I just finished reading another part of the HR 3200, the so named America’s Affordable Health Choices Act of 2009; aka, the Health Care Reform Bill, that is currently winding it’s way through Congress, and being torn asunder, and mended, on a minute-by-minute basis, online, and elsewhere .
Today I read Subtitle B, Section 123, Health Benefits Advisory Committee. The stated purpose of this committee: “There is established a private-public advisory committee which shall be a panel of medical and other experts to be known as the Health Benefits Advisory Committee to recommend covered benefits and essential, enhanced, and premium plans.”
“Covered benefits” is the key word in this paragraph; this defines the whole Plan for all participants. The way I read it, if HR 3200 is passed, this committee will determine how the Plan operates, on a day-by-day basis. I don’t mean to imply that they will actually be involved in the details, but they establish the rules; they determine all of the benefits that will filter down to our own personal health care.
For example, and this is just an off-the-wall example, if they determine, in all their wisdom, that a 92 year-old man is too old for a heart valve replacement, then, that’s the final word; the old guy will die sooner. Their word is final.
So, this committee is a very powerful body, and, literally, will have the power to decide who lives, and who dies, and when that occurs.
Of course, such matters should be decided by the patient, and their doctor, and not by a dispassionate committee of strangers, most of whom are bean counters, and political appointees (see below). On paper, it may seem like a logical, and reasonable decision to deny treatment to the 92 year-old man, unless, of course, you are that 92 year old man who is still looking forward to playing with the grandkids for a few more years.
So, this committee is going to be very important to the future 
health care, and survival, of most of us; we will all be touched by it, in some way, whether it is due to our own health problems, or those of our friends, and relatives.
This committee consists of from 18 to 26 members, and is not oriented toward health care; it is made up mostly of individuals who are bean-counters (no offense, I am a bean counter, myself), and political appointees. I think Section 123 specifically requires at least one practicing physician be appointed to the committee, however, when you read the paragraph, the last sentence, which mentions the physician, it is so unreadable that it is hard to image what they really meant. It looks like they simply tacked-on the last sentence, as an after thought.
It is the sort of sentence that a first-grader would write before they learn proper grammar.
I know this sounds petty, and picky; but it’s not…. stuff like this introduces more confusion to an already complex bill, and it is important to know if there will be any physicians on this important committee. Besides, it’s not the sort of thing that should be in any legal document, let-alone such a massive Bill as this one
At best, this Section displays a certain shoddy work ethic, at worst, it demonstrates that this Bill is not about health care, it’s about saving money, first, with actual health care included as a second thought.
(I can image it, now, someone proof-read the copy, and said, hey, shouldn’t the committee include some kind of health care professional, like maybe a doctor ?
It’s hilarious… it must have been amateur night in the Congress when this bill was produced.)
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This committee, this gang of 26 that will affect our health care, on a daily basis, is only required to include one physician, (I think; it’s not clear for the reason already mentioned); I guess one out of 26 is not bad.
The committee includes:
1) Nine individuals who are not Federal employees, or officers, that are appointed by the President.
2) Nine more individuals who are not Federal employees, or officers, who are appointed by the Comptroller of the U.S., (who is appointed by the President). These are the bean counters.
3) And up to 8 additional individuals who are Federal employees, or officers, and who are also appointed by the President, and probably answer to the President.
I have no idea who these people are, except I would image that there are various Federal departments that will be involved in our health care; (perhaps the IRS, FBI, and the Justice Department, and the CIA, White House, etc; heaven only knows).
Essentially, all 26 members of the committee are there at the convenience of the President; he has the power to give, and to take away.
The President would be the single-most powerful individual when it comes to controlling our health care, and he will have an unprecedented power over the day-to-day lives of the American people; even more so than by appointing a Supreme Court Justice.
To coin his own phrase, President Obama would be the Health Care Czar.
Clearly, this much power should not be in the hands of a single person, including President Obama, or any President. He literally would have the power of life, or death, over a large segment of Americans.
Of the 26 members of the committee, he would have direct control over 17 members through his own appointments, and indirect control over the remaining nine members, because the person who makes those appointments, the Comptroller, is also appointed by the President.
This committee is clearly a political body, who’s policies, and procedures will change whenever a new President is elected, and especially when political parties change hands; it’ll be out with the old, and in with the new.
This committee, as proposed, is not a good idea, and I hope the Congress has the good sense, and the will, to modify this Section, and place the power where it belongs, in the hands of the people, and not the hands of the President.
I also think it would a good idea to charge the committee with finding ways to provide quality health care, at affordable rates, and not the other way around.
And that is just my opinion.
Spencer Holly
www.angrycalifornian.com
0044A
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OTHER RESOURCES
Download HR 3200 in PDF format, U.S. Government Printing Office
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This is Section 123, of Subtitle B, of HR 3200, America’s Affordable Health Choices Act of 2009.
Each line in the bill is numbered, and line numbers restart with each page.
PLEASE review Page 32, beginning on Line 4 to Line 9, and a see if you can understand what they were trying to say.
Page 30
11 SEC. 123. HEALTH BENEFITS ADVISORY COMMITTEE.
12 (a) ESTABLISHMENT.—
13 (1) IN GENERAL.—There is established a pri
14 vate-public advisory committee which shall be a
15 panel of medical and other experts to be known as
16 the Health Benefits Advisory Committee to rec
17 ommend covered benefits and essential, enhanced,
18 and premium plans.
19 (2) CHAIR.—The Surgeon General shall be a
20 member and the chair of the Health Benefits Advi
21 sory Committee.
22 (3) MEMBERSHIP.—The Health Benefits Advi
23 sory Committee shall be composed of the following
24 members, in addition to the Surgeon General:
Page 31
1 (A) 9 members who are not Federal em
2 ployees or officers and who are appointed by
3 the President.
4 (B) 9 members who are not Federal em
5 ployees or officers and who are appointed by
6 the Comptroller General of the United States in
7 a manner similar to the manner in which the
8 Comptroller General appoints members to the
9 Medicare Payment Advisory Commission under
10 section 1805(c) of the Social Security Act.
11 (C) Such even number of members (not to
12 exceed 8) who are Federal employees and offi
13 cers, as the President may appoint.
14 Such initial appointments shall be made not later
15 than 60 days after the date of the enactment of this
16 Act.
17 (4) TERMS.—Each member of the Health Bene
18 fits Advisory Committee shall serve a 3-year term on
19 the Committee, except that the terms of the initial
20 members shall be adjusted in order to provide for a
21 staggered term of appointment for all such mem
22 bers.
23 (5) PARTICIPATION.—The membership of the
24 Health Benefits Advisory Committee shall at least
25 reflect providers, consumer representatives, employ-
Page 32
1 ers, labor, health insurance issuers, experts in health
2 care financing and delivery, experts in racial and
3 ethnic disparities, experts in care for those with dis
4 abilities, representatives of relevant governmental
5 agencies. and at least one practicing physician or
6 other health professional and an expert on children’s
7 health and shall represent a balance among various
8 sectors of the health care system so that no single
9 sector unduly influences the recommendations of
10 such Committee.
11 (b) DUTIES.—
12 (1) RECOMMENDATIONS ON BENEFIT STAND
13 ARDS.—The Health Benefits Advisory Committee
14 shall recommend to the Secretary of Health and
15 Human Services (in this subtitle referred to as the
16 ‘‘Secretary’’) benefit standards (as defined in para
17 graph (4)), and periodic updates to such standards.
18 In developing such recommendations, the Committee
19 shall take into account innovation in health care and
20 consider how such standards could reduce health dis
21 parities.
22 (2) DEADLINE.—The Health Benefits Advisory
23 Committee shall recommend initial benefit standards
24 to the Secretary not later than 1 year after the date
25 of the enactment of this Act.
Page 33
1 (3) PUBLIC INPUT.—The Health Benefits Advi
2 sory Committee shall allow for public input as a part
3 of developing recommendations under this sub
4 section.
5 (4) BENEFIT STANDARDS DEFINED.—In this
6 subtitle, the term ‘‘benefit standards’’ means stand
7 ards respecting—
8 (A) the essential benefits package de
9 scribed in section 122, including categories of
10 covered treatments, items and services within
11 benefit classes, and cost-sharing; and
12 (B) the cost-sharing levels for enhanced
13 plans and premium plans (as provided under
14 section 203(c)) consistent with paragraph (5).
15 (5) LEVELS OF COST-SHARING FOR ENHANCED
16 AND PREMIUM PLANS.—
17 (A) ENHANCED PLAN.—The level of cost18
sharing for enhanced plans shall be designed so
19 that such plans have benefits that are actuari
20 ally equivalent to approximately 85 percent of
21 the actuarial value of the benefits provided
22 under the reference benefits package described
23 in section 122(c)(3)(B).
24 (B) PREMIUM PLAN.—The level of cost
25 sharing for premium plans shall be designed so
Page 34
1 that such plans have benefits that are actuari
2 ally equivalent to approximately 95 percent of
3 the actuarial value of the benefits provided
4 under the reference benefits package described
5 in section 122(c)(3)(B).
6 (c) OPERATIONS.—
7 (1) PER DIEM PAY.—Each member of the
8 Health Benefits Advisory Committee shall receive
9 travel expenses, including per diem in accordance
10 with applicable provisions under subchapter I of
11 chapter 57 of title 5, United States Code, and shall
12 otherwise serve without additional pay.
13 (2) MEMBERS NOT TREATED AS FEDERAL EM
14 PLOYEES.—Members of the Health Benefits Advi
15 sory Committee shall not be considered employees of
16 the Federal government solely by reason of any serv
17 ice on the Committee.
18 (3) APPLICATION OF FACA.—The Federal Advi
19 sory Committee Act (5 U.S.C. App.), other than sec
20 tion 14, shall apply to the Health Benefits Advisory
21 Committee.
22 (d) PUBLICATION.—The Secretary shall provide for
23 publication in the Federal Register and the posting on the
24 Internet website of the Department of Health and Human
Page 35
1 Services of all recommendations made by the Health Ben
2 efits Advisory Committee under this section.
END OF SECTION
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