We'll be updating you with new finds from the Pelosi health care bill this weekend so stay tuned! Here are some of our latest finds:
-- Page 872: Includes language regulating the qualifications of the food services director at all nursing homes receiving reimbursement under Medicare and Medicaid.
Language here:
(a) MEDICARE.—Section 1819(b)(4)(A) of the Social
7 Security Act (42 U.S.C. 1395i–3(b)(4)(A)) is amended by
8 adding at the end the following: ‘‘With respect to meeting
9 the staffing requirement imposed by the Secretary to carry
10 out clause (iv), the full-time director of food services of
11 the facility, if not a qualified dietitian (as defined in sec12
tion 483.35(a)(2) of title 42, Code of Federal Regulations,
13 as in effect as of the date of the enactment of this sen14
tence), shall be a Certified Dietary Manager meeting the
15 requirements of the Certifying Board for Dietary Man16
agers, or a Dietetic Technician, Registered meeting the
17 requirements of the Commission on Dietetic Registration
18 or have equivalent military, academic, or other qualifica19
tions (as specified by the Secretary).’’.
-- Pages 502-520: Here, the bill sets up an Institute of Medicine study on “high-value” health care, and requires the Institute to recommend – and HHS to implement – changes to Medicare policy reflecting the report. Page 510 gives the Secretary blanket waiver authority to implement these changes, unless Congress passed a joint resolution of disapproval blocking them. Because the changes would go into effect unless Congress acts before May 2012, it would effectively require a 2/3 majority to enact a joint resolution of disapproval – since it’s highly unlikely a President Obama would sign a resolution undermining his Administration’s own work.
Most troubling is the lack of anti-rationing provisions throughout this section. In other words, bureaucrats on the IOM and/or HHS could decide “high-value” health care means denying patients effective but expensive treatments, and put their policies into law – unless a 2/3 majority of both houses of Congress stopped them. (Remember too Obama’s own words on rationing in his NYT interview: “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here….There is going to have to be a very difficult democratic conversation that takes place.”)
Page 57: The Democrats amended the reinsurance program, which provides $10 billion in federal funds to employers who cover their retirees age 55-64, to ensure that State/municipal health plans and multiemployer plans were eligible for funding. Those specific references were not in HR 3200. In other words, the Democrats want to make sure that AFSCME and the big multiemployer union plans get their share of the $10 billion in goodies being given away.
-- Page 106: Durable medical equipment now added to the list of mandatory benefits in the coverage all Americans must buy. In other words, we're spending $1.3 trillion on health care so people can go around doing this.
-- Page 216: The bill includes a new clause prohibiting a federal bailout of the government-run health plan (see below). Of course, Fannie Mae and Freddie Mac weren't going to get a federal bailout -- until they did. Does anyone believe that a government-run plan which all experts agree would enroll millions of people would be allowed to fail?
Here's the language:
(3) N
O BAILOUTS.—In no case shall the public
14
health insurance option receive any Federal funds
15
for purposes of insolvency in any manner similar to
16
the manner in which entities receive Federal funding
17
under the Troubled Assets Relief Program of the
18
Secretary of the Treasury.