Health Care Bill Facts & Fiction.

Since there are a ridiculous number of people supporting or protesting HR 3200 and no one seems to know the fact (or at least back up their claims with facts or analysis), I thought I’d tackle it here.

Each week, I’ll take three or four rumors and analyze their validity and/or impact on our lives from a normal John Doe perspective.

This is part 1 of my series.

# 1.  Government audit of all employers that self insure:  TRUE

Numerous sources identify Page 22 of HR 3200 as the source for mandating Government audits of companies who self insure.

I hate using this website as a reference for anything because they are frequently misinformed, but www.truthorfiction.com/rumors/h/health-plan.htm states, “Pg 22 of the HC Bill mandates the Government will audit books of all employers that self insure. - A Matter of Interpretation!”

“The text of the bill reads, "The Commissioner, in coordination with the Secretary of Health and Human Services and the Secretary of Labor Secretary of Labor, shall conduct a study of the large group insured and self-insured employer health care markets.  There is no mention of audits.”

The page in question actually starts on page 21 and is under Section 113 (b) titled “Study”.  Paragraph (b)(1) contains the language stated above by truthorfiction.com, but that is where ToF stops.  What they don’t say is the last sentence of that paragraph states, “Such study shall examine the following:”  The paragraph continues with:

Subparagraph (A) requires the study to be by “types of employer by key characteristics, including size, that purchase insured products versus those that self-insure.”

Subparagraph (B) asks for the similarities and differences between insured and self insured plans.

Subparagraph (C) – the one in question – states, “The financial solvency and capital reserve levels of employers that self-insure by employer size.”

Subparagraph (D) further requires, “The risk of self-insured employers no being able to pay obligations or otherwise becoming financially insolvent”

Subparagraph (E), and the remainder of the section are devoted to the schedule of which these reports are due to Congress.

There is no other way to factually determine a companies’ financial solvency and capital reserve levels other than to require an audit or self-submitted report/statement.  Either way, the Gov’t will now have the financial records of private companies. (Currently, they only have the year end tax statements which are not detailed).

Since many companies are privately owned, this equates to Gov’t having the financial records of private citizens.

Based on the actual language in the text of HR 3200, the claim that the Gov’t will audit books of companies is TRUE.

# 2.  Real time access to bank accounts:  PLAUSABLE

www.inforwars.com (Kurt Nimmo, August 3, 2009) states that, “Section 163 of the bill now in Congress allows the government real-time access to a person’s bank records, including direct access to bank accounts for electronic fund transfers. “Even-though the bill mentions privacy aspects, the fact remains that if approved, Obama’s health care plan will allow government access at any time to your personal bank records,” KFYI News reports.”

According to CNN’s “Truth Squad” on a posting in the “Political Ticker on August 12, 2009, “The provision cited doesn’t affect individuals, but companies involved in medical billing.

The section in question (section 163) centers on inserting new language into Section 1173 of the Social Security Act.

I’m no expert on the provisions of 42 USC 132d (Part C of title XI of the Social Security Act), but it appears that Section 163 of HR 3200 is referring to a “transaction” by way of  determining benefit eligibility, approval, and perhaps even payment to the medical provider.   With that said, there is plenty of questionable language in section 163 and a more detailed analysis of 42 USC 132d and the integration of the changes from HR 3200, section 163 in it is required.

Again, since some (or perhaps many) companies involved in medical billing may be privately owned, this equates to the Gov’t having real time access to selected private citizen bank accounts.

For the time being, I’m calling this one PLAUSABLE, but more analysis is required.

# 3.  A Government Committee will determine what treatment and benefits you are allowed to have:  TRUE – BUT……

Multiple sources report that HR 3200 creates a Government Advisory Committee to determine your health care benefits.

The section in question is Section 123. Health Benefits Advisory Committee.  To make a long story (and section) short, the bottom line is YES, HR 3200 does create a committee to determine levels of benefits.

HOWEVER…..

..That committee outlined in section 123 is a policy level committee and not an individual treatment committee.  It is essentially the same type of committee that a health insurance provider creates to determine what coverage it will offer.

Now, with that said, I have NOT gone through the entire bill to determine if there is other language that further defines the specific treatment an individual will get as a result of a specific claim.

The concerning issue here is that, just like current insurance providers can – and do –deny coverage for various things, it is reasonable to assume the Government will be no different.

In fact, it is also not a far stretch of the imagination to assume that Gov’t will be stingier with actual individual benefits.  The reasoning is simple:  Private insurance companies can make exceptions to policies and draw money from various funds, including its profit margin, to cover the costs if necessary.  The Gov’t, according to the Congressional Budget Office, will end up drawing more money than it has to support HR 3200.  This means there is NO profit margin for the Gov’t to draw from and therefore, it simply will not be able to fund many exceptions to policies.   In fact, it is safe to assume that given federal revenues over time, this HR 3200 reform will end up going bankrupt just as Medicare/Medicaid are on track to do.

So to recap this claim, strictly speaking, the claim is true, but as written it does not determine individual claim request.  But it is safe to presume there will be very tight Gov’t oversight on specific individual claims.

In the end, this claim is TRUE.

More to follow next week.  If you have any rumors you would like me research, drop me an email (I may miss it here).

Thanks,

Duster