The Patient’s Choice Act is a step in the right direction. These are concrete proposals and not generalities that sound like political platitudes.

        ADVERTIZING: My review of the Patients’ Choice Act of 2009 found that $500 million dollars will be spent on bid contracts to advertize and inform on prevention of diseases.

        GRANTS: Grants to States will be made but withdrawn if after 5 years a State has not met the goals designed by the Federal program. Grants will take priority over Centers for Disease Control and Prevention and not exceed $300 million per year.

        HEALTY FOOD STAMPS: The bill will modify the food stamp program to cover only nutritious foods.

        VACCINES: $50 million will be available to purchase vaccines.

        STATE EXCHANGE: The bill authorizes “State Exchange” in each State. Although the language is unclear as to what an “individual purchase” of insurance is, it appears that they will be private insurance plans that compete on the bases of price and quality. “Contracts” will be created between the State Exchange and health insurers. Premiums will be determined by the insurers, but methods of collection of premiums will be decided by the exchange. Terms of the insurance shall be compatible with those enjoyed by Congresspersons.

       OPEN ENROLLMENT:  Enrollment in the plan by individuals is limited to “eligible individuals”. Continued enrollment will result in favorable tax treatment. Section 9801 of the Internal Revenue Code of 1986 will control whether preexisting conditions are covered. Universal coverage is not mandatory.

        LIMIT ON PREMIUMS FOR PRIVATE INSURERS: While the plan states that it will not set premiums it will limit them (Limitation of Exorbitant Premiums). Implementation will be base on a “blend of patient diagnoses and estimated costs.” This does not sound to me like a free market option, and may ultimately result in rationing healthcare to seniors and seriously ill individuals. However, high risk individuals will have access to healthcare through the creation of a reinsurance mechanism. The funding is not set forth in the specific paragraph.

        CROSS STATE ENROLLMENT: Two or more States may establish interstate compacts for sharing an exchange. This sounds like an excellent idea. The more companies that are allowed to participate, assuming that the exchange does not totally dictate the terms of the healthcare plans, the more likely that consumers will find a program that suits their needs; however, the proposal from both parties regulate the to a greater or lesser extent. The difference in in the details.

        ELIGIBLE INDIVIDUAL: The definition of “eligible individual” includes not only citizens and lawfully admitted aliens on permanent resident status, but also those “otherwise residing in the United States under color of law”. This is a catch-all status which can include illegal aliens. Persons covered by Medicare A, B or C are not eligible individuals. The plan defines “ALIENS” as those who are not “lawfully permanent residents of the United States.” But would not include those “under color of law”. Which is an obvious loop-hole, and unless defined more completely, the courts may include a wide variety of individuals.

        TAX CREDITS FOR INDIVIDUALS INSTEAD OF BUSINESSES: This plan will be funded by additional taxes but credits will be allowed.

        INSURANCE AMOUNT IS LIMITED: A qualified plan will have annual and lifetime benefit maximums.

        REIMBURSMENT: Group plans will be eligible for reimbursements under the plan and for taxpayer savings accounts to cover out of pocket or copayment expenses – is designated as a “health insurance reserve account”, but can be used only for qualified medical expenses. No limit is imposed on the tax advantages of these trust accounts. Married persons must file a joint tax return to obtain a tax credit, except for certain married individuals living apart.

        Employer deductions for certain employee benefit plans are revised down.

        The plan does provide for reimbursing patients for pre-payments made to primary care physicians on an as-needed basis.

        PRIVATE HEALTHCARE SAVINGS PLANS: Medical savings plans are permitted for various high deductable healthcare plans.

        CAPITATED DOCTORS: The plan permits capitated primary care programs, which is essentially the assignment to a medical provider a certain number of patients. This arraignment has in the past resulted in conflicts of interest for the medical provider who receives a bonus for saving on medical expenses payable by the healthcare provider.

        COMPLICATED LANGUAGE: The following quote is a good example of how convoluted these legislative plans become making it very difficult for Congresspersons to understand the legislation: “(a) Greater Employer-Provided Contributions to HSAs for Chronically Ill Employees Treated as Meeting Comparability Requirements- Subsection (b) of section 4980G (relating to failure of employer to make comparable health savings account contributions) is amended to read as follows:”

        MEDICARE AMENDED PUBLIC DISCLOSURE: The plan amends Medicaid, especially for long term care. The name of any provider who is paid more than $1 million per year must be publicly available.