Harry Reid & Democrat Obstructionism

Not to be outdone by his counterpart, Speaker of the House, Nancy Pelosi, Harry Reid shows just how whiny and hypocritical he can be. Two days ago, Senate Majority Leader Harry Reid (D-NV) stood on the floor of the U.S. Senate and whined about Republican obstructionism.

He said the lack of Republican votes on the Medicare “doc fix” was another effort of the Republicans to “slow down, divert, and stop” what they (Democrats) are trying to do with health care “and basically everything else”.

He has lamented how things have changed in Washington, and he wants everyone within the sound of his voice to understand that Washington is being driven by a small number of people on the other side of the aisle that are preventing them (Democrats) from doing things that “help the American people”.

Sorry Harry. Those accusations just aren’t going to fly anymore. The Democrats hold a 58-40 majority over the Republicans in the Senate. The two Independent Senators caucus with the Democrats, which gives the Democrats a 60-40 majority.

It takes 60 votes to end debate on legislation and bring it up for a vote. That process is called cloture.

 
If the Democrats are truly doing what’s best for the American people and the “essential legislation” he keeps whining about will actually help Americans, why doesn’t his own party support it?

The truth is, Democrats don’t need Republican support on any legislation. They have the numbers. They have the votes. They can introduce, debate, and ultimately pass any bill they choose to force on the American people. The Republicans, with just 40 votes are unable to stop any of it, not by themselves anyway.

It’s time for Harry Reid to stop whining about Republican obstructionism and face the truth. The truth is, Harry Reid does not want to pass “partisan” legislation, especially where health care and anything else important to the American people are concerned, because he doesn’t want Democrats to take the sole blame for how completely ridiculous and dangerous it really is.

Unrefined Methods & Broken Promises

What a week this has been. Between the perfect storm that came in the form of 15 – 20 inches of rain and the perfect storm known as server mishaps, I am completely exhausted mentally and physically.

After sitting down and relaxing with a few games of chess and some trivia with the kids, I’m settled in enough to share some things I saw today.

Thought #1

It’s pretty clear that some parents don’t trust the new H1N1 vaccine.

In a poll of 1,678 U.S. parents conducted by the University of Michigan’s C.S. Mott Children’s Hospital, 40% said they would get their children immunized against the H1N1 virus — even as 54% indicated they would get their kids vaccinated against regular seasonal flu.

About half of the parents who said they’d pass on the H1N1 flu shot for their kids expressed concern about possible side effects of the vaccine.

I don’t trust it. Why would I? The last time the U.S. distributed a Swine Flu vaccine, more people died from the vaccine than died from swine flu itself.

More than 500 people are thought to have developed Guillain-Barre syndrome after receiving the vaccine and 25 died. No one completely understands what causes Guillain-Barre in certain people, but the condition can develop after a bout with infection or following surgery or vaccination. The federal government paid millions in damages to people who developed the condition or their families.

However, the pandemic, which some experts estimated at the time could infect 50 million to 60 million Americans, never unfolded. Only about 200 cases of swine flu and one death were ultimately reported in the U.S., the CDC said.

There might be good reason to be wary. The vaccine has been rushed to market using unrefined methods.

So how many people will suffer adverse effects from the vaccine this time around? Is it worth subjecting yourself, and your kids, to these increased risks?

Thought #2

Barack Obama isn’t going to be able to close Guantanamo Bay by January, like he promised he would. How many promises does this guy have to break before people wise up?

Thought #3

If you don’t buy health insurance under the proposed health care plan, you will be subject to a $1,900 fine. If you fail to pay that fine, you will be charged with a misdemeanor, face up to a year in jail, and an additional $25,000 fine. Yes, this means if you don’t buy health insurance the government can through you in jail.

Thought #4

Speaker of the House Nancy Pelosi (D-CA) isn’t happy with those measely fines. She wants to make sure that every successful person in America pays an additional tax to cover the health care needs of those who haven’t been quite as succesful.

The House Democratic plan calls for raising income taxes on upper-income people to pay for covering the uninsured. Baucus has instead proposed a tax on high-cost insurance plans worth more than $8,000 for an individual policy and $21,000 for family coverage.

Proponents of the insurance tax, which Obama has endorsed, say it would help to lower health care costs by encouraging people to become more cost-conscious health care consumers.

Isn’t it a given that President Obama has endorsed this additional tax? However that isn’t the funniest part of that article. This is.

If House Democrats adopt the insurance tax, it may help them to reduce the income tax increase that they’ve proposed.

If House Democrats adopt the insurance tax which raises taxes it may help them reduce the income tax increase they’ve proposed. Sorry, an increase is an increase no matter what you call it or where you apply it. The American people will still see tha same (additional) amount come out of their checks and they’ll still remember that it was the House Democrats that screwed them over.

A government big enough to give you everything you want is big enough to take everything you have.

Barry Goldwater

The Dangers Of Bench Legislation

One of my biggest pet peeves is when judges attempt to legislate from the bench. Our system of government is set up with checks and balances for a reason, and some people feel that their “cause” is more important than following the normal course of events as our founding fathers defined them.

With this in mind, it comes as no surprise that some organizations are trying to persuade the Supreme Court to apply the United Nations’ Convention on the Rights of the Child as a matter of binding ‘customary international law’, even though the United States has not ratified the CRC.

Amnesty International believes that international law, rather than American law, should be used to make this decision. We have been warning people for some time that this theory could be used to force this treaty upon an unwilling American public. Americans want to retain family-based decision-making and American-made law. The UN Convention Rights of the Child would undermine both of these principles,” constitutional lawyer Michael Farris said.

If the Supreme Court rules that the international laws defined in the CRC are binding on the American people, a vast majority of family laws from virtually every state could be impacted and no longer applicable.

No international law should supersede an American law within the borders of our sovereign nation and our nation’s laws should originate in an American legislative body not from the hammering of a gavel from the bench.

You can read about these cases which could have a long-lasting impact on families across America, at parentalrights.org.

HR3200 : Division C : Day Two

In addition to the National Health Services Corp (NHS), the government will also establish a new “Public Health Workforce Corps” to ensure they have people to fill the positions they will be “providing” under this section of the bill.

There is established, within the Service, the Public Health Workforce Corps (in this subpart referred to as the ‘Corps’), for the purpose of ensuring an adequate supply of public health professionals throughout the Nation. The Corps shall consist of—

“(1) such officers of the Regular and Reserve Corps of the Service as the Secretary may designate; and

“(2) such civilian employees of the United States as the Secretary may appoint.

This section gives even more unbridled power to the Secretary of Health and Human Services. To appoint such civilian employees as he/she sees fit. Wow. Is that insane or what? Apparently he/she will be doing it under yet another “administration.

Except as provided in subsection (c), the Secretary shall carry out this subpart acting through the Administrator of the Health Resources and Services Administration.

Exactly how many administrations, commissioners, ombudsman, and other positions will it require to manage health care in our country? Does anyone know if the Tootsie-Roll Owl is available to figure this one out for us?

The Director of the Centers for Disease Control and Prevention will help develop the methodology for placing and assigning Corps participants as public health professionals.

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop a methodology for placing and assigning Corps participants as public health professionals. Such methodology may allow for placing and assigning such participants in State, local, and tribal health departments and Federally qualified health centers (as defined in section 1861(aa)(4) of the Social Security Act).

I feel kind of silly now. I thought “Public Health Care” meant, you know, providing health care for the people of the country, little did I know it mean employing everyone in the country in health care. I wonder though, what exactly will the responsibilities for the Reserve Proctologist be?

So, are you thinking of becoming a doctor, but this new bill seems like a lot of bull, so you have decided to treat bulls instead? Don’t worry, President Obama and Congress aren’t going to leave you out of the loop.

To be eligible to participate in the Program, an individual shall—

“(1)(A) be accepted for enrollment, or be enrolled, as a full-time or part-time student in a course of study or program (approved by the Secretary) at an accredited graduate school or program of public health; or

“(B) have demonstrated expertise in public health and be accepted for enrollment, or be enrolled, as a full-time or part-time student in a course of study or program (approved by the Secretary) at—

“(i) an accredited graduate school or program of nursing; health administration, management, or policy; preventive medicine; laboratory science; veterinary medicine; or dental medicine; or

“(ii) another accredited graduate school or program, as deemed appropriate by Secretary;

They were not kidding when they said this bill was going to cover health care “for all”. I wonder if it includes jackasses too?

As part of the National Health Service Corps, the Public Health Workforce Corps will help build and run the Public Health Training Centers. Let’s take a peak at what those training centers may look like.

When deciding whether or not you may like to participate in this training program you will be required to sign a contract.

Contract.—The written contract between the Secretary and an individual under subsection (b)(3) shall contain—

“(1) an agreement on the part of the Secretary that the Secretary will—

“(A) provide the individual with a scholarship for a period of years (not to exceed 4 academic years) during which the individual shall pursue an approved course of study or program to prepare the individual to serve in the public health workforce; and

“(B) accept (subject to the availability of appropriated funds) the individual into the Corps;

“(2) an agreement on the part of the individual that the individual will—

“(A) accept provision of such scholarship to the individual;

“(B) maintain full-time or part-time enrollment in the approved course of study or program described in subsection (b)(1) until the individual completes that course of study or program;

“(C) while enrolled in the approved course of study or program, maintain an acceptable level of academic standing (as determined by the educational institution offering such course of study or program);

“(D) if applicable, complete a residency or internship; and

“(E) serve full-time as a public health professional for a period of time equal to the greater of—

“(i) 1 year for each academic year for which the individual was provided a scholarship under the Program; or

“(ii) 2 years; and

“(3) an agreement by both parties as to the nature and extent of the scholarship assistance, which may include—

“(A) payment of reasonable educational expenses of the individual, including tuition, fees, books, equipment, and laboratory expenses; and

“(B) payment of a stipend of not more than $1,269 (plus, beginning with fiscal year 2011, an amount determined by the Secretary on an annual basis to reflect inflation) per month for each month of the academic year involved, with the dollar amount of such a stipend determined by the Secretary taking into consideration whether the individual is enrolled full-time or part-time.

“(d) Application of certain provisions.—The provisions of subpart III shall, except as inconsistent with this subpart, apply to the scholarship program under this section in the same manner and to the same extent as such provisions apply to the National Health Service Corps Scholarship Program established under section 338A.

As far as I can tell, you are not forced to sign this contract with blood, but that could change once it hits the House floor for debate.

The funding for the Public Health Workforce will be allocated as follows.

For the purpose of carrying out subpart XII of part D of title III and sections 765, 766, and 768, 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) $51,000,000 for fiscal year 2010.

“(2) $54,000,000 for fiscal year 2011.

“(3) $57,000,000 for fiscal year 2012.

“(4) $59,000,000 for fiscal year 2013.

“(5) $62,000,000 for fiscal year 2014.

“(6) $65,000,000 for fiscal year 2015.

“(7) $68,000,000 for fiscal year 2016.

“(8) $72,000,000 for fiscal year 2017.

“(9) $75,000,000 for fiscal year 2018.

“(10) $79,000,000 for fiscal year 2019.”.

A total of $642 million. The government is going to allocate more that double the money for the training of nurses than it will for training and placement of doctors, dentists, and veterinarians under the Public Health Workforce initiative. This tells us who will be doing most of the work doesn’t it? Stop fussing. It costs a lot to supply you with that bedpan and wake you up in the middle of the night to take your meds. (Don’t be offended nurses, I know you do a heck of a lot more than any doctor will ever admit).

Section 2241 will provide scholarships for health professions training for diversity for “disadvantaged students”. Yes folks, it’s affirmative action in health care education. Al Sharpton will be very pleased with Section 2241.

The funds for “health professions training for diversity” will be allocated as follows.

For the purpose of carrying out sections 736, 737, 738, 739, and 739A, 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) $90,000,000 for fiscal year 2010.

“(2) $97,000,000 for fiscal year 2011.

“(3) $100,000,000 for fiscal year 2012.

“(4) $104,000,000 for fiscal year 2013.

“(5) $110,000,000 for fiscal year 2014.

“(6) $116,000,000 for fiscal year 2015.

“(7) $121,000,000 for fiscal year 2016.

“(8) $127,000,000 for fiscal year 2017.

“(9) $133,000,000 for fiscal year 2018.

“(10) $140,000,000 for fiscal year 2019.

Diversity will cost an additional $1,138,000,000, or $1.138 billion. Along with the Workforce funding of $642 million, and “interdisciplinary training programs” which will cost $1,149,000,000 or $1.149 billion, that brings our total to $49.373 billion of the $88.7 billion allocated from the general funds of the Treasury for this “division” of the Health Care bill

Title XXXI, “Prevention and Wellness” establishes a “Prevention and Wellness Trust” which will be allocated from, you guessed it, the “Public Health Investment Fund”. The money will be allocated as follows.

There is established a Prevention and Wellness Trust. There are authorized to be appropriated to the Trust—

“(1) amounts described in section 2002(b)(2)(ii) of the America’s Affordable Health Choices Act of 2009 for each fiscal year; and

“(2) in addition, out of any monies in the Public Health Investment Fund—

“(A) for fiscal year 2010, $2,400,000,000;

“(B) for fiscal year 2011, $2,800,000,000;

“(C) for fiscal year 2012, $3,100,000,000;

“(D) for fiscal year 2013, $3,400,000,000;

“(E) for fiscal year 2014, $3,500,000,000;

“(F) for fiscal year 2015, $3,600,000,000;

“(G) for fiscal year 2016, $3,700,000,000;

“(H) for fiscal year 2017, $3,900,000,000;

“(I) for fiscal year 2018, $4,300,000,000; and

“(J) for fiscal year 2019, $4,600,000,000.

For a total of $35,300,000,000 or $35.3 billion, bringing our total money spent from the $88.7 billion Public Health Investment Fund to $84.673 billion (95.5%).

The strategy of the Prevention and Wellness Trust will be to identify the specific goals and objectives in prevention and wellness activities for “Healthy People and National Public Health Performance Standards”.

Identification of specific national goals and objectives in prevention and wellness activities that take into account appropriate public health measures and standards, including departmental measures and standards (including Healthy People and National Public Health Performance Standards).

Subtitle D, “Prevention and Wellness Research” and Subtitle E, “Delivery of Community Prevention and Wellness Services” set the stage for all of the “big government” infrastructures you might expect in government forced health care that we have not already covered.

The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall establish a program for the delivery of community preventive and wellness services consisting of awarding grants to eligible entities—

“(1) to provide evidence-based, community preventive and wellness services in priority areas identified by the Secretary in the national strategy under section 3121; or

“(2) to plan such services.

The Secretary, once again, will give preference to some entities over others.

In awarding grants under this section, the Secretary shall give preference to entities that—

“(1) will address one or more goals or objectives identified by the Secretary in the national strategy under section 3121;

“(2) will address significant health disparities, including those identified by the Secretary in the national strategy under section 3121;

“(3) will address unmet community prevention needs and avoids duplication of effort;

“(4) have been demonstrated to be effective in communities comparable to the proposed target community;

“(5) will contribute to the evidence base for community preventive and wellness services;

“(6) demonstrate that the community preventive services to be funded will be sustainable; and

“(7) demonstrate coordination or collaboration across governmental and nongovernmental partners.

Title V, Subtitle B, mandates the creation of a school-based health clinic program which basically nationalizes the school nurse programs. As we know most schools eliminated those positions years ago because of the lack of government funding, but now we’re bringing them back with a vengeance.

Not only will the school nurse be taking your temperature and calling your parents when you are sick but now they will be full-fledged clinics meeting requirements established in this bill and otherwise integrating every aspect of your child’s school records into the same database as your financial information, medical information, and criminal history.

Title V, Subtitle C provides for a new “National Medical Device Registry” because they apparently forgot (at least until page 1001) that they wanted to track that information in the database as well.

In developing the registry, the Secretary shall, in consultation with the Commissioner of Food and Drugs, the Administrator of the Centers for Medicare & Medicaid Services, the head of the Office of the National Coordinator for Health Information Technology, and the Secretary of Veterans Affairs, determine the best methods for—

“(A) including in the registry, in a manner consistent with subsection (f), appropriate information to identify each device described in paragraph (1) by type, model, and serial number or other unique identifier;

“(B) validating methods for analyzing patient safety and outcomes data from multiple sources and for linking such data with the information included in the registry as described in subparagraph (A), including, to the extent feasible, use of—

“(i) data provided to the Secretary under other provisions of this chapter; and

“(ii) information from public and private sources identified under paragraph (3);

“(C) integrating the activities described in this subsection with—

“(i) activities under paragraph (3) of section 505(k) (relating to active postmarket risk identification);

“(ii) activities under paragraph (4) of section 505(k) (relating to advanced analysis of drug safety data); and

“(iii) other postmarket device surveillance activities of the Secretary authorized by this chapter; and

“(D) providing public access to the data and analysis collected or developed through the registry in a manner and form that protects patient privacy and proprietary information and is comprehensive, useful, and not misleading to patients, physicians, and scientists.

That Secretary sure is going to be holding a lot of cards, isn’t he/she?

And finally, we come to the last page of the bill. 1017 pages down, one to go, and we learn that States will only receive funding under this provision (Division C) if they agree to fulfill each obligation under Division A and any amendments made by such division application to persons in their capacity as an employer and if they assure that all political subdivisions in the State will do the same.

States are only eligible for money to cover everything I discussed yesterday and today (Division C) if they, and every county and city government within them, agree to every condition in the first four days of posts (Division A).

In other words, the only way a State will qualify is if every city, town, parish, community, county within that State, along with the State itself, agrees to surrender some of the sovereign rights guaranteed to each State under the U.S. Constitution.

America’s Affordable Health Choices Act of 2009 starts by violating our rights as individuals as well as the Tenth Amendment to the U.S. Constitution, and it ends by demanding the voluntary surrender of States rights in order to “participate” in the soon to be required plan.

I don’t know about you, but this entire bill doesn’t sound to “affordable” nor does it seem to offer any choices.

So how many of you actually read the entire bill with me? It only took 12 days. If you read it, like I did, you can ask your Representative, “What did you do on your summer vacation?

I bet only a handful have read the bill, even now.

Make sure you tell your friends about the bill. Make sure they read the bill. Tell them not to listen to the hype and propaganda from either side of the aisle. Tell them to read the bill. The only way to dispel any “myths” in the bill is to read the bill yourself.

You cannot argue a position on the bill if you don’t even know what it says.

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.

HR3200 : Division B : Day Six

Division B, Title VII, Subtitle C covers payments to primary care practitioners, the medical home pilot program (as it will work under Medicaid), translation and interpretation services, option coverage for freestanding birth center services, and inclusion of public health clinics under the vaccines for children program.

Subtitle D begins by defining optional Medicaid coverage of low-income HIV-Infected individuals, extending transitional Medicaid assistance, and then defines the requirement for 12-month continuous coverage under certain CHIP programs. That’s it. I don’t know how or why those three topics relate to each other, but that’s all that is included in Subtitle D titled “Coverage”.

Subtitle E sets payments to pharmacists (Section 1741),

The Secretary shall calculate the Federal upper reimbursement limit established under paragraph (4) as 130 percent of the weighted average (determined on the basis of manufacturer utilization) of monthly average manufacturer prices.

Requires manufacturers to provide rebates for some drugs (Section 1742),

In the case of a drug that is a line extension of a single source drug or an innovator multiple source drug that is an oral solid dosage form, the rebate obligation with respect to such drug under this section shall be the amount computed under this section for such new drug or, if greater, the product of—

“(i) the average manufacturer price of the line extension of a single source drug or an innovator multiple source drug that is an oral solid dosage form;

“(ii) the highest additional rebate (calculated as a percentage of average manufacturer price) under this section for any strength of the original single source drug or innovator multiple source drug; and

“(iii) the total number of units of each dosage form and strength of the line extension product paid for under the State plan in the rebate period (as reported by the State).

In this subparagraph, the term ‘line extension’ means, with respect to a drug, an extended release formulation of the drug.”.

Extends the prescription drug discounts to enrollees (Section 1743), and affords payments for graduate medical education (Section 1744),

Subtitle F, another “waste, fraud, and abuse” section, allows the government to decide which “health care acquired conditions” will be be covered. In other words, the government will be allowed to ration what they pay for and what they don’t. Section 1751 states,

Medicaid non-Payment for certain health care-Acquired conditions.—Section 1903(i) of the Social Security Act (42 U.S.C. 1396b(i)) is amended—

(1) by striking “or” at the end of paragraph (23);

(2) by striking the period at the end of paragraph (24) and inserting “; or”; and

(3) by inserting after paragraph (24) the following new paragraph:

“(25) with respect to amounts expended for services related to the presence of a condition that could be identified by a secondary diagnostic code described in section 1886(d)(4)(D)(iv) and for any health care acquired condition determined as a non-covered service under title XVIII.”.

In other words, if you are in the hospital and you contract a health care acquired condition, you will be rolling the dice as far as coverage is concerned. I’m sure that brings a lot of reassurance to those who will be staying in the hospital.

Section 1759 requires any billing agents, clearing houses, or alternative payees be registered under Medicaid. Every private payment system will be required to register with the government. How many regulatory hurdles will the Secretary impose on them before approving their registration?

Section 1902(a) of the Social Security Act (42 U.S.C. 42 U.S.C. 1396a(a)), as amended by sections 1631(b), 1703, 1753, and 1757, is further amended—

(1) in paragraph (76); by striking at the end “and”;

(2) in paragraph (77), by striking the period at the end and inserting “and”; and

(3) by inserting after paragraph (77) the following new paragraph:

“(78) provide that any agent, clearinghouse, or other alternate payee that submits claims on behalf of a health care provider must register with the State and the Secretary in a form and manner specified by the Secretary under section 1866(j)(1)(D).”.

Subtitle H covers technical corrections to the Social Security Act.

And with that, we finally come to the section where they draw the lines. Remember yesterday when I mentioned they had to draw the lines somewhere?

If they are mandating a minimum income to “qualify” for low-income Medicare, someone has to draw the line somewhere and I can guarantee you that the “we cover everyone” line is nowhere near the low-income line when they are drawn.

It took a few more pages, but we finally found it. Of course, this line only includes persons on Medicare, but heck, it’s a line. I knew they would be drawing lines. They always do.

Title VIII, Section 1801 defines the disclosures to facilitate identification of individuals likely to be ineligible for the low-income assistance under the Medicare Prescription Drug Program to assist the Social Security Administration’s outreach to eligible individuals.

Upon written request from the Commissioner of Social Security, the following return information (including such information disclosed to the Social Security Administration under paragraph (1) or (5)) shall be disclosed to officers and employees of the Social Security Administration, with respect to any taxpayer identified by the Commissioner of Social Security—

“(i) return information for the applicable year from returns with respect to wages (as defined in section 3121(a) or 3401(a)) and payments of retirement income (as described in paragraph (1) of this subsection),

“(ii) unearned income information and income information of the taxpayer from partnerships, trusts, estates, and subchapter S corporations for the applicable year,

“(iii) if the individual filed an income tax return for the applicable year, the filing status, number of dependents, income from farming, and income from self-employment, on such return,

“(iv) if the individual is a married individual filing a separate return for the applicable year, the social security number (if reasonably available) of the spouse on such return,

“(v) if the individual files a joint return for the applicable year, the social security number, unearned income information, and income information from partnerships, trusts, estates, and subchapter S corporations of the individual’s spouse on such return, and

“(vi) such other return information relating to the individual (or the individual’s spouse in the case of a joint return) as is prescribed by the Secretary by regulation as might indicate that the individual is likely to be ineligible for a low-income prescription drug subsidy under section 1860D–14 of the Social Security Act.

In an earlier post, I wondered how the government was going to cover the cost of insuring so many more people under the “public option”. Section 1802 answers the question for funding Medicare.

The government plans to impose a fee on every private health insurance policy (while they last) and every self-insured health plan to fund the

Chapter 34 of the Internal Revenue Code of 1986 is amended by adding at the end the following new subchapter:

“subchapter B—Insured and Self-Insured Health Plans
“Sec. 4375. Health insurance.
“Sec. 4376. Self-insured health plans.
“Sec. 4377. Definitions and special rules.

“SEC. 4375. Health insurance.

“(a) Imposition of Fee.—There is hereby imposed on each specified health insurance policy for each policy year a fee equal to the fair share per capita amount determined under section 9511(c)(1) multiplied by the average number of lives covered under the policy.

“(b) Liability for Fee.—The fee imposed by subsection (a) shall be paid by the issuer of the policy.

The government already deducts a percentage of your paycheck for Medicare. Now they are going to take a piece from those who provide your health plan. What happens if you choose the public option? You know the government is not going to pay themselves, so I’m sure they will pass that fee on to you as well.

Unlike Section 441 which stated that “tax imposed under this section shall not be treated as tax“, this section states,

the fees imposed by this subchapter shall be treated as if they were taxes.

So remember, taxes are not treated as taxes but fees imposed are treated as taxes. Fees are the new taxes.

Title IX, Miscellaneous Provisions, is one of the most disturbing pieces of this legislation (as if the threat of socialism isn’t bad enough, this takes it a bit further) and the last section of Division B.

The section in question is Section 1904. “Grants to States for quality home visitation programs for families with young children and families expecting children.”

The government establishes the creation of “quality home visitation programs”,

The purpose of this section is to improve the well-being, health, and development of children by enabling the establishment and expansion of high quality programs providing voluntary home visitation for families with young children and families expecting children.

While the purpose states that these visits are “voluntary”, states will have a monetary incentive to increase the number of visitations, therefore pressuring more and more families in need to accept those services where government officials will be entering their homes, monitoring their children and teaching the parents the “government standard” for raising their children.

In order to qualify for the grants, each state will be required to submit a needs assessment.

The results of a statewide needs assessment that describes—

“(A) the number, quality, and capacity of home visitation programs for families with young children and families expecting children in the State;

“(B) the number and types of families who are receiving services under the programs;

“(C) the sources and amount of funding provided to the programs;

“(D) the gaps in home visitation in the State, including identification of communities that are in high need of the services; and

“(E) training and technical assistance activities designed to achieve or support the goals of the programs.

And the government must received certain assurances from the State.

Assurances from the State that—

“(A) in supporting home visitation programs using funds provided under this section, the State shall identify and prioritize serving communities that are in high need of such services, especially communities with a high proportion of low-income families or a high incidence of child maltreatment;

“(B) the State will reserve 5 percent of the grant funds for training and technical assistance to the home visitation programs using such funds;

“(C) in supporting home visitation programs using funds provided under this section, the State will promote coordination and collaboration with other home visitation programs (including programs funded under title XIX) and with other child and family services, health services, income supports, and other related assistance;

“(D) home visitation programs supported using such funds will, when appropriate, provide referrals to other programs serving children and families; and

“(E) the State will comply with subsection (i), and cooperate with any evaluation conducted under subsection (j).

They go on to define exactly what they will be looking for while performing these visitations.

“(I) knowledge of age-appropriate child development in cognitive, language, social, emotional, and motor domains (including knowledge of second language acquisition, in the case of English language learners);

“(II) knowledge of realistic expectations of age-appropriate child behaviors;

“(III) knowledge of health and wellness issues for children and parents;

“(IV) modeling, consulting, and coaching on parenting practices;

“(V) skills to interact with their child to enhance age-appropriate development;

“(VI) skills to recognize and seek help for issues related to health, developmental delays, and social, emotional, and behavioral skills; and

“(VII) activities designed to help parents become full partners in the education of their children;

These requirements will make it difficult for any family to refuse the visitations as the government could very well imply that families are abusing their children or neglecting them by refusing the home inspections visitations.

This section completely opens your home to inspection by authorities in your state based on their assessment of your parenting skills, or possibility that you are abusing your children.

It gives the government the right to come into your home to check whether or not your kids are eating properly, whether or not they are going to sleep at an appropriate time, and basically, whether or not you are a good parent.

While this section does not directly impact homeschool freedoms, I think you can see the dangers that lurk if this section is allowed to become law. Many states and communities frown on homeschoolers as it is. How long will it take before States start pressuring homeschoolers to “volunteer” for this visitation program?

With that, we have completed Division B of “America’s Affordable Health Choices Act of 2009“. I’ll leave you with one final thought for the day.

“Don’t you see that the whole aim of Newspeak is to narrow the range of thought?… Has it ever occurred to your, Winston, that by the year 2050, at the very latest, not a single human being will be alive who could understand such a conversation as we are having now?… The whole climate of thought will be different. In fact, there will be no thought, as we understand it now. Orthodoxy means not thinking—not needing to think. Orthodoxy is unconsciousness.”

– George Orwell, 1984, Book 1, Chapter 5

Tomorrow we will begin to tackle Division C, “Public Health and Workforce Development” on page 856. That’s right people, there are only 162 pages remaining and we have covered the entire text of H.R. 3200.