Your Czar has completed reading pages 1-100 of all 1,017 pages, eager to learn how HR 3200, if passed, would make healthcare affordable to all Americans.
It’s a little hard to fathom that the entire country can be powered by the few words and amendments of the United States Constitution, but it takes 1,017 pages to discuss health insurance. Of course, as you shall read, most of these pages have little to do with health care reform, per se.
The whole first section, much as you would expect, covers basic definitions used in this document. If you read a lot of legal paperwork, as we Gormogons sadly often do, you understand the importance of defining key words and phrases early to avoid confusion later. Oddly, quite a few definitions in HR 3200 are simply cross-references to sections much later in the document. You wind up skipping around just to find out what a term even means. But that’s not unusual.
As you begin reading the actual text of the bill, you begin to notice a pattern. Roles and responsibilities of the Secretary of Health and Human Services. Commissioners. Ombudsmen. Auditors. Assistants. Departments. Commissions. You begin to realize you are reading a verbal description of a corporate organizational chart, with lengthy discussions of how these people will be staffed, compensated, replaced, and so on. The Czar was uncertain how this makes healthcare affordable.
The Czar laughed at this one: Sec 133 (a) (2) Plain language requirement: that plan information be written in plain language; or “language that the intended audience, including individuals with limited English proficiency, can readily understand and use because that language is clean, concise, well-organized, and follows other best practices of plain language writing.” Too bad that wasn’t the case when they wrote this bill.
43 pages in, the Czar muttered “Holy cow. Still nothing but definitions of terms and descriptions of people who will have Very Important and Necessary Jobs to do once this is enacted. This is reading more like an operations manual for an insurance company, not a bill.” Take note of that. It becomes important later.
Sec 142 (e) “The Commissioner shall provide for the development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.” Yikes. The Commissioner needs to develop standards for health insurance related terms? What’s wrong with the ones we use today? Oh, that’s right: they don’t spend taxpayer money on frivolous jobs.
The Czar began to notice that a lot of the sections, like 2714 and 2754, purport to discuss ensuring lower premiums. But when he read it, he found nothing that described specifics. Instead, there were blanket statements that it will be someone’s responsibility to find a way to lower premiums. The Czar cannot imagine this in the real, corporate world. “My proposal is to save to you money.” How? “Hire me first, and then I’ll come up with something.”
Then the Czar gasped at Section 1173A, in which it discusses electronic administrative transactions, and then lovingly describes how databases will be established, down to optional fields, and to ensure the ability to “harmonize all common data elements.” Holy crap, when do we discuss font options? HIPAA, godsend of libertarians everywhere, isn’t even discussed until page 62.
Title II talks a lot about the different types of plans, who falls into what plan, when another plan becomes more appropriate, and discusses thinks like “culturally and linguistically appropriate services and communications.” That can only mean trifolds in a bunch of different languages at taxpayer expense.
Still, there’s no discussion of how this will save money; but there are concepts thrown around about how the SecHHS will review a bunch of different options to find the best ones representative for each type of group member. Same as before: we will make healthcare affordable for all Americans by finding a way. Real nice.
As the Czar completed his first 100 pages, he finally connected the dots.
This bill has no intention of saving Americans money on health care premiums. It reads like the administrative and operations manual of an insurance company because, in effect, that is exactly what it is!
This is an operations manual, in effect, for a new insurance company called America, Incorporated. And like new companies, the business model is not solid yet: so instead of specifics about how the company will make money, re-invest capital, or lower costs, it’s filled with SWOT analyses (strengths, weaknesses, opportunities, and threats), and detailed descriptions of jobs, roles, and tasks such as bill collection, arbitration, information technology, and so on.
Of course, this really isn’t a start-up company. It’s the federal government, so it will become a health benefits provider in exactly the same way the United States Armed Forces is a security service, the USPS is a private courier, or the FBI is a speed-trap cop.
And this is the incredible mistake of this legislation. The United States is not a competitive player: it becomes a monopoly. Yeah, the theory is pretty simple: the United States becomes an alternative to the big insurance providers. The problem is that by doing so, it squeezes out the competition, who could never muster the resources enough to counter the government muscle. Within a few years, the United States will become the largest health insurance provider in the country, with only a few niche players surviving (and even thriving).
In the next part, the Czar will review pages 101-200, and he will discuss the tax ramifications, why the bill’s proponents think this thing is so awesomely cool, and why they are completely wrong in their logic.
To read the Czars review of HR 3200, pages 101-200, please click here.
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