Pastor
St. Mary's Catholic Church
Greenville, South Carolina
November 1, 2009
The health bill that House Speaker Nancy Pelosi is bringing to a vote (H.R. 3962) is 1,990 pages. Here are some of the details you need to know.
What the government will require you to do:
• Sec. 202 (p. 91-92) of the bill requires you to enroll in a "qualified plan." If you get your insurance at work, your employer will have a "grace period" to switch you to a "qualified plan," meaning a plan designed by the Secretary of Health and Human Services. If you buy your own insurance, there's no grace period. You'll have to enroll in a qualified plan as soon as any term in your contract changes, such as the co-pay, deductible or benefit.
• Sec. 224 (p. 118) provides that 18 months after the bill becomes law, the Secretary of Health and Human Services will decide what a "qualified plan" covers and how much you'll be legally required to pay for it. That's like a banker telling you to sign the loan agreement now, then filling in the interest rate and repayment terms 18 months later.
On Nov. 2, the Congressional Budget Office estimated what the plans will likely cost. An individual earning $44,000 before taxes who purchases his own insurance will have to pay a $5,300 premium and an estimated $2,000 in out-of-pocket expenses, for a total of $7,300 a year, which is 17% of his pre-tax income. A family earning $102,100 a year before taxes will have to pay a $15,000 premium plus an estimated $5,300 out-of-pocket, for a $20,300 total, or 20% of its pre-tax income. Individuals and families earning less than these amounts will be eligible for subsidies paid directly to their insurer.
• Sec. 303 (pp. 167-168) makes it clear that, although the "qualified plan" is not yet designed, it will be of the "one size fits all" variety. The bill claims to offer choice—basic, enhanced and premium levels—but the benefits are the same. Only the co-pays and deductibles differ. You will have to enroll in the same plan, whether the government is paying for it or you and your employer are footing the bill.
• Sec. 59b (pp. 297-299) says that when you file your taxes, you must include proof that you are in a qualified plan. If not, you will be fined thousands of dollars. Illegal immigrants are exempt from this requirement.
• Sec. 412 (p. 272) says that employers must provide a "qualified plan" for their employees and pay 72.5% of the cost, and a smaller share of family coverage, or incur an 8% payroll tax. Small businesses, with payrolls from $500,000 to $750,000, are fined less.
Eviscerating Medicare:
In addition to reducing future Medicare funding by an estimated $500 billion, the bill fundamentally changes how Medicare pays doctors and hospitals, permitting the government to dictate treatment decisions.
• Sec. 1302 (pp. 672-692) moves Medicare from a fee-for-service payment system, in which patients choose which doctors to see and doctors are paid for each service they provide, toward what's called a "medical home."
The medical home is this decade's version of HMO-restrictions on care. A primary-care provider manages access to costly specialists and diagnostic tests for a flat monthly fee. The bill specifies that patients may have to settle for a nurse practitioner rather than a physician as the primary-care provider. Medical homes begin with demonstration projects, but the HHS secretary is authorized to "disseminate this approach rapidly on a national basis."
A December 2008 Congressional Budget Office report noted that "medical homes" were likely to resemble the unpopular gatekeepers of 20 years ago if cost control was a priority.
• Sec. 1114 (pp. 391-393) replaces physicians with physician assistants in overseeing care for hospice patients.
• Secs. 1158-1160 (pp. 499-520) initiates programs to reduce payments for patient care to what it costs in the lowest cost regions of the country. This will reduce payments for care (and by implication the standard of care) for hospital patients in higher cost areas such as New York and Florida.
• Sec. 1161 (pp. 520-545) cuts payments to Medicare Advantage plans (used by 20% of seniors). Advantage plans have warned this will result in reductions in optional benefits such as vision and dental care.
• Sec. 1402 (p. 756) says that the results of comparative effectiveness research conducted by the government will be delivered to doctors electronically to guide their use of "medical items and services."
Questionable Priorities:
While the bill will slash Medicare funding, it will also direct billions of dollars to numerous inner-city social work and diversity programs with vague standards of accountability.
• Sec. 399V (p. 1422) provides for grants to community "entities" with no required qualifications except having "documented community activity and experience with community healthcare workers" to "educate, guide, and provide experiential learning opportunities" aimed at drug abuse, poor nutrition, smoking and obesity. "Each community health worker program receiving funds under the grant will provide services in the cultural context most appropriate for the individual served by the program."
These programs will "enhance the capacity of individuals to utilize health services and health related social services under Federal, State and local programs by assisting individuals in establishing eligibility . . . and in receiving services and other benefits" including transportation and translation services.
• Sec. 222 (p. 617) provides reimbursement for culturally and linguistically appropriate services. This program will train health-care workers to inform Medicare beneficiaries of their "right" to have an interpreter at all times and with no co-pays for language services.
• Secs. 2521 and 2533 (pp. 1379 and 1437) establishes racial and ethnic preferences in awarding grants for training nurses and creating secondary-school health science programs. For example, grants for nursing schools should "give preference to programs that provide for improving the diversity of new nurse graduates to reflect changes in the demographics of the patient population." And secondary-school grants should go to schools "graduating students from disadvantaged backgrounds including racial and ethnic minorities."
• Sec. 305 (p. 189) Provides for automatic Medicaid enrollment of newborns who do not otherwise have insurance.
Fr. Pavone also said that in his role as President of the National Pro-life Religious Council, he would also involve Churches of other denominations in this project to educate voters on the outcome of the Stupak-Pitts amendment.
Priests for Life is the nation's largest Catholic pro-life organization dedicated to ending abortion and euthanasia. For more information, visit www.priestsforlife.org."Bright-minded young people think poorly of existing institutions and want to abolish them. Well, one doesn't need to be young to dislike institutions. But the dreary fact remains that, even in the darkest ages, it was institutions that made society work, and if civilisation is to survive society must somehow be made to work.
At this point I reveal myself in my true colours, as a stick-in-the-mud. I hold a number of beliefs that have been repudiated by the liveliest intellects of our time. I believe that order is better than chaos, creation better than destruction. I prefer gentleness to violence, forgiveness to vendetta. I believe that in spite of the recent triumphs of science, men haven't changed much in the last two thousand years; and in consequence we must still try to learn from history. History is ourselves."
Lord Kenneth Clark
Although the TAC is not large, being made up of only 20 or so parishes, the vote by the group to accept the invitation is expected to be a strong symbolic blow to the mainstream Anglican Church in its motherland of Britain, where it has been a leader in the acceptance of woman clergy and homosexuality. It is widely acknowledged that the Vatican's decision to extend its hand to traditionalist Anglicans comes in response to repeated requests, made public last year, by the TAC.
In a surprise announcement on October 20, the Vatican said that a document was being prepared that would create "personal ordinariates" that will allow "traditionalist" Anglicans to come into the Catholic Church in groups while retaining their liturgical and pastoral traditions, including the possibility of a married clergy. William Cardinal Levada, the head of the Congregation for the Doctrine of the Faith, said that the move had come in response to many requests from Anglicans around the world, clergy, laity and bishops, who objected to the growing acceptance of homosexuality in Anglicanism, especially in North America and Britain.
The website of the TAC in the UK reported last week, "This Assembly, representing the Traditional Anglican Communion in Great Britain, offers its joyful thanks to Pope Benedict XVI for his forthcoming Apostolic Constitution allowing the corporate reunion of Anglicans with the Holy See, and requests the Primate and College of Bishops of the Traditional Anglican Communion to take the steps necessary to implement this Constitution."
The leadership of the Traditional Anglican Community in Canada told LSN in an interview late last month that the life and family issues are a major factor in the attraction of the Catholic Church. Bishop Carl Reid of the Traditional Anglican Communion in Canada, told LifeSiteNews.com (LSN), "When it comes to issues of morality, especially family and pro-life, our membership is very strongly on the same page as are Roman Catholics."
The pope's offer to Anglicans who adhere to traditionally Christian moral doctrine has infuriated the left in both the secular and religious worlds. Benedict XVI has been attacked most recently by former Catholic theologian and notorious opponent of Catholic moral teaching, Hans Kung, as well as innumerable journalists and editors who see the move as the Vatican turning back the ecclesial clock towards a pre-1960s traditional style. Kung accused Benedict, his former university colleague, of ecclesiastical "piracy" and said that the move undermines the decades-long work of "ecumenical dialogue."
John Allen, the leading American "liberal" Catholic journalist in Rome, gave a more sedate analysis, saying that the invitation to the Anglicans who are in agreement on the nature of truth, doctrine and biblical inerrancy, is indeed part of the pope's greater plan to combat the growing secularist "dictatorship of relativism" that the pontiff has warned is undermining the very structure of our civilization.
"Benedict XVI is opening the door to ... traditionalist Anglicans in part because whatever else they may be, they are among the Christians least prone to end up, in the memorable phrase of Jacques Maritain, 'kneeling before the world,' meaning sold out to secularism," Allen wrote in a column today.
Fr. John Zuhlsdorf, an American priest-blogger with connections inside the Vatican, has commented that with this decision (one that was fought by many bishops in his own Church), the pope has earned the title, "Pope of unity."
The Anglicans who may take advantage of the new "canonical structure," Zhusldorf wrote, "are Christians who are separated from clear unity with the Church. Pope Benedict stresses the importance of his role as Pope as being one of promoting unity. It is not just that they a Christians who tend to agree with him. They are separated. He is trying to reintegrate them."
"If we are going to fight the dictatorship of relativism," Fr. Zuhlsdorf continued, "we need a strong Catholic identity. If we are going to evangelize, we need a strong Catholic identity. If we are going to engage in true ecumenism, we need a strong Catholic identity. Liturgy is the key component in his 'Marshall Plan' for the Church."