Healthcare bill S. 703: American Health Security Act of 2009

        The bill describes benefits due citizens, resident aliens, and non-immigrants. These represent the entire group of legal residents. The bill describes another class, without naming them specifically who are entitled to benefits.  Title I Sec. 102 (c)“Treatment of Other Individuals” is the catch all section for illegal aliens, but not for those who immigrate to the US for the sole purpose of obtaining health. The section contains no guidelines for determining the intent of the person seeking medical treatment. The onus is on the State to prove the intention of the person if denied treatment. This would seem to be an almost impossible burden.

        Under Sec. 106, Medicare benefits (Part B non-hospital) will expire and only the benefits available under the proposed plan will be in effect after January 1. 2011. Veteran’s benefits are excluded from coverage under the new plan. Presumably veterans will be entitled to whatever benefits the veterans administration decides is appropriate. The reasoning is probably that veterans are already covered by the government and not private insurance.

        Title II Sec. 201 (a) provides for treatment if it is “appropriate”. The so-called benefits include “education and training in self-management techniques”. Unless there is a definition of what is “appropriate” it may be appropriate to give a 65 year old woman with breast cancer pain pills to assist her end of life diagnosis.

        Sec. 204 (c) provides for experimental treatment on certain individuals. Sec. 301(b)(1)(A) provides that “eligible persons” will not be discriminated against because of their “age”. It will be interesting to see the number of law suits filed demanding treatment by the elderly who are denied treatment.  Medical providers are not allowed to charge more than provided by the plan.

        Sec. 502 places the decisions as to how patients are to be treated in the hands of a bureaucrat and not in the hands of the doctor.

        Sec. 601 places a monetary limit on the quality and extent of total medical services provided each year. The budget is not to be increased by more than the increase in the GDP. Of course if the GDP decreases, which is not unlikely, the funds available to pay medical providers for treatment will diminish as well. Subparagraph (b) provides for sums to be allocated on the bases of “capitation”. i.e. Each doctor will be assigned a given number of patients and money. When the money runs out the doctor goes on vacation. The bill doesn't actually say that but that is what happens in countries with socialized medicine. Obviously if the money runs out the doctor is not going to remain and work for nothing, nor could he afford to do so. If doctors are not against this plan then they have not done their homework.

        Sec. 602 establishes an amount of money to be allocated per person in the program that is capitated in each State. Red states may well be deprived of money to be spent on residents of Blue states. The board making those decisions is supposedly bi-partisan, but we know from experience that bi-partisanship doesn’t exist in practice.

        Sec. 612 gives the board the power to determine how much a medical provider is entitled to receive for treatments.

        Sec. 615 gives the board the power to determine which drugs will be available to restore employability or self-management. No mention is made of life saving drugs. Prices charged by pharmacies will be determined by the board.

        Sec. 711 provides for grants for certain social illnesses, mental health, sexually transmitted diseases, and HIV infection. Nothing for cancer or other life threatening diseases, but the number and monetary value of all the grants is enormous. In fact the word “cancer” appears in the text of the legislation once in reference to test for “prostate cancer”, although tests for mammograms can also be authorized, but not required.

        Sec. 811 provides for in addition to other taxes, a tax on employers and the self-employed of 8.7% wages paid.

        Sec 59B imposes a personal income tax equal to 2.2% of the taxable income for each taxpayer, per year. No credits are allowed to offset this tax, and reimbursement to the employee by the employer for these sums is strictly prohibited; so much for not taxing anyone earning under $250,000 per year.

        Sec. 901 exempts labor unions and public employees from the terms of this proposed healthcare plan. How is this bi-partisan?

        Sec. 903 provides that workers’ compensation payments made by the plan for work related injuries must be reimbursed by the compensation carrier. Terms of the plan may be construed to prohibit workers’ compensation carriers from providing benefits under its plan that are not provided under the public plan. If it works anything like reimbursement of Medicare, there will be very few settlements offered in compensation court and very few simple and prompt resolutions to cases.

        Sec. 1001 repeals Titles III and IV of the Internal Revenue Code with the exception of subtitles D and H of title III and restores sections of the code repealed by section 342.

        Sec. 1002 repeals part B of Medicare as are certain provisions of the Public Health Service Act by Sec. 1003 of the public plan.