It's that time again. Time to read more of the House Bill for Health Insurance Reform. What amazing wonders will I find this time?

Ya gotta love Barney Frank. He was beautiful. "So what planet do you spend most of your time?" Loved it ! Go get 'em Barney ! How can anyone believe a person that demands to be recognized as someone that refers to the President of the USA as a Nazi? She can't be taken serious. She lost her legitimacy as she turned her statements into hate mongering. It can't be tolerated.


...Under this scenario (click title to entry - thank you), one bill would include the new regulations on insurance companies, such as requiring them not to reject people with preexisting conditions. As conservative opposition to reform has grown at so-called town hall protests this month, President Obama and others have been pushing these regulations as the key lynchpins to reform that would help those with and those without insurance. It is thought these measures could get the more than 60 votes in the Senate needed to survive through any filibuster threat....



Under the House Health Insurance Reform Bill there will enrollments procedures (starting on page 97). They basically look like any other enrollment procedure one would find with an employer. There are special considerations, no different than the private sector, for special circumstances including birth of a child, adoption, marriage with some extra provisions by the bill such as a move outside the service area for a provider, significant change of income and the like. It goes on to say there will be automatic enrollment in one plan or another for people ineligible for Medicaid with 'affordibility' credits upon application for them and acceptance into a program. The bill also states, all plans will be paid directly to the provider and not through the government.

All these provisions are regarding Exchange Eligible people. There is a lot of willingness to have contact with people in need and there will be a website set up to help them in their choices and enrollment, a toll free number, etc. Basically, the bill is making every effort to enroll Americans in a health insurance option that will be appropriate for their eligibility.

I had wondered how this bill would impact SCHIP. There are children in the country with coverage as members of low income families, with parents that cannot afford health insurance. There is a section on page 100 that begins to discuss the provisions of SCHIP. This section also makes it completely clear the health insurance plans are for those born IN the USA.

Page 100, lines 20 through 25 and Page 101, lines 1 through 13.

SPECIAL DUTIES RELATED TO MEDICAID AND CHIP.—
COVERAGE FOR CERTAIN NEWBORNS.—
IN GENERAL.—In the case of a child born in the United States who at the time of birth is not otherwise covered under acceptable coverage, for the period of time beginning on the date of birth and ending on the date the child otherwise is covered under acceptable coverage (or, if earlier, the end of the month in which the 60-day period, beginning on the date of birth, ends), the child shall be deemed— (i) to be a non-traditional Medicaid eligible individual (as defined in subsection (e)(5)) for purposes of this division and Medicaid; and (ii) to have elected to enroll in Medicaid through the application of paragraph 13 (3).

Basically, the health insurance reform bill sides with coverage first and placement of future benefits later. If the parents already have insurance then this section would not apply, but, for those parents (I am thinking primarily new parents.) that do not have health insurance in place when the child is born, then the child will be covered until the time the family can address a plan for coverage.

In regard to SCHIP, it is my estimation that once 'families' are covered there will be children coming off SCHIP to be covered under their family's plan. In receiving coverage as a family, that will relieve the States of some of their programs that cover children as well and assist State budgets to balance without additional burden's of health care for children. That is my understanding to some of this.

There is also a provision within this bill for children currently enrolled through Social Security. A child with such benefits will become automatically 'Exchange eligible' unless the child is already eligible for Medicaid, there would be no further need to qualify. See, there is going to be some shifting of government liability depending on the enrollment status of those served on other government programs.

The bill goes on to say, that the enrollment in Medicaid or in a health insurance on The Exchange remains fluid should eligibility change over time. In other words, if a child is receiving benefits under Medicaid, but, becomes eligible for the Exchange as their parents now have that option, the child can move into a family plan unless the income of the parents dictate the child to be enrolled in Medicaid. Should circumstances change and let's say the parent(s) become unemployed or disabled, the child will always be covered by one method or another. I think what we will see with The Exchange is that parents working in lower paying jobs will qualify for insurance of one kind or another and will be able to include their children on their own insurance plans. Today, the care of children falls to the States or SCHIP without the benefit of parent(s) being covered. I believe that will change.

There will be a Special Inspector General as defined on Page 107, starting with line 18:

DUTIES.—The Special Inspector General shall — conduct, supervise, and coordinate au21
dits, evaluations and investigations of the Health Insurance Exchange to protect the integrity of the Health Insurance Exchange, as well as the health and welfare of participants in the Exchange;

The really interesting aspect to this bill, which can't be appreciated unless one is reading the entire bill personally, are the number of 'past' legislations (existing law) that comes into play in one method of another in this bill. It is as though we, as a nation, have been inching up to this for some time now and this consolidates all the aspects of health care to date in a clear venue of inclusiveness. I sincerely believe this bill consolidates all the past legislative efforts into one clear concise venue. In doing that, there will be a lot of 'duplicity' that will stop with the passage of the bill. This bill isn't nearly as expensive as it seems right now. This bill appears to be very careful to include all citizens at all levels of need or interest without exception, but, I believe in time will trim spending in other areas and absorb much of the other laws it cites. The House was very thorough in their inclusion of all relevant, existing laws.

Page 109, lines 4 through 6: TERMINATION.—The Office of the Special Inspector General shall terminate five years after the date of the enactment of this Act.

Excellant and exactly what I thought this provision was about. See, this bill is so 'careful' in the inclusion of every American citizen it provides a Special Inspector General of oversee the 'start up' of the program. Imagine being a legislator in DC and writing a historical bill such as this is and then find out because of some stupid loophole or lack of wording someone dies when they should have been included under the new law. Imagine how that weighs on the people of the House that wrote these provisions? By providing 'extra help' for the start up of this new law, there will be no losses or misunderstandings. Concise deployment of the law and accounting for the cost and use allowed under the law will be handled by an exclusive office that has oversight while providing oversight. The new law is really intended to streamline health insurance and its cost at every turn. I like it.

Page 109, lines 16 through 21.

PAYMENTS FROM TRUST FUND.—The Commissioner shall pay from time to time from the Trust Fund such amounts as the Commissioner determines are necessary to make payments to operate the Health Insurance Exchange, including payments under subtitle C (relating to affordability credits).

The new law provides for a separate trust fund to be used for expenses exclusive to The Exchange and the operations of the administration of the new law. This trust fund will receive all the taxes and fines from those people that do not abide by the law by subscribing to a health insurance company. Those taxes and fines will be for individuals and companies that are not in complicance with the law. The law doesn't seem to rely on any punitive measures such as prison to reach compliance. If individuals or companies choose to pay the excise tax rather than being in compliance that is their option. There are specific sections of the IRS Tax Code stated in relation to the Trust Fund where monies would be applied and enforced.

Like I said, they were very thorough in their writing of this bill.

There are provisions for States to set up their own health insurance exchanges if State legislators care to engage the issue. The States can even regionalize their exchange if they feel they can provide better than the federal government. However, the State Exchanges have to pass an approval process to be sure they are offering equivalent options at comparable costs or less.

continued below...

continued from above...

If I am reading this correctly, when it comes to the State Exchange, it would have to allow for portability of insurance over State boundaries IF the State Exchange was indeed regionalized and operating under one authority. The law does limit 'One Exchange" per State and it cannot add expenses to the federal government in operation or creation of any State Health Insurance Exchange. There cannot be any degradation of services under a State or Regional Exchange. If the Exchange were found to provide less benefits or fail its citizens in any manner; all or part of the Exchange could be stopped and returned to the Federal Authority.

Here again, the bill serves the people of the country and not any fiscal entity that would benefit from the new law it creates. At the forefront of any of this legislation is the citizen and their needs in health insurance reform. The House should be proud of their dedication to the 'best outcome' for Americans outlined in this bill. It is carefully stated to keep 'the people/person' the focus of the law. The Federal Government gives up no authority to retain any of the provisions for its authority regardless of a State or Regional Exchange. That is how it will maintain its oversight to such programs until they are found to be sound and citizens are protected with viability. It's a good thing.

Page 116, Lines 1 through 17, sets up The Public Option for health insurance. This is the beginning paragraph:

Subtitle B—Public Health Insurance Option
SEC. 221. ESTABLISHMENT AND ADMINISTRATION OF A PUBLIC HEALTH INSURANCE OPTION AS AN EXCHANGE-QUALIFIED HEALTH BENEFITS PLAN.
ESTABLISHMENT.—For years beginning with Y1, the Secretary of Health and Human Services (in this subtitle referred to as the ‘‘Secretary’’) shall provide for the offering of an Exchange-participating health benefits plan (in this division referred to as the ‘‘public health insurance option’’) that ensures choice, competition, and stability of affordable, high quality coverage throughout the United States in accordance with this subtitle. In designing the option, the Secretary’s primary responsibility is to create a low-cost plan without comprimising quality or access to care.

It provides for all the same options within any other insurance offered at The Exchange. This option is to be marketed at The Exchange. It provides for data collection to set rates and prices. This is the paragraph on Page 118, lines 4 through 9:

DATA COLLECTION.—The Secretary shall collect such data as may be required to establish premiums and payment rates for the public health insurance option and for other purposes under this subtitle, including to improve quality and to reduce racial, ethnic, and other disparities in health and health care.

This data will become an information bank for all health insurance companies. If insurance companies want to sincerely compete in the market place they will have to take into consideration the statistics that will come out of the public option in health insurance. If the companies are to compete for the business of the people taking the public option they will have to come to understand who and why they fall under this provision of the law. Once they understand the 'populous' that subscribes to the public option they can begin to taylor more of their own products to meet the needs of those accepting the public option.

This provision is especially interesting. It provides for access to federal courts to assure Medicare participants they will not lose rights under this new law. Page 118, lines 14 through 22:

ACCESS TO FEDERAL COURTS.—The provisions of Medicare (and related provisions of title II of the Social Security Act) relating to access of Medicare beneficiaries to Federal courts for the enforcement of rights under Medicare, including with respect to amounts in controversy, shall apply to the public health insurance option and individuals enrolled under such option under this title in the same manner as such provisions apply to Medicare and Medicare beneficiaries.

I see this provision as a means for 'interest groups' such as AARP to litigate any complaints their members might have. Of course, individuals can always bring suit if necessary, but, more than likely if there is something about the law that impinges on the rights of Medicare recipients it will happen in larger numbers than an individual. So this provision would be of particular interest to 'interest groups' as a method to protect their members.

The section regarding The Public Option goes on for quite a few pages. It discusses the particulars of how the option will provide for people. Of most concern so far is the establishment of a provider network that will accept payments under this option. It is based in the rates Medicare pays, however, the Secretary has the authority to increase said payments to providers if there are too few providers for any geographic area. The idea is to have established by Y 4 payments that will support a provider network for this option. That is upto page 124.

There are going to be two levels of physicians. There is to be no compromise in the quality of care or the quality of physicans. But, the two levels are delineation in relation to payment. Page 127, lines 1 through 16. These are levels of physicans for the Public Option.

PHYSICIANS.—The Secretary shall provide for the annual participation of physicians under the public health insurance option, for which payment may be made for services furnished during the year, in one of 2 classes:
PREFERRED PHYSICIANS.—Those physicians who agree to accept the payment rate established under section 223 (without regard to cost-sharing) as the payment in full.
PARTICIPATING, NON-PREFERRED PHYSICIANS.—Those physicians who agree not to impose charges (in relation to the payment rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C) of the Social Security Act.

The cost for the Public Option will be based on "Affordability Credit." The Affordability Credit will be applied for by persons unable to pay for the entire premium they fall under or their family falls under. The funds to make up the difference will come from the Trust Fund. The Trust Fund must maintain a 90 day balance of funds in the Exchange for anticipated expenditures. Those funds can be appropriated from the General Treasury initially, but, constituted from payments from individuals or companies. That brings us to page 130 of the bill.

During Y1 and Y2 the Affordibility Credit can only be used on the Basic Option. After Y3 the credits can be expanded to other levels of care, however, the difference between the credit and the price of the policy has to be paid by the insured. At no point in time will an Affordibility Credit be transacted into a rebate or refund for cash. They are strickly for the use of purchasing health insurance. The Affordibility Credit is applied to families with incomes 400 percent of the Federal poverty level (or if my math is correct approximately $68,000). The term family may exclude divorced or separated couples depending on their income while raising the family alone. And the term 'income' is to Adjusted Gross Income. There is a formula to apply for calculating the amount a family would pay over a one year plan. Those payments will be broken down into 1/12th of the total to be paid monthly. Not all plans may survive the implementation of the law. If there is limited enrollment of any of the plans, those plans may be dropped from the funding.

Page 137, lines 1 through 3 provides for the scale of premiums for people receiveing Affordibility Credits. The table is on Page 137, to transfer the table here doesn't turn out well enough to make sense of it. The bill goes on to enforce integrity of the provisions, what constitutes income and how it is reported and what constitutes a change in income, etc.

Page 143, line 16 begins to speak to Employer Responsibility in offering health insurance. It goes on to explain the relationship between emloyee and employer, family coverage, percentage of benefit paid, the timeliness of the payment of the benefit, the percentage a company has to pay for its employees. Generally, the employer contribution is 72.5% for individual and 65% for a family. It provides the definition of full time employee, autoenrollment of employees. It addresses the cost of 'Exchange Coverage.' The law allows the Commissioner to set percentages an employer needs to pay for less than full time employees. It also states, a percentage discount on a policy for employees does not constitute payment of the premium. There is also the election by an employee to 'Opt-Out' of any insurance coverage. That action by the employee has to occur in 30 days of the first option for automatic enrollment.

On page 150 the bill starts to explain the law in relation to small businesses and it is here I will stop for this evening.

Death Threats Against President Up 400 Percent, Week of August 13 - 19, 2009. Click title to entry for article - Thank you

"Insults, Rumors, Lies: Why is White Right Attacking First Black President?, Week of August 13 - 19, 2009 (click here for article)

The politics of waging war in Afghanistan. Is it killing our soldiers?

International forces under the banner of the North Atlantic Treaty Organization are continuing to fight Taliban insurgents in Afghanistan. But NATO field commanders are hindered by certain restrictions placed on troops by European governments.

NATO has more than 60,000 troops in Afghanistan as part of a United Nations mandated contingent known as the "International Security Assistance Force" - or ISAF.

ISAF troops are located in most parts of the country. One of their most difficult missions is to fight insurgents in southern Afghanistan - home of the Taliban, ousted from power by a U.S.-led coalition in 2001.

"Caveats"

Analysts say NATO is hindered in its fight against the Taliban by so-called "caveats" - restrictions placed by various NATO countries on what their forces can or cannot do.

Tomas Valasek, at the London-based Center for European Reform, describes some of those restrictions.

"What's happening is that whenever a call for troops comes in for a particular operation, the different contingents come back, or get back to the NATO commanders saying, well we'd love to take part but under the national 'caveat' we are not allowed to operate in this particular area, or we're not allowed to operate this far away from the base, or we are not allowed to operate at night," he said.

Valasek says NATO commanders in the field are finding it difficult to put together a workable strategy....

40 Candidates including two women. Voting for a President in Afghanistan.

An Afghan woman's ink-dipped finger after showing her identity card to vote in Herat, western Afghanistan. Photograph: Rahed Homavandi/Reuters

Afghan poll hailed as a 'success' (click here for video and article)

Afghan President Hamid Karzai and his Western allies have pronounced the country's election a success, after voting passed off largely peacefully.
Mr Karzai hailed Afghans for braving Taliban "bombs and intimidations". His praise was echoed by the US and Nato.
There were some attacks by insurgents, but the UN says the vast majority of polling stations were able to function.
President Karzai is facing challenges from about 30 rivals. Official results are not expected for two weeks.
"The Afghan people dared rockets, bombs and intimidations," he told reporters as polls closed following a one-hour extension.
Mr Karzai praised the citizens who turned out to vote
"We'll see what the turnout was. But they came out to vote. That's great."
In Washington, White House spokesman Robert Gibbs said: "Lots of people have defied threats of violence and terror to express their thoughts about the next government for the people of Afghanistan."...

US military deaths in Iraq war at 4,332

...The figure includes nine military civilians killed in action. At least 3,465 military personnel died as a result of hostile action, according to the military's numbers....

Iraqi PM orders security review (click here for video at article)
Page last updated at 21:50 GMT, Wednesday, 19 August 2009 22:50 UK
...He said Iraqi security forces were "very capable of confronting terrorists", but acknowledged that a security review was necessary.
"The criminal operations that happened today no doubt call for a re-evaluation of our plans and our security methods to face the terrorist challenges," he said in a statement.
The prime minister also said insurgents had taken advantage of government efforts to restore normalcy by removing concrete blast walls from main roads in Baghdad.
"These attacks represent a reaction to the opening of streets and bridges and the lifting of barriers inside the residential areas," he said.
An Iraqi army spokesman said two al-Qaeda members had been arrested in Baghdad in connection with the attacks.
There have so far been no claims of responsibility for the bombings....

Beach poison hit dogs two months ago (New Zealand)

...The Herald understands a council officer and a public health officer checked the beach where the dogs became ill but found nothing.
They cleared seaweed from the beach as a precaution, but, when they did not receive any further reports, concluded that the danger had passed - perhaps after a deliberate poisoning.
Dogs were purposely poisoned last year when sausages laced with a blue substance were left in Auckland parks.
But authorities believe a natural toxin is more likely to be behind the latest illnesses.
Stomach contents of a beagle that died after walking on Narrow Neck beach in early July were sent to MAF for testing. But it was not until a second dog died three weeks later on Monday after walking on the same beach that a public warning was issued.
Dog owners were angry they were not warned sooner, with reports of dogs becoming ill at Waiheke Island, Browns Bay and Karaka Beach in the Eastern suburbs....

The weather in Antarctica (Crystal Ice Chime) is cold:

The Antarctica Challenge: (click title to entry - thank you) A Global Warning to screen in Copenhagen during the United Nations Climate Change Conference
Toronto, 18 August 2009 - The United Nations Environment Programme (UNEP) is partnering with Canada's Polar Cap Production's, Inc. to present Mark Terry's new climate change documentary The Antarctica Challenge: A Global Warning in Copenhagen during this year's United Nations Climate Change Conference, December 7 to 18, 2009....


The winds are moderate with exceptions at the north end and south east end of Antarctica. What is unusual about this 12 Noon image is the directions are opposite of the other images in the 24 hour loop. It could be a change in wind direction due to reappearance of sunlight to the continent. Spring will beginning soon.

August 20, 2009
12 PM UTC
Antarctica Wind Satellite Image (click here for 24 hour loop - 12 AM, 6AM, 12PM, 6PM)

The heat transfer systems off the Equator are noted here and in the image at the bottom of entry. There has definately been a return of frigid air over the continent this winter.

August 20, 2009
1800 GMT
Antarctica Jet Stream/Vortex (click here for 54 hour loop)



August 20, 2009
12 PM UTC
Antarctica temperature image (click here for 24 hour loop - 4 times reporting 12A, 6A, 12P, 6P)


August 21, 2009
0720 AM
Antarctica, Ross Island, Scott Base




August 20, 2009
1327 gmt

Antarctica Satellite


Flights to Antarctica resume (click here)
7:20AM
Thursday Aug 20, 2009
The first flight to Antarctica for six months will depart from Christchurch today.
Following three months of darkness and half a year in isolation, the arrival of spring means the flights can resume to the icy continent.
A US Air Force C-17 Globemaster is being used for the mission.
Scott Base Winter Leader Nathan Cross says the plane will deliver fresh fruit and vegetables, mail and new staff to the New Zealand and US Antarctic stations.
Twenty-six New Zealanders have been stationed at Scott Base for the winter to research the formation of sea ice.
- NEWSTALK ZB

The Warmest Reporting Station

Base Esperanza, Antarctica

8:14 PM GMT

Lat/Lon :: 63.4 South and 57 West

Temperature :: 33 F

Conditions :: Partly Cloudy

Humidity :: 99%

Dew Point :: 33 F

Wind :: 34 mph from the West

Wind Gust :: -

Pressure :: 29.97 inches (Rising)

Visibility :: 6.0 miles

Clouds :: Scattered Clouds 9843 ft
Mostly Cloudy 19685 ft
(Above Ground)

Elevation :: 43 ft

The Coldest Reporting Station

Vostok, Antarctica

Local Time :: 2:15 AM VOST on August 21, 2009 (GMT + 06)

Lat/Lon :: 78.4 South and 106.9 East

Temperature :: -107 F

Humidity :: 26%

Dew Point :: -114 F

Wind :: 9 mph from the WNW

Wind Gust :: -

Pressure :: in (Rising)

Visibility :: 12.0. miles

Elevation :: 11220 ft

The weather at Glacier Bay National Park has been (Crystal Wind Chime) melting.

August 18, 2009
Soldotna, Alaska


August 18, 2009
Soldotna, Alaska

It would appear the owner of the building below knew things were coming to this. For Sale sign and phone number intact.

August 18, 2009
Soldotna, Alaska
Photographer states :: A release from a glacial lake in Skilak Glacier caused minor flooding in low lying areas along the Kenai River.

...The water level peaked at 15.06 feet at the Soldotna Bridge. (click title to entry - thank you) At 12:30 p.m. Tuesday, that level reduced to 14.2 feet, said John Mohorcich, Kenai River Center manager.
The normal water level for this time of year at the bridge is anything below 12.7 feet, usually between 11 and 12 feet. When the Skilak Lake glacial dam breaks, it's no surprise that the water level rises 1 1/2 to 2 feet, Mohorcich said.
The National Weather Service issued a flood warning for the Kenai River from Skilak Lake to the city of Kenai on Sunday. That warning remained in place until 4 p.m. Tuesday....

Local Time :: 10:13 AM AKDT (GMT -08)

Lat/Lon :: 58.8° N 137.0° W

Temperature :: 54 F

Conditions :: Mostly Cloudy

Humidity :: 94%

Dew Point :: 52 F

Wind :: 4 MPH from the SE

Pressure :: 29.78 inches (falling)

Visibility :: 10.0 miles

UV :: 2 out of 16

Clouds :: Few 1000 ft
Scattered Clouds 2800 ft
Mostly Cloudy 7000 ft
(Above Ground Level)

Will California get rain?

The absense of the vortex west of the California coast in the water vapor satellite below is a little unusual. It could be due to higher level water vapor in the troposphere that causes and absense on the radar. At any rate, there my be relief coming to California in the way of rain. It might be torrential in its manifestation and that could cause mudslides, but, it might help with the fires. Let's hope there is relief on the way.


August 20, 2009
1630z
UNISYS Visible Satellite Image (click title of entry for 12 hour loop - thank you)




August 20, 2009
1630z
UNISYS Water Vapor Satellite

Two 'interesting' aspects to this satellite image. The first is Bill nearing the USA coastline and in closer proximity of the air masses of "Claudette" and that over Arkansas. The second is the black hole off shore of California. It really isn't absent of water vapor though. If one looks at a 'visual' satellite image it is quite dense with clouds.


August 20, 2009
1517 gmt
Tropical Atlantic Ocean Satellite

"Bill" is tracking more north than west. After it left latitude 20.70 with a central pressure of 945, the hurricane started to slow with a centeral pressures rising and currently is 951. I said it would and it has. The reason is the lack of water vapor once leaving the area of the Intertropical Convergence Zone.

"Claudette" still remains a diffuse air mass over the Gulf States. It is meeting with a cold air mass currently over Okalhoma, Arkansas and Missouri creating turbulent and wet weather.

Faith groups weigh in on health care - The President is dedicated to bring quallity care to all Americans.

As I continue to read through the tentative House Bill regarding health care reform, I really don't find any untoward provisions, protections or guarantees. There is no intrusive government. The bill is well thought out, including vital aspects of goverance that will make it a success.

According to the House Bill on page 56, lines starting with 7 through 17, there is a clear procedure for an insurance company to drop coverage on anyone. There are no laws currently that provide for such protections.

‘‘SEC. 2746. OPPORTUNITY FOR INDEPENDENT, EXTERNAL
THIRD PARTY REVIEW IN CASES OF RESCISSION.
‘‘(a) NOTICE AND REVIEW RIGHT.—If a health insurance issuer determines to rescind health insurance coverage for an individual in the individual market, before such rescission may take effect the issuer shall provide the individual with notice of such proposed rescission and an opportunity for a review of such determination by an independent, external third party under procedures specified by the Secretary under section 2742(f).

It is good law. It protects citizens of the USA against unfair business practices.

The bill goes to great detail to define all the words used to implement the law. Many of the pages aren't about law at all so much as clearly defining the meaning of words so they cannot be misconstrued later when the law is implemented. To say this legislation is detailed is an understatement. But, where it does discuss the law and changes to implementing health care reform, it is all beneficial to the citizens of the USA. It speaks to an excellant initiative to take away the 'victim' aspect of citizens while returning the role of health insurance companies to provide 'service.'

I like the bill. I am impressed by the dedication of the legislators that took the time to do it right. Maybe a better of putting the 'detail' of this law is that is makes considerable effort to close any loopholes so citizens won't be victimized.

The bill "Grandfather's" in existing coverage and provides for appeal processes.

The mainstay of the bill is on page 72, starting with line 1.

TITLE II—HEALTH INSURANCE EXCHANGE AND RELATED PROVISIONS
Subtitle A—Health Insurance Exchange
SEC. 201. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.
(a) ESTABLISHMENT.—There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.

The Public Option has to exist, but, I believe the reason the President and pundits for the bill state it needs to exist is the least of the reasons for its capacity. The favorite reason stated for the Public Option is to add competition to the market place. It might do that, but, its real value is in its reality to insure the uninsurable.

The bill clearly states their is a fluid relationship between health insurance companies and its members. It is obvious the bill does not want companies removing members from its roles and provides for mitigation and grievance processes to maintain insurance coverage by members. The bill perfers that a health insurance company continue its capacity with new understandings of coverage that would bring fairness to costs, including subscription fees, deductibles and copays.

Where the Public Option has its real value is not in replacing insurance companies or providing competition, but, by providing insurance when no other option is available. The Public Option picks up the slack to the citizens of the USA. Literally. I can imagine a health insurance company denying a claim for services due to expense and while the member might have access to an appeal process to reinstate their coverage and receive services from the insurance company; time marches on and illness waits for no one.

That is the ultimate purpose of any health insurance bill, to be sure coverage is available when a person needs it. That is primarily the complaint of so many when it comes to reform. For those that can get covereage, the 'presence' of insurance at the time of need is somewhat tenative all the time. There is little reassurance to any health insurance subscriber that their needs will be covered. With every admission to an emergency room or hospital room for a scheduled procedure, members have to wait in anticipation of receiving coverage and then left with horrible realities when an insurance company decides adversely.

The Public Option is more than simply another 'player' in the market place, it is actual insurance for all needs of any citizen of the USA. It provides coverage when others don't want to. It provides a place for people to turn when their needs are rejected by conventional, private coverage. It has a place beyond adding competition. In my opinion, the competition it supplies to the market place is the least of its value. Its paramount value is that it will cover citizens when no other entity will. And that is why a Public Option is required in any legislation for health care.

If the private sector is to remain autonomous while adhering to the laws of this bill, then a Public Option has to exist when the private sector fails to commit to the needs of its members. That is the primary purpose for The Public Option. It's there. It will provide. Citizens are safe and are no longer at the mercy of profiteers that seek profits over services.

The bill is thoughtful enough to conduct studies regarding the cost of health insurance and employers and individuals. The bill does not simply set rules regarding employer related health care without seeking to understand the viability of the business or individual related to the costs of that health care. On page 83, lines 1 through 11 the bill asks the question, "How is everyone doing?"

IN GENERAL.—The Commissioner shall conduct a study of access to the Health Insurance Exchange for individuals and for employers, including individuals and employers who are not eligible and enrolled in Exchange-participating health benefits plans. The goal of the study is to determine if there are significant groups and types of individuals and employers who are not Exchange eligible individuals or employers, but who would have improved benefits and affordability if made eligible for coverage in the Exchange.

There is nothing wrong and everything right with performing 'follow up' to legislation as vital as national health insurance reform. The bill provides for review of the options for individuals and employers in relation to opening up options for them as needs require. The bill makes no assumptions of complete knowledge of the need of Americans and their employers. What it does do is provide for transparency to allow changes in the law to include or exclude participants as presented over time. There is a lot correct in that focus.

The bill also goes through great trouble to delineate 'Smallest Employers' from 'Small Employers' to 'Large Employers.' While there isn't exact explanations at this point to their difference in definition, it looks as though the delineation is important and probably allows for certain participation with costs scaled to the viability of the business itself. I really believe there is a lot here for small business owners.

Page 83, lines 12 through 21.

ITEMS INCLUDED IN STUDY.—Such study also shall examine—
the terms, conditions, and affordability of group health coverage offered by employers and QHBP offering entities outside of the Exchange compared to Exchange-participating health benefits plans; and the affordability-test standard for access of certain employed individuals to coverage in the Health Insurance Exchange.

The complaining by citizens and small business owners just doesn't match what the bill states. Page 86 provides for explanations of 'tiered' plans and needs. What more do people want?

(A) IN GENERAL.—A basic plan shall offer the essential benefits package required under title I for a qualified health benefits plan.
B) TIERED COST-SHARING FOR AFFORDABLE CREDIT ELIGIBLE INDIVIDUALS.—In the case of an affordable credit eligible individual (as defined in section 242(a)(1)) enrolled in an Exchange-participating health benefits plan, the benefits under a basic plan are modified to provide for the reduced cost-sharing for the income tier applicable to the individual under section 244(c).
ENHANCED PLAN.—A enhanced plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(A).
PREMIUM PLAN.—A premium plan shall offer, in addition to the level of benefits under the basic plan, a lower level of cost-sharing as provided under title I consistent with section 123(b)(5)(B).
PREMIUM-PLUS PLAN.—A premium-plus plan is a premium plan that also provides additional benefits, such as adult oral health and vision care, approved by the Commissioner. The portion of the premium that is attributable to such additional benefits shall be separately specified.

Not everyone will have a premium plan available to them if they need cost sharing. Why does that sound fair and equitable?

Page 91, line 4 through 7

CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES AND COMMUNICATIONS.—The entity shall provide for culturally and linguistically appropriate communication and health services.

I am still waiting to find the terrible parts.

Page 95, lines 8 through 18, stands in definance of anyone stating handicapped persons/children would be victimized by the bill. Why does the bill go through so much trouble in finding people who may qualify under the provisions of the bill if it were going to eliminate such 'needy' people from insurance services? The entire 'idea' that the USA would harm any handicapped or challenged person or child is simply outrageous.

OUTREACH.—The Commissioner shall conduct outreach activities consistent with subsection (c), including through use of appropriate entities as described in paragraph (4) of such subsection, to inform and educate individuals and employers about the Health Insurance Exchange and Exchange-participating health benefits plan options. Such outreach shall include outreach specific to vulnerable populations, such as children, individuals with disabilities, individuals with mental illness, and individuals with other cognitive impairments.

Why go through the trouble of outreach at all if the bill were seeking to victimize them and harm them? The entire allogation that the people of the USA would do harm to any of its citizens is completely abhorrent to our values as a nation.

Page 96, lines 4 through 9

IN GENERAL.—The Commissioner shall establish a process consistent with this title for enrollments in Exchange-participating health benefits plans. Such process shall provide for enrollment through means such as the mail, by telephone, electronically, and in person.

I'll end with page 99 today and begin with page 100 tomorrow with expectations of completing upto page 199. Those that seek political power due to health insurance reform are barking up the wrong tree. There is nothing here to fear to to shy away from. This bill is written by decent people with good intentions with detail I didn't expect.

It seems to me the attacks in Baghdad are to keep the American occupation away from the Kurdish areas. The attacks are the fault of the occupation.

Smoke rises near the Iraqi Foreign Ministry after a massive bomb attack in Baghdad, Iraq, on Wednesday. (Khalid Mohammed/Associated Press)

There have been many attacks in Iraq since January 1, 2009 when the new security pact took effecf. There is a Canadian article that cites them all with link at title to entry. One group or another had a reason. They didn't miss one month. This bombing is more of the same.

"We close at 5pm." - Judge faces censur or termination of office.

Sharon Keller was too busy to receive final papers from the attorneys for Michael Wayne Richard. She was attending to a repariman at her home and refused to read 'final stay' papers on a death row inmate soon to be executed. She replied at one point, "We close at 5PM." The execution occurred at 8:30 PM by lethal injection.

Beaumont tornado causes fear and panic, no fatalities

Dave Ryan Beaumont Enterprise
Employees of the Beaumont Wal-mart store hug one another as they view the damaged overturned cars that were sitting in the parking lot after a tornado touched down.

By MIKE D SMITH Beaumont Enterprise
Aug. 18, 2009, 11:17PM

...Ten people were treated at Christus St. Elizabeth Hospital for cuts and abrasions caused by storm debris, a spokeswoman said. .
Tim Ocnashek, emergency man­agement coordinator for Beaumont, praised residents and first responders for their quick thinking and actions.
“We were real fortunate that so few people were hurt,” Ocnashek said. “It seems like everyone worked together real well and everybody — even the public — complied.”...

Claudette wasn't a minor storm. (click title to entry - thank you)

August 18, 2009
Birmingham, Alabama
No comment by photographer

Claudette loses steam
By Leesha Faulkner
Selma Times-Journal
Published Monday, August 17, 2009
The first named tropical storm of the 2009 Atlantic hurricane season hit land in Florida, then fizzled.
Tropical Storm Claudette formed as a tropical depression in the Gulf of Mexico off the coast of Florida and Alabama with seemingly no warning late Saturday.
She gained enough strength by Sunday to become a tropical storm and rumbled toward land.
The National Weather Service in Birmingham issued several watches, including a tropical storm high wind watch for Dallas and other counties as Claudette slowly moved toward landfall.
“We thought she would move more in our direction,” said Rhonda Abbott, interim director of the Dallas County Emergency Management Agency. “But she shifted more toward the west and Mississippi....

Tornado Touches Down In South Park (click title to entry - thank you)

August 18, 2009

Denver, Colorado

Photographer states :: Was happy to get a shot of the daytime lightning - the hail started almost immediately after this,should have paid more attention to the green in the sky

DENVER -- A tornado touched down in South Park, Colo., Tuesday afternoon as a band of thunderstorms quickly moved across the state.
The tornado touched down at 1:20 p.m., near 11 Mile State Park. South Park is at 9,500 feet and it is rare to have a tornado hit at such a high elevation. However, it's just a testament to how strange this summer has been. No injuries were reported.
There was only minor damage at the state park, park rangers said....

Tracking a few degrees to the northwest, "Bill" is now a Cat 4 with central pressures of 948 and falling.

There are still significant remnants of "Ana" and "Claudette" to cause rains in the region.

Ana remnants may regain strength in Gulf of Mexico (click here)
Wed Aug 19, 2009 8:28am EDT
NEW YORK (Reuters) - As the remnants of Ana drift into the warm waters of the eastern Gulf of Mexico later Wednesday, there is a small chance it could regenerate into a tropical depression as it moves northwest toward the eastern Gulf Coast, weather forecasters predicted.
The U.S. National Hurricane Center said the system, which was producing showers over the northwestern Bahamas, South Florida and the northwestern Caribbean Sea, had a low chance - less than 30 percent - of becoming a tropical cyclone again during the next 48 hours....

August 19, 2009
1349 gmt
Gulf of Mexico Satellite

The 'eye' is a considerable distance from land, but, the outer bands aren't. The diameter of this storm places heavy rains over the islands. The storm is moving very quickly.


For 12 hour loop click title to entry - thank you.

The Justice Department has a victory.

One has to wonder if the Madoff empire has monies there. According to estimates reported in the International Herald Tribune (click here) the accounts hold upwards of $18 billion.
.
...Switzerland's largest bank (click title to entry - thank you), UBS AG, is set to give the U.S. government information on 4,450 accounts suspected of hiding money from the IRS. In June, the U.S. and Swiss governments came to an information-sharing agreement after a six month battle over how much the bank would divulge. The Swiss government says it will fulfill a request for the information within a year....

Saving our nation's health care from greed and demise.

The Republicans won't be joining us, with the exception of one or two in the Senate, in 'cleaning up' the health care industry in the USA. I think there are recommendations from one Republican Senator that have studied the subject and set a goal for reform before President Obama was even a candidate. That would be Senator Baucus. Unless the winds have shifted with him since this article in USA Today.

...Senator Baucus (click here): "Well, we are going to cut spending and that's the basic way we're able to come up with a way not to add to the national debt. People think it adds to the debt. But the dollars spent on health care will not add one thin dime to our national debt."...

...Senator Baucus: "Nothing is certain. But I think that this is a lot different than when President Clinton attempted health care reform. This time around costs are so high and second the major groups are on board."...

The President tried to reach out in bi-partisanship, but, for that effort there are Republicans such as Grassley that rather try to make a fool of Presient Obama for his trust placed with Senator Grassley. It is why I stated, Senator Grassley is incompetent. I defy any member of the Senate or Congress to come forward 'in good faith' to be an advocate and participant in bipartisanship only to laugh behind our President's back for acting in good faith in return. That isn't even politics. That is playing with the future of our nation. Grassley is incompetent. He might be a joker too, but, more than that he is a joke.

It's time for Obama to stop handwringing and put on the boxing gloves (click title to entry - thank you)

...It's beyond ironic that those rallying in rage at town hall meetings portray Obama as some malevo.lent tyrant driving a steamroller over them and their concerns. In fact, though, he's cripplingly starry-eyed about bipartisanship, dialogue and compromise when it's quite clear that his opponents see this as a weakness they can exploit....

Kyl is the Senate Minority Whip. It doesn't take any more words from the GOP to know they have every intention of ending a health care debate.

Secretary Sebelius mentioned the 'idea' of Health Care Insurance Co-ops as an alternative to a Government Option that was being proposed by the Senate. Well, she put faith in the "W"rong people. The Senators that were proposing such a 'competitive' option aren't going to anymore. They have withdrawn from any participation and are completely opposed to health care reform in the USA.

They don't care. It is better that the President, his staff, his cabinet and leadership in the House and Senate come to terms with the fact the only interest Republicans have in health care reform is to stall it as long as possible in hopes of defeating it.

I suggest the President ask Commerce and Treasury to convince any Democratic Senators and House members of the soundness of this measure while they linger in doubt today.

I'll tell you something, this House Bill is really 'dry' reading. From page 30 forward it spells out all the particulars in deployment of the bill after it is passed and how the administrative components will manifest. Sadly to some there is no additional salary to the members of any board. Traveling expenses, but, no additional salary to the one they already receive. In other words, the Surgeon General has to add this to his job description.

The bill requires 'plain language' by any insurance entities, it requires fairness in advertising and this is a good one, it demands timely payment of claims. There will definitively be data collection for the purpose of finding further efficiencies:

Page 43, Lines 19 through 24:

DATA COLLECTION.—The Commissioner shall collect data for purposes of carrying out the Commissioner’s duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health care and may share such data with the Secretary of Health and Human Services.

Don't fool yourself to believe your insurance companies aren't already doing this for internal purposes such as finding greater profits. In addition, this is like the CIA and FBI sharing information. I don't know if that is a great analogy, but, at least the Secretary of Health and Human Services and the CDC won't be duplicating work. That is a savings all by itself. And the best part is that the data will be real and truthful, not derived statistically by a study group.

The bill provides for clear and concise language to be used that already exists within the USA health care industry. There is no trickery or anything up anyone's sleeve. The language in all documents between the government and any private entity or citizens themselves will reflect words already defined and used by the industry. The 'additional' definitions of the bill that does not exist in the industry today is due to the 'new' entity of that this bill produces.

The bill leaves open the ability of the Commission to consultation with any other entity, including attorneys general, NAIC (National Association of Insurance Commissioners, regulators, appropriate state agencies, etc. The new Commission will be fluid and blend with existing authority without undermining any other authority that already exists. The new entity for our health care reform will consult with any state or federal agency to apply the new standards without misinterpretation.

There will be the creation by appointment of a Qualified Health Benefits Plan Ombudsman. This basically is a consumer advocate that receives complaints and administrates them. Most every state has at least one, especially when it comes to dealing with issues of the elderly. This is just a different level of government that will do basically the same thing to be sure there is equity in the administration of the policy set forward by the bill. As a rule, Ombudsman are blind to government when it comes to advocacy for citizens. The Ombudsman will receive complaints from individuals and not the industry alone. The Ombudsman will answer directly to Congress in oversight by annual reports. That removes any conflict of interest in administering any health care insurance or care.

The way I see the Ombudsman is as a critical component in the first year or two of the new law until everyone gets used to it. The volume of its work will probably diminish as time goes by and there is better understanding of the law.

The House bill goes on to state this new law will not interfer with any previous government health insurance already existing. There is also a provision that laws regarding state laws and their application to any circumstance when providing a greater benefit. I have to mention here that it is my opinion, the passage of this bill help relieve some state budgets of their current health insurance initiatives. There is a good chance that 'charity care' or whatever other verbiage one wants to call it may very well be something of the past if people currently uninsured now find themselves insurable and a member of a plan. That will assist many states with budget issues they are facing today.

There are provisions that prevent discrimination. That is something never addressed by any entity anywhere in the government, except, at some state agencies that administer their own plans. But, that is a vital part of this bill. It will be the first time Americans cannot be discriminated against for any reason in applying for and using the health care industry in this country. It will literally be a brave new world when this bill is passed. Nice. I think that is very appropriate for the USA. Absolutely. It is a matter of civil rights.

There is also protection for Whistleblowers, too. That is always a good thing. No misbehaving by anyone.

This may be one of the big reasons Republicans simply cannot get their minds around reform:

Page 53, Lines 9 through 14

SEC. 154. CONSTRUCTION REGARDING COLLECTIVE BARGAINING.
Nothing in this division shall be construed to alter of supercede any statutory or other obligation to engage in collective bargaining over the terms and conditions of mployment related to health care.

See, if anyone can get Kyl to say 'Collective Bargaining' without fainting. If you do, get it on tape, it will be a once in a lifetime chance.

Page 53, Lines 21 and 22 start talking about 'Ensuring Value and Lower Premiums.' Wow.

Subtitle G—Early Investments
SEC. 161. ENSURING VALUE AND LOWER PREMIUMS.

Ready for this one. Sit down you won't believe this one. Seriously, sit down for this one. Ready? We get money back. This that flyin' amazing or what?

‘‘SEC. 2714. ENSURING VALUE AND LOWER PREMIUMS.
‘‘(a) IN GENERAL.—Each health insurance issuer that offers health insurance coverage in the small or large group market shall provide that for any plan year in which the coverage has a medical loss ratio below a level specified by the Secretary, the issuer shall provide in a manner specified by the Secretary for rebates to enrollees of payment sufficient to meet such loss ratio.

Why don't I end there on a good note. I don't care how long it takes to get through this bill. It has its upside in actually reading this and writing about it. I think it is a historically great document. In sincerely do.

Until tomorrow.

Chevy Volt - The Future is Here. I am more happy than measurable. I am even more happy it is Chevy. Nice. Very nice.

230 miles per gallon.

Nice job !!!

It's over.

The struggle for the future is over.

Chevy gave it to us.

We now have sane transportation with no tropospheric insult.

What would have happened to the Volt if we didn't save GMC? Americans have every reason to be proud of their leadership in saving the American Auto Manufacturer. Look, we all knew it wasn't going to be cheap taking the country back from decades of corruption. This is the future of our children. I think it is worth it. Very worth it.

I don't want to hear about the $40,000 sticker price either. The vehicle will pay for itself in one year or less, on fuel savings alone.

Now, if we could just stop those stacks from emitting !