Mar 11 2010
Zero Credibility Means Zero Trust In Government Health Care
The main reason so many Americans reject the idea of Government-Run Health Care is credibility. Frankly. there is none. There is simply no confidence that our elected officials can do anything right, much less improving something as personal and intimate as health care.
H.R.3590, the Patient Protection and Affordable Care Act, all 2,409 glorious pages of it, is the end-game version that Reps. Pelosi and DeLauro are attempting ram through the House by St. Patrick’s Day at the latest.
To illustrate just how convoluted the reconciled health bill really is, let’s take a look at all the agencies and grant programs that will be implemented right after President Obama signs the bill into law. ResistNet provides this list, but honestly, it gets tiresome real fast:
1. Grant program for consumer assistance offices (§ 1002, p. 37)
STOP! Before we go any further, let’s take a look at H.R. 3590, Section 1002, and see what we’re getting for our money. Now, subsection (e)(1) says Section 1002 costs $30,000,000 for the first year, and (e)(2) promises “such sums as may be necessary to carry out this section” thereafter. Such sums could be more than $30,000,000 a year, of course. Here’s the text of the GPO version:
(a) In General- The Secretary shall award grants to States to … provide support for–
(1) offices of health insurance consumer assistance; or
(2) health insurance ombudsman programs.
(b) Eligibility-
(1) IN GENERAL- blah blah blah
(2) CRITERIA- blah blah blah.
(c) Duties- The office of health insurance consumer assistance or health insurance ombudsman shall–
(1) assist with the filing of complaints and appeals …
(2) collect, track, and quantify problems and inquiries …
(3) educate consumers on their rights and responsibilities…
(4) assist consumers with enrollment …
(5) resolve problems …
(d) Data Collection- blah blah blah.
(e) Funding …
Never mind funding. We’ve already established a price tag of $30,000,000 or more for program (1.) in our list, which establishes information offices to help people find their way through the Pelosi-Reid-Obama-DeLauro maze. (Does anyone believe these “help desks” will actually help anyone? Do they ever?)
Let’s continue on with our list, keeping in mind the whole time that Rep. Pelosi and DeLauro insist this bill will genuinely reduce the deficit:
2. Grant program for states to monitor premium increases (§ 1003, p. 42)
3. Committee to review administrative simplification standards (§ 1104, p. 71)
4. Demonstration program for state wellness programs (§ 1201, p. 93)
5. Grant program to establish state Exchanges (§ 1311(a), p. 130)
6. State American Health Benefit Exchanges (§ 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (§ 1311(i), p. 150)
8. Grant program for state cooperatives (§ 1322, p. 169)
9. Advisory board for state cooperatives (§ 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (§ 1322(d), p. 177)
11. State basic health plan programs (§ 1331, p. 201)
12. State-based reinsurance program (§ 1341, p. 226)
13. Program of risk corridors for individual and small group markets (§ 1342, p. 233)
14. Program to determine eligibility for Exchange participation (§ 1411, p. 267)
15. Program for advance determination of tax credit eligibility (§ 1412, p. 288)
16. Grant program to implement health IT enrollment standards (§ 1561, p. 370)
17. Federal Coordinated Health Care Office for dual eligible beneficiaries (§ 2602, p. 512)
18. Medicaid quality measurement program (§ 2701, p. 518)
19. Medicaid health home program for people w/chronic cond. & planning grants (§ 2703, p. 524)
20. Medicaid demonstration project to evaluate bundled payments (§ 2704, p. 532)
21. Medicaid demonstration project for global payment system (§ 2705, p. 536)
22. Medicaid demonstration project for accountable care organizations (§ 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care (§ 2707, p. 540)
24. Grant program for delivery of services to ind. w/postpartum depression (§ 2952(b), p. 591)
25. State allotments for grants to promote personal resp. ed. programs (§ 2953, p. 596)
26. Medicare value-based purchasing program (§ 3001(a), p. 613)
27. Medicare value-based purchasing dem. program for critical access hospitals (§ 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing facilities (§ 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies (§ 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (§ 3012, p. 688)
31. Grant program to develop health care quality measures (§ 3013, p. 693)
32. Center for Medicare and Medicaid Innovation (§ 3021, p. 712)
33. Medicare shared savings program (§ 3022, p. 728)
34. Medicare pilot program on payment bundling (§ 3023, p. 739)
35. Independence at home medical practice demonstration program (§ 3024, p. 752)
36. Program for use of patient safety org. to reduce hospital readmission rates (§ 3025(b), p. 775)
37. Community-based care transitions program (§ 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory tests (§ 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (§ 3140, p. 850)
40. Independent Payment Advisory Board (§ 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board (§ 3403, p. 1027)
42. Grant program for tech. asst. to providers impl. health quality practices (§ 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (§ 3502, p. 1048)
44. Grant program to implement medication therapy management (§ 3503, p. 1055)
45. Grant program to support emergency care pilot programs (§ 3504, p. 1061)
46. Grant program to promote universal access to trauma services (§ 3505(b), p. 1081)
47. Grant program to develop and promote shared decision-making aids (§ 3506, p. 1088)
48. Grant program to support implementation of shared decision-making (§ 3506, p. 1091)
49. Grant program to integrate quality improvement in clinical education (§ 3508, p. 1095)
50. Health and Human Services Coordinating Committee on Women’s Health (§ 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (§ 3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s Health (§ 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s Health (§ 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (§ 3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council (§ 4001, p. 1114)
56. Adv. Group on Prev., Health Promotion, and Integrative and Public Health (§ 4001(f), p. 1117)
57. Prevention and Public Health Fund (§ 4002, p. 1121)
58. Community Preventive Services Task Force (§ 4003(b), p. 1126)
59. Grant program to support school-based health centers (§ 4101, p. 1135)
60. Grant program to promote research-based dental caries disease management (§ 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (§ 4108, p. 1174)
62. Community transformation grants (§ 4201, p. 1182)
63. Grant program to provide public health interventions (§ 4202, p. 1188)
64. Demonstration program of grants to improve child immunization rates (§ 4204(b), p. 1200)
65. Pilot program for risk-factor assmts. prov. through comm. health centers (§ 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity (§ 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (§ 4305, p. 1238)
68. National Health Care Workforce Commission (§ 5101, p. 1256)
69. Grant program to plan health care workforce development activities (§ 5102(c), p. 1275)
70. Grant program to implement health care workforce development activities (§ 5102(d), p. 1279)
71. Pediatric specialty loan repayment program (§ 5203, p. 1295)
72. Public Health Workforce Loan Repayment Program (§ 5204, p. 1300)
73. Allied Health Loan Forgiveness Program (§ 5205, p. 1305)
74. Grant program to provide mid-career training for health professionals (§ 5206, p. 1307)
75. Grant program to fund nurse-managed health clinics (§ 5208, p. 1310)
76. Grant program to support primary care training programs (§ 5301, p. 1315)
77. Grant program to fund training for direct care workers (§ 5302, p. 1322)
78. Grant program to develop dental training programs (§ 5303, p. 1325)
79. Dem. program to increase access to dental care in underserved comm. (§ 5304, p. 1331)
80. Grant program to promote geriatric education centers (§ 5305, p. 1334)
81. Grant program to promote health professionals entering geriatrics (§ 5305, p. 1339)
82. Grant program to promote training in mental and behavioral health (§ 5306, p. 1344)
83. Grant program to promote nurse retention programs (§ 5309, p. 1354)
84. Student loan forgiveness for nursing school faculty (§ 5311(b), p. 1360)
85. Grant program to promote positive health behaviors and outcomes (§ 5313, p. 1364)
86. Public Health Sciences Track for medical students (§ 5315, p. 1372)
87. Primary Care Extension Program to educate providers (§ 5405, p. 1404)
88. Grant program for dem. projects to address health workforce shortage needs (§ 5507, p. 1442)
89. Grant program for dem. projects to dev. training prog. for home health aides (§ 5507, p. 1447)
90. Grant program to establish new primary care residency programs (§ 5508(a), p. 1458)
91. Program of pmts. to teaching health ctr. to sponsor med. residency training (§ 5508(c), p. 1462)
92. Graduate nurse education demonstration program (§ 5509, p. 1472)
93. Grant program to est. dem. projects for comm.-based mental health settings (§ 5604, p. 1486)
94. Commission on Key National Indicators (§ 5605, p. 1489)
95. Quality assurance and perf. improv. program for skilled nursing facilities (§ 6102, p. 1554)
96. Special focus facility program for skilled nursing facilities (§ 6103(a)(3), p. 1561)
97. Special focus facility program for nursing facilities (§ 6103(b)(3), p. 1568)
98. National independent monitor pilot program for skilled nursing facilities (§ 6112, p. 1589)
99. Dem. projects for nursing facilities involved in the culture change movement (§ 6114, p. 1597)
100. Patient-Centered Outcomes Research Institute (§ 6301, p. 1619)
101. Standing methodology cmte. for Patient-Centered Outcomes Research Inst. (§ 6301, p. 1629)
102. Board of Governors for Patient-Centered Outcomes Research Institute (§ 6301, p. 1638)
103. Patient-Centered Outcomes Research Trust Fund (§ 6301(e), p. 1656)
104. Elder Justice Coordinating Council (§ 6703, p. 1773)
105. Advisory Board on Elder Abuse, Neglect, and Exploitation (§ 6703, p. 1776)
106. Grant program to create elder abuse forensic centers (§ 6703, p. 1783)
107. Grant program to promote continuing education for long-term care staffers (§ 6703, p. 1787)
108. Grant program to improve management practices and training (§ 6703, p. 1788)
109. Grant program to subsidize costs of electronic health records (§ 6703, p. 1791)
110. Grant program to promote adult protective services (§ 6703, p. 1796)
111. Grant program to conduct elder abuse detection and prevention (§ 6703, p. 1798)
112. Grant program to support long-term care ombudsmen (§ 6703, p. 1800)
113. National Training Institute for long-term care surveyors (§ 6703, p. 1806)
114. Grant program to fund State surveys of long-term care residences (§ 6703, p. 1809)
115. CLASS Independence Fund (§ 8002, p. 1926)
116. CLASS Independence Fund Board of Trustees (§ 8002, p. 1927)
117. CLASS Independence Advisory Council (§ 8002, p. 1931)
118. Personal Care Attendants Workforce Advisory Panel (§ 8002(c), p. 1938)
119. Multi-state health plans offered by Office of Personnel Management (§ 10104(p), p. 2086)
120. Advisory board for multi-state health plans (§ 10104(p), p. 2094)
121. Pregnancy Assistance Fund (§ 10212, p. 2164)
122. Value-based purchasing program for ambulatory surgical centers (§ 10301, p. 2176)
123. Demonstration project for payment adjustments to home health services (§ 10315, p. 2200)
124. Pilot program for care of ind. in env. emergency declaration areas (§ 10323, p. 2223)
125. Grant program to screen at-risk individuals for env. health conditions (§ 10323(b), p. 2231)
126. Pilot programs to implement value-based purchasing (§ 10326, p. 2242)
127. Grant program to support community-based collaborative care networks (§ 10333, p. 2265)
128. Centers for Disease Control Office of Minority Health (§ 10334, p. 2272)
129. Health Resources and Services Administration Office of Minority Health (§ 10334, p. 2272)
130. Substance Abuse & Mental Health Svc. Admin. Office of Minority Health (§ 10334, p. 2272)
131. Agency for Healthcare Research and Quality Office of Minority Health (§ 10334, p. 2272)
132. Food and Drug Administration Office of Minority Health (§ 10334, p. 2272)
133. Centers for Medicare and Medicaid Services Office of Minority Health (§ 10334, p. 2272)
134. Grant program to promote small business wellness programs (§ 10408, p. 2285)
135. Cures Acceleration Network (§ 10409, p. 2289)
136. Cures Acceleration Network Review Board (§ 10409, p. 2291)
137. Grant program for Cures Acceleration Network (§ 10409, p. 2297)
138. Grant program to promote centers of excellence for depression (§ 10410, p. 2304)
139. Advisory cmte. for young women’s breast health awareness ed. campaign (§ 10413, p. 2322)
140. Grant prg. to prov. asst. to provide info. to young wmn. w/breast cancer (§ 10413, p. 2326)
141. Interagency Access to Health Care in Alaska Task Force (§ 10501, p. 2329)
142. Grant program to train nurse practitioners as primary care providers (§ 10501(e), p. 2332)
143. Grant program for community-based diabetes prevention (§ 10501(g), p. 2337)
144. Grant program for prov. who treat high % of medically underserved pop. (§ 10501(k), p. 2343)
145. Grant program to recruit studnets to practice in underserved comm. (§ 10501(l), p. 2344)
146. Community Health Center Fund (§ 10503, p. 2355)
147. Dem. proj. to provide access to health care for uninsured at reduced fees (§ 10504, p. 2357)
148. Dem. program to explore alternatives to tort litigation (§ 10607, p. 2369)
149. Indian Health dem. program for chronic shortages of health prof. (S. 1790, § 112, p. 24)*
150. Office of Indian Men’s Health (S. 1790, § 136, p. 71)*
151. Indian Country modular component facilities demonstration program (S. 1790, § 146, p. 108)*
152. Indian mobile health stations demonstration program (S. 1790, § 147, p. 111)*
153. Office of Direct Service Tribes (S. 1790, § 172, p. 151)*
154. Indian Health Svc mental health technician training program (S. 1790, § 181, p. 173)*
155. Indian Health Svc prog. for treatment of child sex abuse vict. (S. 1790, § 181, p. 192)*
156. Indian Health Svc prog. for treatment of dom. violence, sexual abuse (S. 1790, § 181, p. 194)*
157. Indian youth telemental health demonstration project (S. 1790, § 181, p. 204)*
158. Indian youth life skills demonstration project (S. 1790, § 181, p. 220)*
159. Indian Health Svc Director of HIV/AIDS Prevention and Treatment (S. 1790, § 199B, p. 258)*
No doubt, this must be what Speaker Pelosi meant when she said “Health insurance reform is about jobs. This legislation alone will create 4 million [Government Dependent] jobs, about 400,000 jobs very soon.”
Yes… 400,000 federal (dependent) employees, that is. Receiving on average $70,000 per year with mandatory 5% annual raises, $40,000+ “Cadillac” health care plans, and lucrative pensions. And the price for this new class of dependents is designed to increase.
At the same speech to the 2010 Legislative Conference for National Association of Counties, Rep. Pelosi also said, “You’ve heard about the controversies within the bill, the process about the bill, one or the other … But we have to pass the bill so that you can find out what is in it, away from the fog of the controversy.”
Yes… We have known what’s inside her bill for about nine months, no thanks to the House Speaker. That’s why the Boaz ItsHaky for Congress campaign offers REAL hope and REAL change by promising: “The Age of Pelosi is Coming to an End.”
Anyone who hasn’t contacted their Representative to lodge a complaint about H.R.3590 should do so NOW.
