Health Reform - The Fraser Email
A recent email purportedly sent by a Dr. Stephen Fraser, an anesthesiologist located in Indiana, made a number of claims about H.R. 3200, the House Democrat health reform plan. A number of organizations have issued responses that claim Fraser’s email was inaccurate. Therefore, Chamber staff have investigated the claims in the email we received, and provide the following claim-by-claim analysis. Overall, some of the fifty-one claims may be speculative or somewhat inaccurate, but others are substantially true.
1) Page 22 of the HC Bill: Mandates that the Government will audit books of all employers that self insure!!
Possible. The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor, would conduct a study of the large group and self-insured employer health care markets. Presumably, all large employers that self-insure would be audited. There may be self-insured employers that are not part of the large group market, and therefore, would not be audited.
2) Page 30 Sec 123 of HC bill - THERE WILL BE A GOVERNMENT COMMITTEE that decides what treatments/benefits you get.
True. The Health Benefits Advisory Committee would determine the treatment/benefits that would be considered “essential benefits” in a minimum benefits package. A health insurer would still be able to offer medical services that are above the minimum benefits package, but all insurers, including those that are self-insured (after the five year grace period) would be required to provide the minimum benefits package, as prescribed by the government.
3) Page 29 lines 4-16 in the HC bill: YOUR HEALTH CARE IS RATIONED!!!
Slightly inaccurate. Cost-sharing would be limited to $5,000 for an individual and $10,000 for a family. This provision may lead to rationing of care, but that would depend on how providers and physicians react when patients who exceed the cost-sharing limit use their services.
4) Page 42 of HC Bill: The Health Choices Commissioner will choose your HC Benefits for you. You have no choice!
Slightly inaccurate. The Health Choices Commissioner would be responsible for the establishment of qualified health benefits plan standards, in coordination with State insurance regulators and the Secretaries of Labor and the Treasury. The Health Choices Commissioner would not choose your healthcare benefits for you. The Health Choices Commissioner would be responsible for enforcing the minimum benefits package standard set forth by the Health Benefits Advisory Committee.
5) Page 50 Section 152 in HC bill: HC will be provided to ALL non-US citizens, illegal or otherwise
Possible. The bill would prohibit discrimination by health insurers with regard to the provision of high quality care or services. There is no actionable way to distinguish between citizens, immigrants and illegal aliens in the legislation.
6) Page 58 HC Bill: Government will have real-time access to individual’s finances & a National ID Healthcard will be issued!
True. The government would have real-time determination of an individual’s determination of an individual’s financial responsibility at the point of service, and to the extent possible, prior to service, including whether the individual would be eligible for a specific service with a specific physician at a specific facility, which may include the utilization of a machine-readable health plan beneficiary identification card.
7) Page 59 HC Bill lines 21-24: Government will have direct access to your banks accounts for elective funds transfer.
True. The electronic standards developed would enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice. This could lead to increased collection powers for the federal government.
8) Page 65 Sec 164: is a payoff subsidized plan for retirees and their families in Unions & community organizations: (ACORN).
Slightly inaccurate. The Secretary of Health and Human Services would determine eligible employment-based plans that would be reimbursed for claims submitted to the government. This includes ACORN-like groups and unions, but also other employers.
9) Page 84 Sec 203 HC bill: Government mandates ALL benefit packages for private HC plans in the Exchange.
True. The Health Choices Commissioner would specify the benefits to be made available under Exchange-participating health benefit plans.
10) Page 85 Line 7 HC Bill: Specifications for of Benefit Levels for Plans = The Government will ration your Healthcare!
Conjecture. Although this section would provide the specification of cost-sharing requirements in plans offered through the Exchange, it is difficult to forecast how both the insurance and provider markets would respond to these new regulations.
11) Page 91 Lines 4-7 HC Bill: Government mandates linguistic appropriate services. Example - Translation: illegal aliens.
Possible. The government does mandate linguistic appropriate services. The bill includes a statement of policy that illegal aliens are not covered under any provisions of the Act. However, the bill contains no way for the government to enforce this policy. Therefore, illegal aliens may benefit from this provision.
12) Page 95 HC Bill Lines 8-18: The Government will use groups i.e., ACORN & Americorps to sign up individuals for Government HC plan.
Possible. The Health Choices Commissioner would determine the appropriate entities to inform individuals and employers about the Health Insurance Exchange and Exchange-participating health benefit plan options. These groups would aid the Health Choices Commissioner in signing up individuals for plans offered in the Exchange.
13) Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans. AARP members - your Health care WILL be rationed.
Unclear. The market will determine ultimately if health care is rationed by the government.
14) Page 102 Lines 12-18 HC Bill: Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.
Slightly inaccurate. The Health Choices Commissioner would provide a process for auto-enrollment under Medicaid. Auto-enrollment would only occur if an individual has not elected to enroll in an Exchange-participating health benefits plan.
15) Page 124 lines 24-25 HC: No company can sue GOVERNMENT on price fixing. No "judicial review" against Government Monopoly.
True. There would be no administrative or judicial review of a payment rate or methodology established under the public plan option.
16) Page 127 Lines 1-16 HC Bill: Doctors/ American Medical Association - The Government will tell YOU what you can make! (salary)
Possible. The government would dictate salary for physicians who participate in the public plan option. However, in the past, payment models in Medicare have seeped into the private sector.
17) Page 145 Line 15-17: An Employer MUST auto enroll employees into public option plan. NO CHOICE!
Possible. An employer would be required to auto-enroll employees into the employment-based health benefits plan they provide with the lowest applicable employee premium. Thus, if the employer participates in the Exchange, and the public plan has the lowest premium in the Exchange, they would be required to enroll employees into the government-run plan.
18) Page 126 Lines 22-25: Employers MUST pay for HC for part time employees AND their families.
True. An employer would be permitted to treat part-time employees separately from full-time employees, and may opt to let part-time employees enter into the Exchange and pay the pro-rated penalty.
19) Page 149 Lines 16-24: ANY Employer with payroll 401k & above who does not provide public option pays 8% tax on all payroll.
Inaccurate. An employer with payroll over 400,000 who did not provide the specified health benefits as dictated by the government would be required to pay 8% tax on payroll.
20) Page 150 Lines 9-13: Business's with payroll btw 251k & 401k who doesn't provide public option pays 2-6% tax on all payroll.
Inaccurate. An employer with payroll between $250,000 and $400,000 who did not provide the specified health benefits would be required to pay 2-6% tax on payroll.
21) Page 167 Lines 18-23: ANY individual who doesn't have acceptable HC according to Government will be taxed 2.5% of income.
True. An individual who did not have “acceptable” health care insurance coverage would be taxed 2.5 of adjusted gross income.
22) Page 170 Lines 1-3 HC Bill: Any NONRESIDENT Alien is exempt from individual taxes. (Americans will pay)
True. The penalty for not having health insurance would not apply to any non-resident alien.
23) Page 195 HC Bill: Officers & employees of HC Admin (GOVERNMENT) will have access to ALL Americans finances /personal records.
Inaccurate. The Secretary of Health and Human Services, upon written request from the Health Choices Commissioner or the head of a State-based health insurance exchange approved by the Health Choices Commissioner would disclose to officers and employees of the Health Choices Administration or the State-based health insurance exchange, return information of any taxpayer whose income is relevant to determining the affordability credit. The return information would be limited to the taxpayer identity information; the filing status; the modified adjusted gross income; the number of dependents; such other information as is prescribed by the Secretary by regulation as might indicate whether the taxpayer is eligible for affordability credits; and the taxable year with respect to which the preceding information relates or, if applicable, the fact that such information is not available.
24) Page 203 Line 14-15 HC: "The tax imposed under this section shall not be treated as tax" Yes, it says that! (What the ___ ???)
True. The bill is worded this way. The surtax would not be treated as a tax when determining affordability credits.
25) Page 239 Line 14-24 HC Bill: Government will reduce physician services for Medicaid Seniors, low income and poor are affected.
Slightly Inaccurate. This provision would permanently reform the formula that annually updates reimbursement rates for physician service in Medicare, including placing a limitation on physicians’ services included in the target growth rate computation.
26) Page 241 Line 6-8 HC Bill: Doctors, doesn't matter what specialty you have, you'll all be paid the same!
Possible. Doctors who participate in the Medicare program would be paid the same, regardless of their specialty.
27) Page 253 Line 10-18: Government sets value of Doctor's time, profession, judgment etc. Literally value of humans.
Accurate. The Secretary would establish a process to validate relative value units under the fee schedule for physicians who participate in Medicare. This process may include validation of work elements (such as time, mental effort and professional judgment, technical skill and physical effort, and stress due to risk) involved with furnishing a service and may include validation of the pre, post, and intra-service components of work.
28) Page 265 Sec 1131: Government mandates & controls productivity for private HC industries.
Accurate. The bill would beginning in 2010, incorporate a productivity adjustment into the market basket update for outpatient hospital services and also for ambulance services, ambulatory surgical centers, and durable equipment not subject to competitive bidding.
29) Page 268 Sec 1141: Federal Government regulates rental & purchase of power driven wheelchairs.
Accurate. The Secretary of Health and Human Services would regulate the rental and purchase of power-driven wheelchairs in the Medicare program.
30) Page 272 SEC. 1145: TREATMENT OF CERTAIN CANCER HOSPITALS - Cancer patients - welcome to rationing!
Slightly inaccurate. The Secretary of Health and Human Services would direct a study to determine whether existing cancer hospitals that are exempt from the inpatient prospective payment system have costs under the outpatient prospective payment system that exceed costs of other hospitals, and to make an appropriate payment adjustment under the outpatient prospective payment system, based on the results of that study.
31) Page 280 Sec 1151: The Government will penalize hospitals for whatever Government deems preventable re-admissions.
Accurate. The Secretary of Health and Human Services would determine the penalties for hospitals that have preventable re-admissions.
32) Page 298 Lines 9-11: Doctors, treat a patient during initial admission that results in a re-admission -Government will penalize you.
Possible. The Secretary of Health and Human Services would conduct a study to determine how the readmissions policy could be applied to physicians. In conducting the study, the Secretary would consider approaches such as creating a new code and payment amount under the fee schedule in section 1848 of the Social Security Act for services furnished by an appropriate physician who sees an individual within the first week after discharge from a hospital or critical access hospital; develop measures of rates of readmission for individuals treated by physicians; apply a payment reduction for physicians who treat the patient during the initial admission that results in a readmission, and other methods for attributing payment or payments reduction to the appropriate physician or hospital.
33) Page 317 L 13-20: PROHIBITION on ownership/investment. Government tells Doctors what/how much they can own!
True. The legislation would prohibit physician ownership in hospitals that are new as of January 1, 2009.
34) Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion- Government is mandating hospitals cannot expand.
True. The bill would prohibit a specialty hospital from expanding the number of operating rooms, procedure rooms, or beds of the hospital at any time after January 1, 2009.
35) Page 321 2-13: Hospitals have opportunity to apply for exception BUT community input is required. Can u say ACORN?!!
True. The Secretary of Health and Human Services would establish and implement a process under which a hospital may apply for an exception to the prohibition on expansion. The Secretary would promulgate regulations to carry out this process, and this process would include input from person and entities in the community in which the hospital applying for an exception is located.
36) Page 335 L 16-25 Pg 336-339: Government mandates establishment of outcome based measures. HC the way they want. Rationing.
Exaggeration. Medicare Advantage plans would receive quality payment adjustments based on established quality measures endorsed by HEDIS and CAHPS, and such other measures of clinical quality as the Secretary specifies. The Secretary would rank the plan performance of each Medicare Advantage plan.
37) Page 341 Lines 3-9: Government has authority to disqualify Medicare Advance Plans, HMOs, etc. Forcing people into Government plan.
Inaccurate. In identifying a “high quality Medicare Advantage plan”, and an “improved quality Medicare Advantage Plan”, the Secretary of Health and Human Services would possess the authority to not identify a Medicare Advantage plan if the Secretary identifies deficiencies in the plan’s compliance with the rules established under the program.
38) Page 354 Sec 1177: Government will RESTRICT enrollment of Special needs people! Unbelievable!
Slightly inaccurate. The bill would grandfather Medicare Advantage plans that had a contract with a State that had a State program to operate an integrated Medicaid-Medicare program that had been approved by the Centers for Medicare & Medicaid Services as of January 1, 2004. The legislation would permit in the case of a specialized Medicare Advantage plan for special needs individuals, before January 1, 2016 for grandfathered plans and January 1, 2001 for all other specialized Medicare Advantage plans, the opportunity to restrict the enrollment of individuals under the plan to individuals who are within one or more classes of special needs individuals.
39) Page 379 Sec 1191: Government creates more bureaucracy - Tele-health Advisory Committee. Can you say HC by phone?
True. The Telehealth Advisory Committee would be created. The Telehealth Advisory Committee is not connected to the Health Choices Commissioner. The role of the Telehealth Advisory Committee would be to provide recommendations to the Secretary of Health and Human Services on policies of the Centers for Medicare & Medicaid Services regarding telehealth services.
40) Page 425 Lines 4-12: Government mandates Advance Care Planning Consult. Think Senior Citizens end of life patients.
Inaccurate. The government would reimburse Medicare physicians every five years for advance care planning. This is an option that a patient would choose to exercise. However, government creation of a billing procedure for this may suggest to some an endorsement of non-resuscitation orders and declining care.
41) Page 425 Lines 17-19: Government will instruct & consult regarding living wills, durable powers of attorney. Mandatory!
Inaccurate. If the patient chooses to have an advance care planning consultation, the patient’s physician would include a discussion of the use of advanced directives, such as living wills and durable powers of attorney, and their uses.
42) Page 425 Lines 22-25, 426 Lines 1-3: Government provides approved list of end of life resources, guiding you in death. (assisted suicide)
Inaccurate. If the patient chooses to have an advance care planning consultation with their provider, this consultation would also include a list of national and State-specific resources to assist consumers and their families with advance care planning, including the national toll-free hotline, the advance care planning clearinghouses, and State legal service organization.
43) Page 427 Lines 15-24: Government mandates program for orders for end of life. The Government has a say in how your life ends.
Inaccurate. The bill would establish that as part of the advance care planning consultation, orders for end of life sustaining treatment be discussed.
44) Page 429 Lines 1-9: An "advanced care planning consultant" will be used frequently as patients health deteriorates.
Slightly inaccurate. An advance care planning consultation with respect to an individual may be conducted more frequently if there is a significant change in the health condition of an individual.
45) Page 429 Lines 10-12: "advanced care consultation" may include an ORDER for end of life plans. AN ORDER from GOVERNMENT!
Inaccurate. The consultation may include the formulation of an order regarding life sustaining treatment or a similar order. The patient and the physician would jointly decide end of life plans.
46) Page 429 Lines 13-25: The GOVERNMENT will specify which Doctors can write an end of life order.
True. The Secretary of Health and Human Services would determine which physicians who participate in Medicare, and other health care professionals (such as a nurse practitioner or physician assistant) would be able to write an actionable medical order for life sustaining treatment as part of the advanced care planning consultation.
47) Page 430 Lines 11-15: The Government will decide what level of treatment you will have at end of life!
Inaccurate. The treatment for end of life would be decided as part of the advanced care planning consultation between the patient and their doctor.
48) Page 469: Community Based Home Medical Services = Non profit organizations. Hello, ACORN Medical Services here!!?
Possible. The bill would create community-based medical homes. These medical based homes would include a nonprofit community-based or State-based organization that provides beneficiaries with medical home services under the supervision of and in close collaboration with the primary care or principal care physician.
49) Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORIGINATION. 1 monthly payment 2 a community-based organization. Like ACORN?
Slightly inaccurate. There would be one monthly payment to a community-based or State-based organization. It is more likely that the community-based organization would be a hospital system, rather than ACORN. An organization would need to provide medical home services under the supervision of and in close collaboration with the primary care physician or nurse practitioner, and also employ community health workers, including nurses or other non-physician practitioners, lay health care workers, or other persons as determined appropriate by the Secretary, to assist the primary care physician or nurse practitioner in chronic care management activities. Although it is possible that ACORN workers could be used as “lay workers,” it is unlikely that ACORN would be the organizer and overseer of medical homes, because physicians are more likely to work for other organizations.
50) Page 489 Sec 1308: The Government will cover Marriage & Family therapy. Which means they will insert Government into your marriage.
Slightly inaccurate. State-licensed or certified marriage and family therapists would be eligible for reimbursement in Medicare.
51) Page 494-498: Government will cover Mental Health Services including defining, creating, rationing those services.
Possible. This provision would add mental health service providers to the Medicare program, and would pay them the same as social workers under the program.
This site is the Chamber of Commerce (hint: the government) selling the Power Grab to you. Total disinformation and spin on the truth. This government is criminal to the core, don't believe anything they say. Global warming is a lie, yet they refuse to admit it now that has been officially proven, H1N1 vaccines are a fraud, and on and on. The New World Order is here! Research and learn the Truth!
http://www.youtube.com/patriotreport
Posted by: JBF | December 04, 2009 at 10:56 AM
It seems to me that the most vulnerable members of our society, those too tired or weak,the frail, elderly, disabled (young and old) will have the most to lose under this health care plan. That is why those who are able must have their voices heard by this administration before the day comes that we too are so vulnerable. It is an experiment at best. An experiment that will take place at the same time as other government experiments such as the stimulus bill and multiple government bailouts. Our economy is not stable enough for such an experiment at this time. There is too much uncertainty, too many unknowns for anyone to be able to say with certainty that this will make us a better country. Doing something is not always better than doing nothing when the stakes are too high and the stakes have never been higher. Why do I feel like our government officials have turned into a bunch of used car dealers - they are trying too hard to get us to buy something that we know is a lemon. The time deadline, same old sales pitches (daily by the president and congress),the pressuring, the manipulation and lies. If you are feeling pressured now it is nothing compared to what you will feel when you are sitting in the doctors office and told you are no longer eligible for a pacemaker or cancer treatment because you are not a valued member of our society. This is "America", land of the free home of the brave. We must save our country and not allow a used car salesman to sell us a bill of rights which we know is nothing more than a lemon. Health Care Reform is too important to be bought and sold on a used car lot. Our country deserves better and yes even the most vulnerable in our society deserve life, liberty and the pursuit of happiness. May God Bless all Of America!
Posted by: Caroline G. | August 15, 2009 at 10:49 PM
It is good that people are setting the record straight on this erroneous email. I personally am reading the bill (h.r.3200) and detailing what it actually says at www.FaithfulinPrayer.wordpress.com. I feel it is so important people who the details and not just hear all the spin. Come join the journey.
Posted by: Jackie Durkee | August 13, 2009 at 02:56 PM
It was unclear to me whether or not the US Chamber of Commerce supports the Health Care Reform bill or not.
If passed many, many small businesses will go out of business and many more will have to lay off some employees.
The Chamber of Commerce should be opposed to this bill(s), both the house and the senate.
I have a copy of both bills and had legal counsel review them. These bills are not about health care reform they are about the government gaining more control of our lives.
Saying who has the right to live and who will die. This is not America.
Posted by: Frank Ani | August 09, 2009 at 02:26 PM
"...speculative or somewhat inaccurate, but others are substantially true."
And therein lies the rub, doesn’t it. No specifics, only vagueness. Vague enough where once this bill becomes law the bureaucrats and special interests can legislate and manipulate the actual application. Vagueness invites abuse. Disagreements become the purview of courts, lawyers and politicians. This bill, or any similar "bi-partisan" compromise is an ambulance chaser’s crack.
There are no safeguards written into this bill to prevent abuses. Politicians are always screaming about rights. A bill of rights and limitations of government authority seem to be missing from the language of this bill. There’s not even a consensus whether abortion funding is authorized. Vagueness implies authority. If it isn’t specifically prohibited, it’s approved. I don't see much of anything prohibited in this bill. In fact, it seems to be all about what they will do...to us, not for us.
This whole debate can be reduced to one word…trust. Do we trust self serving politicians and bureaucrats to exercise this level of control over our lives? What I see when I read this bill is control. I don’t read compassion.
Posted by: Scott30303 | August 09, 2009 at 12:03 PM