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Saturday, August 29, 2009

At my request, Ayelet Waldman sent sent me the link to a draft of the Kennedy Healthcare Bill:

http://briefingroom.thehill.com/2009/06/05/download-the-kennedy-healthcare-bill-here/

I've begun reading. It's 167 pages in PDF form and I'm getting deep into it. I've also been posting up at Facebook as I read, but have reposted here, for comments and input. Everything below is my own commentary at Facebook, read and post: not posting other peoples' comments, since I have no permission or right to do so.

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Thanks to Ayelet for sending me the link to the Kennedy healthcare bill. Am reading. Page 2, I am already holding up a hand and saying "um.....hold it...." And not because the idea is wrong - HCR is desperately needed. But by the time I reached the Declarations, I'm already cranky (see below for why, if curious).

"Sec.2, item c): HEALTH CARE PROFESSIONALS SHOULD JUDGE WHAT IS BEST FOR THEIR PATIENTS - Doctors, nurses and other health professionals have the right to judge what is best for their patients."

Um - NO, fucko, the PATIENT is the final say. We call it "choice". If they have the final say and not us, we're not patients, we're CHATTEL. And I am no one's chattel.

Back to reading. There had best be some serious answers to my questions in this thing. (My note: someone commented that they thought it meant "professionals, not bean counters". Maybe, but the language needs to say that. This is a loophole you could drive an ambulance through.)

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I'm seeing a trend in this thing: A wonderful humanist intelligent heading followed by a list of stuff that qualifies it into mush. Section 2702, GUARANTEED AVAILABILITY OF COVERAGE" Awesome! As it should be. Followed one subsection (b) later by: " B1: RESTRICTION: A health insurance issuer described in section (a) may restrict enrollment in coverage described in such subsection to special or open enrollment periods."

Um - meaning, what? "Sorry I wasn't able to fill out the 87 pages of forms during the three days of the past six months when "open enrollment" was applicable, but I was getting chemo and radiation. Now what...? Oh, wait for the next open or special enrollment period? When - oh, next year...?"

Back to reading.

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Section 2704 is a beauty. Glorious, if they could enforce it or get a single megolithic soulsucking corporate greed-fed "screw your stupid disease, where's my profit margin?" insurance company out there to agree to it. About as likely as me being nominated as Citizen of the Year by Rush Limbaugh, which is to say, not at all.

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Section 2706, the anti-discrimination section, excellent. Right up until the "[further conforming changes to this section may be needed]" thing at the end. I'm being asked to sign my name to support a draft for which every section is liiely going to undergo massive changes. What happens if someone gets the bright idea to outlaw birth control as a rider to one of these sections as a condition to passing it? There are certainly enough whackjobs in both houses of congress to pull a stunt like that, or worse. And there are certainly few enough congresscritters out there with the stones to smack them down.

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I'm a HUGE fan of socialised healthcare, but I'm not signing my support to anything until I've read the whole thing and made my decision based on that. So far, nice intent and not enough meat.

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The main roadblack to desperately-needed health care reform in the country is the mindset: every corporation thinks it's somehow guaranteed profit. WRONG, buckaroos. You takes your chances. And that's especially true of insurance, any kind, which is essentially by nature legally enforced gambling: "I'm betting you $870 a month that you'll get catastrophically ill! HAHAHAHA! Roll the dice!"

Until we address the mindset that Corporate America is somehow entitled to profits, we are hosed, SOL, kerfuckety.

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And here's a perfect example of why I'm molar-grinding: nice intent, shiny statement, issuing a mandate - and ZERO details as to how it's to be done:

"Section 2707: ENSURING THE QUALITY OF CARE". It has a long series of subheads, all incredibly cool and right-on and needed - but all they are, are vague directives. "Insurer shall develop chronic ... Read Moreillness care" - um, HOW, goddamnit?!?! How do you plan on enforcing that? If this is a law you're talking about, what's the regulating reality?

I want substance. Why is it so hard to provide that?

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Section 270, redux. Second half is followed by a series of sub-sections that basically say "at some point not more then [ ] period of time after passage of this act, we'll figure out some of the details.

NO. You are talking about a @#%%$$ LAW here, people. Details are important - it's where the devil lives, remember? Get your shit together and GIVE ME SUBSTANCE.

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Section 2708, Preventives, looks quite good, until we get to (b). (b) isn't evil, it's just so badly written, I can't figure out what in hell they're talking about. Anyone? Bueller?

"(b) SITES OF CARE - Nothing in subsection (a) shall be construed to prohibit a group health plan or health insurer issuing group or individual health insurance coverage from establishing conditions for coverage for the services described in subsection (a) that requires that such services be [performed by providers with appropriate expertise?]"

Everything, including the brackets and the question mark, is theirs, not mine, as written. I can't figure out what in hell that means. "You have the right to have people with medical degrees perform medical procedures"? Quois...?

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And that's all for tonight. There will be more read-and-post tomorrow. Tonight, need dinner and if I read any more of this without food, head will go 'splodey.

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