In the last installment of my review of The Affordable Care Act, otherwise known as Obamacare. We focused on the government oversight and spending obligations for this program. Where I feel like an overhaul to the health care system is much needed. I’m not sure that it’s worth it to sink billions of taxpayer dollars into it. I think there may have been a better way to address the problem. But, we are no longer debating the law, it is now the law. I wish that lawmakers would realize this and use their powers in the house and the senate to help make the law better rather than just trying to scrap it. With that being said let’s move on to the next topic in the bill.
Section 4102 opens up with a 5 year plan to promote dental care. This i guess was supposed to start in 2011? I haven’t noticed any real shift in the advertising or promotion of dental care? Have you? They report that there should be an increase on the emphasis on dental care in schools. Where I live it seemed like that program was already in place before this act was put into law.
The next section 4103 jumps back into medicare, it creates a standard for an annual wellness visit. And at this visit the patient will receive a personalized prevention plan. This is where all of the data collection that we discussed before comes in. They will establish plans, give recommendations and suggest lifestyle changes based on data collected across the nation. The wellness exam will be a once a year deal for people with medicare and will be used to coordinate care for any issues that arrive during this consultation. It also looks like this once a year visit and any preventable procedures will be free, no coinsurance or copay, and not subject to a deductible. However, based on the guidance of the data collection they have the right to add or remove services as they seem fit.
In section 4106 they pretty much repeat what they did with medicaid, they improve the access to preventative services for folks on medicaid. Then further down in 4107 there is a whole section devoted to helping pregnant woman in the medicaid program quit smoking. This includes counseling services and pharmacotherapy (prescriptions).
The next sections 4106 and 4201 list more grant opportunities to states and state run programs to promote healthy living. They will create activities and campaigns and document certain measurements in exchange for these services. This way they can track the progress on a state by state basis. I can also see these programs as a way of penalizing states who do not follow their program.
The next spot of interest in our review is section 4203, its title heading is Removing Barriers and Improving Access to Wellness for Individuals with Disabilities. This sounds like a good section but, they have established standards for the equipment that will be located at the doctors office and at the hospital. Also, they established standards on the individual pieces of equipment as well. And right under that section 4204 gives the Secretary of Health and Human Services the right to negotiate prices and control the supplies of immunizations. If that doesn’t give you cause for concern, I don’t know what does. What happens if we get some kind of crazy disease and our country is having problems with a certain state? They could simply just not supply the vaccine to that state. Hopefully my conspiracy theories never come true.
I’m sure all of you active truck drivers out there have been to a fast food joint or a sit down restaurant in the last couple of days if not the last couple of hours. Did you notice the changes to the menu where it lists the caloric values of the food and possibly some additional nutritional information? Well, if you like the idea that you can now see how healthy your food choices are then you can thank Obamacare for that. In section 4205 it mandates that the restaurants put this information up so you can see it. It has sure made me think twice between the fish sandwich and the double quarter pounder.
Another great addition to this law for women is in section 4207 titled Reasonable Break Time for Nursing Mothers. More and more we see households that have two incomes. Well, this mandate calls for employers with 50 employees or more to allow for women to handle their nursing activities whether it be feeding the child or pumping to a bottle up to one year after giving birth. This time unfortunately does not have to be compensated time, however it does provide for the time for the mother to provide the milk for the child while at work.
Section 3101 gives out the rules on the data collection. Nothing too obtrusive on our society, just basically any and all information they deem necessary. Again, this is definitely a case of “pandora’s box”, if they use the information to assist in diagnosis, efficiency and to coordinate care in rare diseases it potentially has a huge upside. However, I do believe that this information, if put into the wrong hands could be very dangerous. For most average Americans, I don’t see this being a huge problem. But, as Rand Paul was saying in one of his speeches, this could turn into a case of the movie “Gattaca”, where we could be segregated by our health status see http://en.wikipedia.org/wiki/Gattaca for more information on that theory.
The next several sections talk about increasing governmental committees to study and report findings on different areas of the health care data collections. From the looks of it they are supposed to put eyes and ears on many different portions of the new system. However, I’m not too optimistic when it comes to weeding out the fraud. We have huge amounts of tax return fraud, medicaid fraud, medicare fraud and every other governmental assistance program. So I really see this more of a waste in spending than anything else. We do need oversight to make sure Obamacare doesn’t get crazy but, we need to simplify things a lot more I believe.
The next several sections discuss the implementation of expanding loans and grants to basically anyone that wants to enter the medical field. So, if you would like to go back to school to be a nurse, doctor or dentist and so on this would be an excellent program to take advantage of. If your happy with being a truck driver then you will do what I’m doing and keep on trucking. They will actually be helping medical health professionals pay off their student loans based on length of time at their new job. The strange part of this section is appointing a reserve medical corps to work in times of national emergency. If this is attached to F.E.M.A. in any way then it could get ugly as F.E.M.A. has such powers as to declare martial law and other wildly end of days tactics. However, the corps may be a good thing for natural disasters like Hurricane Katrina or Super Storm Sandy.
They have also set aside a bunch of grants to help with hiring of staff to teach new medical professionals. Including funding community training centers, tech schools and higher education facilities like colleges and universities. This way they will have more programs available for people to learn the new skill. I for one am in favor of this because if you have ever looked into getting into the medical profession, the waiting lists and standards to get in a program are ridiculous. Try like 3.9 G.P.A. and two to five years. Most people including me move on to something else like truck driving during the waiting period.
In section 6001 and a little further down it looks as though they are requiring physicians and hospitals to submit reports on any financial gain they will receive on referral services. As well as requiring drug reps to give information on the samples that they distribute to doctors. It also has a lot more oversight on procedures and policies for doctors and hospitals to address. I think this may be counterproductive and an invasion of privacy at the same time. If these doctors and facilities are so worried about reporting requirements it could discourage many of them to enter into the health care field or to even shut down. I guess time will tell.
On that same topic section 6101 delivers more oversight in the nursing home sector. I do believe there is a lot of malpractice that goes on with our assisted living centers and old age homes. However, this may just drive the costs of those centers even higher, as if they weren’t already out of control. It may create jobs though to assist in the reporting and accountability practices. There will also be penalties for not complying or failure in meeting the standards set forth. And, they have expanded background checks to long term care facilities as well.
A really interesting snippet I found is a fee that is imposed in section 4375 to all insured and self insured health plans. It’s not much but, basically it looks like a two dollar tax on each health plan to fund the Patient-Centered Outcomes Research Trust Fund. Which is just another example of data collection and reporting to “supposedly” discover better treatments and to become more efficient.
As we wrap up this portion of the ACA review I can say that much like yesterday I am really amazed at the amount of privacy issues, oversight, control and spending this bill actually is. Billions and billions of dollars just thrown about. Language that gives the government huge control over our “supposed to be private health information”. The information to dissect in this blog as before comes from http://housedocs.house.gov/energycommerce/ppacacon.pdf. Please let me know your feelings, observations and opinions about what we’ve discussed here, or any feedback on my writing style. I look forward to discussing other important issues besides Obamacare in the future. Thanks and be safe out there!