atients and doctors should make personal medical decisions. That’s a fundamental principle of the ongoing health care debate with which nearly every American agrees. But the House Democrats’ government takeover of health care paves the way for something quite different: it would allow government bureaucrats to intercede and make decisions for patients and their doctors. That limits choices for patients and reduces overall quality of care. Is a new layer of federal bureaucrats what middle-class Americans already fed up with health care bureaucracy really want? House Republican Leader John Boehner (R-OH) says no:
“A relationship between a patient and his or her doctor is one built on trust and honesty. Placing a government bureaucrat in the middle of that relationship undermines it and limits choices for patients and their families. That’s not ‘reform.’ That’s a prescription for declining quality of care. Republicans have offered a better solution that expands Americans’ access to affordable care and keeps patients and doctors in charge of personal medical decisions. Democrats should shelve their government takeover of health care and work with us on a plan that delivers the reforms Americans expect.”
A detailed analysis of the Democrats’ government-run plan makes clear how bureaucrats will limit choices for patients:
- Page 97; Section 205 – The bill requires the “Health Choices Commissioner” to automatically enroll exchange-eligible individuals into a government sanctioned plan with rationed care. The bill says the Commissioner may enroll people in to plans through a “random assignment.” In reality, the Commissioner has every incentive to enroll people into the government-run plan. Since the Commissioner can auto-enroll Exchange eligible individuals who have not elected coverage to any plan in the Exchange, this provision is a de facto method for signing millions of Americans up for the government-run plan.
- Page 102; Section 205 – The bill requires that the Commissioner enroll Medicaid eligible individuals who have not elected to be part of the program into Medicaid.
- Page 115; Section 208 – The measure allows states to establish their own exchange or join together with other states in a multi-state exchange. The bill, however, also gives the Commissioner the authority to tell states what their state or multi-state exchanges can and cannot do.
- Page 128; Section 241; Page 740; Section 1701 – The bill expands Medicaid eligibility to all individuals up to 133 percent of poverty and “low income” subsidies can go to a family of four making more than $88,000. This will shift even more Americans onto the government rolls.
- Page 424-430; Section 1233(a)(1)(B) – One troubling provision of the House bill makes available to seniors a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care. The sessions cover highly sensitive matters such as whether to receive antibiotics and “the use of artificially administered nutrition and hydration.”
- Page 16; Section 102(a)(2) – The bill pays lip-service to allowing individuals to remain in the “grandfathered” private plans, but the requirements to qualify for the grandfathering are so stringent, they will soon force individuals into the government-run health plan. As soon as anything changes in the plan – such as a change in co-pay or deductibles or even added benefits or coverage of a new life-saving drug or treatment, which many insurers change every year – you will be forced out of that coverage and be forced into a government-approved qualified plan instead.
- Page 146; Section 312 – The bill not only requires employers to provide coverage for their employees that the government deems “acceptable” but it also requires that employers pay for a specific amount of the employees’ premium costs – 72.5 percent for individual plans and 65 percent of family plans – or pay a new eight percent tax.
- Page 9; Section 100(c)(6) – The measure defines “employment-based health plan” as including governmental plans, which includes TRICARE. It then provides a five-year grace period for current employment-based health plans (section 102(b)(1)(A) (page 17) before the plan has to meet the requirements of a qualified health benefits plan under section 101. Section 101 requires qualified health benefits plans to meet the requirements of subtitle B (relating to affordable coverage), subtitle C (relating to essential benefits), and subtitle D (relating to consumer protection). This means that the bill would subject TRICARE to any future requirements on employer-based health plans.
- Pages 26-27; Section 122 – The bill requires government-approved benefits be equivalent to average prevailing employer coverage. By requiring that the future “essential benefits package” of any “qualified health benefits plan” include benefits equivalent to the current prevailing average employer-sponsored coverage, this section necessarily raises the average scope of health benefits covered by future health plans. Businesses will not be free to vary the mix of benefits available to determine which ones help attract quality employees; instead, they will be forced to offer a certain minimum level of health benefits regardless of the demonstrated preferences of their employees (for higher salaries in lieu of pricier health benefits for example).
Democrats appear poised to go it alone and pass their government takeover of health care with no bipartisan support. Don’t Americans deserve a strong patient-doctor relationship – one free of a massive government bureaucracy?