Jump to content

Recommended Posts

Well from what I have gathered about the health plan he is proposing (and this is only my opinion), is that Obama is not trying to enstate a government run healthcare system, only that he is trying to put something in place to keep the insurance companies from blatently fucking people over as they have been for a long time now.

This opinion maybe too general, and parts of it maybe uninformed. But from everything I have read, that seems to be the gist of it. Again not health care controlled by the governement but at least kept in check... Much like other areas of society are now.

Link to comment
Share on other sites

  • Replies 96
  • Created
  • Last Reply

Top Posters In This Topic

Well from what I have gathered about the health plan he is proposing (and this is only my opinion), is that Obama is not trying to enstate a government run healthcare system, only that he is trying to put something in place to keep the insurance companies from blatently fucking people over as they have been for a long time now.

This opinion maybe too general, and parts of it maybe uninformed. But from everything I have read, that seems to be the gist of it. Again not health care controlled by the governement but at least kept in check... Much like other areas of society are now.

I think that's the SPIRIT of what he is trying...that does not mean by any measure that everyone on his 'team' has the same plan...

Link to comment
Share on other sites

I think that's the SPIRIT of what he is trying...that does not mean by any measure that everyone on his 'team' has the same plan...

Yeah.... and of course with anything that large and tangled... it is hard to assign blame or praise for success or failure.

Link to comment
Share on other sites

So, someone explain why it's a good thing that if this Bill passes the government will have direct real time access to everyones bank accounts? (Section 163 of the Bill)

Because "$3.4 Trillion minus $17 Billion is still $3,383,000,000,000"

Link to comment
Share on other sites

http://www.politifact.com/truth-o-meter/article/2009/jul/30/e-mail-analysis-health-bill-needs-check-/

Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer. Barely True: Section 163 sets out goals for electronic health records. One of the goals is to include features that "enable electronic funds transfers, in order to allow automated reconciliation" between payment and billing. The legislative summary says the intent in the section is "to adopt standards for typical transactions" between insurance companies and health care providers. The legislation generically describes typical electronic banking transactions and does not outline any special access privileges.

Stop making shit up.

Link to comment
Share on other sites

http://www.politifact.com/truth-o-meter/article/2009/jul/30/e-mail-analysis-health-bill-needs-check-/

Stop making shit up.

Oh...so, peoples will pay for what they should...Hmm...now, I hear (see) how the Rightys are spinnin' it...the spin is just to scare the middle-roaders onto the Right...not much that'll do at the current junction...

Link to comment
Share on other sites

Try reading the Bill. I'm not making shit up. Section 163 outlines direct real time access to individual bank accounts for payment purposes. it also sets up direct real time access to bank accounts for any business that provides it's own insurance, to make sure fines are paid. it also sets up direct real time access for businesses that give access to the government program.

READ THE BILL.

Link to comment
Share on other sites

Try reading the Bill. I'm not making shit up. Section 163 outlines direct real time access to individual bank accounts for payment purposes. it also sets up direct real time access to bank accounts for any business that provides it's own insurance, to make sure fines are paid. it also sets up direct real time access for businesses that give access to the government program.

READ THE BILL.

Too bad our representatives can't understand that simple concept...don't vote for something until you actually read it.

Edited by TitsMcGee
Link to comment
Share on other sites

I will trust politifact.com over you any day of the week, and twice on Sundays. "Direct, Real Time Access" sounds scary outside of the context of Insurance companies paying for services rendered.

Stop making shit up.

So that means instead of actually reading the bill you will just trust some website. Wow you sound a lot like the people we have in Washington DC.

Link to comment
Share on other sites

Not "some website", TM. The Pulitzer prize winning politifact.com, ran by the St. Petersburg times.

Politifact.com has never, ever, ever lied to me. Gaf lies to me all the damn time. Like in posts numbered 55 and 58 of this thread.

But by not reading the actual bill, you really have no room to give opinions on this matter since you don't actually know what the bill says.

Link to comment
Share on other sites

In peoples general opinions.... is the Bill easy to understand? Or is some inturpritation needed?

Just wondering.

NONE of these bills are easy to understand...that's part of the 'magic-trick' that our politics & bureaucracy have become.

Edited by Rev.Reverence
Link to comment
Share on other sites

NONE of these bills are easy to understand...that's part of the 'magic-trick' that our politics & bureaucracy have become.

If this is true.... then one would have to get inturpritation from educated sources as well as read the bill would they not?

Link to comment
Share on other sites

SEC. 163. ADMINISTRATIVE SIMPLIFICATION.

(a) Standardizing Electronic Administrative Transactions-

(1) IN GENERAL- Part C of title XI of the Social Security Act (42 U.S.C. 1320d et seq.) is amended by inserting after section 1173 the following new section:

‘SEC. 1173A. STANDARDIZE ELECTRONIC ADMINISTRATIVE TRANSACTIONS.

‘(a) Standards for Financial and Administrative Transactions-

‘(1) IN GENERAL- The Secretary shall adopt and regularly update standards consistent with the goals described in paragraph (2).

‘(2) GOALS FOR FINANCIAL AND ADMINISTRATIVE TRANSACTIONS- The goals for standards under paragraph (1) are that such standards shall--

‘(A) be unique with no conflicting or redundant standards;

‘(B) be authoritative, permitting no additions or constraints for electronic transactions, including companion guides;

‘© be comprehensive, efficient and robust, requiring minimal augmentation by paper transactions or clarification by further communications;

13

‘(D) enable the real-time (or near real-time) determination of an individual’s financial responsibility at the point of service and, to the extent possible, prior to service, including whether the individual is eligible for a specific service with a specific physician at a specific facility, which may include utilization of a machine-readable health plan beneficiary identification card;

‘(E) enable, where feasible, near real-time adjudication of claims;

‘(F) provide for timely acknowledgment, response, and status reporting applicable to any electronic transaction deemed appropriate by the Secretary;

‘(G) describe all data elements (such as reason and remark codes) in unambiguous terms, not permit optional fields, require that data elements be either required or conditioned upon set values in other fields, and prohibit additional conditions; and

‘(H) harmonize all common data elements across administrative and clinical transaction standards.

‘(3) TIME FOR ADOPTION- Not later than 2 years after the date of implementation of the X12 Version 5010 transaction standards implemented under this part, the Secretary shall adopt standards under this section.

‘(4) REQUIREMENTS FOR SPECIFIC STANDARDS- The standards under this section shall be developed, adopted and enforced so as to--

‘(A) clarify, refine, complete, and expand, as needed, the standards required under section 1173;

‘(B) require paper versions of standardized transactions to comply with the same standards as to data content such that a fully compliant, equivalent electronic transaction can be populated from the data from a paper version;

4

‘© enable electronic funds transfers, in order to allow automated reconciliation with the related health care payment and remittance advice;

‘(D) require timely and transparent claim and denial management processes, including tracking, adjudication, and appeal processing;

1

‘(E) require the use of a standard electronic transaction with which health care providers may quickly and efficiently enroll with a health plan to conduct the other electronic transactions provided for in this part; and

‘(F) provide for other requirements relating to administrative simplification as identified by the Secretary, in consultation with stakeholders.

‘(5) BUILDING ON EXISTING STANDARDS- In developing the standards under this section, the Secretary shall build upon existing and planned standards.

‘(6) IMPLEMENTATION AND ENFORCEMENT- Not later than 6 months after the date of the enactment of this section, the Secretary shall submit to the appropriate committees of Congress a plan for the implementation and enforcement, by not later than 5 years after such date of enactment, of the standards under this section. Such plan shall include--

‘(A) a process and timeframe with milestones for developing the complete set of standards;

‘(B) an expedited upgrade program for continually developing and approving additions and modifications to the standards as often as annually to improve their quality and extend their functionality to meet evolving requirements in health care;

‘© programs to provide incentives for, and ease the burden of, implementation for certain health care providers, with special consideration given to such providers serving rural or underserved areas and ensure coordination with standards, implementation specifications, and certification criteria being adopted under the HITECH Act;

‘(D) programs to provide incentives for, and ease the burden of, health care providers who volunteer to participate in the process of setting standards for electronic transactions;

‘(E) an estimate of total funds needed to ensure timely completion of the implementation plan; and

‘(F) an enforcement process that includes timely investigation of complaints, random audits to ensure compliance, civil monetary and programmatic penalties for non-compliance consistent with existing laws and regulations, and a fair and reasonable appeals process building off of enforcement provisions under this part.

‘(b) Limitations on Use of Data- Nothing in this section shall be construed to permit the use of information collected under this section in a manner that would adversely affect any individual.

‘© Protection of Data- The Secretary shall ensure (through the promulgation of regulations or otherwise) that all data collected pursuant to subsection (a) are--

‘(1) used and disclosed in a manner that meets the HIPAA privacy and security law (as defined in section 3009(a)(2) of the Public Health Service Act), including any privacy or security standard adopted under section 3004 of such Act; and

‘(2) protected from all inappropriate internal use by any entity that collects, stores, or receives the data, including use of such data in determinations of eligibility (or continued eligibility) in health plans, and from other inappropriate uses, as defined by the Secretary.’.

(2) DEFINITIONS- Section 1171 of such Act (42 U.S.C. 1320d) is amended--

(A) in paragraph (7), by striking ‘with reference to’ and all that follows and inserting ‘with reference to a transaction or data element of health information in section 1173 means implementation specifications, certification criteria, operating rules, messaging formats, codes, and code sets adopted or established by the Secretary for the electronic exchange and use of information’; and

(B) by adding at the end the following new paragraph:

‘(9) OPERATING RULES- The term ‘operating rules’ means business rules for using and processing transactions. Operating rules should address the following:

‘(A) Requirements for data content using available and established national standards.

‘(B) Infrastructure requirements that establish best practices for streamlining data flow to yield timely execution of transactions.

‘© Policies defining the transaction related rights and responsibilities for entities that are transmitting or receiving data.’.

(3) CONFORMING AMENDMENT- Section 1179(a) of such Act (42 U.S.C. 1320d-8(a)) is amended, in the matter before paragraph (1)--

(A) by inserting ‘on behalf of an individual’ after ‘1978)’; and

(B) by inserting ‘on behalf of an individual’ after ‘for a financial institution.’

(b) Standards for Claims Attachments and Coordination of Benefits -

(1) STANDARD FOR HEALTH CLAIMS ATTACHMENTS- Not later than 1 year after the date of the enactment of this Act, the Secretary of Health and Human Services shall promulgate a final rule to establish a standard for health claims attachment transaction described in section 1173(a)(2)(B) of the Social Security Act (42 U.S.C. 1320d-2(a)(2)(B)) and coordination of benefits.

(2) REVISION IN PROCESSING PAYMENT TRANSACTIONS BY FINANCIAL INSTITUTIONS-

(A) IN GENERAL- Section 1179 of the Social Security Act (42 U.S.C. 1320d-8) is amended, in the matter before paragraph (1)--

(i) by striking ‘or is engaged’ and inserting ‘and is engaged’; and

(ii) by inserting ‘(other than as a business associate for a covered entity)’ after ‘for a financial institution’.

(B) EFFECTIVE DATE- The amendments made by paragraph (1) shall apply to transactions occurring on or after such date (not later than 6 months after the date of the enactment of this Act) as the Secretary of Health and Human Services shall specify.

As you can see, this is why I relied on politifact.com for clarification. Go ahead, TM. Read that section, and tell me that politifact.com is lying to me. I haven't read it fully, yet. I will start now, and I might just have to change my mind about politifact.com.

I doubt it, though.

Link to comment
Share on other sites

But by not reading the actual bill, you really have no room to give opinions on this matter since you don't actually know what the bill says.

TM, did you read the bill thingy?

You know I did not... I haven't got a translator, nor, a bank account...Hm, I wonder if THAT'S why I don't give 2-squirts...

...& I saw a quote from the bill, that's not opinion...that's a fact to back his stance (opinion) in this here DEBATE (argument)...but, again, I don't care...I just want to know, does it cover DENTAL!??!?!

Link to comment
Share on other sites

TM, did you read the bill thingy?

You know I did not... I haven't got a translator, nor, a bank account...Hm, I wonder if THAT'S why I don't give 2-squirts...

...& I saw a quote from the bill, that's not opinion...that's a fact to back his stance (opinion) in this here DEBATE (argument)...but, again, I don't care...I just want to know, does it cover DENTAL!??!?!

I'm reading it right now, and yes he did finally quote the actual bill. Before he was quoting the website he uses, there is a difference. As for the dental part, since Medicaid doesn't even cover dental, I highly doubt this will.

Edited by TitsMcGee
Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Forum Statistics

    38.9k
    Total Topics
    820.2k
    Total Posts
  • Who's Online   0 Members, 0 Anonymous, 78 Guests (See full list)

    • There are no registered users currently online

×
×
  • Create New...

Important Information

By using this site, you agree to our Terms of Use.