by Angela Chagnon
Senator Bernie Sanders has introduced a Single Payer bill to the Senate that is similar to Vermont’s recently devised system in H.202.
The 188-page bill seeks to establish a “State-Based American Health Security Program” that will cover services furnished on or after January 1, 2013.
Among the policies that would be implemented “to ensure higher quality, better prevention, and lower per capita costs”, Sanders suggests placing “global budget caps on total health care spending” to keep costs down (p.4 line 14.)
Bernie apparently believes that setting a limit for healthcare costs will miraculously prevent citizens from needing more care.
Will illegal aliens be covered under this system? While the bill does set residency standards for participation in the new system, the following paragraph on page 9 seems to suggest that some illegals will have coverage.
“(b) TREATMENT OF CERTAIN NONIMMIGRANTS.- 18 (1) IN GENERAL.-The American Health Security Standards Board (in this Act referred to as the ”Board”) may make eligible for benefits for health care services under the appropriate State health security program under this Act such classes of aliens admitted to the United States as nonimmigrants as the Board may provide.”
Who will be on the American Health Security Standards Board, and what are their duties? That information can be found on pages 63-73. The short version is the Board will consist of 7 members: the Secretary of Health and Human Services and 6 members “appointed by the President on advice and consent of the senate”. This Board will control all aspects of healthcare payment and delivery.
But they will have some assistance from the “American Health Security Advisory Council”. This Council will advise the Board on its activities. It will consist of the Chair of the Board and 20 members appointed by the Board “without regard to the provisions of title 5, United States Code, governing appointments in the competitive service.” It is not clear which part of title 5 of the USC this is referring to, but the link to the code is here.
Duties and responsibilities of the Council can be found on pages 73-78 of the bill.
While the bill claims that dental services are covered, further reading proves that this benefit is quite limited (pp. 37-38). Only those services “consisted with a periodicity schedule established by the Board” are covered.
Page 22 reveals that in order for preventive services to be covered under the plan, the services must first be determined by the Board to be “effective”:
“(b) PREVENTIVE SERVICES.-
(1) IN GENERAL.-In this title, the term ”preventive services” means items and services-
(A) which- (i) are specified in paragraph (2); or
(ii) the Board determines to be effective in the maintenance and promotion of health or minimizing the effect of illness, disease, or medical condition; and (B) which are provided consistent with the periodicity schedule established under paragraph (3).”
“Comprehensive health service organizations” or CHSO’s are defined in the bill as a “public or private organization” that provides Board-approved health care services in a specific geographical area. Under “Enrollment”, the bill reads:
“(1) IN GENERAL.-All eligible persons living in or near the specified service area of a CHSO are eligible to enroll in the organization; except that the number of enrollees may be limited to avoid overtaxing the resources of the organization.”
Also of interest is a provision that concerns issuance of a “health security card” (aka “smart cards”) on pages 12-13:
(c) ISSUANCE OF HEALTH SECURITY CARDS.-In
conjunction with an individual’s enrollment for benefits under this Act, the State health security program shall provide for the issuance of a health security card (to be referred to as a ”smart card”) that shall be used for purposes of identification and processing of claims for benefits under the program. The State health security program may provide for issuance of such cards by employers for purposes of carrying out enrollment pursuant to subsection (a)(2).
Sanders’ bill would likely crush private insurance companies, which has been his stated goal.
“(c) NO DUPLICATE HEALTH INSURANCE.-Each State health security program shall prohibit the sale of health insurance in the State if payment under the insurance duplicates payment for any items or services for which payment may be made under such a program.” (p.21)
Being a strong union supporter, Bernie also makes allowances for collective bargaining on page 21:
“(f) TAFT HARTLEY AND MEW BENEFIT PLANS.- Notwithstanding any other provision of law, a health plan may be provided for under a collective bargaining agreement or a MEWA if such plan is limited to coverage that is supplemental to the coverage provided for under the State-based American Health Security Program and available only to employees or their dependents or to retirees or their dependents.”
Should a state fail to submit a plan, page 79 reveals that the Board will make one for that state to be implemented.
(4) STATES THAT FAIL TO SUBMIT A PLAN.- In the case of a State that fails to submit a plan as required under this subsection, the American Health Security Standards Board Authority shall develop a plan for a State health security program in such State.
Pages 79-82 list the requirements for approval of each state plan by the Board.
Look for the next piece in this series in the next edition of TrueNorthReports.com.