SENATE BILL: Reforming Atlasian Public Health Act of 2014 (Debating)

[Southern Senator North Carolina Yankee]

This was originally a bill sponsored by Tmthforu94. I have taken this over because I am generally favorable to the idea of HSAs, though I am willing to be rather flexible on any of the details present here, including the numbers in section 1.

[Southern Senator North Carolina Yankee]

Making his healthcare more efficient=making healthcare more expensive for all but the wealthiest of Atlasians? Ok.

This bill seeks to return to the days of old, where preventative care was disregarded. That benefits those who want to profit off of the livelihood of atlasians "we can fix you once you get sick". Well excuse me for supporting a system that encourages early cancer detections via regular screenings and actually getting well instead of sitting around the house watching tv while sick as US flu deaths set records in many states.

All these HSAs do is add more bureaucracy and reduce benefits- the worst of both worlds.

Read the last sentence here Nappy. It clearly preserves complete funding for the very preventative care you are referring to:

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You will also note that in the speech I made last month on healthcare, I stated that it is essential to fund such preventative care for precisely the reason you describes, as well as the fact that success rates are higher and it is by far cheaper then the alternative.

[Southern Senator North Carolina Yankee]

So lets examine what Federalists are trying to do here, because the premise of this bill is truly infuriating to me.

Why should it be? We are just having a debate.

Slashes benefits to lower income Atlasians while leaving the benefits for wealthier Atlasians intact.

Doesn't it remove the cap on out of pocket expenses for wealthy though?

Removes the pay cap for the wealthy that could result in a family going bankrupt because of a major catastrophe.

Would it be acceptable at a million a year?

Denies worker's rights to hospital employees, becahse cheaper is always better of course.

I understand the need for them to be repesented, they have a tough job. But on the flip side I tend to be reminded of the fact that public unions don't organize against the personal self interest of a private enterprise and it's owners, but against the public interests of taking care of the sick and spending of tax payer dollars. There has to be balancing act to be sure, but when it comes to public servants there is no balance whatsoever for obvious reasons lest the public good be sacrificed.

Moves the system away from preventative care and toward an archaic HSA approach, which will make health care more expensive for all, less effective for all, without any proper reason or objective for doing so.

As stated previously, the text appears to do the exact opposite. Now granted, it might be at cross purposes one section to the next, but that is a problem of structure and consistency and can be fixed obviously.

Its really a shame. As the primary author/architect/whatever of the current system, the goal of the New Atlasian Healthcare Act was a bipartisan reform to fix a broken, bloated healthcare system. Left and right were able to work together to reduce prescription drug costs, consolidate various existing programs, move away from government healthcare to subsidized private plans that could compete against each other to lower costs while making sure we had universal access and affordability. I left the Senate before the bill was passed and most of the legislative dirty work was taken up by two great and dedicated FEDERALISTS- namely Scott and Sbane. We made healthcares budget impact rather neutral and strengthened our institutions. To undo that, for "cost saving purposes" (presumably to offer tax cuts to the rich down the road or something) we undo a stable and successful program tbat Atlasians enjoy for no good reason.

It was an improvement to be sure, but in terms of it being perfection itself, I have my doubts.

We don't have a healthcare problem. We certainly don't need this "solution".

That is the biggest factual innaccuracy in this entire thread if for no other reason then Mental Health remains a disgrace as do numerous other aspects of the system.

[Southern Senator North Carolina Yankee]

Also you can't just roll over 25% of unused funds to the general fund, the regions are responsible for the administration of costs and services and therefore it would carryover each year. You can't really just snatch the money back.

That is also innaccurate. The program is administered by the communitty Health Partnerships, and they are public corporations created by the Atlasian Senate with authority delegated to them, probably under Art 1, Section 7, Clause 28,  but function independently beyond that. The only connection to the Regions, is the borders in which these CHPs operate.

Your bill's Section:

Regional Administration
1.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.
2.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.
3.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.
4.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;
1.The provision of funding for general practitioners and medical prescriptions.
2.The commission of hospital and mental health services from the private sector.
5.All members, directors and associated bodies shall be accountable to the Health Directorate as outlined in Section 3 of this Act.


Fritz's
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;
1.The provision of funding for general practitioners and medical prescriptions.
2.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.

It came from a Scottsman though
https://uselectionatlas.org/FORUM/index.php?topic=99368.msg2079105#msg2079105

[Southern Senator North Carolina Yankee]

I will include this small note about the CHPs.

I recall their being some limit on the Fed's ability to dictate to them, from the Mental Health debate last year, but I cannot recall what exactly. I do know the Regions aren't running them as Nappy seemed to indicate on page 1.

[Southern Senator North Carolina Yankee]

As I recall the intent behind six was to ensure that patients weren't getting billed for services covered by Fritzcare and thereby essentially a double billing scheme of sorts. Though that doesn't do much in the way of preventing untintended effects of the wording.

[Southern Senator North Carolina Yankee]

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Sponsor Feedback: Hostile
Status: A vote may be opened on this amendment at any time after noon.

[Southern Senator North Carolina Yankee]

I didn't vote for Fritzcare, I highly doubt I would vote for Single Payer.

[Southern Senator North Carolina Yankee]

We have a largely sound system underlying the core of the system at present (dare I call it Nappycare? ).

I think we can have a debate over where the sliding scale should be of benefits or of premiums, and we certainly have to fix the problem with the wording of that once clause. There are some ideas that I think Lumine and Simfan were discussing that were good in the thread in the other board.

Also, I must say my heart is not in this fight like it would have been a few months ago because with the recent death of someone close to me in after spending five weeks in the hospital from what appears to be little more then negligence and incompetents, it hits just a little too close to home. So forgive me for taking a somewhat arms length approach to this as opposed to say 2009.

[Southern Senator North Carolina Yankee]

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[Southern Senator North Carolina Yankee]

Is my amendment invisible? Are we going to get a vote on that?

I sent a PM to the Vice President about it, with link included, two days ago.

[Southern Senator North Carolina Yankee]

NAY

[Southern Senator North Carolina Yankee]

Vote on Amendment 60:06 by TNF:

Aye (3): bore, TNF and TyriontheImperialist
Nay (4): Goldwater, Lumine, NC Yankee and shua
Abstain (0):

Didn't Vote (2): DC al Fine and Talleyrand
Vacant Seats (1): Mr. X

With four votes in the negative and only three in the affirmative, with time having expired, the VP may declare this amendment has having failed. 

[Southern Senator North Carolina Yankee]

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Sponsor Feedback: Origination
Status: The VP may call 24 hours on objections.

[Southern Senator North Carolina Yankee]

Clause 2 is the anti-union nonsense, no? I apologize for being too lazy to hit the back button.

Yes:

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Its a lazy amendment design so don't feel bad. The horrible part is that I have go through an change all those damn Fritzcare references now.

[Southern Senator North Carolina Yankee]

The amendment has been adopted.

[Southern Senator North Carolina Yankee]

I hate to keep deferring stuff to later (compiling the current text), but I didn't expect Cincy to want to get ahead start on learning the ropes today so I lost time to that that I wasn't counting on.

[Southern Senator North Carolina Yankee]

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[Southern Senator North Carolina Yankee]

The unconstitutional section on the unions is now gone and all Fritzcare references have been replaced with ANHC.

I recall some complaints about format as this relates to the present law (amended form passed in 2012). Could someone repost that concern so that it can be addressed.

We have also already established that the bill retains full coverage for preventative care. If there is an inconsistency later in the text, please draw attention to that so that we can address that concern as well.

Aside from that, remains the exact numbers we find acceptable for the various levels of support.  

[Southern Senator North Carolina Yankee]

Also there is that billing issue with the present law that we amentioned on page three that needs to be resolved as well.


What is the status of Oakvale's group?

If that isn't going to produce a product in the near future I recommend proceeding with this and addressing those issues that have already come up.

[Southern Senator North Carolina Yankee]

Then the debate should be shifted back to something that an acheive enough support to pass based off of this framework as the basic idea here has substantial support and at the right numbers, the administration as well most likely. I think 11 has to have less of as reduction as well as some increase in the coverage for that lowest income bracket for starters.

First off, lets fix the wording on the problem in the current statute concerning the billing issue. That will get us back to discussing the specifics of this proposal, particularly numbers and the various benefit changes as well.

I could have an amendment in a day or two, but we got nasty storms coming tomorrow.

[Southern Senator North Carolina Yankee]

I can't claim to speak for anyone other than myself, but if I've given the impression that I agree with anything in this bill then I need to clarify that this is not the case.

As its original sponsor is gone and the Senate has made virtually no progress in improving it over the past month, I don't know why you'd want to waste more effort on it unless someone has an idea for a quick fix that can win the support of at least some Laborites.

It seems they all want a single payer system and there is no way I can support that and Duke has stated his opposition as well.

We pare this down, fix the billing issue and agree to a set of numbers, we have a chance at achieving something. But I don't see anything that group is discussing getting a consensus more or less having the support to get passed if it revolves around moving to a single payer system, either.

[Southern Senator North Carolina Yankee]

I would also point out that a lot of the lack of progress stemmed from slow processing of amendments under the previous Vice President as well and that tempered debate and made it take longer.

A lot of the complaints spouted at the beginning were either bs (removing coverage for preventative care) or are now irrelevant (union section and referneces to Fritzcare).

[Southern Senator North Carolina Yankee]

Whether we move toward a single payer system or a more market-oriented one is beside the point. I was only indicating exactly what Oakvale said in the post following mine.

Which is what, exactly? That Labor doesn't support the bill, so it should be canned. Yet I got that on page one.

And so far I am not getting any concise criticisms of the core proposal save for appendages that can be removed (like the union thing) or other minor, vague, generic and otherwise meaningless sound bites more suited for a campaign add then a Senate debate. Now we got you saying there is nothing in this bill you support, which is cerainly a rather convient shift since the unnconstitutional complain is no longer valid, the Fritzcare references are gone, we have an active administrator of the thread and I offered to boost support and alter the numbers for the poor and so forth.

[Southern Senator North Carolina Yankee]

That is why I inserted the acronyme after the name of the program. I realize that you didn't but I think Scott and maybe NAppy did raise the naming issue.


1. As I have been saying, we can fix that by changing the wording of that particular clause, could you not?

2. As I have been asking for days for people to point out inconsistency, then fine, we can address that.

3. It would depend on the private market an to what extent that would cover people