So-called Pilot's Healthcare "Analysis" Debunked

Another "euthanasia order" debunked.

(Snopes)

"Your thoughts?

"This looked like something you would like to sink your research teeth into."

— A frequent reader

Pre-bunking here.

Another anti-reform chain email?

I'll take a whack at it.

1. The bill is dated July 14, 2009, a long time ago, by congressional standards. The bill that was just passed by the House Energy and Commerce Committee on Friday July 31st isn't the same bill we're looking at here:
   
   http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf
   
   That committee made significant changes to the legislation. Then there's the Senate version, too, so this isn't the "new" healthcare bill or the newest, and it's not even the only one.


2. The very last item on the list, "Should the government be requiring seniors to attend end of life counseling?" has been thoroughly debunked, so has the item referred to below: Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
   
   The so-called end-of-life orders mentioned in the legislation aren't issued by the government. They're the usual written orders made by a senior citizen or anyone else while writing up his or her DNR, living-will, or medical power of attorney.
   
   AARP has responded to these healthcare reform scare tactics, calling them rife with gross, cruel distortions".


3. Page 16: Eliminates the choice to purchase private health insurance!
   
   This is section 102 of Title 1, which defines standards for "qualified plans". What's a qualified plan? Qualified for what? Qualified only under this bill? Qualified only for the exchange? Qualified to exist at all? The only limitation I see is that all individual plans (strictly private plans, as opposed to the public option and the enviable federal-employee-like plan), must be sold through the healthcare exchange. Employer plans and group plans may be offered outside of the exchange.


4. Page 22: Mandates audits of all employers that self-insure!
   
   This is not an audit and doesn't mention auditing "all employers". It's a study to determine "The risk of self-insured employers not being able to pay obligations or otherwise becoming financially insolvent." It's similar to the problem AIG suffered, writing insurance plans above and beyond its ability to pay out. This sounds like a worthy study, and the email authors effort to call it "a mandated audit of all employers" is disingenuous.


5. Page 29: Admission: your health care will be rationed!
   
   Section 122, defining essential benefits, minimum services allowable, limitations on cost sharing (co-payments). I don't see any limitations on benefits, only limitations on co-payments on the basic plans as opposed to the enhanced plan and premium plans.


6. Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process).
   
   Section 123 established the Health Benefits Advisory Committee, chaired by the Surgeon General, members appointed by the president and the Comptroller. They only make recommendations about benefits that may be offered in various plans, but they are not responsible for the adoption of such standards. There is no mention of what the email author refers to as an appeals process, but public input is required in the committee's deliberations. Also, these benefits will be offered through an insurer, so the email author's suggestion that they are not is incorrect.


7. Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.
   
   So which is it? Is it the above committee who decided how you will die or this commissioner of another committee who decides how you will die?
   
   The email author isn't being honest about who decides how you will die. Did you know that in almost all cases of airplane crashed a pilot was behind the wheel? Why would we take their word about killing people? I'm going to stop here because the email is obviously an exercise in cherry-picking terms that can be disingenuously misinterpreted in the most scary way, much like other fear-mongering emails that have been traced back to the usual suspects purporting to be ordinary people simply concerned about your well-being.


8. Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
   
   Okay, I couldn't help it. Just one more. This section says "all health care and related services (including insurance coverage and public health activities) covered by this Act shall be provided without regard to personal characteristics extraneous to the provision of high quality health care or related services."
   
   Nowhere does it say that all non-US citizens illegal or not will be provided with free healthcare services.
   
   By the way, if as a US citizen you injured yourself in the UK, you'd be treated for free, instead of being rejected by your insurance plan for being in an out of plan emergency room. Would you like that or to die in an ambulance your family wouldn't be able to afford after it spent hours circling the city looking for the best place to dump your body?


9. Every person will be issued a National ID Healthcard.
   
   This is addictively fun. It's like shooting fish in a barrel. Poor fish... new barrel.
   
   This section says that insurance policies "may include utilization of a machine-readable health plan beneficiary identification card," not that everyone will be issued a national ID card.
   
   HOWEVER... a few sections up in Section 2746, the bill specifically trounce the email author's unfounded claim that the committee and/or the commissioner mentioned above will have the final say.
   
   "If a health insurance issuer determines to rescind health insurance coverage for an individual in the individual market, before such rescission may take effect the issuer shall provide the individual with notice of such proposed rescission and an opportunity for a review of such determination by an independent, external third party under procedures... If the individual requests such review by an independent, external third party of a rescission of health insurance coverage, the coverage shall remain in effect until such third party determines that the coverage may be rescinded."
   
   Okay, now I'm going to quit. No really, I can stop any time I want, but that doesn't mean I don't have the choice to do it again anytime I like. It'sa Merica, after all


10. Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
    
    Sigh...This establishes as a minimum standard that payment can be made with your debit or credit card through electronic banking. Cash payment is not required, nor should it be, or should it be? I always forget, but I'd hate it if the emergency room wouldn't take anything but cash on demand.


11. Page 65: Taxpayers will subsidize all union retiree and community organizer health plans.
    
    This program is actually available to ALL employment-based plans participating in a particular program. Employers participate in this plan (or not!) by making financial contributions to the plan. It DOES seem to be a form of federal health insurance for retirees supported by the participating employer's voluntary contributions.
    
    By the way, there's also... wait for it... an appeals process so employers can... appeal decisions. Here, there IS an actual audit of claims data of participating employer-based plans. Nowhere, though, are "union retirees" or "community organizers" mentioned. The email authors referral to union retirees and community organizers is preposterous. Community organizer health plans? PuLeeeeze! It's SUCH a coded terminology meant to freak Republicans out, because we all know "community organizers" are uppity black people running for president, or worse... ACORN! This is one of the more embarrassing claims.
    
    
    Seriously, the next time you fly, you should worry whether this so-called pilot is flying your plane, but I suspect that if Captain Scully had never safely landed the plane in the Hudson River we'd be reading this same exact email from a purported fireman instead. Beware of so-called analysis from anonymous members of the latest heroic profession.

If the first ten items are demonstrable misinterpretations, it doesn't bode well for the rest. I'd like to look at them too, but you get the disingenuous gist of it.

That's not to say I don't have some concerns.

As shrill and hysterical as these anti-reform nuts sound, the administration has given them something to hang their hat on when officials talk about things like end-of-life options... speaking somewhat briefly... with the sense that most people understand what they mean. But many people don't know what a DNR, a living-will, or a medical power of attorney is. They hear "end-of-life order" and believe the order is coming from someone else.

At that press conference on ABC a few weeks ago, there was the woman whose 100 year old mother lived to be 105 instead of accepting the initial doctor's recommendation that there was little hope. The daughter asked Obama if her mother's care would have been rejected under healthcare reform. Instead of saying Yes or No and Here's why... Obama started explaining the concept of pointless end of life care, leaving a very odd impression that this particular woman wouldn't have gotten the life-extending care.

Unless they REALLY mean the doctor and patient don't have a say, they REALLY need to make it clear that the best-practices guidelines they're talking about aren't written in cold, Vulcan stone.

In the context of pointless end-of-life options... on the subject of procedures that aren't going to benefit the patient as much as they offer dubious hope... reformers have spoken in somewhat short, curt terms about a delicate, nuanced, and frightening subject... giving the nuts, anti-reform lobbyists, and activists this opening.

Something from a frequent reader:

From: anonymousMouse
Sent: Sunday, August 02, 2009 5:28 AM
Subject: Fwd: Analysis of New Healthcare Bill (Must Read!)

Your thoughts?

This looked like something you would like to sink your research teeth into.

---

Now would be a good time to let our elected representatives know how we feel about this legislation.

One of the pilots I fly with actually read the proposed Healthcare Bill and put this summary together. Regardless of your political persuasion, we should all be telling every elected official we can NOT to endorse this madness. (There's a link to a pdf copy of the entire bill if you want to check the accuracy of this summary.)

Read the entire proposed Healthcare Bill (you will be more qualified than congressional representatives).

Click on the following link. (It takes a few minutes to open the file.)

HR2300.pdf http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=111_cong_bills&docid=f:h3200ih.txt.pdf

Here are a few highlights of some problems with the healthcare bill.

These problems highlight the reason every bill must be read by the American people before they are signed. (if these points don't get you upset, please check your pulse and call 911):

Disclaimer: This summary was sent from a colleague. We encourage you to conduct additional research on your own.

• Page 16: Eliminates the choice to purchase private health insurance!


• Page 22: Mandates audits of all employers that self-insure!


• Page 29: Admission: your health care will be rationed!


• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)


• Page 42: The "Health Choices Commissioner" will decide health benefits for you. You will have no choice. None.


• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.


• Page 58: Every person will be issued a National ID Healthcard.


• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.


• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans.


• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.


• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)


• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens


• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.


• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.


• Page 124: No company can sue the government for price-fixing. No "judicial review" is permitted against the government monopoly. Put simply, private insurers will be crushed.


• Page 127: The AMA sold doctors out: the government will set wages.


• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.


• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.


• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll


• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll


• Page 167: Any individual who doesnt' have acceptable healthcare (according to the government) will be taxed 2.5% of income.


• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).


• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
  
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected."


• Page 241: Doctors: no matter what speciality you have, you'll all be paid the same (thanks, AMA!)


• Page 253: Government sets value of doctors' time, their professional judgment, etc.


• Page 265: Government mandates and controls productivity for private healthcare industries.


• Page 268: Government regulates rental and purchase of power-driven wheelchairs.


• Page 272: Cancer patients: welcome to the wonderful world of rationing!


• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.


• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.


• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!


• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.


• Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.


• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.


• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.


• Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
  
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
  
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.


• Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
  
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
  
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient's health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.


• Page 430: Government will decide what level of treatments you may have at end-of-life.
  
• Page 469: Community-based Home Medical Services.
  
• Page 472: Payments to Community-based organizations.
  
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
  
• Page 494: Government will cover mental health services: defining, creating and rationing those services.
  

Talk to Your Family, Friends, Neighbors & Co-Workers

You must talk to people about this. We need to get as many people informed about this as possible. Here are a few key points:

This issue is not Republican vs. Democrat. It is government vs. individual rights.

• "What's the proper role of Government in our lives?"


• "Do we really want the government making decisions for us that should be between me and my doctor?"


• "Should the government be eliminating personal health insurance plans?"


• "Should the government be requiring seniors to attend 'end of life counseling'?"

— A frequent reader

Read nother debunking here.