This Blog is created to stress the importance of Peace as an environmental directive. “I never give them hell. I just tell the truth and they think it’s hell.” – Harry Truman
(I receive no compensation from any entry on this blog.)
U.S. Defense Secretary Robert M. Gates, right, and Navy Adm. Mike Mullen, back right, chairman of the Joint Chiefs of Staff, exchange greetings with U.S. Ambassador to Mexico Carlos Pascual and Mexican officials after arriving in Mexico City, March 22, 2010. DoD photo by U.S. Air Force Master Sgt. Jerry Morrison
By Army Sgt. 1st Class Michael J. Carden (click title to entry - thank you) American Forces Press Service
WASHINGTON March 23, 2010
Top U.S. defense officials met with their Mexican counterparts in Mexico City today to strengthen the U.S.-Mexico military partnership in the fight against drug cartels there. Defense Secretary Robert M. Gates and chairman of the Joint Chiefs of Staff Navy Adm. Mike Mullen are in Mexico today as part of a U.S. delegation led by Secretary of State Hilary Clinton. U.S. Secretary of Homeland Security Janet Napolitano and Director of National Intelligence Dennis Blair also are part of the delegation.
The high-level talks are part of the Merida initiative, a partnership promised by President Barack Obama last year to help the region combat drug trafficking and related violence by the cartels. The three-year program provides $1.6 billion to fund drug-fighting initiatives.
The talks demonstrate the level of commitment the United States has in aiding Mexico in its struggle against the cartels and to impede the drug trade from crossing the border into the United States, Pentagon press secretary Geoff Morrell told reporters at a news conference here today....
Patti Muldowney of Manheim, Pa., took this underwater photo while she and her husband, John, were on vacation in Aruba in early October 2009. John Muldowney says he has a gut feeling that the picture may show the remains of Natalee Holloway.
Updated: 2 days 11 hours ago (March 20) -- Authorities in Aruba (click title to entry - thank you) said today they would launch a new search in the Natalee Holloway case after a Pennsylvania couple came forward with an underwater photo that they believe may show human remains.
Patti Muldowney snapped the image while she and her husband were snorkeling off the coast of Aruba.
"It would be great if this is Holloway, and her family could get the closure that's needed," 78-year-old John Muldowney told AOL News.
The photo was captured in October in about 15 feet of water, but the film was not developed until December, according to Muldowney. As they looked through the shots, Patti remarked, "'My God, this looks like a skeleton,'" he said. "And then we all looked and said, 'It sure does.' Our first thought then was that it was Natalee Holloway.'"...
Last Update: 3/21 10:00 am There's still no word from Aruban police authorities on what, if anything, a search for underwater remains has turned up. Initial reports said the island police would be searching this weekend.
The latest development in the Natalee Holloway disappearance was triggered by an underwater photograph taken by a vacationing Pennsylvania couple. Although the image is not distinct, some feel the photo shows skeletal remains.
Aruban authorities said they would dispatch a dive team to what they think is the site...which the Pennsylvania couple could not pinpoint....
The law that is cited is at the link I have above. That is the law that is amended.
‘SEC. 2794. ENSURING THAT CONSUMERS GET VALUE FOR THEIR DOLLARS.
The Health Care Reform Act is blind to the past. Does everyone understand that? Writing this law, the legislators took 'the need' of the people of the USA and wrote what would 'construct' good law.
While there are provisions that will allow citizens to keep their medical insurance as it exists today, it is because the provisions work through the 'existing' health care insurance infrastructure.
But, the law as it is written starts from scratch to construct the new FUNCTIONAL infrastructure from the old dysfunctional infrastructure. They aren't destroying it and starting over. They put the health of the nation first in knowing that there has to be an infrastructure to uphold the needs of the people, while molding a more functional design that RESTRAINTS exploitation, abuse and negligence.
So, some of this may seem silly to some folks, but, it is necessary to 'establish' a solid foundation to the new infrastructure.
‘(a) Initial Premium Review Process-
Here again, the rights of the states is considered and the State Regulators are still in place. No one has removed them. They are still there doing their work. This is authority to begin to build a relationship with the federal government to tighten up the health care insurance industry to best serve the people. There will be regional differences that will emerge. The people of the industrialized northeast will have different and similar health concerns than those of the agricultural midsection of the country. There is a chance the price infrastructure may emerge in some differences as well. This is NOT a method to 'homogenize' the country or exploit one region for another. It is a method to 'best serve' the citizens to be sure they have 'reasonable costs' to their health care.
The Republicans always scream one has to cut taxes to grow business. Well, what also grows business is an equitable distribution of the income of Americans. While Americans have monies to spend and should do it well there are some realities to that spending that comprises an economy.
If I may.
There are basic needs citizens have. Education, housing, food, health care, etc. There are choices within those NEEDS that comprise its own economy. BUT. There is also the economy that is 'DISPOSABLE INCOME.' Those are the choices that are somewhat fluid, such as, vacations, electronics, furniture, cosmetics, clothing above that what is necessary to function in life, etc.
All those 'parts' of the economy are vital. There is not one more important than the other WHEN the USA economy is 'happy.' Right now the USA economy is not a happy economy, it is a bit contracted and worried about the future, so it is reserving judgment on spending on items that are a bit unnecessary.
When citizens are unsure about their future there will be less spending in areas of 'interest' vs. need. What will occur with this Health Care Reform Bill is that people will be able to discern what the necessary aspects of living will cost and will be able to build a budget for items that are disposable in their concept. The fun things of life, such as, vacations, etc. So, to realize what this bill will do and how it will not only contribute to a citizens best interest in being well and able to work and able to better enjoy a higher quality of life, it will also make income and expenses more predictable.
With all that said, the economy should expand and become more varied in its dynamics. That is a good thing. Variability in dynamics is directly related to 'growth.' A lot to consider and think about.
But, to return to THE LAW. It is no longer a bill.
‘(1) IN GENERAL- The Secretary, in conjunction with States, shall establish a process for the annual review, beginning with the 2010 plan year and subject to subsection (b)(2)(A), of unreasonable increases in premiums for health insurance coverage.
‘(2) JUSTIFICATION AND DISCLOSURE- The process established under paragraph (1) shall require health insurance issuers to submit to the Secretary and the relevant State a justification for an unreasonable premium increase prior to the implementation of the increase. Such issuers shall prominently post such information on their Internet websites. The Secretary shall ensure the public disclosure of information on such increases and justifications for all health insurance issuers.
‘(b) Continuing Premium Review Process-
‘(1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS- As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall--
‘(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and
‘(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.
What does all that mean? It means citizens will be PROTECTED from draconian practices by companies that USE their enrollees as a means to profits, unreasonable profits. I already read where the insurance companies will be able to discern up to 20% profit margin in their bottom line. But, the companies that insist on having higher profit margins than what is reasonable to their enrollees in premiums will be eliminated as providers to citizens in 'the health care insurance exchanges.' That is good thing and for more than obvious reasons.
The exchanges as I understand them right now, will be where small businesses can go to join a pool of enrollees to receive good quality health care benefits without huge costs. They will be able to distribute their monies differently. They will be able to 'grow' their businesses, not through draconian tax cuts, but, by receiving better 'cost' vs 'income' to their balance sheets.
Do you see how this works? Just because tax cuts are valued by a 'segment' of the Right Wing does not mean it grows small businesses. If the 'costs' to small businesses aren't contained, there is no 'guarantee' the businesses will grow.
Quite literally, what can occur is that tax cuts provide 'tax relief' to small businesses, but, if they have skyrocketing costs in health care premiums where does the growth go? To economic growth in the country or to Wall Street profits? I really don't think I have to answer that question. And where is the growth of the nation best served? In Wall Street stockholder profits OR in the growth of small businesses and higher variability in the economy? And where will GROWTH be best served, in Wall Street stockholder profits or in small businesses in the country?
‘(2) MONITORING BY SECRETARY OF PREMIUM INCREASES-
‘(A) IN GENERAL- Beginning with plan years beginning in 2014, the Secretary, in conjunction with the States and consistent with the provisions of subsection (a)(2), shall monitor premium increases of health insurance coverage offered through an Exchange and outside of an Exchange.
This is a little complicated in that it is a dynamics of 'decision making' by two sovereign entities and it is intricate. First there is cooperation established in the law between the federal and State authorities. Each has rights in the relationship. The wording strongly indicates this relationship between these two sovereign authorities is cooperative in nature. However, it can change should the relationship become tainted with corruption or adverse outcomes to the States citizens.
The law requests the States to monitor costs of PREMIUMS, not the intricacies of CEO decisions with the companies. The law is clear that this does not control companies. It, however, through its strong interest in the citizens will maintain an interest of the impact of the premiums on that aspect of the business dynamic.
It is establishing, from a somewhat blind perspective, the best relationship between business and the peasants. Sorry, it is the way I see it. Peasants are different from citizens. Peasants are something that is controlled by the company. Peasants are an ownership issue as if the company can do what they want when they want it. The relationship of the citizen with the government is different. Citizen is participatory.
I am going to go on a tangent here. If one recalls the 'up tick' of patriotic symbolism by 'advertising' post Bush/Cheney of 2002, it becomes obvious how businesses pander to citizens to attract their 'value' to their profit margin. That is all I am going to say to entertain the imagination about the difference.
Back to the law. I can't help myself here. Companies are NOT patriotic. Ask the auto workers. "Roger and Me." There is no loyalty to them. However, there is a strong relationship of loyalty between government and citizens. No one can tell me the investment banks gave a darn about the citizens of the country when they through their peasants to the wolves in October of 2008. End of that.
Now, back to the law.
‘(B) CONSIDERATION IN OPENING EXCHANGE- In determining under section 1312(f)(2)(B) of the Patient Protection and Affordable Care Act whether to offer qualified health plans in the large group market through an Exchange, the State shall take into account any excess of premium growth outside of the Exchange as compared to the rate of such growth inside the Exchange.
Okay, so there is some fluidity in decision making. When a State sets up an exchange (and this is where a Public Option plays a heavy roll and I'll get into that. I'll 'weigh' it pro and con.) there is to be monitoring of the premiums inside the exchange and outside the exchange. If the cost of premiums are better outside of the exchange AND availability is to all the participants in the exchange there is little reason to continue that exchange.
There is a 'real chance' that the health care insurance industry MIGHT recover from its slide into higher prices with the requirement of all citizens to carry their own coverage. That is a good possibility and I would not under estimate that potential.
HOWEVER,there is also the possibility that they may only continue to 'self protect' and not involve themselves in the exchanges and continue to find their own way and continue to self destruct (as far as I am concerned) with continually rising premiums.
In both those dynamics lies success for the Health Care Reform Law. If the insurance companies move away for very silly priorities by having a better cash flow then the law will have served the best possible outcome from the perspective that the 'economic integrity' that is valued by so many citizens as unique to Americana actually does work when government is involved to protect citizens and their economies. That is best case scenario.
Worst case scenario is that the insurance companies are irretrievably broken. They will be unable to recover AND provide services to their peasants. The question as to whether they have found a way to still serve their stockholders is up to them to answer, but, that is not the PURPOSE or focus to the law.
The purpose and focus of the law is to protect citizens from exploitation and provide a reasonable cost to health care insurance so they can have high quality lives and DON'T DIE due to Health Insurance Decisions that don't care about peasants. We all know the way the health insurance companies make profits is to raise premiums while cutting services AND eliminating ill peasants.That methodology causes a vicious cycle of escalating costs that are perpetuated by the insurance companies as it relates to the health care DELIVERY infrastructure, i.e. Emergency Rooms, bankruptcies, etc..
So, if that occurs and the insurance companies can't survive even in a 'hyper-optimum' cash flow cycle, in my opinion, then here is the Public Option waiting in the wings and why it should be there as a TRIGGER to failure of this very supportive law to health care insurance companies.
Now, remember, the insurance companies and their CEOs are not controlled by the law. They could literally design the exchanges to fail, followed by the return to draconian practices that will put the citizens back where they were before the law 'set up' the exchanges.
What could occur if the health care insurance companies completely fail and/or return to exploitive practices is the 'federalization' of health care and then the citizens of the country are looking at a Single Payer System. That would be necessary to serve the citizens. It would be absolutely necessary and Homeland Security should have in place a method for that to occur.
A Homeland Security methodology would be emergency distribution of monies from the treasury to pay the health care infrastructure to immediately implement Singer Payer. It is why it is best to work on the deficit and return a 'buffer' of functionality to the USA Treasury.
Now, why the Public Option could best be left out of the picture is that WITHOUT it, the health care insurance companies could recover on their own and literally provide a service at a cost that the Public Option might not be able to compete with. That is what I am hoping happens, SO LONG AS, all the citizens are covered and receiving care.That is also why a Public Option should at least exist in paperwork somewhere so that it is not a foreign entity to the understanding of the government should all else fail.
The idea that a Public Option should compete with Private Insurance is still THE BEST option to any scenario at all. It would be in place and available and act as a lever against ANY exploitive 'plan' or 'practice' by private health care insurance companies.Could the Public Option actually do damage to health care insurance company recovery? Not likely. However, could the Public Option be make to look 'as a fool?' Absolutely. That is why I believe it should be written in as a trigger to an event in case it is needed by citizens and they aren't getting the relief they need and deserve.
The other consideration is that with controlled costs to the citizens and their small businesses what does GROWTH look like and is the economy recovering as well? In that case, the Public Option is a necessity to achieve an end.
Companies and Corporations don't have conscience, the people that run them do. It is why the Robert's Court decision regarding corporations as if a citizen is so completely hideous. In reality the decision was to allow 'the plutocracy experiment' to begin.
‘(c) Grants in Support of Process-
‘(1) PREMIUM REVIEW GRANTS DURING 2010 THROUGH 2014- The Secretary shall carry out a program to award grants to States during the 5-year period beginning with fiscal year 2010 to assist such States in carrying out subsection (a), including--
‘(A) in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage; and
‘(B) in providing information and recommendations to the Secretary under subsection (b)(1).
The exchanges are vital to containing the health care insurance costs without the Public Option in place. The federal government is offering grants to states and territories of the USA in order to assist in setting up the monitoring and the establishment to the infrastructure of the exchanges beginning in 2010. Without monitoring there won't be any way to enforce the law. This is all necessary and vital.
‘(2) FUNDING-
‘(A) IN GENERAL- Out of all funds in the Treasury not otherwise appropriated, there are appropriated to the Secretary $250,000,000, to be available for expenditure for grants under paragraph (1) and subparagraph (B).
$250,000,000 US. That isn't much considering all the work the citizens of the country is getting in return. Not only that it will serve to expand the tax base when new jobs erupt due to the expansion of the agencies that will carry out this law.I remind, the USA is a huge country with 50 States and multiple territories and 300 + million citizens.
‘(B) FURTHER AVAILABILITY FOR INSURANCE REFORM AND CONSUMER PROTECTION- If the amounts appropriated under subparagraph (A) are not fully obligated under grants under paragraph (1) by the end of fiscal year 2014, any remaining funds shall remain available to the Secretary for grants to States for planning and implementing the insurance reforms and consumer protections under part A.
‘(C) ALLOCATION- The Secretary shall establish a formula for determining the amount of any grant to a State under this subsection. Under such formula--
‘(i) the Secretary shall consider the number of plans of health insurance coverage offered in each State and the population of the State; and
‘(ii) no State qualifying for a grant under paragraph (1) shall receive less than $1,000,000, or more than $5,000,000 for a grant year.’.
The above provisions are simply the 'mechanics' of the law to issue grants. It is fairly straight forward and the only question is what will the 'formula' look like. I am not venturing a guess, nor should anyone else. Like I said, each State is a sovereign authority with a unique relationship with the Federal government in this law. I'm not going to try to guess what the Secretary sees as a necessary formula to that relationship.
SEC. 1004. EFFECTIVE DATES.
(a) In General- Except as provided for in subsection (b), this subtitle (and the amendments made by this subtitle) shall become effective for plan years beginning on or after the date that is 6 months after the date of enactment of this Act, except that the amendments made by sections 1002 and 1003 shall become effective for fiscal years beginning with fiscal year 2010.
(b) Special Rule- The amendments made by sections 1002 and 1003 shall take effect on the date of enactment of this Act.
That is also very straight forward. I believe the 'special rule' provision is being addressed with the Reconciliation Act of 2010 that is currently before the USA Senate.
I'm going to end here for today regarding the new law.
There is a series of meetings to help decide how to prioritize the crisis. I believe the country cannot afford to ignore the crisis of this library. (click title to entry - thank you)
As part of the ongoing public process, four community meetings and one online meeting will be held in March and April in order to collect feedback on library services. The dates, times, and locations of these meetings are:
Saturday, March 27, at Harborside Community Center , 10:00-11:30am 312 Border Street in East Boston Interpreter: Spanish
Saturday, April 3, at Codman Square Branch Library, 2:00-3:30pm 690 Washington Street in Dorchester
Monday, April 5, at Honan-Allston Branch Library, 6:00-7:30pm 300 North Harvard Street in Allston
Tuesday, April 6, at Curley Middle School , 6:00-7:30pm 493 Centre Street in Jamaica Plain Interpreter: Spanish
Wednesday, April 7, at www.bpl.org (online moderated chat) 6:00-7:30pm.
Additional special meetings of the Board of Trustees will also occur:
Wednesday, April 7 in Rabb Lecture Hall, Central Library in Copley Square, 8:30am
Friday, April 9 in Rabb Lecture Hall, Central Library in Copley Square, 8:30am
"W"rong again. Just because these Governors are embarrassed they didn't take proper care of their citizens doesn't mean they can simply IGNORE the need.
Article One, Section 8, Clause 18 of the USA Constitution explicitly states, that the federal government has the right to render law when it isNecessary and Proper.
To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.
The States have neglected their citizens with the exception of Massachusetts and now they are all scrambling to cover their butts.
TOO BAD !!!!!!!!!!!
How many dead peasants are enough for them?
I want them to answer that question. When these news people talk to the politicians ask they how many dead peasants are enough for them before they finally pass a health care reform bill? Jerks !
They need to withdraw their complaints and deal with the issues within their States if they want to promote their own politics. This issue is CLOSED, except for implementation.
...BJ Services Co. acknowledged in January 2008(The EPA under Bush) to investigators from the House Oversight and Government Reform Committee that it had violated a 2003 agreement not to use diesel in specific types of hydraulic fracturing. When that was disclosed last month, a BJ Services executive said that the company had "self reported" the violation to EPA.
But EPA says the company never told agency officials. And documents show the company has twice since then told the environmental agency that it has always been in compliance with the agreement....
"BJ Services continued through January to tell us they had not" used diesel in fracturing, said EPA spokeswoman Enesta Jones....
WASHINGTON - In a speech today at the Association of Metropolitan Water Agencies (AMWA) annual conference in Washington, D.C., U.S. EPA Administrator Lisa P. Jackson announced the agency is developing a broad new set of strategies to strengthen public health protection from contaminants in drinking water. The aim is to find solutions that meet the health and economic needs of communities across the country more effectively than the current approach. EPA is also announcing a decision to revise the existing drinking water standards for four contaminants that can cause cancer.
"To confront emerging health threats, strained budgets and increased needs -- today's and tomorrow's drinking water challenges -- we must use the law more effectively and promote new technologies," said EPA Administrator Jackson. "That means fostering innovation that can increase cost-effective protection. It means finding win-win-win solutions for our health our environment and our economy. And it means broad collaboration. To make our drinking water systems work harder, we have to work smarter."...
LA PAZ, March 23 (NNN-PRENSA LATINA) – Bolivia began celebrations of the World Water Day established by the United Nations N 17 years ago with a call the rational use of water.
According to the Minister of Environment and Water María Esther Udaeta, a Water Fair will also be held in La Paz this weekend to attract the public, especially young people.
The United Nations (UN) choose ”Clean Water for a Healthy World” as theme for World Water Day this year, which sums up importance of supplying superior water to improve people’s health and living conditions....
Juliette Terzieff | Bio | 23 Mar 2010
As the United Nations spearheaded efforts to mark World Water Day on Monday, scarcity was at the top of the agenda. And with an increasing number of communities around the world lacking sufficient water supplies, the push to classify access to potable water as a basic human right is gaining ground among a variety of stakeholders....
‘(c) Standard Hospital Charges- Each hospital operating within the United States shall for each year establish (and update) and make public (in accordance with guidelines developed by the Secretary) a list of the hospital’s standard charges for items and services provided by the hospital, including for diagnosis-related groups established under section 1886(d)(4) of the Social Security Act.
‘(d) Definitions- The Secretary, in consultation with the National Association of Insurance Commissions, shall establish uniform definitions for the activities reported under subsection (a).
‘SEC. 2719. APPEALS PROCESS.
‘A group health plan and a health insurance issuer offering group or individual health insurance coverage shall implement an effective appeals process for appeals of coverage determinations and claims, under which the plan or issuer shall, at a minimum-- ‘(1) have in effect an internal claims appeal process;
‘(2) provide notice to enrollees, in a culturally and linguistically appropriate manner, of available internal and external appeals processes, and the availability of any applicable office of health insurance consumer assistance or ombudsman established under section 2793 to assist such enrollees with the appeals processes;
‘(3) allow an enrollee to review their file, to present evidence and testimony as part of the appeals process, and to receive continued coverage pending the outcome of the appeals process; and
‘(4) providean external review process for such plans and issuers that, at a minimum, includes the consumer protections set forth in the Uniform External Review Model Act (click here) promulgated by the National Association of Insurance Commissioners and is binding on such plans.’.
The Uniform External Review Model Act is being implemented as this bill becomes effective. Its purpose is to bring equity to all the appeal processes and hearing in regard to health care insurance. It is a good idea and brevity in that it takes review processes out of the hands of insurance companies that deny benefits to those Americans that need them. It will be an opportunity to weigh the benefits of 'value' and new technologies with investigative capacity to save lives as a component to value. It is necessary in today's Wall Street environment of draconian companies that view human beings as peasants as well as disposable people with families that will benefit from their life insurance rather than their HEALTH insurance.
The states have no room to complain. There will be additional funding to provide support to its citizens as the health care insurance transitions to a user friendly structure.
‘SEC. 2793. HEALTH INSURANCE CONSUMER INFORMATION.
‘(a) In General- The Secretary shall award grants to States to enable such States (or the Exchanges operating in such States) to establish, expand, or provide support for--
‘(1) offices of health insurance consumer assistance; or
‘(1) IN GENERAL- To be eligible to receive a grant, a State shall designate an independent office of health insurance consumer assistance, or an ombudsman, that, directly or in coordination with State health insurance regulators and consumer assistance organizations, receives and responds to inquiries and complaints concerning health insurance coverage with respect to Federal health insurance requirements and under State law.
‘(2) CRITERIA- A State that receives a grant under this section shall comply with criteria established by the Secretary for carrying out activities under such grant.
There is no reason for any State to ignore this opportunity to provide more support to their citizens in regard to health care insurance. There is not a case on record whereby State Regulators PREVENTED injury, deterioration or death of a citizen due to the draconian practices of the health insurance industry.This new law will provide every citizen with the opportunity to have health insurance and every State should rise to that directive and enforce the new standards.
The 'existing' review process through appeals is all contained within the health care insurance companies themselves and they have proven UNTRUSTWORTHY.
‘(c) Duties- The office of health insurance consumer assistance or health insurance ombudsman shall--
‘(1) assist with the filing of complaints and appeals, including filing appeals with the internal appeal or grievance process of the group health plan or health insurance issuer involved and providing information about the external appeal process;
‘(2) collect, track, and quantify problems and inquiries encountered by consumers;
‘(3) educate consumers on their rights and responsibilities with respect to group health plans and health insurance coverage;
‘(4) assist consumers with enrollment in a group health plan or health insurance coverage by providing information, referral, and assistance; and
This section is frequently accessed in bills other than health care reform to set appeal processes. This bill seeks sound content in existing law and the appeals process to health care with insurance companies are no different. These are procedures are familiar to corporate attorneys so the cost to any of this is negligible to an upstart. The corporations are now going to have to weigh their attorney costs along with providing care as they should to their peasants.
The down side to any of the appeal processes is that the peasant is suffering from illnesses that need attention NOW !
‘(d) Data Collection- As a condition of receiving a grant under subsection (a), an office of health insurance consumer assistance or ombudsman program shall be required to collect and report data to the Secretary on the types of problems and inquiries encountered by consumers. The Secretary shall utilize such data to identify areas where more enforcement action is necessary and shall share such information with State insurance regulators, the Secretary of Labor, and the Secretary of the Treasury for use in the enforcement activities of such agencies.
The above statute is quality control to focus on where appeals are mostly being conducted so the federal authorities can decide if the appeals are draconian and unnecessary to the peasants.
‘(e) Funding-
‘(1) INITIAL FUNDING- There is hereby appropriated to the Secretary, out of any funds in the Treasury not otherwise appropriated, $30,000,000 for the first fiscal year for which this section applies to carry out this section. Such amount shall remain available without fiscal year limitation.
$30 million US? That's all? Fine. Why do I especially feel like a peasant at this point?
‘(2) AUTHORIZATION FOR SUBSEQUENT YEARS- There is authorized to be appropriated to the Secretary for each fiscal year following the fiscal year described in paragraph (1), such sums as may be necessary to carry out this section.’.
This might be an improvement to the $30 million to initiate the quality assurance to the peasants in regard to their health care insurance.There are after all 50 states and other USA territories and native lands.
5 Reasons Republicans Should Let Go of Health Care (click title to entry - thank you)
I love that picture of the President and Vice President after the vote to the Reconciliation Bill. That is Vice President Biden and President Obama after the vote to the Reconciliation Bill was passed. President Obama spoke to the nation. Of course Vice President Biden will be near the Senate when the Reconciliation Bill comes to the floor for a vote.
The Republicans need to change their view of taxes. They always brag about how much they donate to charities. Well, they can think of their additional taxes as a social donation to the health of FELLOW Americans.
The Florida Attorney General, Bill McCollum has absolutely no case against the Health Care Reform Bill which he intends to file a petition to declare it unconstitutional law as soon as it is signed. He stated that the bill is allowing a commerce of taxes and regulation where none exists and does not provide services. He PROTECTED the mandatory car insurance bill the State of Florida has by stating there is an 'exchange' of goods in demanding insurance for all motorists because people have the 'pleasure' of driving their car.
He went on to say the federal health care bill is like saying someone in their easy chair at home is actually engaged in commerce where there is no good exchanged. Right. The argument doesn't hold water. The highest level of bankruptcies occur over health care bills. There is plenty of use of homes in the USA that go to foreclosure due to health care costs. He doesn't have an argument. So while that Florida man is sitting in his 'easy chair' in his home without engaging in health care, there is some point in time when he will need it and seek it and might require it if in an accident with his car, but, it will also keep him sitting in that easy chair in his home.
The size of the document is amazing to most who view it. It is significant. It is also sadly unfortunate the bill has to achieve that volume to mandate regulation of the unthinkable in the USA by the health insurance industry.
‘SEC. 2718. BRINGING DOWN THE COST OF HEALTH CARE COVERAGE.
‘(a) Clear Accounting for Costs- A health insurance issuer offering group or individual health insurance coverage shall, with respect to each plan year, submit to the Secretary a report concerning the percentage of total premium revenue that such coverage expends--
The health care insurance companies have to had the Secretary of Health and Human Services a spread sheet of costs and benefits vs. profits for 'each plan year.'
‘(1) on reimbursement for clinical services provided to enrollees under such coverage;
‘(2) for activities that improve health care quality; and
(3) on all other non-claims costs,including an explanation of the nature of such costs, and excluding State taxes and licensing or regulatory fees.
The Secretary shall make reports received under this section available to the public on the Internet website of the Department of Health and Human Services.
‘(b) Ensuring That Consumers Receive Value for Their Premium Payments-
‘(1) REQUIREMENT TO PROVIDE VALUE FOR PREMIUM PAYMENTS- A health insurance issuer offering group or individual health insurance coverage shall, with respect to each plan year, provide an annual rebate to each enrollee under such coverage, on a pro rata basis, in an amount that is equal to the amount by which premium revenue expended by the issuer on activities described in subsection (a)(3) exceeds--
In other words, the Secretary of Health and Human Services will review the balance sheets of the insuring companies and determine they have made a ? reasonable ? profit WITHOUT exploitation of costs. Once that profit is realized for each company there will be a determination to the EXCESS of monies paid by the enrollees to provide their care. There is a great deal of incentive to enrollees here as well. The incentive is to stay well and achieve wellness to the extent their physical conditions allow it. If their insuring companies have monies that are in excess of costs and profit then that is to be refunded to the enrollees as a rebate for each 'benefit year.' There is a strong incentive for insurers to 'get it right,' because, to issue checks whenever a benefit year is ended is an additional expense to enrollees and stockholders. They also don't want to get caught with their hand in the 'till and referred by the Secretary to the Justice Department for further investigation.
I really don't expect to hear any criticism about this either, as the health care industry has been corrupt to the core. There was testimony from within their own corporate structure as to how they played god in determining life and death of peasants. End of discussion.
‘(A) with respect to a health insurance issuer offering coverage in the group market, 20 percent, or such lower percentage as a State may by regulation determine; or
The bill makes room for States. There is absolutely no reason for any State to have a court action.
The percentages are generous to the amount the companies can keep in their coffers over and above operating costs. It would be wise to for the State Regulatory Agencies to monitor the compliance with a mandate to maintain health insurance coverage. The reason being that if the costs are too high as opposed to the 'value' they deliver there will higher non-compliance, people will suffer and the cost to the State and Federal government will escalate while the savings to the country will be hurt.
‘(B) with respect to a health insurance issuer offering coverage in the individual market, 25 percent, or such lower percentage as a State may by regulation determine, except that such percentage shall be adjusted to the extent the Secretary determines that the application of such percentage with a State may destabilize the existing individual market in such State.
Some of the more angry lords and ladies of the Republican Right Wing are stating they will sell their shares in the companies that insure the country and/or have unions. They akin it similar to the boycott of apartheid. Imagine that Desmond Tutu and Nelson Mandella has boycotting American Health Care Reform. The Right Wing ANYBODY are legitimately 'wackos.' If they boycott go right ahead. It is more stock futures for the rest of us to own and from the look of the insurance stocks these days, I doubt anyone is giving it up.So, for those that want to sell their stocks in companies that have unions, go ahead, do it today ! Don't wait not one more day.The peasants are longing to purchase your shares.
(2) CONSIDERATION IN SETTING PERCENTAGES- In determining the percentages under paragraph (1), a State shall seek to ensure adequate participation by health insurance issuers, competition in the health insurance market in the State, and value for consumers so that premiums are used for clinical services and quality improvements.
This sets up parameters the States need to comply to in order to issue different percentages. It requires participation by the public to add to the dynamics the State Regulators will issue law.
‘(3) TERMINATION- The provisions of this subsection shall have no force or effect after December 31, 2013. After that date the laws begin on January 1, 2014.
A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves. At the beginning of this process we made a strategic decision:...
The Republicans always treat the electorate as if they are manipulative 'head cases.' Peasants.Why bother educating them?
That statement by David Frum, a Canadian American conservative journalist active in both the United States and Canadian political arenas, is correct. The party of 'No' did make a strategic decision. To 'kill the bill' was to sink the Obama Presidency. We heard it over and over again. The Republicans CHRONICALLY place themselves FIRST POLITICALLY before the needs and best interests of the American people. All the time. They don't care about people. They care about money and that does not always equate to the best outcome of 'the peasants.'
In Arizona the State Income Tax is among the lowest in the nation, yet, they are chronically complaining about the cost of illegal immigrants on their health care system and the cost of maintaining State Parks. They have gone so far as to continue to ignore their MORAL OBLIGATION by paying 'enough' State Income Tax to support their responsibilities including the heritage to precious places of nature in their State Parks.
Arizona has the MOST draconian Senators in the country and the most extreme. If the citizens of Arizona were to add a half a percent to their State Income Tax their problems would be solved and their complaining would end. Will they do it? No, they'll wait for the federal government to recognize the problems they face and intervene. What should occur is the federal government should see the neglect of the State government to GOVERN and take them to court to do the right thing for their children.
So, if the Republicans continue to NOT GOVERN rather than take care of citizens it will destroy its own party if it hasn't already. HOWEVER, the Democrats cannot afford to become lazy after their victory.
One thing that concerns me about the Health Insurance Industry is the potential for a cartel. I hope there is enough interest in that to be sure there is an Anti-Trust clause to prevent that from occurring. Each company is not the same. There is no reason for them to raise rates in unison to exploit the insured.
I am going to go through this section and opt to finish my sleep rather than a cup of coffee. I don't 'do' substances. It is a health care thing I have.
‘(b) Wellness and Prevention Programs- For purposes of subsection (a)(1)(D), wellness and health promotion activities may include personalized wellness and prevention services, which are coordinated, maintained or delivered by a health care provider, a wellness and prevention plan manager, or a health, wellness or prevention services organization that conducts health risk assessments or offers ongoing face-to-face, telephonic or web-based intervention efforts for each of the program’s participants, and which may include the following wellness and prevention efforts:
This is a necessary provision that is intended to bend the cost curve down. If wellness and prevention programs can be competently handled by 'trainers' and/or 'educators' that will cut down on the visits to providers that could charge far more for their services. It is also more economical if the professionals that provide wellness and prevention services hold group meetings and clinics to reduce the cost to the insured/peasants.
The list here are no-brainers.The 'idea' of having professionals that even provide holistic or non-traditional services that are PROVEN effective in patients/peasants increases the job market and improves the tax base of the economy.
‘(1) Smoking cessation.
Imagine having the right to be reimbursed for "Weight Watchers" so long as DOCUMENTED progress can be validated. Nice. "Weight Watchers," by the way is a great and long lived program. It is very vigilant of its participants so far as including necessary nutrients in any one day. There encourage participants to drink anywhere from two to three glasses of milk per day. They derive their recommendations from standard sources.
‘(2) Weight management.
Imagery, massage or other tried and true techniques can all be legitimate under health care coverage.And probably encouraged to be so. Why wait for the need to go to Cancer Treatment Centers of America? Do it before it happens.
‘(3) Stress management.
Health maintenance. If one is going to 'do' "Weight Watchers" the level best thing to do along with the diet is to exercise and then maintain the weight loss by continuing that 'HABIT.'
‘(4) Physical fitness.
This is a counseling sort of thing. Nutrition counseling.
Nutrition counseling (click here) is an ongoing process in which a health professional, usually a registered dietitian, works with an individual to assess his or her usual dietary intake and identify areas where change is needed. The nutrition counselor provides information, educational materials, support, and follow-up to help the individual make and maintain the needed dietary changes.
‘(c) Regulations- Not later than 2 years after the date of enactment of the Patient Protection and Affordable Care Act, the Secretary shall promulgate regulations that provide criteria for determining whether a reimbursement structureis described in subsection (a).
On the passage above the Secretary has 2 years to decide whether the benefits within this section are to be included in any information to peasants. Depending on the decision by the Secretary there will be then six months for the GAO review.
‘(d) Study and Report- Not later than 180 days after the date on which regulations are promulgated under subsection (c), the Government Accountability Office shall review such regulations and conduct a study and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report regarding the impact the activities under this section have had on the quality and cost of health care.
The reason it is inequitable is because Israel has proprietary authority in East Jerusalem and the Palestinians do not. They worry about their heritage and their access. This isn't about land as Israel wants it to be, it is about culture.
It isn't about just access. It is about belonging. The culture of Palestine needs a presence as a claim to belonging. Different than deed restrictions. It really is more of a sovereignty issue for Palestine then Israel is willing to admit.
It is only a bit ludicrous to allow Palestinians 'access' while excluding them from sovereign rights. It is one thing to be able to live in Jerusalem as opposed to visiting it and walking among the homes of Israelis. I would think Israel would recognize that danger to its citizens.The people of Israel could become the targets of hatred if there isn't willingness in resolving this issue and then what good are homes?
The settlements in Jerusalem
...Pointing to what he has described as a national consensus in Israel over its claim to all of Jerusalem, Netanyahu told AIPAC that all Israeli governments had carried out construction in what he termed the city's "Jewish neighborhoods" since 1967.
"Everyone knows, everyone -- Americans, Europeans, Israelis certainly, Palestinians -- everyone knows that these neighborhoods will be part of Israel in any peace settlement. Therefore, building them in no way precludes the possibility of the two-state solution," he said.
In her speech, Clinton said new construction in East Jerusalem or the West Bank "undermines mutual trust and endangers the proximity talks" that are the first step toward full negotiations, suspended since December 2008.
"It exposes daylight between Israel and the United States that others in the region could hope to exploit. And it undermines America's unique ability to play a role -- an essential role, I might add -- in the peace process."
But she said U.S. support for Israel was "rock solid, unwavering, enduring, and forever."...
