(cross-posted at Quadsville.com in Dr Dx's Blog)

Under HR 3200, uninsured individuals and small businesses
that can’t afford decent health insurance for their employees will purchase
either a private or public insurance plan at the Health Insurance Exchange. The
private plans and the public plan will be regulated and standards will be set
for a minimum level of benefits that must be provided. This is important
because right now the individual market is full of “junk insurance” that
doesn’t provide adequate benefits. People often don’t realize they have junk
insurance until they get sick and get stuck with the bills. I wrote a post at
BlogforIowa.com on the problem of underinsurance based on a study published in Consumer Reports in May 2009. It seems that this definition of what constitutes a reasonable minimal level
of coverage has morphed into “your health care will be rationed!”

Speaking of rationing, do any of you have private insurance?
Does it cover every procedure and test your doctor orders? It is very common
for private insurance companies to “ration” care by denying payment for things
they deem unnecessary, no matter what you or your doctor thinks. If we want to
control costs, this type of rationing may be unavoidable. Although HR 3200
provides some additional regulation of private insurance companies, it doesn’t
prevent them from continuing this type of rationing. So if you are concerned
about rationing, maybe you should be pushing for laws to prevent private insurance
bureaucrats from coming between you and your doctor.

 ~Dr Dx

************

Here are some of the false claims regarding rationing or
determination of benefit packages made about the House bill, HR 3200 (you can
read the full text of the bill here).
The Truth comes from Health Care for America Now, one of the lead coalition groups fighting for health care reform. 

“Page 29: Admission: your health care will be
rationed!”

TRUTH: Page 29 continues to define the “essential
benefits package” and discusses limits on what Americans will have to
spend on health care under this minimum standard. In no way does this section
stipulate the rationing of care.

“Page 30: A government committee will decide what
treatments and benefits you get (and, unlike an insurer, there will be no
appeals process)” 

TRUTH: Page 30 begins to describe the Health Benefits
Advisory Committee which establishes certain minimum standards for health
insurance plans. In no way does this committee deny treatments and benefits to
Americans with health insurance.

“Page 42: The 'Health Choices Commissioner' will decide
health benefits for you. You will have no choice. None.” 

TRUTH: Page 42 begins to describe the Health Choices
Commissioner's duties. The idea that this person will decide what benefits
Americans receive is patently false, given that most Americans will keep their
current plans under reform, and Americans within the exchange will have the
choice of purchasing many different kinds of health plans. Rather, the
Commissioner will establish minimum standards to protect Americans.

“Page 272: Cancer patients: welcome to the wonderful
world of rationing!”

TRUTH: Over usage of the hot-button word
“rationing” is a way to deflect attention away from the actual
language of the bill and incite unjustified fear.  This section only
compares costs incurred by cancer hospitals to costs incurred by similar
hospitals, and adjusts payments to reduce the possibility of fraud and abuse.

“Page 335: Government mandates establishment of
outcome-based measures: i.e., rationing.” 

TRUTH: This provision is included in order to allow the
government to base payments on practices that work.  Nowhere does it say
health care will be rationed.  The attempt to isolate what works and what
does not work in Medicare Advantage plans only benefits the health care system
in general.

“Page 354: Government will restrict enrollment of
SPECIAL NEEDS individuals.” 

TRUTH: This section only deals with how to handle special
needs individuals who need to enroll outside of the open enrollment
period.  Almost every type of plan operates with open enrollment
periods.  This section does not create more restrictions.

Find Dr Dx right here on Blog for Iowa every afternoon for the next couple of weeks.