Senate Bill 400, sponsored by Jim Ferlo, is the "Family and Business Healthcare Security Act." This rather benign-sounding bill is anything but; it's everything that progressives in the US Congress are dreaming of and more. To put it bluntly, this legislation if passed would put a single payer health care system in place in the state of Pennsylvania. It's mostly filled with the vague, feel-good language you've come to expect from government, aiming to do things such as "(i)nvestigating proposals for innovative approaches to the promotion of health, the prevention of disease and injury, patient education, research and health care delivery." Make no mistake, this legislation's aim is nothing less than a complete and total usurpation of the health care system from top to bottom.
Here are some of the highlights:
An 11 member board appointed by the Governor, the President pro tempore of the Senate, and the Speaker of the House of Representatives composed of individuals representing hospitals, organized labor, consumers, business, agriculture, physicians, public sector employees, nurses, pharmacists, long-term care facilities, and social workers. The initial board gets to set their compensation (aka salary and benefits). How nice!
Some of the board's specific duties include:
- deciding who is eligible for the plan, adopting a benefits package for participants of the plan
- acting directly or through one or more third party contractors as the single payer administrator for all claims for health care services made under the plan
- deciding what is "fair and reasonable" regarding reimbursements to providers
- implementing policies and developing mechanisms and incentives to assure "culturally and linguistically sensitive" care
- establishing rules and procedures for implementing a no-fault compensation system to deal with issues of malpractice
- recruiting a "health advisory panel" that will advise the board on things such as "the establishment of policy on medical issues, population-based public health issues, research priorities, and scope of services (you know, instead of you and your doctor deciding what's best for you)
- establishing a centralized electronic health record system containing all of your medical information
- employ and fix the compensation of agency personnel as needed by the agency to properly discharge the agency's duties
This legislation also aims to create the "Pennsylvania Health Care Agency" which would "administer the plan and is the sole agency authorized to accept applicable grants-in-aid from the Federal Government and State government. It shall use such funds in order to secure full compliance with provisions of Federal and State law and to carry out the purposes established under this act. All grants-in-aid accepted by the agency shall be deposited into the Pennsylvania Health Care Trust Fund established under this act, together with other revenues raised within this Commonwealth to fund the plan." The executive director would be appointed by the governor. Oh and by the way, the board, advisory panel, and agency have immunity i.e. you essentially have no one to sue should their actions cause you direct harm.
Who's covered, you ask? EVERYONE! You heard me right. Citizens, non-citizens, legals, and illegals. There is a "presumption of eligibility" clause indicating that in instances of emergency they will cover you and sort it out later. They will reimburse any participating provider who "renders humanitarian emergency or urgent care" to non-eligible patients.
The board will establish one benefits plan to which everyone will be a member. Long-term care is provided for those who can no longer care for themselves. There are no exclusions for pre-existing conditions. There are no co-pays, deductibles, or other point-of-service charges if you go to a participating provider. On the downside, any treatment determined by the board to be non-therapeutic (i.e. palliative treatments that ease the pain of cancer patients) won't be covered.
The board wants total control over participating providers. Any capital investments valued at $1 Million or more (including studies, surveys, etc.) or that change the bed capacity by 10% must be approved by the board. There is also a provision for required investments: "The board is authorized to adopt programs to assist participating providers in making capital investments responsive to best practice recommendations."
How will this leviathan be funded, you ask? First, employers (including those that are self-employed) will be taxed 10% of gross payroll. If, as a consumer, you choose to not participate in the system, you will be subject to the "Individual Fair Share Health and Wellness Tax" of 3% of your income. For those of you that lose their jobs in the health care industry as a result of this legislation, you will be eligible to receive up to $5,000/month for two years or until you find a new job, whichever comes first. You can also get training assistance of up to $20,000 to help you get a new job.
As I've written previously, reform can best be achieved through market-based means and any additional government intervention in the health care marketplace is counterproductive. Considering the Republican majority in the PA Senate, the likelihood of this legislation passing is slim; yet given the events of the last year or so, I personally wouldn't take anything for granted. Write your PA Senator and let them know how you feel about the matter.
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