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If Congressional representatives and senators, as a
wit once suggested, were allowed to vote only on legislation that they
could certify that they had read in its entirety, much ill-considered
legislation could be avoided. The size and detail of last year's budget
deal prevented a good understanding of its provisions. It wasn't helped by the fact that the bill itself was constantly being revised as the
different parties negotiated the final language. Look at
Section 4507 of last year's 1,200-page budget bill.
The Health Care Financing Administration (HCFA), the people who administer Medicare, had interpreted ambiguous technical corrections to the Medicare law in 1995 as increasing their regulatory power even over doctors and patients engaged in care outside Medicare. Indeed, HCFA's position was that, in order for a patient to undertake care outside Medicare coverage, they would have to drop out of Medicare Part B altogether. This is roughly equivalent to setting up a system where participation in Social Security prohibits individuals from making additional provisions for retirement income. Even under the nationalized health care provisions in Britain, individuals still have the real right to engage private services. The intention of Congress last year was to expand patient choices in engaging alternate services. Section 4507 of last year's budget deal begins with: " . . nothing in this title shall prohibit a physician or practitioner from entering into a private contract with a Medicare beneficiary for any item or service for which . . ."and then follows a list of limitations. Most of these make perfect sense. For example, such a contract can not be entered into "at a time when the Medicare beneficiary is facing an emergency or urgent health care situation." However, a dozen paragraphs later, Section 4507 prohibits any such contract unless the doctor agrees to not receive payment for a Medicare claim from any patient for a "2-year period." In other words, the only way a Medicare beneficiary can enter into a private contract with a doctor is if the doctor completely opts out of Medicare for all patients. Essentially, only doctors who exclusively serve the rich can be privately contracted. There are pieces of legislation introduced by Jon Kyl (R-AZ) in the Senate and Bill Archer (R-TX) and Bill Thomas (R-CA) in the House to remedy this flaw. Clearly some Congressional staffers were asleep on the job during last year's final negotiations. Nonetheless, the words did not just write Go To Page: 1 2
The copyright of the article The Devil in the Details in Conservative Politics is owned by Frank Monaldo. Permission to republish The Devil in the Details in print or online must be granted by the author in writing.
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