The president has proclaimed on numerous occasions that if you like your health care plan, you need not worry because it WON'T change. Is this true? A thorough analysis of the bill leaves a lot of doubt.
The nexis, if you will, of government control starts on page 72 and page 84. Those two pages establish the government health exchange, define the government's role in it, and define what providers must enroll in it. The health care exchange will be administered by a new bureaucracy, the Health Choices Administration. Any insurer, health practitioner, or hospital in the health care exchange will be subject to the regulations of the exchange as laid out by the Health Choices Administration.
Who needs to be in the exchange? Any health care provider that provides health care that is paid in whole or in part by a third party must be in the exchange. In other words, any hospital that accepts insurance must be part of the exchange. All insurance companies must be part of the exchange. Chiropractors, laser surgeries, and other procedures that don't accept insurance would not be part of this exchange. As such, almost the entire health care industry would fall under the control of the health care exchange. The health care exchange would now be regulated by the Health Choices Administration.
As such, it is totally misleading to say that if you like your health care it won't change. That's only if your current health care plan conforms to whatever regulations are created by the Health Choices Administration.
The control only begins there. A lot of businesses and organizations are self insured. For instance, IBM has created its own insurance company for its employees. Several other companies as well as other groups like churches have also created an insurance company for their members or employees. Since they are self insured, they are not subject to this health care exchange. Remember, the exchange is only for those that have third party costs. Now, the hospitals that IBM employees go to would almost certainly be part of the exchange but that's another story. For those types of companies and groups, on page 22. Those employers, and other organizations that self insure, will then be mandated to a government audit. These audits will measure: financial solvency, their ability to pay the premiums, the extent to which ratings rules will cause adverse selections of their groups in the market. In other words, the government will audit all self insured organizations to make sure their health insurance plan is up to par as the government measures par.
Then, there is the introduction of an alphabet soup of new government bureaucracies to regulate health care. These new bureaucracies include: the Telehealth Advisory Committee, the aforementioned Health Choice Administration, the Independent Medical Avisory Council, the the Office of Civil Rights, the Office of Minority Health, the Public Health Investment Fund, and the Health Affordibility Administration. All of these new bureaucracies will have new regulatory authority over the administration of health care. In all, the bill creates 53 new bureaucracies.
The most insidious government control comes in pages 425-430. Here, the government will regulate "advanced care planning consultation". In layman's terms, the government will regulate how older folks will be treated and by so doing, just how much treatment will be provided to them. (I'll get more into this in the rationing portion but in here is language that will mandate that health care be provided if it isn't cost effective)
On page 335, there is the "Outcomes Based Measures". This will measure the cost effectiveness of all procedures done in the country. (this will also be revisited in the rationing portion) In other words, the government will do sort of health care polling of all procedures to determine if they are worth the cost. Of course, in order to do that, the government has to have access to the medical records of all procedures. This pages creates this"outcomes based measures" and by so doing, gives the government that access.
On pages 57-59, there is the establishment of the standardization of electronic administration. This will provide such things as real time determination of an individual's financial responsibility at the point of service, harmonize all common data points across administrative and clinical transactions, and describe all data points in unambiguous terms. On page 58, a National Health Care ID card is created. This card will be used by the government to create the ability to make real time financial determinations of a patient. As such, this will give the government real time access to bank statements, investment accounts and anything else necessary to make this decision. Thus, we finish off the Orwellian takeover of health care by the government.
On page 195, the Health Choice Administration is given access to the tax records of all Americans in the health care exchange. Here is the relevant text
The Health Choice Act of 2009, shall disclose to officers and employees of the Health Choice Administration, or such state based health insurance exchange, as the case may be, return information of any tax payer whose income is relevant
Finally, on page 241, government bureaucracies will set salaries for doctors. Here is the relevant portion.
...Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.