Here’s two good bits of news about America’s Affordable Health Choice’s Act of 2009: First, after you download the over 1,000-page bill and read it, you can cut the pages in two and have enough paper to reduce your bathroom’s carbon footprint for 30 years. Second, it spares you the trouble of reading the Senate’s more dishonest version.
I’m kidding of course. But so are the Democrats who produced this legislation. How do we know? Because on page 116 of the bill, the public “option” is introduced as something that will “create a low-cost plan without comprimising quality or access to care.” Get it? Comprimise. Not compromise. Of course by creating a public plan that is low-cost we won’t compromise care and destroy the private market. See? But we’re not serious about that either.
AAHCA really isn’t about creating a low-cost plan that promotes quality and access to care. Most of all it’s just a way to take care of the interest groups that got the Dems elected. Secondarily it’s about establishing a single payer health plan.
Right off the bat, in both plans the unions get their health care benefits completely protected and subsidized. And their retirees get (at least) a $10 billion government fund to pay for all their health care benefits up to $90,000 per person, per year.
AARP — the travel and drug benefits company that uses its membership to pretend it is a real interest group representing the elderly — gets price controls and additional rebates that will fatten its bottom line in exchange for staying quiet in the face of nearly $600 billion in Medicare cuts of unknown impact on quality (see below).
If you think that all this bargaining buys America affordable health choices, the joke’s on you again!
For the first two years you get to choose only among the basic, El Cheapo private health plan, Medicaid of some form, and the “public option” (PU for short). Then there are more conditions. El Cheapo has to spend a certain percentage of its dollars for health care services under the watchful eye of something called the Health Choices Administration. Who determines that percentage? A new Health Choices Czar. The Choice Czar chooses the medical services the plan should provide, how much, how often. And at what price doctors should do it. Oh, your use of credits can be audited to make sure you don’t spend it on something other than the Czar’s choice.
Meanwhile, the public plan is created to “compete” alongside private plans. Except that as a government entity it does not take orders from any stinking Czar. The public plan reports directly to the Secretary of Health and Human Services. This is called “a level playing field. ”
Now you might be wonder, how the government plan recruits doctors and providers to this exciting new enterprise? Actually, it forces any provider getting paid by Medicare to join the plan.
Do doctors have a “choice”? Of course! They can “opt out in a process established by the Secretary.” Translation: No public option patients, no Medicare patients. (The Senate version hedges on such coercion, but it basically limits who can enroll in private plans and the amount of subsidies to the point that the government plan will be the default setting. It does this mostly by expanding Medicaid and barring people from ever leaving. So much for eliminating health disparities. )
A lot’s been written about how government health care will be paid for by raising taxes. In fact, both bills cover the cost by making people wait for needed tests and treatments and forcing doctors to skimp on care to meet a government standard of “quality.”
AAHCA uses price controls. And there is no room for discussion: The bill states: “There shall be no administrative or judicial review of a payment rate or methodology established under this section or any other section.”
Both bills presume that Medicare rates already 25-30 percent cheaper than private plans will be the starting point for government plan fees. And these will be cut for Medicare using estimates of savings “productivity gains” used at Taco Bell in order to get patients “served” as cheaply as possible. (In both bills, a quality Czar, along with a Comparative Effectiveness Commission, decides what quality is and whether paying for more is worth it.)
There is one exception to this approach to defining healthcare down in the House bill. And it reveals both a dark sense of humor and glimpse of how much damage government regulation does to medicine. While rationing restricts what doctors do in the rest of America, the House bill creates a special zone where the government actually pays providers more, not less. And where might that zone be located? I will give you a clue. It is in a really big state, with a governor who is a former movie star and home of the congressman who chairs the committee that wrote AAHCA. His first name is Henry.
If you want access to affordable health care of reasonable quality, don’t go to Congress or President Obama. Go West. There is only one place left where health care will flow like milk and honey. And that is in the new medical Republic of Waxmania. That might be funny if it weren’t true.
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