remaining 47.6% of the Public Health Investment Fund or are we talking about allocating money somewhere else?

Tomorrow we’ll begin with Subtitle C, “Public Health Workforce” on page 898.

One thought on “HR3200 : Division C : Day One

  1. THANK YOU SO MUCH!!!
    For my political science class I had to read Division C title 1 and 2 which is like, 100 pages of bullshit. I’m 19 years old and in my immature head i was thinking…”geezzz…this is a lot of money, where is it going to come from?” and the whole part about the secretary deciding where people are going to learn and study on “need based” areas gave me creepy deja vu of the book 1984…

    im just so glad someone else carefully read this part and had similar feelings of “this is fucked uuuuup” i guess im not as paranoid as i thought i was. thanks again!!!!

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