On a slightly different note, here's an interesting bill that is getting zero publicity.

http://healthcare.change.org/blog/view/the_healthy_americans_act_so_crazy_it_jus t_might_work

And just as important, here is what is NOT included in the bill:

Tort Reform

That's true. It really only addresses one small piece of the problem, but I find that approach more palatable than trying to fix everything at once.

I haven't seen a MomMD post this rude in a long time.

How about we keep up this discussion without personal attacks.

Sorry, Melbelle, I was saying that tort reform is not included in HR 3200.

Melbelle - great link. I agree actually think the Widen Bennett Bipartsan proposal is the most rational of them all and I'd like to see it gain some traction. It phases out employer sponsored health insurance but brings much stricter regulation to the insurance industry forcing both patients and insurers to act more responsibly.

Also, HAM can you provid source of the document you are referring too - I assume it is HR 3200 but the document on the congressional website is divided by section, not pages. I would like to see the specific language of the document you are citing.

sahmd - no problem. It's not in the Widen Bennet bill either. It definitely needs to be addressed, hopefully sooner than later.

I'm not HAM, but here is a link to the 1017-page text of HR 3200, not including any recent changes by committees. You can look up the relevant passages for yourself by page number.

http://defendyourhealthcare.us/houseandsenatebills.html

The problem with analyzing a bill like this is that it is written ambiguously. It is open to interpretation. If passed, who will interpret it? Some accountant who has been assigned to cut costs or else? Zeke???

Of particular interest to me is the description of the Health Benefit Advisory Committee that will recommend what will be covered and what will not be covered in an acceptable plan.

(5) PARTICIPATION.—The membership of the
24 Health Benefits Advisory Committee shall at least
25 reflect providers, consumer representatives, employ-

1 ers, labor, health insurance issuers, experts in health
2 care financing and delivery, experts in racial and
3 ethnic disparities, experts in care for those with dis4
abilities, representatives of relevant governmental
5 agencies. and at least one practicing physician or
6 other health professional and an expert on children’s
7 health and shall represent a balance among various
8 sectors of the health care system so that no single
9 sector unduly influences the recommendations of
10 such Committee.


Technically, this entire committee could be formed without even one physician representative, as the wording is "at least one physician or other health professional".

Asunshine - the post was not intended to be rude. I apologize if it came across that way. It contained rhetorical questions to prove my point. There was no personal attack included therein. I reviewed the bill and don't believe the page numbers are necessarily accurate. It takes some searching but is all included.

The following is a terrific commentary in the Wall Street Journal written by a physician. Its entertaining to read and drives one of the many points arguing against this bill home.

Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.

At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)

Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.

Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.

• Legal "DRGs." Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine's Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I'm surprised lawyers don't tack shipping and handling onto their bills.

• Legal "death panels." Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you're on your own.

• Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that' s tough: What do you want for "free"?

• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.

• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many. This reform will guarantee a selection of mediocre, unmotivated attorneys but should help slow rising legal costs. Big shot under indictment? Classified National Archives documents down your pants? Sitting president defending against impeachment? Have FBI agents found $90,000 in your freezer? Too bad. Under reform you too may have to go to the government legal shop for advice.

• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily.

• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.

• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.

• Collect data about the supply of and demand for attorneys.Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.

• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.

Enthusiastically embracing the above legal changes can serve as a "teachable moment" and will go a long way toward giving the lawyers who run Congress a taste of their own medicine.

Dr. Rafal is a radiologist in New York City.