President Obama's Heath Care plan
After all the broo haha that i've heard about the health care plan i thought the best thing to do was to sit down and read it myself. All 1008 pages. I've seen all kinds of interesting misinformation pass by my email box and I had no idea idea if it was true or not and thought "Well, hey we live in interesting times. who knows!" I tried to pull out some interesting things and i also tried to address some of the remarks that have been passing by my email. And I will politely say to all parties. Give up the rhetoric and lets try to put something together that is viable and makes sense.
My impression of the entire bill is that it is very ambitious. And extremely verbose. Its like some one sat down and said "I'm going to fix all the wrongs and make them right." Very Don Quixote like.
So my biggest suggestion would be this. Lets do a few attainable things at a time. Lets say this year we're going to do this this and this. Make sure that takes and then move on and say "Cool! Well did that now lets do this!"
All the things the Secretary of Health would have to do they wold have to be superhuman and work about 42 hours a day. If I was the secretary of health i'd say "Hey Congress!!!! Hello hello are you kidding me?"
The whole first part is about plans that people get thru work and the difference between self insured and buying into a plan and congress is trying to make sure that if people deserve it they are covered thru their work and if they are covered that their bills are being paid.
NONDISCRIMINATION IN BENEFITS; PARITY IN
MENTAL HEALTH AND SUBSTANCE ABUSE
historically these benefits are very limited and the mental health community has been fighting for years for equal benefits. The issue here is that because of the discrimination psychiatric hospitals have had to be much more efficient in their treatment which is not necessarily a bad thing. Having treatment plans and outcomes is nothing new and historically there has been a lot of abuse and waste in this area.
I'm for parity. I'm a psychiatric nurse. I'm for excellent mental health care for all who need it. I think parity is so important it should be a separate bill onto itself passed on "mental Health" day and that day should be used to educate the public on mental health issues and congratulate the people who have fought for this over the years. We've come a long way from drilling holes in people heads to let the spirits out and insulin shock and what else we used to do. Its really a cause for celebration. I'm also for objective and critical pathways and a decent nurse-patient ratio so people can get the care they deserve. We've been fighting this battle for years. Its a very big deal.
Health Benefits Advisory Committee
A committee of experts that recommend stuff. Define expert for me. Please.
We already have this in "The Joint!" (Joint Commission JACHO) and in our state we have people that come around and do the same thing. Another layer of experts with an opinion.
This committee does not receive a salary and are not part of the federal government -they do however receive a perdium for their expenses and its not their job to be reading peoples charts its their job to make recommendations.
These people are not taking health care choices away from doctors and patients they are simply there to make general recommendations about various conditions.
There are appeals and in fact there are consumer protections in there for those appeals to protect the patient and not the insurance company.
i don't understand the health care exchange is? Maybe someone can explain that to me.
Individual rights and remedies under State laws shall apply.
This whole thing about electric funds is actually to protect the consumer so they will know how much they have to pay and bring rural areas up to speed.
All data is still protected under the existing HIPPA regulations (which no one understands and we just all copy everyone else's HIPPA forms and tell the patient to read it and sign it and please don't me any questions. Because as health care workers we are all trained in understanding that patient information is confidential and I still see patient sign in sheets in every doctor's office I go to.
CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS
This is so people can actually understand their treatment plan and make intelligent decisions.
This actually basic training for health care workers to understand different cultures and act accordingly.
EMPLOYMENT TAXES ON EMPLOYERS NOT PROVIDING ACCEPTABLE COVERAGE
Yes its true but the standard that the employer has to provide is not that stringent
and it goes back to states right just asking the states to organize themselves.
The Secretary shall design and implement the payment
mechanisms and policies under this section in a manner that
(1) seeks to improve health outcomes; reduce health disparities (including racial, ethnic, and other disparities); provide efficent and affordable care; address geographic variation in the revision of health services.
NO FEDERAL PAYMENT FOR UNDOCUMENTED AlIENS.
So my question is -who pays? Someone has to pay? This is not a political statement. Its a perfectly valid question. A pregnant woman who is undocumented shows up in your emergency room. You can't deny her treatment. Someone needs to pay. So Who pays?
EC. 401. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE
HEALTH CARE COVERAGE. this i don't understand. Someone does not have the money to pay for health insurance so we're going to have them pay money?
EXCESS READMISSION RATIO
i think is looking at the reason people are getting readmitted - i think they are trying to put the onus on the hospital for doing their job and on post acute services like nursing homes and home health to do their jobs but I have no idea where this is coming from.
There seems to be huge amount of micromanagement and paper work! Yikes. I'm all for numbers. Numbers are important. But who is going to do it? And what does that take away from patient care.
COMPARATIVE EFFECTIVENESS RESEARCH
A whole new thing. Isn't this what they do at NIH?
I didn't see any thing about forced hospice counseling for seniors. Or acorn being deputized to sign up people "on the new socialist" healthcare plan or even anything about forced euthanasia (Welcome to the Monkey House!)
I saw lots of numbers --big numbers - and no one is saying how its all going to get paid for. There is a lot of good stuff about prevention and wellness.
I think who ever put this together had their heart in the right place but I've got to say if I presented this to my Boss as my strategic plan he'd throw me out on my ear and tell me not to come back until I had something realistic.
My best advice is if you have any questions or if some of the accusations seem a bit too wild- read it yourself and make your own mind. and my best advice would be to do this.
1. Create Parity and let AMI have its day in the sun and use that day to educate the public in mental illnesses.
2. Get rid of the duplication of services like COMPARATIVE EFFECTIVENESS RESEARCH and create this within the National Institute of Health if its not already there.
3. Have a sit down with JACHO - they are already on the ground and let them do their thing.
So thats that and I invite comments and more information so I can pass it a long to my friends and patients.
All this talk of health care reform made me nostalgic for my friend Dr Albert Robbins the subject of my first documentary called the "Musician Physician" Since my film was placed on UVU (Thanks you guys!) it played at the Delray Beach Film Festival, portions played on Mia Lorenzo's show and Dr Robbins was voted "The Best of Ft Lauderdale." Nice!
One of the songs he wrote and I featured in my Doc was "We The Doctors." At the time George Bush was president and he dedicated this song to the next President of the United States. So you could say "Hey President Obama this ones for you!"
Here is the Trailer and I'm including the links. It all still stands today.
Produced and written by Cyndi Lenz
Edited by Adam and Cyndi Lenz (Tx Adam!)