SENATE BILL: The New Atlasian Healthcare Act (Law'd)

[Governor Scott]

I suggest mentioning the health payroll part of the funding in the text of this bill (whether you keep it as is, change it or repeal/replace it), so that it is comprehensive.

It would be appreciated if the sponsor, Senator Scott, could respond to this point and soon.

I would not object to this.

[Senator North Carolina Yankee]

We need a text to amend the bill then, correct?

[Jayhawker]

After consideration,

Nay

[Senator North Carolina Yankee]

The amendment has failed.

[ilikeverin]

Sigh.  Has anyone yet drafted a proposal having to do with speech pathology issues?

[Senator Sbane]

No, you should go for it!

[Yelnoc]

A question from the peanut gallery (sorry, but I'm not going to read all nine pages):

Does this bill have a provision within it to repeal the other Atlasian Healthcare Act we passed not to long ago?  Duplicity should be avoided.

[Senator Sbane]

Well, this is mostly just amendments to that. Do we need to repeal it? If needed then yeah we should do that before we pass this.

[Senator North Carolina Yankee]

We don't need to repeal the old one for this one to work. We need to insert language saying "Fritzcare (insert the official name for that) is amended as follows", or something like that.

[Senator Sbane]

We don't need to repeal the old one for this one to work. We need to insert language saying "Fritzcare (insert the official name for that) is amended as follows", or something like that.

Ok then, let's do that.

[Senator North Carolina Yankee]

I take it that I am supposed to write that language, Sbane?

[Senator Sbane]

Yes, that would be nice.

[Senator North Carolina Yankee]

Have any changes been made to this since you posted this on the fifth of April?

Section 1- Eligibility and Benefits

    (a.) All individuals residing in Atlasia are eligible covered under the Atlasian National Health Care Program entitling them to a universal, best high quality standard of care.
    (b.) The health care benefits under this Act cover all medically necessary services, including at least the following:

            Primary care and prevention.
            Inpatient care.
            Outpatient care.
            Emergency care.
            Prescription drugs.
            Durable medical equipment.
            Long-term care.
            Palliative care.
            Mental health services.
            The full scope of dental services (other than cosmetic dentistry).
            Substance abuse treatment services.
            Chiropractic services.
            Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).
            Hearing services, including coverage of hearing aids.
            Podiatric care.
            Contraceptive services

    (c.) Such benefits are available through any licensed health care clinician anywhere in Atlasia that is legally qualified to provide the benefits.
    (d.) No deductibles, co-payments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits, but additional insurance from private sources is not forbidden.
    (e.) All private and public hospitals and doctors are required to be participating providers, and are not permitted to deny care on the basis of one's enrollment in the Atlasian National Health Care Program.
    (f.) All health insurance companies, public or private, shall be required to join the health insurance Exchange to be legally licensed to provide services. No company in the Exchange may deny coverage on the basis of previous health condition. The Exchange shall be governed by the Health Directorate, who shall be responsible for determining proper levels of reimbursement, management, administration and other related health industry needs.
(g.) Prescription drug companies shall not be allowed to advertise their products outside of certified medical journals.

Section 2- Finances

    (a.) The Atlasian Government, through the Atlasian National Health Care Program's regional offices, shall be financially obligated to cover: 90% of costs from services and benefits provided to the enrolled by the participating providers for individuals below 250% the poverty level; 50% of the costs from services and benefits provided to the enrolled by the participating providers for individuals between 250% the poverty level and $250,000; and 10% of the costs from services and benefits provided to the enrolled by the participating providers for individuals above $250,000. The total out of pocket payment for you or your family for the whole year may not exceed beyond 5% of your income if you make less than 250% of the poverty level. It cannot exceed 15% of your income if you make between 250% of the poverty level and $250,000 a year. It cannot exceed above 25% of your income if you make more than $250,000 a year. Nothing will need to be paid for preventative care by anyone of any income.
    (b.) Licensed health care clinicians who accept any payment from the Atlasian National Health Care Program may not bill any patient for any covered service.
    (c.) Funding for this proposal shall be drawn from the following sources:

            Cost reductions in other federal health programs, including Medicare and Medicaid, as a result of administrative and cost savings and shifts in funding priorities
            Taxes levied on health insurance benefits as follows: 0.5% for incomes below 250% the poverty level; 2% for incomes between 250% the poverty level and $250,000; 3.5% for incomes between $250,001 and $1,000,000; and 5%5.5% for incomes above $1,000,000.

Section 3- Administration

    (a.) This Act shall be administered by the Health Directorate, made up by a Chairman and the Executives of the regional CHP boards.
    (b.) Medicare and Medicaid shall be phased out, with all necessary personnel and services being transferred to the Atlasian National Health Care Program upon its establishment.

Section 4- Regional Administration

    (a.) The provision of healthcare and the administration of budgets and services shall be the responsibility of independent Community Health Partnerships (CHPs) congruent to the existing Regions These shall be established as public sector corporations. Each CHP shall be headed by a board consisting of one Executive and further non-executive members.
    (b.) CHP members shall be selected by the Health Directorate and shall be a non-partisan gathering of experts in the medical, pharmaceutical, and health insurance and administration industries.
    (c.) All boards shall be required to have an audit committee consisting only of non-executive members on which the chair may not sit. This committee shall be entrusted with the supervision of financial audit and of systems of corporate governance within the CHP.
    (d.) CHP's shall have responsibility for delivering primary and community services and commission them from other providers, and are involved in commissioning secondary care. Each CHP shall have their own budget and set their own priorities and shall directly provide a range of community health services including but not exclusive to;

            The provision of funding for general practitioners and medical prescriptions.
            The commission of hospital and mental health services from the private sector.

    (e.) All members, directors and associated bodies shall be accountable to the Health Directorate as outlined in Section 3 of this Act.  

I am highlighting the changes made to the original law passed in 2009 including the two amendments that have been added on and the parts that have been struck out.

[Senator Sbane]

As the amendment to take out chiropractic services was defeated, no. Also how do we want to add in that this amends the original law? Do it in the wiki or put it in this bill?

[Senator North Carolina Yankee]

It would get a new wiki page most likely. Hopefully with a notation added to the old one about subsequent amending.

As for this text, I would just include a phrase such as the italicized:

The New Atlasian Healthcare Act

The Atlasian National Healthcare Act of 2009 is amended as follows:

Section 1- Eligibility and Benefits

    (a.) All individuals residing in Atlasia are eligible covered under the Atlasian National Health Care Program entitling them to a universal, best high quality standard of care.
    (b.) The health care benefits under this Act cover all medically necessary services, including at least the following:

            Primary care and prevention.
            Inpatient care.
            Outpatient care.
            Emergency care.
            Prescription drugs.
            Durable medical equipment.
            Long-term care.
            Palliative care.
            Mental health services.
            The full scope of dental services (other than cosmetic dentistry).
            Substance abuse treatment services.
            Chiropractic services.
            Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).
            Hearing services, including coverage of hearing aids.
            Podiatric care.
            Contraceptive services

    (c.) Such benefits are available through any licensed health care clinician anywhere in Atlasia that is legally qualified to provide the benefits.
    (d.) No deductibles, co-payments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits, but additional insurance from private sources is not forbidden.
    (e.) All private and public hospitals and doctors are required to be participating providers, and are not permitted to deny care on the basis of one's enrollment in the Atlasian National Health Care Program.
    (f.) All health insurance companies, public or private, shall be required to join the health insurance Exchange to be legally licensed to provide services. No company in the Exchange may deny coverage on the basis of previous health condition. The Exchange shall be governed by the Health Directorate, who shall be responsible for determining proper levels of reimbursement, management, administration and other related health industry needs.
(g.) Prescription drug companies shall not be allowed to advertise their products outside of certified medical journals.

Section 2- Finances

    (a.) The Atlasian Government, through the Atlasian National Health Care Program's regional offices, shall be financially obligated to cover: 90% of costs from services and benefits provided to the enrolled by the participating providers for individuals below 250% the poverty level; 50% of the costs from services and benefits provided to the enrolled by the participating providers for individuals between 250% the poverty level and $250,000; and 10% of the costs from services and benefits provided to the enrolled by the participating providers for individuals above $250,000. The total out of pocket payment for you or your family for the whole year may not exceed beyond 5% of your income if you make less than 250% of the poverty level. It cannot exceed 15% of your income if you make between 250% of the poverty level and $250,000 a year. It cannot exceed above 25% of your income if you make more than $250,000 a year. Nothing will need to be paid for preventative care by anyone of any income.
    (b.) Licensed health care clinicians who accept any payment from the Atlasian National Health Care Program may not bill any patient for any covered service.
    (c.) Funding for this proposal shall be drawn from the following sources:

            Cost reductions in other federal health programs, including Medicare and Medicaid, as a result of administrative and cost savings and shifts in funding priorities
            Taxes levied on health insurance benefits as follows: 0.5% for incomes below 250% the poverty level; 2% for incomes between 250% the poverty level and $250,000; 3.5% for incomes between $250,001 and $1,000,000; and 5%5.5% for incomes above $1,000,000.

Section 3- Administration

    (a.) This Act shall be administered by the Health Directorate, made up by a Chairman and the Executives of the regional CHP boards.
    (b.) Medicare and Medicaid shall be phased out, with all necessary personnel and services being transferred to the Atlasian National Health Care Program upon its establishment.

Section 4- Regional Administration

    (a.) The provision of healthcare and the administration of budgets and services shall be the responsibility of independent Community Health Partnerships (CHPs) congruent to the existing Regions These shall be established as public sector corporations. Each CHP shall be headed by a board consisting of one Executive and further non-executive members.
    (b.) CHP members shall be selected by the Health Directorate and shall be a non-partisan gathering of experts in the medical, pharmaceutical, and health insurance and administration industries.
    (c.) All boards shall be required to have an audit committee consisting only of non-executive members on which the chair may not sit. This committee shall be entrusted with the supervision of financial audit and of systems of corporate governance within the CHP.
    (d.) CHP's shall have responsibility for delivering primary and community services and commission them from other providers, and are involved in commissioning secondary care. Each CHP shall have their own budget and set their own priorities and shall directly provide a range of community health services including but not exclusive to;

            The provision of funding for general practitioners and medical prescriptions.
            The commission of hospital and mental health services from the private sector.

    (e.) All members, directors and associated bodies shall be accountable to the Health Directorate as outlined in Section 3 of this Act.

Sponsor Feedback: NO VALID ENTRY

[Governor Scott]

The amendment is friendly.

[Senator North Carolina Yankee]

Senators have 24 hours to object.

[Senator North Carolina Yankee]

The amendment has passed.


Is it possible to cap the Payroll tax hike and find a way to make up the loss of revenue from foregoing the final leg of implementation?

[shua]

The amendment has passed.


Is it possible to cap the Payroll tax hike and find a way to make up the loss of revenue from foregoing the final leg of implementation?

Or you could consider capping it in any case. Reducing the rate from the ultimate 6.5% to the current 4.5% would mean a loss of revenue of about $225 billion. This bill would save at least $300 billion in spending.

[Senator North Carolina Yankee]

What do the other Senators think?

[clarence]

This bill being revenue neutral boosts is case...if it allows us to afford a tax cut then excellent

[Senator Sbane]

The amendment has passed.


Is it possible to cap the Payroll tax hike and find a way to make up the loss of revenue from foregoing the final leg of implementation?

Or you could consider capping it in any case. Reducing the rate from the ultimate 6.5% to the current 4.5% would mean a loss of revenue of about $225 billion. This bill would save at least $300 billion in spending.

So we would save only $75 Billion a year? I think keeping the rate at 6.5% is probably a good idea so we can get savings of $300 Billion a year. And I am certainly not in favor of using those savings to have tax cuts. We should pay down the debt with that. That is the fiscally responsible thing to do.

[Senator North Carolina Yankee]

It is not 6.5% currently, but it will increase to 6.5% in July.


When we passed that last year, it was with the intent that we would either get an alternative or find some way to forgo atleast that last leg of implementation. I don't want to speak for shua who worked with me on that, but I beleive we both felt that this choice was an option of last resort that if it could be altered later, it should.

[Secretary Polnut]

The amendment has passed.


Is it possible to cap the Payroll tax hike and find a way to make up the loss of revenue from foregoing the final leg of implementation?

Or you could consider capping it in any case. Reducing the rate from the ultimate 6.5% to the current 4.5% would mean a loss of revenue of about $225 billion. This bill would save at least $300 billion in spending.

So we would save only $75 Billion a year? I think keeping the rate at 6.5% is probably a good idea so we can get savings of $300 Billion a year. And I am certainly not in favor of using those savings to have tax cuts. We should pay down the debt with that. That is the fiscally responsible thing to do.

I agree with this... I think debt reduction should be the short term goal, it saves money in the medium-long term.

[Senator North Carolina Yankee]

Actually, the current text of this bill, if I read it right, repeals the payroll tax entirely.

Section 4: Health Insurance
1. The present 1.45% medicare payroll tax levied on both employees and employers is renamed the Health Care Payroll Tax

2. The Health Care Payroll Tax rate applied to both employers and employees shall rise from 1.45% to 3% on January 1st, 2012, from 3% to 4.5% on April 1st, 2012, from 4.5% to 6.0% on July 1st, 2012, and finally from 6.0% to 6.5% on September 1st, 2012. Clauses 1 and 2, shall be inserted as the third and fourth bulleted items in clause (c.), of Section 2, of the Atlasian National Health Care Act

They aren't even included in the bill.