LC 2.5 The Lincoln Single Payer Healthcare Act (General debate)

[lfromnj]

Is abortion covered under reproductive care?

[lfromnj]

An act to establish a regional single payer healthcare system in the region of Lincoln

Section I: Elegibility and benefits
1. A new government program, named the Lincoln Healthcare System, or LHS, shall be created
2. All residents of Lincoln shall be entitled to benefits under this Act
3. No person shall be excluded from participation in or be denied the benefits of the program or be subject to any reduction of benefits established under this Act for discriminatory reasons. These include, but are not limited to age, race, gender, pre-existing medical conditions, etc
4. The enrollment of new individuals in this program shall be automatic upon adquiring the condition of legal resident of Lincoln. The government shall issue a card to all individuals enrolled in this program
5. From the moment this bill is enacted, it shall be unlawful for private insurers and employers to provide or sell benefits that duplicate those of this act. However extra benefits not covered by this act may still be provided by private insurers and employers

Section II: Coverage
1. The government of Lincoln shall pay on behalf of the individuals covered by this program for the following items and services if they are medically appropiate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition:

a) Hospital services, including inpatient and outpatient hospital care, including 24-hour-a-day emergency services and inpatient prescription drugs.
b) Ambulatory patient services.
c) Primary and preventive services, including chronic disease management.
d) Prescription drugs and medical devices, including outpatient prescription drugs, medical devices, and biological products.
e) Mental health and substance abuse treatment services, including inpatient care.
f) Laboratory and diagnostic services.
g) Comprehensive reproductive excluding abortion except in the case of where the fetus threatens the mothers life or came from a case of rape., maternity, and newborn care.
h) Pediatrics.
i) Oral health, audiology, and vision services.
j) Rehabilitative and habilitative services and devices.
k) Emergency services and transportation.
l) Early and periodic screening, diagnostic, and treatment services
m) Long-term care services and support

2. No cost-sharing measures shall be imposed on individuals for the services covered by this Act

Section III: On Healthcare Providers
1. Each health care provider has a duty to act in the exclusive interest of each individual under the care of such provider according to the applicable legal standard of care, such that no financial interest or relationship impairs any health care provider’s ability to furnish necessary and appropriate care to such individual.
2. A health care provider is considered to be qualified to furnish covered items and services under this Act if the provider is licensed or certified to furnish such items and services in the region of Lincoln
3. The government of Lincoln shall establish minimum standards for institutional providers of services and individual health care practitioners.
4. An institutional, individual or privately owned provider may not bill or enter into any private contract with any individual eligible for benefits under the Act for any item or service that is a benefit under this Act.
5. All healthcare providers by the start of the year 2030 shall be public or non-profit providers. The government of Lincoln will work for a smooth transition. The year of application of this section may be extended by the governor.
6. Individuals covered by this act shall be free to choose among all providers and institutions that participate in this Act

Section IV: Payments to Providers
1. Not later than the beginning of each fiscal quarter during which an institutional provider of care (including hospitals, skilled nursing facilities, Federally qualified health centers, home health agencies, and independent dialysis facilities) is to furnish items and services under this Act, the government of Lincoln shall pay to such institutional provider a lump sum.
2. The amount of each payment to a provider described in Section IV.1 shall be determined before the start of each fiscal year through negotiations between the provider and the state director with jurisdiction over such provider.
3. Payments to providers under this Act may not take into account:
a) The provider's marketing
b) The profit or net revenue of the provider
c) Political contributions
4. Providers receiving payment under this Section shall be prohibited from using funds designated for operating expenditures for capital expenditures or profit; and viceversa
5. The prices to be paid for covered pharmaceuticals, medical supplies, medical technologies, and medically necessary equipment covered under this Act shall be negotiated annually

Section V: Relation with the federal Reforming and Regionalizing Public Healthcare Act of 2017
1. The region of Lincoln hereby opts out of the AtlasCare program, as established in Part II, Section 1 of that bill.

Section VI: Enactment

This is the amendment I propose. I think Suburban should be satisfied with this.

[lfromnj]

I support lfromnj’s amendment added to this bill

So, I vote AYE on the amendment, but not the bill

We need to wait for the final vote on the bill.


Also to tack I do not object to the grammatical changes.

[lfromnj]

I propose the following amendment:

Section I: Elegibility and benefits
1. A new government program, named the Lincoln Healthcare System, or LHS, shall be created
2. All residents citizens of Lincoln shall be entitled to benefits under this Act
3. No person shall be excluded from participation in or be denied the benefits of the program or be subject to any reduction of benefits established under this Act for discriminatory reasons. These include, but are not limited to age, race, gender, pre-existing medical conditions, etc
4. The enrollment of new individuals in this program shall be automatic upon adquiring the condition of legal resident Atlasian citizen of residing in Lincoln. The government shall issue a card to all individuals enrolled in this program
5. From the moment this bill is enacted, it shall be unlawful for private insurers and employers to provide or sell benefits that duplicate those of this act. However extra benefits not covered by this act may still be provided by private insurers and employers

I'm hoping this was an oversight. It's not appropriate to offer healthcare benefits to noncitizens, particularly illegal aliens.

Expecting taxpayers to fund healthcare for this group is an unpopular if not fringe position. If you want to do something about catastrophic care so there isn't big emergency room debt, then the only logical way would be taxing remittances, which I imagine has to be at the federal level.

Please consider this amendment, Mr. Speaker.

I agree that illegal aliens should certainly not be given healthcare access, other than emergency one.

However, I see no reason for legal residents of Lincoln to be discriminated on access to healthcare. Unless you are trying to prevent "medical tourism"? That is indeed also something to be prevented. But all legal residents with the exceptions of tourists should be given access to healthcare.

My personal preference would be to limit to citizens and legal permanent residents.

In practice, yes, the two instances you've mentioned – illegal aliens and medical tourists – are the biggest concerns. RE:Illegal aliens, I'll take a look at AtlasCare and propose an additional amendment.

Does anybody have any ideas about how to combat the latter? Should there be tiers to service? Or should we just have a flat cutoff for residence (I don't know what would make sense, 2 or 3 years maybe?).

What about residents of Lincoln who live here on a H1b Visa or a similar item? Could we perhaps keep a 5 year legal residency law?

[lfromnj]

After some thinking, I think I'd prefer a lower limit, of say, 4 or 6 months (or abolish it entirely). Who would be the most likely people on temporary visas?

Temporary workers? Students? Who else?

My main idea is thinking about people stuck in the immigration system waiting for a green card.

[lfromnj]

Im fine with any reasonable year. Currently I settled at a year although six months is fine. 5 years was the first number that came to the top of my head.

[lfromnj]

NAY!!!!!

This is stunning, coming from a moderate like you, however, I do hope you remain involved in the game, your moderation, independence, and bipartisanship, is something that we can all learn from and admire

Wulfric has a leftist persona in game.

[lfromnj]

Aye on the amendment.

[lfromnj]

Aye although i can vote for a lower number for the limit.