Notes on HR 3200: A response to Rick Joyner's "Special Bulletin: National Health Scare"
The health care reform debate is a huge topic right now and there is much heated rhetoric flying back and forth. But how do we know who is right? How do we know what to believe?
Dana and I have been interested in health care reform for about 2 years now and support a single payer system. We see fundamental problems with how the profit motive has conflicted with quality health care in the US private insurance market.
In the past few days we have received a link to something that Rick Joyner wrote about the health care bill being currently considered in the House of Representatives. It contains a number of claims that Dana and I find to be suspicious - especially the claim that this bill would encourage euthanasia and set a massive bureaucracy which would decide who lives and who dies (i.e. what care will be given or not). Rick likened this bill to Nazi Germany or Stalinist Russia.
These are big claims and must be examined. At the end of the bulletin is an "outline of this bill [HR 3200] put together by Mat Staver of the Freedom Foundation and Liberty Counsel"
This outline of the bill is what prompted me to actually read the bill. Dana and I support change to the health care system, but we really should be looking at what exactly the bill actually says. The Devil is in the details.
Therefore what follows are links to the house bill, the afore-mentioned Bulletin and a set of notes I will be taking as I read through the bill.
Links:
Special Bulletin: National Health Scare by Rick Joyner
Text of HR 3200 (PDF)
Huffington Post also has HR 3200 available for reading online where one can leave specific questions or comments about lines in the text. The Link is:
http://www.huffingtonpost.com/2009/07/14/health-care-bill-released_n_232206.html
Notes:
- Pages 1-5 outline the purpose of the bill.
- Pages 5-8 lay out the contents of the bill.
- pp.8-14 - definitions.
- p.15 - January 1st 2013 is when government regulations begin for "Qualified Health Benefit Plans" (QHBPs) - all new health insurance plans, public or private, would be regulated for "affordable coverage," "essential benefits," and "consumer protection"
- p.16 - all insurance plans that began before Jan. 1 2013 will be "grandfathered" into the system.
- p.17
- "RESTRICTIONS ON PREMIUM INCREASES.—The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner."
- In other words, insurance premiums cannot be increased for any individual without also increasing the premiums for all others in the same "risk group"
- p.17 - Grandfathered plans will have 5 years grace period to comply with new regulations.
- p.18 deals with exceptions
"Subtitle B—Standards Guaranteeing Access to Affordable Coverage"
- p.19 - (IMPORTANT!!!) This Law (if passed) will prevent health insurance companies from denying coverage to patients on the basis that they have some preexisting condition or other health problems.
- p.20 - Health insurance companies will not be able to dump coverage of a patient without notice.
"Rescissions of such coverage shall be prohibited except in cases of fraud as defined..."
- p.21 - sets up regulations on price variations by age, area, and individual vs. family rates so that the prices can't be excessively high for one group.
- p.22 - sets out rules on how the health commissioner will study the effects of this health reform bill and report to congress after a year and a half.
- p.23&24 - This section empowers the health commissioner to lay out rules to prevent discrimination in health benefits.
- p.24 - (IMPORTANT!!!) The Health Comissioner will set a minimum "medical loss ratio" - the percentage of each dollar from insurance premiums that insurers spend on actual health care. If the company spends less on health care than the minimum medical loss ratio then they have to refund their clients.
- For instance, if the comissioner requires 90% of each dollar to be spent on actual medical care (instead of overhead costs or profits) but an insurance company only uses 80% of their income on providing medical care, then they would have to repay their customers the 10% not used on actual health care.
- The commissioner is to set the "highest level medical loss ratio possible ... to ensure adequate participation ... competition in the health insurance market ... and value for consumers so that their premiums are used for services."
- pp.26-7 - Limits cost-sharing, gets rid of annual or lifetime limits on insurance payments.
- pp.27-8 - Essential Benefits include: hospitalization, outpatient and emergency services, prescription drugs, rehabilitation, mental health & substance abuse services, preventative health, vaccines, maternity care, baby & child care...
- p.29 - (IMPORTANT!) Contrary to the claim made in Rick Joyner's bulletin that page 29 in the health care bill establishes health care rationing, this section of the bill actually caps the amount of pocket money a person must put out for medical treatment and stops the use of "co-insurance" where the insurance company only pays a percentage of a medical bill.
- pp.30-7 - Establishes an "advisory committee" of "medical and other experts" (who will not be Federal Employees!) called the "Health Benefits Advisory Committee." They will "recommend covered benefits and essential, enhanced, and premium plans." Members of the board are to be drawn from all parties involved (doctors, consumers, insurance companies, unions, employers, financial experts, etc.) so as to "represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee."
- (IMPORTANT!) Contrary to the portrayal in Rick Joyner's bulletin of a "government committee that decides what treatments/benefits you get," this committee will actually be composed primarily of non-government sector experts who will be establishing minimum standards of care that insurance companies may not go below.
- The way the system operates now is that insurance companies regularly deny coverage of, or restrict treatments in order to save as much money as possible (their real goal is the maximization of profits after all). This bill has set up a correction for this problem. Pages 26-8 set out minimum requirements for care and pages 30-5 merely establish a committee which will be responsible for updating and clarifying these minimum standards.
- pp.36-7 - Adoption of Advisory Committee's Recommendations - The Secretary of Health and Human Services will either adopt the standards set by the committee or send back the recommendation for review.
Labels: ethics, health care, HR 3200, reform, Rick Joyner, single payer
posted by Joel & Dana @ 9:13 pm
17 Comments
17 Comments:
Thanks for the summary thus far, I Google's Rick Joyner and Health Care - and your blog came up on the first page. I read the email from Rick Joyner also, it all seems so inflammatory. As a believer how do we care for the widows and the orphans? And what does "reasonable" information sharing look like in these modern times? Many blessings,
I also appreciate your response to Rick Joyner's well-publicized "Special Bulletin." It is sad that he skipped Page 19 of the bill. It was his chance to at least agree with something in the bill, unless of course there is nothing he or Mr. Staver agree with, including pre-existing coverage. Which churches have addressed the crises some of their members face due to lack of coverage? Which churches have sought out ways to make certain all of their members/flock are covered.
There was a popular concept about ten years ago in the circles of ministers Rick Joyner is in that talked about pastors being responsible to shepherd their communities, not just their members.
Lastly, why is the enemy of our Church painted as so absolutely horrifying. Jesus Christ is risen from the dead and is going to return. I feel pretty safe myself. My responsibility is to make certain others have their basic needs provided for as well.
I would like to share a response I prepared for a friend who sent me this same email:
Hello all,
Again, I would like to comment on another circulating missive concerning the debate over our country's health care. I went to Morningstar Ministries website to verify that Rick Joyner was actually the author of these words, because it saddened me that someone of his stature and character could be caught up in the misinformation being circulated by those who are seeking to protect an entrenched system.
Tonight, I read the portions of HR 3200 which pertain to Advance Care Planning Consultation (sec 1233). Because it is essentially an amendment to the Social Security Act (42 U.S.C chapter 7), I also had to look THAT up so as to acquaint myself with particular references within the bill. I can verify, as can many others who have read the bill that the information Rick Joyner viewed on Fox News and which has now been repeated by both members of Congress and by members of the media, is false. This idea that HR 3200 allows for euthanization of the elderly appears to be a conspiracy theory first inserted into public discourse by a former Republican Lt. Governor and conservative commentator Betsy McCaughey on Fred Thompson's radio show earlier this week. Her claim was subsequently published in the NY Post and elsewhere. It is patently false. Doctor assisted suicide is illegal in almost every state and the portion of the bill referenced in the claim refers to counseling regarding "the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title." Much seems to be made of this dubious-sounding insertion:
"(5)(A) For purposes of this section, the term 'order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that--
...
'(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.
Vague, legislative language can sound dubious indeed when so much distrust as been sown. However when you read the Social Security Act sec.1866(f)(3), it turns out that...
(3) In this subsection, the term “advance directive” means a written instruction, such as a living will or durable power of attorney for health care, recognized under State law (whether statutory or as recognized by the courts of the State) and relating to the provision of such care when the individual is incapacitated.
This is a part of the legislation that was passed, I believe in 1988.
If you've read this far, I want to thank you for keeping an open mind and heart. And please, do not stop believing in our country simply because the Presidency has shifted parties. We need for ordinary citizens to be vigilant, seeking the facts assiduously and giving our lawmakers (in BOTH parties), the benefit of our respect.
For those who are interested, here is something I found which summarizes this particular issue. But please do not rely on websites such as fact-check or any other website or media personality to inform yourself on an issues this important to our society. Original sources are available to anyone who takes the time to find them.
http://www.factcheck.org/2009/07/false-euthanasia-claims/
Devin Greenwood
- Show quoted text -
...and a second response:
Upon re-reading the bill, I wanted to make a couple of further observations with respect to some language that could appear suspect upon a cursory encounter.
In (F)(ii), language concerning "an explanation of orders regarding life sustaining treatment" begins appearing with respect to advanced care counseling.
I want to point out that in (5)(A), "the term 'order regarding life sustaining treatment' means," a medical order that is "(i) is signed and dated by a physician" ... "who is acting within the scope of the professional's authority under State law in signing such an order," This DOES NOT REFER TO A GOVERNMENT ORDER regarding end of life care, but to as you say, "DOCTOR'S ORDERS".
In addition, I thought it noteworthy that the bill specifically stipulates in (F) (ii) (II), (iii) (IV) that any counseling requirements be limited to states in which designated programs are in place which are "guided by a coalition of stakeholders includ[ing] representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association."
This CLEARLY MANDATES A WIDE NET OF LOCAL AND STATE ACCOUNTABILITY and is AT ODDS with the claim that such counseling would either be dictated by the federal government or would include information intended to persuade the elderly to end their lives.
This is all from the section of the bill, 1233, which pertains to advance care planning consultation, please read it for yourself and help put a stop to the false allegations and division.
Good night all,
d
Yes, there is plenty of rumor and misinformation that needs to be corrected. I would, however, respectfully disagree with Joel and Dana's belief that the federal government will do a better job in allocatiing health care resources than profit-seeking insurance compannies. Profit is a good thing. Without a profit, you will not stay in business. You will not be able to provide the valuable services your business provides. The best check against "exorbitant" profit is other profit seekers competing for the demand for health care insurance, not bureaucrats issuing edicts from their governmental offices. For all its imperfections, a free market ensures the most efficient, most responsive, most effective allocation of resources in demand.
We can choose to trade this economic freedom for greater economic security but in doing so we will increasingly become the indentured slaves of an increasingly powerful State
Well, I was very shocked by Rick's bulletin when I first read it, but you know what, like you said, it made me and many others actually read and care about the legislation and what it Actually says. That is, i am sure, what he was trying to do, get people involved and caring.
In response to MANSE, I also feel safe because I know that God is often most glorified in tribulation and I welcome His Coming. But that is no excuse to align yourself with and support the works of the devil(i.e. SECULAR HUMANISM)... Health Care is not a right and we are not entitled to live long lives; As Christians we are to work for the Glory of God, not the glory of man. improving the human condition shouldn't be our main focus, but that IS the main focus of humanism, it says we must improve the human condition because WE HUMANS are the source of all meaning and worth, we are not. We need to repent of the idolization of man and stop esteeming our own intellect.
To God be the Glory
For the last person who commented, we are called by God to heal the sick, so yes, universal health care would be one step towards fulfilling this edict, although not complete. Furthermore, the whole bible is filled with scriptures about taking care of the elderly and the poor, and I think it would be splitting hairs and going against the spirit of God's word to say that taking care of their physical infirmities is not included in those admonishments. Indeed, as we would do so to the least of men, we would do so unto Christ.
I also reject the view that the call to heal the sick is only in some "super-spiritual" sense also (the most common argument). While referring to food, the bible clearly states that we are not just to pray (i.e.-Be warm and filled) and not actually provide sustenance. Certainly, I do not believe that the edict to heal the sick is just for miracles, and that the prayer, be well and healed, should be followed by medicine if it is easily within our power to give. Is not God who sustains the healing powers of medicine through the laws of nature and the gifts of human intellect.
As for saying that anything that tries to help man is secular humanism and the devil, that of course is absurd. We are called to work for the glory of God, which largely consists in helping uplift our fellow man, which should be obvious as it is heavily laden throughout the entire canon of scripture. Do you really believe that when the early church was selling its goods to give to the poor, that the apostles would have took the time to rebuke the Romans if they started caring for the sick? Such a thought is totally ludicrous.
Incidentally, the church did just that at one time, building hospitals and taking care of the sick...it was a time when many people came to the church because of the evidence of their good works. If we still gave wholeheartedly as the church towards such noble goals, we might not need a national system. As the call for a national system shows just how much the church has changed and fallen behind its calling, we should at least have the decency to get behind it, instead of fighting it, which must only add to our deserved contempt as selfish and uncaring hypocrites.
I wanted to amend something I had said earlier. I meant to say " let it be ", instead of " get behind it " in the previous post. I am in no way saying that as Christians we are mandated to support this particular health plan, and personally, I would rather see a more efficient single payer system.
What I am saying is that I believe universal healthcare is certainly compatible with the tenants and spirit of Christianity. As such, we should not take any opposition to it we may have and try to integrate it with our Christianity.
Certainly, if you think it is a horrible plan, you may do whatever is morally permissible to God, and legally permissible as a citizen of our country (Just not as the Church).
Well Paxton, This is your anonymous poster...Where do I start...Well, I am thankful for your feed back. I am a social work student, so I am by no means saying that we should just ignore people's needs and just pray for them. Faith without works is dead. But honestly if you haven't noticed, the federal government is trying to take over our nation one sector at a time(automotive and banking and possibly energy), I do not know if you are an American, but here we are about freedom and capitalism. (and yes capitalism has its flaws i.e. greed)
And yes (the common argument) Ideally we would live in a somewhat Marxist/Christian Socialistic society, but that is not going to happen until Jesus comes again. And *He* will be the one to build such a society, not us. If you read revalation it is all supposed to go to hell in a handbasket, then he comes back to judge and deliver. We don't gradually improve society until one day it is perfect, reaching to the heavens, like the tower of babble.
The main difference is in the motive. Most Americans want HC reform because they think they are entitled to it, as if God (or the rich people) are obligated to assure them of good health. Instead we should know that God is for the sanctity of life and desires his creatures to prosper and well.. live. Certainly God is for the holistic healing of individuals. But I am with rick on this one, this is not about helping people, this about the government taking over sectors of our economy and lives... just read the bill. The mark of the beast is in it... An electronic machine readable card that shows your financial status at that present moment, which you will need to access health care. Its on Pg 58 line 5-15
Not to mention the whole abortion part and what not. I do not want to pay to have a half-birthed child's skull drilled into and brain matter sucked out. Sorry.
Just wait until the government starts to use the H1N1 pandemic as an excuse to shut down inter-state commerce and stifle the flow of accurate information across borders. Then maybe you will start to see what I see.
Thanks for your comments... it has made me think more thoroughly about my previous statements, as I hope my do to you.
And yes I am in favor of reform, mainly tort reform and state run co-op insurance plans... They are the safest and require less government intervention. You should look into the whole co-op thing.
Bless You
h.r. 3200 is shit. h.r. 676 is a much better proposal. def see pnhp.org
on cost:
capping insurance profitability at current industry averages won't bring cost down.
on care:
the primary problem is inability to pay despite having some form of insurance. in terms of lives lost, we're talking 100k plus yearly. how will a legislated 35% deductible make that difference?
Bill Watts,
You claim that "Profit is a good thing" and that "the best check against "exorbitant" profit is other profit seekers competing..." but let me draw your attention to the issue of exorbitant profits in the health care industry as it is ACTUALLY run. I have posted a letter I wrote on the medical loss ratio.
http://joel--dana.blogspot.com/2009/07/open-letter-to-editor-and-to-our.html
You can look up Wendell Potter who is a former head of PR at Cigna.
http://www.pbs.org/moyers/journal/07102009/watch2.html
Anonymous, you said:
"Americans want HC reform because they think they are entitled to it, as if God (or the rich people) are obligated to assure them of good health."
Your claim implies that we should let people die if they can't pay for the health care that might save their lives. Are you a supporter of euthanasia?! A social Darwinian - you know, survival of the fittest (or richest)?
Teacherguy,
I must agree with you to some extent. I too would really love to see HR676 pass and become law. Unfortunately I don't think it has a chance. However, I'm really hoping that economist Paul Krugman is right that although this legislation may be flawed in some ways, it is the first step in the right direction of keeping corporate greed in check and providing health care consumers with some protection.
I have not finished my reading of the bill, but so far it looks fairly good.
Joel, I am not a supporter of any of that. I think that we should strive for the best possible standards of HC for everyone, with out impeding on people's freedom. I have come to realize that, yes, my some what judgmental or cynical spirit has been brought out by this health care debate. but you know what, that gives me the opportunity to examine my motives and beliefs and be healed of the bad ones.
But this whole ingrained thing about everyone should be equally blessed physically/materially is simply not truth. Yes, we are all equal before God, but here in this life, on this earth, there are going to be inequalities and it isn't our place to take from one, and redistribute their wealth in order to make everyone equally blessed. Which also discourages entrepreneurship and peoples desire to be productive citizens; because what they do does not positively effect them or the charities which they find appealing. Then, the overall production of a society plummets. Simply stated, Socialism doesn't work.
And yes, I am all about VOLUNTARY wealth and resource redistribution and all of those good things. I just don't think that the government is the way to do it. And eventually it is going to lead to a world where God and His return are unwanted and unneeded, because we have figured all of this out ourselves. But naturally that cannot happen... so really that should not be a concern.
And on a more personal note, to anyone who cares:
Well all of this health care debate is going on, and I have been pretty heated up about it. But was convicted today of my motives/desires. I realized that a large portion of me wants this nation to go to hell in a hand basket because I want people to repent and know God, and judgment of wickedness to be carried out. I realized that this is more out of a hatred for evil and the enemy, than it is for true righteous judgment, which brings life and peace. On the other hand it is easy for others to not desire the Lord’s return because they want to make a difference in the world and his coming would interfere with their ministry to others and their ability to “leave a legacy.” And yes I have been in both of these situations. *I am not entirely sure why I included this last bit*
And I am sorry if I have caused any commotion in your blog. I am not a normal reader and simply found this when I ran a search for an HR3200 outline, and having already read Rick's bulletin this caught my eye.
I am sure you are all great people and good Christians. Be Blessed.
I have to say that Anonymous' last post was touching and aroused my admiration. Such honesty is the sign of an open and true heart.
I recognize truth in the assessment that all the "heat" in this debate stems not only from policy differences on health care but from all of our various anxieties about the direction our country is headed, both on the left and on the right. Add to that our deepest spiritual convictions and beliefs and we have a recipe for the combustible debate at hand.
That assessment notwithstanding, I want to add my opinion to what was said. I do not believe that a society in which everyone is equally blessed physically and materially is either desirable or possible. Although we are all fashioned after our Creator, we are endowed with differing capabilities, strengths, weaknesses and most importantly the freedom to choose the way in which utilize them. Someone who is industrious, patient and conscientious should by all standards of good sense, have a better chance of living a life of comfort and ease than someone who is lazy, stubborn and foolish. There is a moral distinction here that is sometimes discarded offhand but is often critical nonetheless.
It also however becomes apparent that there are many other traits which do not seem to call for a moral qualification: cleverness or lack thereof, geographical upbringing, race, gender, looks. These factors also determine how people will fare in life, as do factors such as disease, personal history and tragedies like abuse. There is certainly evidence that as often as we fail to judge those who morally deserve our indignation, we unrighteously judge those who are only deserving of our compassion and concern.
There is little argument that the church is charged with taking care of the "least of these". What is less clear is what the role of the government should be in providing for those who seem unable to provide for themselves, especially when the best efforts of institutions like the church prove insufficient.
There are some needs that, although controversial in the past, we now accept as the government's responsibility. Among them is the need for a federal military, the need for access to schooling for all children through high school and for medical care for the elderly. If for example we discovered a situation in which a child was not able to receive an education-- even as they were earnest, hardworking and teachable-- because they could not afford it, many of us would assess that as unacceptable in a wealthy, western society.
Individuals in this country are unable to develop their full potential for a host of reasons, some of which are tragic. But we have agreed that not having access to a basic education because of an inability to pay for it should not be one of them. This is a value that most, if not all, western democracies have decided to adopt and is something of which we are generally proud.
I believe that we are approaching the time, when our country will decide collectively that all of our citizens have the right to be free of the disadvantages of untreated illness, not because it is mandated in scripture or in the Constitution, but because we will decide that it's a value we want to share. I believe we will come to accept this as the moral imperative of a continually developing country that has embraced the God-given endowments of life, liberty and free pursuit, even as we are understanding it to be an economic imperative. For the facts tend to suggest that in some ways we already have a universal health care system. We refer to it as Emergency Room care and it is the most expensive way to treat human illness in the world.
Thank you Anonymous for your candid and honest post, and please all, continue to pray about this issue with an open heart.
Devin Greenwood
Well, profit is a good thing. Without a profit, you will not stay in business. You will not be able to provide the valuable services your business provides.
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