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Monday, August 10, 2009

Ambiguity: The Real House Health Care Bill Nightmare

SIn defending Sarah Palin yesterday, Newt Gingrich said that this bill puts full faith of the citizens in the government.

Newt is dead on here. The real danger of the House Health Care bill is that it is 1013 pages of ambiguity. Let's start with this. Out of this bill, there will be created 53 new regulators. Now, that should be enough for everyone to oppose the bill. Conservatives think there's too much regulation. Libertarians think there's way too much regulation, but even liberals can't possibly think that health care needs 53 new regulators. What's even scarier is the ambiguous set of power that each of these new regulators will get. Let's take the Health Choices Administration as an example. This is from pages 41-42.

There is here by established as an independent agency in the executive branch by the Government


Duties include the establishment of qualified health benefits and standards under this title, including the enforcement of such standards in coordination with state insuruance regulators and the Departments of Labor and Treasury.

Now, that ambiguous statement pretty much means the Health Choices Administration can regulate anything that relates to health care in any way. Now think about this for a minute. The president has proclaimed, often, that if you are happy with your health insurance nothing will change. What happens if the Health Choices Administration isn't happy with your health insurance? This ambiguous language gives that new regulator the power to do just about anything it wants to your health insurance.

Let's look at another new regulator. Let's look at the Agency for Health Care Reserach. This regulator, incidentally, is a sub group of another regulator, the Center for Comparative and Effectiveness Research. This is found on page 502.

The Secretary shall establish with the Agency for health care Research and Qulaity Center for Comparative Effectiveness Research to conduct, support, and synthesize research with respect to the outcomes, effectiveness, and appropriateness of health services and procedures in order to identify the manner in which diseases, disorder, and other health condition can most effectively and appropriately be diagnosed, treated, and managed.

Essentially, this new bureaucracy has power to regulate research and treatment in any way it sees fit. Keep in mind this is a subset of an even larger and more powerful new regulatory body. So, when the president says if you're happy with your health care that won't change, that's not necessarily true because if you health care is deemed "not effective" by this new regulator, it can be eliminated. That's how ambiguous the power is.

Then, there's the now infamous page 425. Some say this page mandates "advanced care planning consultations". Others say its merely optional. The problem is the language is totally ambiguous.

subject to paragrapth 3 and 4 the term advanced care planning consultation means a consultation between the individual and a practitioner described in paragraph 2 regarding advanced care planning, if subject to paragraph 3, the individual involved has not had such a consultation in the last five years.

Now, that pretty much could mean anything as all sorts of other parts of the bill are referenced. Those parts are as ambiguous and confusing. Yet, it does appear clear that if you haven't had in the last five years, then you're supposed to get it. Yet, again, it's the ambiguous language that leads this bill to mean whatever anyone wants it to be. Keep in mind the Health Choices Administration has the power to do just about anything and so even if these advanced health care planning consultations are optional, that regulator can just as easily make them mandatory.

Then, there's this section on pages 240-241

For services furnished on or after January 1, 2009 each of the following categories of physicians services shall be treated as saparate service categories...

It then lists some services like long term care, managed care, etc. and finishes like ths.

Service categories established under this paragraph shall apply without regard to the specialty of the physician furnishing the service.

So, what does that mean? That's a good guess. One doctor told me that it allows the government to set salaries witout regard to specialty. In fact, this section is so ambiguous and confusing that in fact it could mean anything.

Now, let's look at page 272 which deals with "treatment of CERTAIN cancer hospitals"

Insofar as the Secretary determines under the sub paragraph A that costs incurred by hospitals described in section 1866 (d) (1) (b) (v) exceed those costs incurred by other hospitals furnishing services under this subsection, the Secretary shall provide for an appropriate adjustment under paragraph (2) (E) to reflect those higher costs effective for services furnished on or after January 2011.

Now, this sounds as though if a cancer treatment center costs more than the average cancer treatment center, the HHS Secretary can "provide for appropriate adjustment. What does that mean? Well, it means whatever the HHS Secretary at the time wants it to mean. Here you have a confusing and ambiguous section that even references two other sections that are each no less confusing or ambiguous. In the end, it gives the HHS Secretary the power to do as they please with regard to CERTAIN cancer hospitals. What does certain mean? That isn't addressed either. So, certain also means what the HHS Secretary at the time wants it to mean.

Now, I have highlighted a handful of pages, a handful of regulators, regulations, out of a thousand plus pages and 53 regulators. Already, I have shown that only a handful of regulators can do as they please with the new health care plan, and I've only scratched the surface.

The real fear here is that this bill is so ambiguous, with so many new regulators, that it allows the government to do as it pleases in any which way.

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