Quoting EA772LR (Reply 395): He was compassionate but not a hippie holding up peace signs.

So Jesus was kidding when he said "Love your enemies and pray for those who persecute you" and "If someone strikes you on the right cheek, turn to him the other also"?

Quoting EA772LR (Reply 395): Why you're even trying to make the assumption that Christ would be some leftist commie, or the fact you're even politicizing Christ or Christianity is absurd.

Acts describes the early church as decidedly commune-like, holding all property in common.

Quoting DXing (Reply 398): Incorrect, it is mandated that you will receive the counsuling every five years.

Time to break out the reading comprehension skills. The portion of the bill you quoted is an amendment to the Social Security Act. The part being amended is a list of services that are covered under Medicare, and very precise definitions of those services. Not everyone is required to receive all the services on the list; however, if they want/need a service on that list, Medicare will cover it. It's the same thing with the end-of-life consults; you don't have to get one, but if you want one, Medicare will cover it. As for the 5-year thing, that language simply means that if you have had an end-of-life consult within the past five years, Medicare won't cover you getting another one. It's certainly not a requirement that you get one every five years; in fact, five years is set as the minimum time between consults, even if you want them more often.

Quoting KC135TopBoom (Reply 399): So, you did not read the entire 12th amendment?

The 12th Amendment governs how the Electoral College selects a president. It says nothing about how states select their Electors--those are state elections.

Quoting KC135TopBoom (Reply 399): BTW, I never said the POYUS/VPOTUS were directly elected by the voters.

Then what did you mean by this statement:

Quoting KC135TopBoom (Reply 384): People do not vote for electors to the electroal college, they vote for the President and Vice President of the United States.

Quoting DXing (Reply 398): Incorrect, it is mandated that you will receive the counsuling every five years.

No, it adds coverage for end-of life counseling to the Social Security Act. The five year counseling is a limitation on how often it is covered, not a mandate that you get it done.
Here's the Social Security Act it's referencing:
http://www.ssa.gov/OP_Home/ssact/title18/1861.htm
The bill would add a section (hhh) at the end. The added section just defines what is covered.

Quoting Max550 (Reply 401): No, it adds coverage for end-of life counseling to the Social Security Act. The five year counseling is a limitation on how often it is covered, not a mandate that you get it done.

Incorrect. H.R.3200 or whatever the health care bill ends up being called will be stand alone legislation. The parts you refer to are to ammend the SS act, Medicare act, Medicaid act all to conform to the new law. Once you get below those addendums it is all new law. It will require that you have an end of life consultation, no matter what the state of your health, every 5 years. All bills, that are in conflict with established law, have these types of addendums incorporated into them so the laws don't conflict with each other.

I don't ordinarily agree with Kathleen Parker and I disagree with several statements she makes in her column today, but the end lines I do agree with as well as the paragraphs speaking directly to what is in H.R. 3200.

http://www.chron.com/disp/story.mpl/editorial/outlook/6570603.html

A simple amendment to HR 3200 would do much to cool tempers. All that's needed is specific language saying that these end-of-life consultations are not mandatory — either for physicians or patients — and that there would be no penalty, either in coverage or compensation, for declining to participate.

Quoting Yellowstone (Reply 400): Not everyone is required to receive all the services on the list; however, if they want/need a service on that list, Medicare will cover it.

Exactly! It's the same thing as Medicare covering annual mammograms and a screening colonoscopy every ten years. It doesn't mandate that anyone EVER has to have either procedure, but those are the intervals at which the procedures are covered by Medicare for those who want them. It's the same thing with the end-of-life consultations.

Most advance directives and living wills are absolute garbage! They are far too vague to be of practical use in a true end-of-life situation. I KNOW this for certain, because I've dealt with it for nearly 25 years. Patients need much more counseling about specific procedures to be included or excluded, and how long they are to be carried out if done, for the documents to be of any use. Such counseling takes a LOT of time, and cannot easily be done at the time of any regular patient visit to an MD, especially since there is no reimbursement and most of us have back-to-back patients scheduled every 15 minutes. Some of you guys are so paranoid and filled with blind rage that you are reading things into the end-of-life counseling component that just aren't there.

Quoting DXing (Reply 402): Incorrect. H.R.3200 or whatever the health care bill ends up being called will be stand alone legislation. The parts you refer to are to ammend the SS act, Medicare act, Medicaid act all to conform to the new law. Once you get below those addendums it is all new law. It will require that you have an end of life consultation, no matter what the state of your health, every 5 years. All bills, that are in conflict with established law, have these types of addendums incorporated into them so the laws don't conflict with each other.

What parts I refer to? I was referring to the same part you were:

Quoting DXing (Reply 398): pages 424-425 20 ‘‘Advance Care Planning Consultation 21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the 22 term ‘advance care planning consultation’ means a con 23 sultation between the individual and a practitioner de 24 scribed in paragraph (2) regarding advance care planning, 25 if, subject to paragraph (3), the individual involved has 1 not had such a consultation within the last 5 years. Such 2 consultation shall include the following:

It amends the SS Act. Open the SS Act that I linked for you, go to the bottom, find Kidney Disease Education Services(ggg), then below that add this amendment (hhh).

Paragraph 3 is stating that if you get a physical, during which you discuss end-of-life care, it does not count as the consultation you are limited to getting once every 5 years.

Quoting Max550 (Reply 404): It amends the SS Act. Open the SS Act that I linked for you, go to the bottom, find Kidney Disease Education Services(ggg), then below that add this amendment (hhh).

It amends the SS act to reflect the new law that will be whatever HR 3200 becomes. I fail to understand how you can discount a whole new bill that will be new law. That is the entire substance of the debate. New law always contains addendums to amend previous law so it conforms to the new law and there is no conflict between the two. The new law states that you will be mandated to receive "end of life consultation" every 5 years. The addendum sipulates and changes the SS act so that you don't get charged for that consultation which up till now has been voluntary. The second part I quoted reinforces that fact in that if you have a yearly physical, that cannot be counted as an "end of life" consultation.

Quoting DXing (Reply 405): The new law states that you will be mandated to receive "end of life consultation" every 5 years. The addendum sipulates and changes the SS act so that you don't get charged for that consultation which up till now has been voluntary. The second part I quoted reinforces that fact in that if you have a yearly physical, that cannot be counted as an "end of life" consultation.

No, you are misinterpreting this. Nothing you have quoted has said that such a consultation is mandatory. Kathleen Parker's point is that, while the proposal doesn't say such a consultation is mandatory, adding language specifically saying it is NOT mandatory will eliminate the confusion for people like you. The second part means that discussing end-of-life issues as part of a yearly physical does not exclude the possibility of having a separate end-of-life counseling session that will be reimbursed during the five year interval.

Quoting DXing (Reply 405): I fail to understand how you can discount a whole new bill that will be new law.

I'm not discounting it, we're talking about a part of the new bill that amends the SS Act to make it the law that end-of-life consultations are covered under Medicare.

Quoting DXing (Reply 405): The new law states that you will be mandated to receive "end of life consultation" every 5 years.

Where does it state that? The part we're discussing is clearly an amendment to the SS Act, that's why it's labeled (hhh), because it goes under (ggg).

Nowhere in the bill does it mandate that you ever go to a doctor (with the exception of children). You're required to have health insurance, not required to use it. John Edwards was the only candidate pushing for health care reform that would mandate preventative care.

Quoting DXing (Reply 405): New law always contains addendums to amend previous law so it conforms to the new law and there is no conflict between the two.

Which doesn't change the fact that new law, quite often, consists entirely of amendments to old laws. If you want to make a change in Medicare, for instance, you don't write an entirely new law - that would hopelessly scatter the laws about Medicare all over the US legal code. Instead, you write a law that edits the portion of the Social Security Act defining Medicare.

Quoting Dvk (Reply 406): No, you are misinterpreting this. Nothing you have quoted has said that such a consultation is mandatory.

pages 424-425

20 ‘‘Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
22 term ‘advance care planning consultation’ means a con
23 sultation between the individual and a practitioner de
24 scribed in paragraph (2) regarding advance care planning,
25 if, subject to paragraph (3), the individual involved has
1 not had such a consultation within the last 5 years. Such
2 consultation shall include the following:

I don't see how anyone could read it as anything other than mandatory. As Parker suggests, since it is vauge only the fool assumes the best case scenario. The proof will come if a Represenative pushes an amendment with Parker's suggestion and it gets shot down.

Quoting DXing (Reply 409): I don't see how anyone could read it as anything other than mandatory. As Parker suggests, since it is vauge only the fool assumes the best case scenario. The proof will come if a Represenative pushes an amendment with Parker's suggestion and it gets shot down.

Reading comprehension's clearly not your thing, DX, although I'll admit the lawmakers don't make it easy. "A consultation shall include the following" means that if any of the listed items are omitted, it isn't an Advance Care Planning Consultation. It does not mean that such a consultation is required. I could write a law reading "Egg Fried Rice shall include the following: rice and eggs," but that wouldn't mean you were required to eat it.

Quoting Yellowstone (Reply 410): "Egg Fried Rice shall include the following: rice and eggs," but that wouldn't mean you were required to eat it.

It would if it were required that it be read to you every 5 years which is what the bill says.

Quoting DXing (Reply 409): the 22 term ‘advance care planning consultation’ means a con 23 sultation between the individual and a practitioner de 24 scribed in paragraph (2) regarding advance care planning, 25 if, subject to paragraph (3), the individual involved has 1 not had such a consultation within the last 5 years.

Means=requirement.

Quoting DXing (Reply 411): Means=requirement.

No, it's defining what the term "advance care planning consultation" means.

Go through the rest of the SS Act, every section begins with a definition of what the term means, because if the the term is not defined it could mean anything.

As for the "shall include the following" part, it's defining what a consultation is. If one part is missing then it's not an 'advance care planning consultation' and isn't covered. It's not really even meant for the patient, it's telling the doctor that for him to be reimbursed for the consultation it must include certain things. My health insurance policy is worded the same way, if it weren't defined a doctor could do anything, call it a consultation, and be reimbursed for it.

Quoting DXing (Reply 411): Means=requirement.

Oxford English Dictionary:

Quote: mean, v. To signify; to convey or carry a meaning, significance, consequence, etc.

Nothing to do with requirement. And just because the law defines something does not mean that everyone has to use it.

Quoting Max550 (Reply 412): Go through the rest of the SS Act,

Again, this will be a new law. It is not part and parcel with the SS act anymore than it is part and pacel with the Medicare or Medicaid act. When you understand that then you can understand the requirement of the new law.

Quoting Yellowstone (Reply 413): Nothing to do with requirement. And just because the law defines something does not mean that everyone has to use it.

Agreed but in this case it does.

Quoting DXing (Reply 414): Again, this will be a new law. It is not part and parcel with the SS act anymore than it is part and pacel with the Medicare or Medicaid act. When you understand that then you can understand the requirement of the new law.

What part of "Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended" are you having trouble understanding? This portion of the bill is an amendment to the Social Security Act, no more, no less. Parts of HR 3200 make new law, and other parts--like this one--edit old law. And even if it were new law, its defining a term does not imply any sort of requirement. The law defines first degree murder - do we all now have to go out and kill someone?

Quoting DXing (Reply 414): Again, this will be a new law. It is not part and parcel with the SS act anymore than it is part and pacel with the Medicare or Medicaid act. When you understand that then you can understand the requirement of the new law.

It is a new law, a law that amends the SS Act. That's why it starts off with:
"(1) IN GENERAL- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--"

Quoting DXing (Reply 409): I don't see how anyone could read it as anything other than mandatory. As Parker suggests, since it is vauge only the fool assumes the best case scenario

And I don't see how you can keep pulling up that same section and insist it mandates the counseling when it does nothing of the kind. It neither states NOR implies a mandate. There is not ONE item in all of Medicare pertaining to patient treatment or counseling that requires a patient to do ANYTHING they don't want, and this proposal does not change that! The only thing a physician is expected to do is to offer treatment, diagnostic testing, and counseling, and to document that it has been offered. A patient is free to refuse anything he doesn't want, PERIOD. That includes end-of-life counseling!

Quoting Yellowstone (Reply 415): Parts of HR 3200 make new law, and other parts--like this one--edit old law.

They do both. It is new law and it edits old law so there is no conflict between the two. Almost all new laws do that.

Quoting Max550 (Reply 416): It is a new law, a law that amends the SS Act. That's why it starts off with: "(1) IN GENERAL- Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--"

and then it goes on to the new law. Go look at the penal code. Almost every law that has been adopted in the past 50 years amends a previous law so that the two laws don't conflict.

It's standard practice. One does not eliminate or over turn the other. They are written that way so they can coexist.

Quoting Yellowstone (Reply 415): its defining a term does not imply any sort of requirement. The law defines first degree murder - do we all now have to go out and kill someone?

Quoting Dvk (Reply 417): And I don't see how you can keep pulling up that same section and insist it mandates the counseling when it does nothing of the kind

And I don't see how you can read it any other way. That is why I am in favor of Parkers suggestion of adding an amendment that makes clear that it isn't a requirement. Obviously it is not clear in the way it is written now.

Quoting DXing (Reply 418): They do both. It is new law and it edits old law so there is no conflict between the two. Almost all new laws do that.

But not this part of the law. If it were doing what you suggest, there should be one part of the bill that writes the new law regarding the requirement for these consults, and a separate part amending the SSA to match the new law. But it doesn't do that. Only the second part exists; ergo, the only function of that portion of the bill is to amend the old law.

Quoting Yellowstone (Reply 419): But not this part of the law.

Yes it is. The section contains the addendums to the SS act and then describes the new law.
It starts with "In General" and describes the changes to the SS act and Medicare. On line 20 a new title "Advanced Care Planning Consultation" and goes on to describe what the new law will require. You can keep banging your head if you wish but this is the way most bills read. The first part lists the addendums to old law to make it conform to new law then the description of the new law is made.

Quoting DXing (Reply 418): And I don't see how you can read it any other way. That is why I am in favor of Parkers suggestion of adding an amendment that makes clear that it isn't a requirement. Obviously it is not clear in the way it is written now.

It's very clear that the counseling is not mandatory, but if a statement saying specifically that "end-of-life counseling is recommended, but not required" is needed to reassure the paranoid and irrational, I'm all for it. It will remove what has been a false and hysterical claim by Sarah Palin and her fans so the real issues that need to be ironed out about health care/insurance reform can be debated, fine-tuned, and compromised rationally where needed to improve the U.S. health care system. As Americans, we should all want a health care system that isn't just the world's most expensive, but actually provides measurable outcomes at least equal to or better than those in countries that already have universal coverage at lower cost.

Quoting Dvk (Reply 421): It's very clear that the counseling is not mandatory, but if a statement saying specifically that "end-of-life counseling is recommended, but not required" is needed to reassure the paranoid and irrational, I'm all for it.

Yep, this is why we take the liberals seriously. Of course the other section of the bill which gives the new Health Commisioner, who doesn't work for Social Security, wonder how that works since this is all just an amendment to the SS act according to some, the right to make this mandatory as well as many other powers that are not specifically enunciated in the bill should just be ignored as well correct?

Quoting DXing (Reply 420): Yes it is. The section contains the addendums to the SS act and then describes the new law. It starts with "In General" and describes the changes to the SS act and Medicare. On line 20 a new title "Advanced Care Planning Consultation" and goes on to describe what the new law will require.

The tabbing in the bill is a bit confusing, and I can see how you might misinterpret it, since the texts of amendments to other laws are tabbed separately from the main text of the bill. However, the key is lines 18 and 19 - Sec. 1233, subsection (a)(1)(B), which reads:

Quote: by adding at the end the following new subsection:

That line sets up the following portion, from page 424 line 20 to page 430 line 17, as part of Sec. 1233, subsection (a)(1)(B), after which the bill proceeds to subsection (a)(2). Note the quote marks that proceed all of those paragraphs - that entire thing is the text of one big amendment to the Social Security Act. No separate new law is made.

Quoting DXing (Reply 396): Absolutely. It is against the law to wire tap calls made within the United States without a warrant. Any such evidence would be inadmissable in a court.

Quoting KC135TopBoom (Reply 399): Where were all those "illegal wiretaps" done, who did them, and what did they do with that information they got from the datamining?

Yes. Where are they? Oh, that's right. They are part of Bushs' "War On Terror" and are, therefore, top secret and are not allowed to be viewed by the public. Those records would "compromise security" if anyone found out. Riiiiiight. Every single call and every single e-mail? Really? I do admit there are probably a few phone calls and e-mails that are very important in tracking al-Qaida and terrorism. However, I can not believe that every single one has something to do with a threat or is related to terrorism in some way.

Quoting KC135TopBoom (Reply 399): The government has no business sticking thier nose in such an improtant and personal decision.

Yet, letting a patient linger for years and years when either it was their wish to not linger, but they never let their physician know or it is costing the health care company thousands of dollars a month and they are trying to use attornies to unplug them while the family is using attornies to keep them plugged in? You righties complain about how much this government run health care would cost, then, when a cost effective point is brought up *BY ONE OF YOUR OWN* you complain about how horrible it is. This would save a lot of money and a lot of grief and heartache. But, since it is "socialist" and "communist" and "evil" and all those other sin words you all have, it is not acceptable.

Quoting Seb146 (Reply 424): But, since it is "socialist" and "communist" and "evil" and all those other sin words you all have, it is not acceptable.

And don't forget that we evil liberals all lack personal responsibility, never study an issue in depth or understand it, don't love America, don't work as hard as the right wingers, and we want to take everything away from hard-working patriotic Americans and give it to lazy louts who don't deserve it. Oh, and we always whine and complain about everything. The right never does that. Not even the unnamed frequent poster who set a new standard for whining and complaining (virtually crying in print) the day after the socialist Obama won the Presidency.
     

To get back to the original question, I really don't think the GOP as a party has much of an interest in fixing health care. If they did, they could have done it many times over the past 28 years, since they have held the Presidency and/or at least one house of Congress all but 2 1/2 of those years. They have been more than happy to maintain the status quo, with the exception of Medicare part D, or proposed tax breaks that were no reform at all and wouldn't have been enough to help most of the uninsured afford insurance anyway.

Quoting Yellowstone (Reply 423): and I can see how you might misinterpret it,

I see clearly how you have misinterpeted it. Again, the addendums are always there to make the new and old laws sync. The new law will require you to have an end of life counsuling session once every 5 years.

Quoting Dvk (Reply 425): To get back to the original question, I really don't think the GOP as a party has much of an interest in fixing health care. If they did, they could have done it many times over the past 28 years,

Explain 1993? Then explain how the democratic party is truly interested in fixing health insurance which is what reallyneeds fixing, not health care. In 1993 the democratic party held the White House and both Houses of Congress and yet they would not even bring a bill to committee for markup. For that matter out of those 28 years the democratic party held both Houses of Congress for 15 years, more than half the time. and yet they didn't even produce a bill that a GOP President could have vetoed. The fact of the matter is this isn't about health care or health insurance, it's about concentrating more power in Washington.

Quoting DXing (Reply 426): I see clearly how you have misinterpeted it. Again, the addendums are always there to make the new and old laws sync. The new law will require you to have an end of life counsuling session once every 5 years.

There is no old or new law, it's a piece of a law which adds to an existing law. Within that law there is nothing about requiring end of life counseling, so even if it were standing alone it still doesn't require you to do anything.

Quoting Max550 (Reply 427): There is no old or new law, it's a piece of a law which adds to an existing law

Incorrect. This is not an addition to the SS act or Medicare or Medicaid. As it is written now, it is totally new legislation creating the "Health Choices Administration".

7 Subtitle E—Governance
8 SEC. 141. HEALTH CHOICES ADMINISTRATION; HEALTH
9 CHOICES COMMISSIONER.
10 (a) IN GENERAL.—There is hereby established, as an
11 independent agency in the executive branch of the Govern
12 ment, a Health Choices Administration (in this division
13 referred to as the ‘‘Administration’’).

See page 41 of HR 3200. The addendums sync up the new law with existing law in various agencies to include the IRS.

Quoting DXing (Reply 426): I see clearly how you have misinterpeted it. Again, the addendums are always there to make the new and old laws sync. The new law will require you to have an end of life counsuling session once every 5 years.

One more time. I showed you in post 423 that the language in HR 3200 beginning "Advance Care Planning Consultation," line 20 page 424 through line 17 page 430, is the text of the amendment to the Social Security Act. You claim that that amendment serves to align the Social Security Act with the text of the new law formed by HR 3200. If that is true, you should be able to find for me that new law requiring the consults somewhere within the pages of HR 3200. Go find it for me, then I'll believe you.

And let's get one thing clear - you'd better not come back with the portion beginning on line 20 page 424. That text cannot serve both as new law and as an amendment to the old law.

What's more, even if that text was going to serve as a stand-alone new law rather than an amendment, you have yet to show how defining the consults in any way requires people to have them. I give you again the example I used earlier. The law defines the term "first-degree murder" - does that mean we are required to commit them?

Quoting DXing (Reply 426): In 1993 the democratic party held the White House and both Houses of Congress and yet they would not even bring a bill to committee for markup.

But they at least tried, even though they failed miserably before they could even bring a bill to committee. At least they TRIED. Something the Republicans never did.

Quoting DXing (Reply 426): fixing health insurance which is what reallyneeds fixing, not health care

The two are inextricably intertwined, particularly for the uninsured or underinsured who, without employer-provided coverage, pay in excess of $400/month for single coverage that is pure sh**--covering only hospitalization and no outpatient MD visits or tests, medications, or preventive services.

Quoting DXing (Reply 426): The fact of the matter is this isn't about health care or health insurance, it's about concentrating more power in Washington.

More right wing paranoia. Eight years of Bush and Cheney making unprecedented grabs for increased executive power without accountability didn't bother you a bit, but Obama and the Democrats wanting to fix a serious problem that the private sector hasn't done diddly to correct is a power-grabbing conspiracy.

Quoting DXing (Reply 426): For that matter out of those 28 years the democratic party held both Houses of Congress for 15 years, more than half the time.

Wrong. The Democrats have held both houses now for 2 years. The GOP had both for 12 years before that (minus the brief period when Jim Jeffords went independent) . The Democrats would have had to control both houses for 13 of the 14 years from 1981 to 1995 for your math to work. That's not only mathematically impossible, but wrong from the outset because the Republicans controlled the Senate for several years after the Reagan landslide.

Quoting Yellowstone (Reply 429): And let's get one thing clear - you'd better not come back with the portion beginning on line 20 page 424. That text cannot serve both as new law and as an amendment to the old law.

Because the sync with the old law runs from line 6 page 424 to line 19 page 424. Those lines contain the addendums to the SS act. I did not say that line 20 is an amendment to the SS act, I said that is the new law. From line 20 on it is not an amendment to the SS act, it deals with the bill entitled ‘‘America’s Affordable Health Choices Act of 2009’’ which is virtually the only bill under consideration at this time.

Quoting Yellowstone (Reply 429): What's more

What's more is that you don't want to see it as a requirement so nothing I can say will convince you and I'm tired of trying. The language is clear, the actual leeway of how to implement the law will be left to the Health Commissioner who will not work for the SS Administration but will be most likely a cabinet officer in his or her own right as is described on page 41.

Quoting Seb146 (Reply 320): What, exactly, did Iraq have to do with Sept 11?

Nothing, which is why it is so queer that Cheney & Rumsfeld were not fighting to avoid a war there.

But then there is a lot about Cheney & Rummy that is really queer.

Quoting DXing (Reply 426): The new law will require you to have an end of life counsuling session once every 5 years.

You must be listening to Rush too much. Mandatory counseling is bull.

After having a father die of cancer, however, it is obvious to me that there is benefit in having the ability to talk to your doctor about options when you believe your time is short.

My wife and I both have a living will - which will hopefully protect us from unnecessarily suffering simply because extreme measures are available.

Quoting Ken777 (Reply 432): Mandatory counseling is bull.

Agreed but there it is in the HR 3200.

Quoting Ken777 (Reply 432): After having a father die of cancer, however, it is obvious to me that there is benefit in having the ability to talk to your doctor about options when you believe your time is short.

After going through the same thing I agree. The difference being it was because my father wanted to, not because it was mandatory.

Quoting Ken777 (Reply 432): My wife and I both have a living will - which will hopefully protect us from unnecessarily suffering simply because extreme measures are available.

Same here, but if someone decides they don't want one or are not interested, that should be their perogative.

Quoting DXing (Reply 431): Because the sync with the old law runs from line 6 page 424 to line 19 page 424. Those lines contain the addendums to the SS act. I did not say that line 20 is an amendment to the SS act, I said that is the new law. From line 20 on it is not an amendment to the SS act, it deals with the bill entitled ‘‘America’s Affordable Health Choices Act of 2009’’ which is virtually the only bill under consideration at this time.

Then explain to me the syntax in lines 7, 8, 18, and 19, page 424:

Quote: (1) IN GENERAL.--Section 1861 of the Social Security Act (42 U.S.C. 1395x) is amended--...(B) by adding at the end the following new subsection:

Clearly, the text that immediately follows this part (that is, lines 20 and onward) must be the new subsection being added to Section 1861 of the Social Security Act. It says, plain as day, that the following subsection (lines 20 and onward) is part of an amendment to Sec. 1861 of the Social Security Act.

For the love of God!

1. Deregulate the health insurance industry. It is insane that there are 1,300 health insurance companies in this country that cannot cross state lines. This barrier alone is a huge cost.
2. Pass Tort Reform. Enough with the frivilous lawsuits. Its not like they'll stop under any of these nightmare plans anyway. You can't fix health insurance without fixing this.


LEAVE THE REST OF US ALONE!

Quoting FlyPNS1 (Reply 347): Again, private universities compete against public universities all the time. FedEx/UPS compete with the Post Office and do fine. Private industry can compete with the government.

In both of your examples, the private sector option is used less, cost more and has a better product. Yet, the public option has more use, is always costing more operate than forecast, and is of lower quality.

Great examples!

[Edited 2009-08-13 22:30:47]

Quoting MSNDC9 (Reply 435): Quoting FlyPNS1 (Reply 347): Again, private universities compete against public universities all the time. FedEx/UPS compete with the Post Office and do fine. Private industry can compete with the government. In both of your examples, the private sector option is used less, cost more and has a better product. Yet, the public option has more use, is always costing more operate than forecast, and is of lower quality. Great examples!

Berkeley, UCLA, Univ. of Virginia, etc. must be amused by your analysis.

Quoting DXing (Reply 433): Same here, but if someone decides they don't want one or are not interested, that should be their perogative.

It will be. The bill says nothing about it being a mandate.

I think you've done a very good job of answering the question posed in the thread title.

Quoting Yellowstone (Reply 434): Clearly, the text that immediately follows this part (that is, lines 20 and onward) must be the new subsection being added to Section 1861 of the Social Security Act. It says, plain as day, that the following subsection (lines 20 and onward) is part of an amendment to Sec. 1861 of the Social Security Act.

   Lines 1-17 show single word changes. From 18 pg to line 17 pg 430 the SS act subsection 1861 will be changed to mirror the new law which,at this time, would be HR 3200 to known as ‘‘America’s Affordable Health Choices Act of 2009’’. If they didn't do that there would be a conflict between the two laws. Look through the rest of the bill. It is replete with changes to various statutes so that they properly reflect and mirror what the new law will be. America’s Affordable Health Choices Act of 2009 is not a part of the SS act, if it were it would be administered by the Social Security Administration. Clearly it is not described that way as listed in the Governance section.

Quoting Max550 (Reply 437): It will be. The bill says nothing about it being a mandate. I think you've done a very good job of answering the question posed in the thread title.

It says everything about it being a mandate. If it were voluntary the bill would read "may choose to" or "insurance will pay for an end of life consultation" or some other language that says that it is offered but not mandatory. Anytime it is not spelled out as optional the leeway exists for the bureaucrat to claim it is mandatory.

The thread title has been addressed several times. Unfortunately the left is not interested in discussing things that would actually save money like tort reform, insurance deregulation, and allowing a Part D type program which has actually been shown to work and lower cost. Those items have been brought up several times by GOP lawmakers only to be shot down immediately and without debate by the democratic leadership.

Fortunately at least one GOP Senator that the democratic party leadership was counting on for support has said the end of life provision has got to go.

http://www.cbsnews.com/stories/2009/08/13/politics/main5240198.shtml

Key senators are excluding a provision on end-of-life care from health overhaul legislation after language in a House bill caused a furor.

Senator Chuck Grassley of Iowa, top Republican on the Senate Finance Committee, said in a statement Thursday that the provision had been dropped from consideration because it could be misinterpreted or implemented incorrectly.

Quoting Max550 (Reply 407): Quoting DXing (Reply 405): I fail to understand how you can discount a whole new bill that will be new law. I'm not discounting it, we're talking about a part of the new bill that amends the SS Act to make it the law that end-of-life consultations are covered under Medicare.

Quoting Yellowstone (Reply 410): Quoting DXing (Reply 409): I don't see how anyone could read it as anything other than mandatory. As Parker suggests, since it is vauge only the fool assumes the best case scenario. The proof will come if a Represenative pushes an amendment with Parker's suggestion and it gets shot down. Reading comprehension's clearly not your thing, DX, although I'll admit the lawmakers don't make it easy. "A consultation shall include the following" means that if any of the listed items are omitted, it isn't an Advance Care Planning Consultation.

Quoting Yellowstone (Reply 415): Parts of HR 3200 make new law, and other parts--like this one--edit old law.

When you amend and exsisting law as a result of a new law, then the amendment is really part of the new law, as the older law would not have changed if it weren't for the new law. So, this part of HR-3200 is a new law, and has to update the older SS laws to bring them into complience with the new one. DXing has it correct, and there is no problem with his comprehension. Ask any lawyer if what I said is, or is not true.

Quoting Yellowstone (Reply 413): Quoting DXing (Reply 411): Means=requirement. Oxford English Dictionary: Quote: mean, v. To signify; to convey or carry a meaning, significance, consequence, etc. Nothing to do with requirement. And just because the law defines something does not mean that everyone has to use it.

In ordinary speach, you are correct. However, in writtten laws, words have different, or additional meanings. That is why written laws are so confusing to lay people. They get hung up on traditional defianitions, not one the new defined meanings of words as applied by the law.

Quoting Max550 (Reply 407): John Edwards

The guy who made millions "chasing ambulances" as a "slip and fall" lawyer? Oh yeah, I would trust any health care bill he proposes..............NOT.

Quoting DXing (Reply 438): From 18 pg to line 17 pg 430 the SS act subsection 1861 will be changed to mirror the new law which,at this time, would be HR 3200 to known as ‘‘America’s Affordable Health Choices Act of 2009’’.

So at least you admit that page 424 line 20 to page 430 line 17 is the text of a change to Section 1861 of the Social Security Act. Good. Now, you claim that the change is made to bring the SSA into alignment with the future America's Affordable Health Choices Act. I want you to find for me the text in HR 3200, that is going to be part of the AAHCA, with which the SSA is brought into alignment by the amendment on pages 424-430.

Quoting DXing (Reply 438): America’s Affordable Health Choices Act of 2009 is not a part of the SS act, if it were it would be administered by the Social Security Administration.

The bill that instituted Medicare and Medicaid was the Social Security Act of 1965, which was itself one massive amendment to the original Social Security Act from the 1940s. Title XVIII of the Social Security Act is entitled "Health Insurance for the Aged and Disabled" - a.k.a. Medicare. So, whenever you want to change the way Medicare works, such as by adding another thing to the list of services it pays for, you've got to amend the Social Security Act.

http://www.ssa.gov/OP_Home/ssact/ssact-toc.htm

http://en.wikipedia.org/wiki/Social_Security_Act_of_1965

Quoting DXing (Reply 438): It says everything about it being a mandate. If it were voluntary the bill would read "may choose to" or "insurance will pay for an end of life consultation" or some other language that says that it is offered but not mandatory. Anytime it is not spelled out as optional the leeway exists for the bureaucrat to claim it is mandatory.

That's generally not how laws work. For example, if you look in Section 1861 of the Social Security Act, a bit before the new subsection (hhh) that would define Advance Care Planning Consultations as a service Medicare will pay for, you find subsection (fff), "Pulmonary Rehabilitation Program." That subsection never says "may choose to" or "insurance will pay for"--it reads exactly like the amendment on page 424 line 20 and on, just a basic definition beginning "The term 'pulmonary rehabilitation program' means..." By your logic, that means every senior on Medicare is required to receive pulmonary rehabilitation, because the law doesn't say it's not mandatory.

That, of course, is silly. If it were mandatory, it would explicitly say so. If it doesn't say it's mandatory, it's not. End of story.

Quoting DXing (Reply 438): If it were voluntary the bill would read "may choose to" or "insurance will pay for an end of life consultation" or some other language that says that it is offered but not mandatory. Anytime it is not spelled out as optional the leeway exists for the bureaucrat to claim it is mandatory.

So instead of "such consultation shall include the following" you would like it to say "such consultation may include the following" or something like that? If it were worded that way it would mean the doctor could take you in for a normal check-up, mention end of life care, and then get reimbursed for a consultation which is much more expensive than a check-up.

Let's pretend you are correct about what it says. What happens when I refuse to have an end of life consultation? There's no penalty so it would effectively be voluntary..

Quoting KC135TopBoom (Reply 439): The guy who made millions "chasing ambulances" as a "slip and fall" lawyer? Oh yeah, I would trust any health care bill he proposes..............NOT.

I wasn't saying I agreed with his plan, I don't think you can force people to go to a doctor, I was just pointing out that he was the only candidate who proposed making preventative care mandatory.
I don't think you need to worry much about Edwards, I think he's done in national politics for a while.

Quoting DXing (Reply 438): Anytime it is not spelled out as optional the leeway exists for the bureaucrat to claim it is mandatory.

Even if it was mandatory (which it's not), there's no way to enforce the mandate. There's no rule/regulation that says what the penalties would be if you refused the consultation. There's no way to make someone go to the consultation. If there was an intent on making this mandatory, you would have to put a mechanism in place to actually enforce it.

Of course, there's no reason for such a mechanism because the consultations are not mandatory. Sadly, reading comprehension appears to be a dying art among many.

So, one question I have for those still thinking there are "death panels" on the horizon: When your doctor says "I see you have not had XYZ test in a long time. Can we do that now?" Does s/he then strap you down and perform said test and charge insurance for it, even if you do not want the test either because you do not have the time or money or both for it? No. It is voluntary. Just because it is there does not mean it has to happen. Yes, living wills and end of life decisions are very good ideas. I see that even righties have said that. But, they are not going to be required because some people just do not want to discuss it. My father, for example. He had two heart attacks and was at risk for another. He lived at risk for three years before having a third that finally took him. He never had a living will nor did he discuss end of life wishes. He even worked as an LPN in a nursing home! He knew. My mom has talked about her end of life wishes with her doctor but on her own and in passing; not as part of her regular routine like cholesterol screening and things. This is the same insurance that jacked up the price she pays for her meds because it would be cheaper. uh-HUH. Cheaper for who?

Quoting Yellowstone (Reply 440): So at least you admit that page 424 line 20 to page 430 line 17 is the text of a change to Section 1861 of the Social Security Act.

Never said differently because after line 17 it is all new law therefore the SS act has to be amended to reflect the new law.

Quoting Yellowstone (Reply 440): I want you to find for me the text in HR 3200, that is going to be part of the AAHCA, with which the SSA is brought into alignment by the amendment on pages 424-430.

Since it isnew law it won't be there. Let's go about it this way, what part of new law don't you understand? What part of having to amend the old SS act to mirror the new AAHCA don't you understand? If you can answer that we might be able to make some headway because obviously you are caught up on what has to happen to old law to conform to new law. You're not stupid so if you can explain where you think you are hung up please do because you're making this much more difficult than it really needs to be.

Quoting Yellowstone (Reply 440): you've got to amend the Social Security Act.

Now we're getting somewhere. I've never said that the SS act wasn't being amended. What is happening is both simultaneously as soon as the bill is passed and signed into law.

Quoting Yellowstone (Reply 440): That's generally not how laws work.

   It is written that way so as to give the Health Commissioner the leeway needed to do it. If it does not specifically say that something is voluntary, then you can assume it will be mandatory from the beginning, or will be made so at a later date. That is why the amendment that Parker suggested makes sense. That way, either at the beginning, or at a later date. some bureaucrat can't decide it is mandatory.

Quoting Max550 (Reply 441): Let's pretend you are correct about what it says. What happens when I refuse to have an end of life consultation? There's no penalty so it would effectively be voluntary..

It won't make any difference. If you have private insurance you'll still be billed for the co-pay if there is one, if you are on the public option, you're paying taxes that are going to cover the doctor, or health care provider as listed charging the government for you. That's now. There is nothing there to say that a penalty could not be assessed above and beyond that at a later date. All bills are written as to give the agency overseeing them leeway to act. Again, this is where Parkers suggestion is a good idea. Even better is Sen. Grassley's idea of dropping the provision all together.

Quoting FlyPNS1 (Reply 442): Even if it was mandatory (which it's not), there's no way to enforce the mandate.

Of course there is as described above. The leeway is there for the Health Commissioner to do whatever they feel is neccessary which is why Parkers suggestion makes sense. Of course if you haven't had XYZ test in several years you can decline now, because you are in charge of your health care. That goes away with government run health care. They will decide what tests you can have and what you can't and how long you will wait if they do decide you can have it, it's called a monopoly. Won't happen right away, but as Rep. Frank has said, it may take 10-15 years but we'll get there.

I don't understand why there is such opposition to inserting an amendment stipulating that these consultation will be strictly voluntary. Instead of compromise all that has been done in the past 4 posts above this one is diversion and the tossing of insulting remarks. It begins to explain why the GOP has tired of even trying to get the simplest of things done with the democratic party. The amended line would not hurt anyone yet even the one comment that said ok was couched with insulting language all around it. The GOP is interested in fixing health insurance, which is where the real problem lies, unfortunately it's pretty obvious that the left doesn't want ideas or even to really fix the problem, just subservience.

Quoting Cws818 (Reply 436): Berkeley, UCLA, Univ. of Virginia, etc. must be amused by your analysis.

Compared to Harvard and Yale....

Quoting MSNDC9 (Reply 445): Quoting Cws818 (Reply 436): Berkeley, UCLA, Univ. of Virginia, etc. must be amused by your analysis. Compared to Harvard and Yale....

Should only people that can afford - or qualify - Harvard or Yale be the only ones allowed to go to school?

Quoting MSNDC9 (Reply 435): In both of your examples, the private sector option is used less, cost more and has a better product. Yet, the public option has more use, is always costing more operate than forecast, and is of lower quality.

My mail gets here. Unceremoniously and takes a few days - but i get it. 90% of the time i do not need the bells and whistles that FedEx provides.

So a cheap, public option that satisfies the basic needs of (how many people use regular mail) millions of people doesn't sound too bad.

Quoting DXing (Reply 444): Of course if you haven't had XYZ test in several years you can decline now, because you are in charge of your health care. That goes away with government run health care.

Absolutely not true. You can drag up every obscure line of the proposal you want and twist and turn it as you will, but it doesn't say anywhere that people will lose control of their own health care. You are engaging in gross distortion of what is written.

Quoting DXing (Reply 444): It begins to explain why the GOP has tired of even trying to get the simplest of things done with the democratic party. The amended line would not hurt anyone yet even the one comment that said ok was couched with insulting language all around it

Make me laugh a little more. Since the GOP ideologues of the Gingrich mentality took over most Republican seats in Congress from 1994 on, the GOP has made minimal effort to work with the Democrats on anything, and that hasn't changed since the GOP lost control two years ago. With regard to insulting language, take a look in the mirror. You have used plenty yourself, with your recurring accusations that liberals lack personal responsibility, only look at issues superficially, etc. I'm sorry you find words like paranoid and irrational insulting, but they accurately apply to those who have so baselessly, obstinately and obsessively created this non-issue.

Quoting Max550 (Reply 441): I don't think you need to worry much about Edwards, I think he's done in national politics for a while.

I gree with you there. Thank God he is gone, at least for a while.

I wish this was my idea , but alas .

A suggestion today I heard was to propose another option to help the poor obtain health care.

Wrap there care into the VA system. If the democrats believe it is so good then all we need to do is set a income level requirement then go ahead and throw the doors open at the local VA. What a great idea ..... what do you all think ?