After hearing of Ben Nelson's gutless selling of his soul to the Devil (see Perrin's post below and numerous news accounts)... I decided I should tune in C-Span 2 to watch the destruction of the Republic as we know it first hand. As I sit and watch the clerk reading the Reid amendment to the healthcare bill on the floor of the United States Senate – I thought I would share some of the tidbits, besides the obvious use of the word "shall" over and over and over again...
The clerk can barely read the bill it is so complicated. After reading through a bunch of highly technical language about asbestos-related diseases, he read the definition what a “frontier county” means. And he then said that the clause shall not apply where a state received a “non-labor-related share adjustment under paragraph 5h.” A few sentences later, he said:
the area wage adjustment factor applicable under the payment system established under this subsection to any hospital outpatient department which is located in a frontier state as defined in section 1886d3e32 may not be less than 1.00. The preceding sentence shall not be applied in a budget neutral manner. B. Limitation. This paragraph shall not apply to any hospital outpatient department located in a state that receives a non-labor-related share adjustment under section 1886d5h.
Now, in a new section (and with a new clerk - it get tiring reading this stuff, you know), we get to the juicy stuff where the “Secretary” (read: HHS bureaucrats, regardless of whether the Secretary is Republican or Democrat) gets to define things:
Section 10329: Developing Methodology to Assess Health Plan Value
A: Development. The Secretary of Health and Human Services, referred to in this section as “the Secretary,” in consultation with relevant stakeholders, including health insurers, healthcare consumers, employers, healthcare providers and other entities determined appropriate by the Secretary shall develop a methodology to measure health plan value. Such methodologies shall take into consideration, where applicable, 1. the overall cost enrollees under the plan, 2. the quality of the care provided for under the plan, 3. the efficiency of the plan in providing care, 4. the relative risk of the plan’s enrollees as compared to other plans, 5. the actuarial value or other comparative measure of the benefits covered under the plan, and 6. other factors determined relevant by the Secretary.
Forgive any typos in my transcription, but thus is the state of your Republic...