With all the publicity given to the individual mandate, most Americans are unaware that the most ominous - and certainly unconstitutional - feature of Obamacare is the benignly named Independent Advisory Payment Board. But I call it the Dracula Board because like Dracula, it is uncontrollable and almost can’t be killed.
The Dracula Board comes to life once Medicare per enrollee spending exceeds a specified level. Well, that happens about every year. When that happens, as few as five bureaucrats can decide how to cut provider reimbursement to reduce spending to the yearly threshold. Although these guys are not suppose to be able to ration patient care, they can effectively do that simply by setting reimbursement rates for certain medical procedures so low that doctors will not offer them to patients. Say goodbye to “fee for service” payment (where doctors make more by providing more services) and say hello to a payment system where doctors profit providing fewer services. They could do that.
Or they could pass other cost control rules such as expanding the definition of “experimental treatments” which are not covered by Medicare.
Once activated, the Dracula Board will wield power over our health care system like no peacetime agency in any field in American history. Their “proposals” to cut spending automatically become law unless the House, the Senate, and the President can all agree on a substitute measure that will cut as much. How often does that happen in the health care area?
What is unique about the Dracula Board is that it is not subject to administrative or judicial review at all, and is almost immune to political review. Not even the president can veto one of its mandates. Nor may Congress by the usual majority vote override one its commands. Only if Congress AND the president all agree on a substitute cost cutting can the Dracula Board be defeated.
Nor - unlike virtually all other agencies - is the Dracula Board even required to give notice of its Medicare changes to the public and invite public comment. In short, a group of 15 bureaucrats (quorum is 8 so as few as 5 can make decisions) will sit in a room and make rules that govern key aspects of the Medicare benefits our seniors receive.
Like Dracula, this Board is very difficult to kill- the Dracula Board cannot be killed by Congress unless a three fifth super majority votes to repeal by August 15, 2017. Incredibly, if Congress misses this deadline, the ACA precludes future repeal. Like Dracula, the Board is close to being immortal.
Credit to Mr. Ryan for recognizing the horror posed by letting a few bureaucrats decide the fate of Medicare on their own. He is leading a repeal effort. But for those Obama care supporters on this Board who say Obamacare can only limit provider reimbursement and not patient care, you are wrong. The Dracula Board can do this by controlling reimbursement rates.
-- Modified on 9/2/2012 1:32:42 PM
Ryan first championed the IPAB in 2008, so like Romney he was far it before he was against it. Nothing Marikod says about the IPAB is true, but it's the usual bullshit Republican mantra because they hate black presidents and they want to abolish Medicare to give 5 trillion in tax breaks to the extremely wealthy. Like Ryan, marikod is a chronic boldfaced liar.
Fee for service medicine is alive and well in ACA. I've discussed this at length in scores of other posts. Ryan's plan would immediately cost seniors $6400 out of pocket for Medicare, and $3500 out of pocket because of the Part D donut hole.
marikod has bought into the $240 million bullshit disinformation campaign as to ACA with no real understanding of either what constitutes effective clinical medicine or the ACA.
Ryan would destroy medical care for the elderly and the poor. He would substitute Vouchercare in 10 years and the repeal of Obamacare would again subject people to caps for insurance as well as pre-existing condition denial.
IPAB's supermajority was designed to take Congressional control of Medicare away because Congress are corrupt providers whose clients are the special interest corporate johns. IPAB members must be approved by the Senate.
IPAB recommendations only kick in when Medicare's expenses exceed its targets.
John Yoo, the egregious author of the Bush torture and waterboarding memoranda, is a Cato Director, and it's completely run by a Board of Right wing zealots and has been for years. It's Board of Directors reads like a whos who of delusional right wingnuts.
Marikod has no clue as to how to deliver health care to patients, and apparently no understanding of what Ryan's Vouchercare would do to wreck health care delivery. It would kick 65 million people off insurance, and Ryan would take Medicaid away from millions of children and disabled elderly who are Medicaid's chief beneficiaries.
IPAB will not be able to set physician reimbursement so low that phycians won't care for patients, but SGR 2012 and the GOPutz Congress' refusal to fix it would wreck Medicare by kicking in another 31.2% reduction in physicain reimbursement on top of the already 60% payment that Medicare makes to physicians and other care providers.
Currently the Republican Senate demands a supermajority for nearly every bill the democrats propose, and they are making greater than 72% filibuster requirements, a record.
IPAB could certainly be subjected to judicial review just as the ACA in fact was, and was ruled constitutional by the Supreme Court much to the chagrin of marikod.
Cato is owned 50% by the Koch Brothers, and they are currently suing to hog grab another 25%. It has long been the tool of the Republican party and a propaganda lie machine.
The only credit Romney and Ryan deserve is that they are cowards and systemic liars who didn't outline one specific economic plan or proposal during the entire GOPutz convention in Tampa.
Every political point they made was a major lie; they made sure not to mention Afghanistan; the Armed forces, any economic plans, their war on the poor, or how they would wreck Medicare and Medicaid and deny medical care to 65 million poor or underinsured children or elderly people.
Romney and Ryan propose a major shunt from insurance and social programs like Pell grants to a pure cash windfall for the very rich to promote a trickle down policy that has been a total clusterfuck since the ineffective President the GOPutz call St. Ron Reagan.
This is a party who instead of advancing whatever or their ideas that they are ashamed of and want to hide, put a whackjob performance by Clint Eastwood center stage because of their unparalleled stupidity.
-- Modified on 9/2/2012 9:11:31 PM
“Nothing Marikod says about the IPAB is true”
Dude, while my statements as to what the Dracula Board might do are obviously projections of future conduct which may or may not come to pass, my statements about the powers of Dracula Board come right from the statute. Can you identify anything I said as untrue? I didn’t think so.
“IPAB could certainly be subjected to judicial review”
You have not read the statute, have you? Here is the “no judicial review” part of the statute:
“(5) Limitation on review — There shall be no administrative or judicial review under section 1395ff of this title, section 1395oo of this title, or otherwise of the implementation by the Secretary under this subsection of the recommendations contained in a proposal.”
Want to try that one again? In discussing the Supreme Court’s ruling of whether the individual mandate was unconstitutional, you are confusing a court’s jurisdiction to determine if a statute is constitutional with a court’s power to say that a particular decision of the Dracula Board is either wrong or beyond its power. Of course a court has the power to do the former and the authors of the article I have linked have referred to that litigation; but the Obamacare statute deprives courts of jurisdiction to do the latter. As I stated judicial review of the decisions of the Dracula Board is prohibited – all a court can do is declare the statute unconstitutional.
“Fee for service medicine is alive and well in ACA.”
No one disputes that it is now. What I said is that the Dracula Board has the power to change this system – which almost all critics agree leads to wasteful spending – under the guise of cutting costs.
“IPAB will not be able to set physician reimbursement so low that physicians won't care for patients”
I did not say that either. Try to pay attention. What I said was “Although these guys are not suppose to be able to ration patient care, they can effectively do that simply by setting reimbursement rates for certain medical procedures so low that doctors will not offer them to patients.”
In other words, instead of providing a full range of treatment options for a particular medical condition, the Dracula Board can set reimbursement rates for one option so low that doctors will not offer it but will offer only the higher reimbursement options.
Come on – I was expecting a little better from you other than a rant about the Cato Institute, Mr. Ryan’s plan (I made no comment about that), or your assumption that I oppose the Affordable Care Act (I oppose the statute that creates the Dracula Board).
In your last paragraph you state and I quote
" Come on – I was expecting a little better from you other than a rant about the Cato Institute,"
You can't possibly have meant that statement. That's exactly the type of response that I expected out of Jeffy poo. Nothing related to your actual post, just a bunch of almost incoherent screaming about how Romney/Ryan/GOP want to kill children and old people.
which is of course why tranygamblypoo never discusses anythng specific. Its comments are directed at two areas--so and so doesn't know what they're talking about with no specifics, or the delusional accounts of the fictional life of gambly. Gambly, Ryan, and Romney are equal opportunity bullshitters yammering full of sound and fury signifying nothing.
-- Modified on 9/2/2012 10:45:00 PM
I don't know why I should have to repeat myself because you lack reading comprehension but think you're a constitutional lawyer of proportions to Neal Katyal.
YOU pay attention and try to comprehend what you've said.
LOL Dude. I do think so and because you don't think so doesn't change the truth.
1) The IPAB isn't a "Dracula board". You haven't been mainlining True Blood or did you drink all of Lilith's blood and go crazy?
2) You based your pompous bullshit on a tired phony GOPutz meme by quoting the biggest joke that calls itself a "think tank" Cato, and my link appropriately showed what a GOPutz corporate Koch brothers puppet it is. You didn't address that did you?
3) The statute does not prevent someone from suing to challenge the IPAB. And conceivably the GOPutz are stupid enough to try to challenge the ACA again. They don't give a shit what the recent precedent is. I'm not talking about a particular decision of the IPAB being challenged. I'm talking about the entire concept of the IPAB being challenged by challenging the statute.
Title III Section 3403 of the ACA which establishes the Independent Payment Advisory Board (IPAB) could be challenged. Section 3001 which establishes value based purchasing of hospital services could be challenged, and and Section 3015, which collects data on quality could be challenged. The subsequent reforms the administration has proposed to save more money that can be found on pages 33-37 of the President’s 2013 budget proposal, and they could be challenged. They include expanding IPAB’s mandate such that it can change Medicare’s benefit package and setting a growth cap on Medicare of GDP+0.5 percentage points — which is the same as Paul Ryan's.
I know what you said about lowering reimbursement to the point docs won't see patients, and the ACA doesn't do that, nor will the IPAB do that. What does threaten that as I said once is the SGR 2012 and apparently that goes right by you. You don't understand what it is, and you haven't read my multiple explanations of what SGR 2012 is. Google it with the search term AMA news added. "SGR 2012 AMA news".
What is most significant is that Romney and Ryan simply put, in order to raise 5 trillion to give tax cuts to the rich and 2.3 trillion over ten years to make absurdly stupid defense budget increases want to attack health care from the poor and take away Medicaid for its two largest in number beneficiaries children and elderly disabled institutionalized patients.
That's why Romney and Ryan were scared shitless to talk about any specifics of their budget Thursday night and they'll get slaughtered in debates when Obama and Biden hammer them with it.
And the Nation article on the Cato Institute which is 50% owned by one of the Koch brothers who is suing a widow for another 25% underscores the Cato Institute is a pawn of the Republican party--it's hardly an independent think tank and you used it as your source in the first place. I didn't bring it up--I merely characterized if for the phony pawn of the right wing it is.
Read Ezra Klein's Wonk blog in WAPO as to Ryan's war on the poor and his speech replete with lies. The IPAB doesn't concern me nearly as much as the weakness of the exchanges and the GOP governors taking coverage away from the poor by refusing Medicaid expansion funds as the idiot from Georgia Deal has vowed to do.
-- Modified on 9/2/2012 11:03:12 PM
I am concerned about what is actually the law rather than some proposed plan that will never be passed.
And I did not quote anything from the article I linked - I quoted the Affordable Care Act statute itself. The article goes far beyond what I said in the post but did contain a good discussion of how the Affordable Care Act insulates the Dracula Board decisions from judicial review (you really don't understand this after I quoted the statute? you really do not understand the difference between suing to have the statute declared unconstitutional as opposed to suing to challenge a reimbursement decision?) , administrative, review and political review - hence the analogy to Dracula.
Once Mr. Obama nominates persons for the Dracula Board and they go before the Senate for conformation, the Dracula Board will be in the news. At that time, you can revisit your misapprehensions about it. If you are willing to let as few as five bureaucrats make unreviewable decisions about Medicare, then you should support the Board.
Not interested in addressing your rant about all things Republican. Check with Nuguy about that.
I know the on point controlling law in the ACA on IPAB and I know it's implications so quit your fucking school marmy pontificating--there's a lot of Borderline Narcissism among you fuckboard righties:
IPAB from KFF
http://www.kff.org/medicare/upload/8150.pdf
1) Your position is the ad nauseam GOPutz position that they hate the IPAB. At no time can did I say that they could sue to challenge a reimbursment decision and you are misconstruing what I said in fact and you can't quote me saying that. I said the constitutionality of sections of the ACA could be challenged in the future and I expect the imbeciles who are GOP governors to keep wasting millions they don't have to waste in legal fees to continue to do so forever until they are dead.
2) I made it clear I know the difference and I cited parts of the ACA that could be challenged constitutionally yet in the future and made it explicitly clear that I wasn't referring to particular decisions the IPAB might make "if triggered."
3) You did nothing but actually parrot what Ryan's been saying lately but Ryan lacked the balls to say what his economic policy is in front of the biggest audience he every had access to one time in his life (never again will he have access except when he gets his ass wipeed in one debate then it's buh buh).
4) You're right about one thing. It will be Mr. Obama who nominates that Board and his nominations will be confirmed by the Democratically controlled Senate because your candidates are douche bags and the voters are learning that rapidly.
5) Why are you telling me how the IPAB works when I understand it a lot more completely than you do and this is a fuckboard with 8 people on it at one time. None of your other FBR know what the fuck the IPAB is and they don't really give a rat's ass except possibly Timbow and he's not hear. BigPapasan knows but he's not among the Buck Board Righties like you.
You're missing the big picture here, and the big picture here is the stupid budgets of Ryan and Romney that even Tom Brokaw and Tom Friedman understood on Meet the Press with Carley Horse Face Fly HP Into the Ground Fiorina making an ass out of herself repeating false GOPutz platitudes. The Big Picture that the two Toms articulated is that Ryan and Romney are intrepid liars and that they're budgets could not possibly work. Here are their fucking budgets. And don't give me this phony you don't care what the GOPutz mantra is because you keep delivering it. They hate the IPAB. They hate the ACA. They hate Obama and every time I see expressions of that hate I feel fucking great.
The real Romney-Ryan budgets cuts aren’t to Medicare. They’re to programs for the poor.
http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/22/the-real-romney-ryan-budgets-cuts-arent-to-medicare-theyre-to-programs-for-the-poor/
Rep. Chris Van Hollen: ‘The Romney-Ryan Medicare plan would have immediate cost increases for seniors’
http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/18/rep-chris-van-hollen-the-romney-ryan-medicare-plan-would-have-immediate-cost-increases-for-seniors/
Paul Ryan isn’t a deficit hawk. He’s a conservative reformer.
http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/08/11/paul-ryan-isnt-a-deficit-hawk-hes-a-conservative-reformer/
"On Medicare, Ryan originally proposed eliminating the traditional Medicare plan entirely and replacing it with a menu of private plans. He subsequently softened the proposal to include the traditional Medicare plan as one option on the menu, But either way, he would remake Medicare from a defined-benefit plan, in which seniors are simply guaranteed Medicare coverage, to a defined-contribution plan, in which they are given a voucher equal to the cost of the cheapest plans on the menu, and if they don’t want those plans, they have to pay the difference.
On Medicaid, Ryan proposed turning the program over to the states and limiting the federal contribution — which now increases alongside Medicaid’s actual expenses — to block grants that grow more slowly than health-care costs. The nonpartisan Kaiser Family Foundation estimated that this would cut Medicaid spending by more than $700 billion over the next decade, but at the cost of throwing between 14 and 19 million people, many of them children, off Medicaid.
The list goes on. Ryan’s Social Security proposal, which was among the most ambitious put forward by any member of Congress, would have diverted Social Security contributions into private accounts. Ryan’s health-reform proposal would have ended the tax exclusion for employer-based health care and replaced it with a refundable tax credit for individuals. Ryan has even sponsored legislation ending the requirement that the Federal Reserve work to achieve full employment.
Some of these policies, like Ryan’s Medicaid plan, would reduce deficits. Some of them, like his tax plan, would be likely to increase them. Many of them would have an unclear effect, which is why Ryan’s savings tend to come from instructions he gives the Congressional Budget Office to assume that Congress sticks to extremely austere spending paths — that is how, for instance, he gets all non-entitlement spending down to 3.75 percent of GDP by 2050.
But the real north star of Ryan’s policy record isn’t deficits or spending, though he often uses those concerns in service of his agenda. It’s radically reforming the way the federal government provides public services, usually by privatizing or devolving those public services away from the federal government."
You're just worshipping at the alter of your lying idol Paul Ryan.
But I will help you with a few of the points that still confuse you.
“Why are you telling me how the IPAB works when I understand it a lot more completely than you do”
First, congratulations on understanding the Dracula Board better than I do, particularly since you obviously have not read the statute. But the answer to your question can be found in your very post on the thread where you said:
“Nothing Marikod says about the IPAB is true”
So I asked you to specify something I said that was incorrect. You were unable to do so but did make some confused statements about judicial review that I explained to you.
“At no time can did I say that they could sue to challenge a reimbursment decision and you are misconstruing what I said in fact and you can't quote me saying that. I said the constitutionality of sections of the ACA could be challenged in the future”
Finally, you have grasped this key point almost correctly, although you seem not to comprehend that is is unique in the law. But, to be completely accurate, you should have said “all sections of the ACA" can be challenged as unconstitutional. No, sorry, you did not use the word “constitutional” in your earlier posts, although I could tell that was what you meant– you said there was no “judicial review,” unaware of the ACA statute that says exactly that.
I think a big part of your problem is not understanding legal terminology, such as your post about the ACLU being a party to the Applewhite litigation (no, they were the attorney for the party), or your post about Romney being "convicted" for an SEC filing even though the statute of limitations had long passed, and your mistaken use of the phrase “judicial review” when you meant constitutional review. No reason to be embarrassed about these mistakes.
As to the rest of your post, I’m not addressing Ryan’s plan. In fact I have not even read it. Why bother since it will never become law? In my post, I gave Mr. Ryam credit for recognizing the problems with the Dracula Board. That was as far as I went.
1) I've always indicated the ACA and its parts could be constitutionally reviewed.
2) I've read the ACA with far more understanding than you ever will and I have to deal with it in real life with real patients and you don't.
3) I understadn far more profoundly what it is to know and Rx the appropriate med for older individuals who can't afford the meds because they have to eat and that problem has faced us for years.
4) I'm well aware of the context of every voting rights case in every state court, the ones that are Section 5 reviewed by 3 judge panels as the Texas case where the GOPutz lost last week, and I'm well aware that the ACLU is contributing and on the brief in Pa. at least to the extent that one of their attorneys is co-writing the briefs and will be present and actively contributing at the Sept. 13 oral argument before the Pa. S. Ct. whether he is formally listed as one of the parties in the case or not. That's just a fact. Call him if you don't believe me. He's very actively engaged in that case and contributing.
5) You're misinterpreting my words and then high fiving yourself and jerking off at the same time.
6) I never said Romney was "convicted" in any SEC action, however he could be in the future for his most recent returns, and Bain Capital is among the venture capital companies currently being investigated by the NY AG and he could be acting as a special AUSA in that potential litigation if DOJ designates that.
7) Why when you're so obviously a GOPutz partisan hack won't you engage on their lying shit policies?
Of course Romney's lawyer says he's not implicated in the investigation. Time will tell.
Inquiry on Tax Strategy Adds to Scrutiny of Finance Firms
http://www.nytimes.com/2012/09/02/business/inquiry-on-tax-strategy-adds-to-scrutiny-of-finance-firms.html?pagewanted=all
Mari, you're a graduate from one of the leading universities in the U.S. Have you not read any of his ridiculous posts? He is an idiot. He is a partisan piece of shit idiot. He's on bi-polar and ADD medication, and you're debating him. And he brought his cousin Daffy with him.
Now, if by some chance you can convince him to meet with GaGambler in person, I will be more than happy to parlay our Kentucky/Duke basketball bet. The parlay bet is a over/under of 30 seconds. You can pick either one. The over/under has to do with how fast or slow GaGambler drops his ass. I'll give you a clear advantage, Jeffeng is obese, take the under. GaG, can you do a little rope-a-dope for 30 seconds? I would actually fly to ATL for this, though I prefer Vegas for a twofer. (lmao).
when it was on the table. I would have been killed. What a team-Dwight Howard, Kobe, Gasol. Howard is the one guy Miami can't handle.
I suspect Halley's Comet will come around before Jeff and GaGAmbler have drinks again. But, in the meantime, I think I should get a $100 bonus if a Duke player stomps a Kentucky player in their matchup, just because it feels so good.
Oh, and for your reading pleasure tonight, I picked this article just for you.
Is he truly 6-11? Are they measuring him to his scalp or to the top of his hair. He's got 6 inches of hair. For a second I thought it was another one of the Wayans Brothers clan (lol).
The NCAA is investigating the entire UCLA recruiting class. Does it ever end? See the article below.
Yes I agree the Lakers can handle the Heat, but I still believe Oklahoma is the team to beat in the West. Just something about youth, talent and speed.
http://www.sbnation.com/2012/9/2/3287260/shabazz-muhammed-kyle-anderson-tony-parker-ucla-ncaa
trying to intimidate people on a fuckboard. How fucking pathetic.
St. Croix post your exercise routine up here for the admiring crowds you ugly moron.
And put your Chrisco Christie pic up here while you're at it. You and your pathetic delusional fake oil tycoon. What fucking equally stupid clowns. Yammering about imaginary meds and diagonses when you couldn't clean the latrines in a med school you pith brained imbecile.
and it should be plain to everyone what a liar you are commenting on the physical shape someone you've never met is in.
You OTOH I have met, and I know just what an out of shape, lard you are. I'd put up fat ass Christie against you any day of the week, he might be a fat ass, but he's got heart. Truth be told, I'd be loathe to go up against him myself, unless of course we were going to run a race. Not all fat guys are pussies, well you are, but not that doesn't mean all fat guys are.
and it should be plain to everyone what a liar you are commenting on the physical shape someone you've never met is in.
You OTOH I have met, and I know just what an out of shape, lard you are. I'd put up fat ass Christie against you any day of the week, he might be a fat ass, but he's got heart. Truth be told, I'd be loathe to go up against him myself, unless of course we were going to run a race. Not all fat guys are pussies, well you are, but not that doesn't mean all fat guys are.
St. Croix is fond of fantasizing things he wishes were true with no way to prove them.
St. Croix post a picture of your out of shape ass.
And whoa Mari is a graduate of one of the best universities in the US. Now that is beyond impressive. How about you shitferbrains?
You assume the rest of us have no education is that it?
What a fucking duche bag with one spirochete ridden Betz cell you are like Trannygamblypoo.
If you would read his posts, you would see he is a pretty smart guy, except for his basketball picks (I hope). But these meltdowns you have about GaGAmbler and St. Croix are pretty silly, don't you think?
If you had any degree of intellectual confidence, you would not get so upset when someone tells you you are wrong. Think about that for a while. If you go to pieces everytime you are challenged, you just tip your true feelings about your intellectual ability. It's like a "tell" in poker.
and yes I can do a rope a dope for thirty seconds. The only problem is, i don't know if Jeffypoo can even dance around the ring for thirty seconds without keeling over. He's the type of old fat guy that the providers are worried about keeling over in the middle of their two minute session. So I will try, but I can't guarantee that Jeffy can make it thirty seconds, even with me carrying him. I honestly think he was out of breath just walking outside from the bar, not too mention the look of fear he had on his face when a couple of black panhandlers came up to us as we were leaving the place.
Maybe we could engineer a fake contest for Jeffy to win? you know an all expense paid vacation to LV, if we could sell tickets to the event, we might even make a profit, although we might have to deal with a bit of fallout when the "event" ends fifteen seconds into the first round. lmao
Another thing we might have to consider. Mari, what is our legal liability if he drops dead of a heart attack, simply climbing into the ring?
...but it's my understanding that new law always supercedes old law. So Congress can write a law that says this "Dracula" Board no longer exists in 2020, and poof! it's gone.
crazy shit anyway. He's already indicated that. None of the absurd budget plans they have has the chance of an ice cube in hell no matter who would get elected President even if the House remains Repuboputz dominated.
Marishit just likes to spew a few legal terms and thinks he's dazzled the world.
But in fact he invoked the Repuboputz owned and dominated Cato Institute as his source in rehashing Paul Lyin' Ryan's current repudiation of IPAB-- a concept that Ryan pushed in 2008 and 2009. Shades of Romneycare and all the clips you now see of Romney supporting Obamacare for years.
These Fuck Board Rightie clowns don't get any crazier.
To prevent future Congresses from repealing the Dracula Board, the statute says the Board can only be discontinued in 2017:
"(f) Joint resolution required to discontinue the Board (1) In general — For purposes of subsection (e)(3)(B), a joint resolution described in this paragraph means only a joint resolution — (A) that is introduced in 2017 by not later than February 1 of such year; (B) which does not have a preamble; (C) the title of which is as follows: "Joint resolution approving the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Payment Advisory Board under section 1899A of the Social Security Act"; and (D) the matter after the resolving clause of which is as follows: "That Congress approves the discontinuation of the process for consideration and automatic implementation of the annual proposal of the Independent Payment Advisory Board under section 1899A of the Social Security Act.".
Whether this is constitutitional is another matter. But the drafters of Obamacare clearly have tried to make the Board immortal if Congress misses the 2017 window.
a handful of people vs. the multitude of faceless persons in all the medical insurance companies. They are a much harder target to zoom in on, and I hope you're not trying to tell me that they're not doing the same things that you say this board will do. I speak to people everyday that get the axe taken to payments for their medical treatment that they had coverage for in the past. Same policy, but the company just changed the rules.
-- Modified on 9/3/2012 3:18:18 AM
Private health insurers who cut too far are subject to the marketplace- cut too much and you will lose too many customers to be profitable.
Here we have as few as five unelected people given the power to make law just like Congress without judicial or administrative review. If for example the EPA passes a regulation making a dratic restritiction in CO2 emississions, that reg is always subject to administrative and judicial review as to whetehr it is arbtrary and capricious.
Not so the decisions of this Board.
Sadly, I think you've only scratched the surface. Problem with the libs particularly on this board is that they don't seem to have a clue as to what the law actually contains. They only know the "one liners" put forth by an administration whose propensity to tell lies is well established and yet the libs give them a pass on that too. They'd much rather bloviate about tax returns, comedians, imaginary republican positions postulated by pundits. But ask any one of them to defend their guy and the silence is unmistakeable. And then their are these holier than thou accolades about giving healthcare to 65 million who they claim don't have it... what a condemnation to think that based on their numbers (which I doubt are accurate) one third of the population is reliant on the government for their very existence. And they think that's good.
RR would abolish the EPA if only Congress would let them. LOL And at this moment the market dynamics are not controlling Karen Ignataw and insurance one scintilla. Maybe you enjoy paying much higher rates because you can afford them, but most people can't.
And Mari you've never addressed the whackjob budgets of Romney and Ryan. I'm not dazzled a bit by your ocassional sprinkling of lol "arbitrary and capricious" terms you learned in law school.
There um wouldn't be any appeal from EPA agency decisions to the appropriate federal circuit court if there were no EPA would there Mari?
Speaking of appeals from US Agency decisions Mari
A few years ago, a federal judge from GAND (Northern District of Georgia) Jack Camp who went to prison as the 5th federal judge convicted by a federal court in US History had his law clerk write a fairly decent 20 something page opinion and published it in Fed Supp.
It always makes me smile because the second I read it, I knew how stupid Camp was as to procedure, but it was a very complete review of a case law on an individual's right to due process and much of the case law on point and its progeny.
There was only one problem and it took me about 5 seconds to realize it after seeing Camp's memorandum opinion and that was that Camp had no jursidiction whatsoever and the parties were stupid as well because appeal of an FAA decision goes straight to the Circuit by USC and they had appealed to Camp in the district court.
Here are the cites for your edification. It shows law students that federal judges and their law clerks can be dumb as a rock as to federal appellate procedure, but you have to give Camp credit. Getting stung in a parking lot with guns at a drug buy for your provider has a certain flamboyance doesn't it?
Green v. Brantley, 719 F.Supp. 1570, 1576 (N.D.Ga.1989).
Green v. J Brantley 895 F2d 1387 (11th Cir. 1990)
Green v. Brantley, 992 F.2d 330 (C.A.11 (Ga.), 1993)
DENIAL OF REHEARING EN BANC.
Green v. Brantley, 981 F.2d 514 (C.A.11 (Ga.), 1993)
CAMP AND LAW CLERK WERE IGNORANT OF 49 U.S.C.App. § 1486
Eleventh Circuit vacated the order entered by Jack Camp and remanded it with instructions it be dismissed because Camp and law clerk did not know the basic information that federal agency licensure appeals, like pilot's licenses for the FAA must be appealed to the federal circuit courts directly. This should be taught in the first year of law school if not middle school or high school. I knew it. Why didn't Camp?
Green's suit is an impermissible collateral challenge of the final agency order. Because the courts of appeals have exclusive jurisdiction over review of FAA orders under 49 U.S.C.App. § 1486, the district court is without subject matter jurisdiction. We therefore vacate the order entered by the district court, and remand the action with instructions that it be dismissed for lack of subject matter jurisdiction.
Page 514
981 F.2d 514
J. Kenneth BRANTLEY, Edgar V. Lewis, Craig R. Smith, and
Garland P. Castleberry, Defendants-Appellants.
No. 89-8150.
United States Court of Appeals,
Eleventh Circuit.
Jan. 21, 1993.
Page 516
James R. Schulz, Asst. U.S. Atty., Atlanta, GA, Barbara L. Herwig, Appellate Staff, Civ. Div., Dept. of Justice, Wendy M. Keats, Robert Kopp, Supv. Atty., Washington, DC, for defendants-appellants.
Gerald Cunningham, Office of Gerald Cunningham, Atlanta, GA, for plaintiff-appellee.
Appeal from the United States District Court for the Northern District of Georgia.
Before KRAVITCH and ANDERSON, Circuit Judges, and LYNNE *, Senior District Judge.
LYNNE, Senior District Judge:
The question facing the panel on this interlocutory appeal after remand from the en banc Court, Green v. Brantley, 941 F.2d 1146 (11th Cir.1991), is whether the court below should have granted the defendants-appellants' motion for summary judgment based on qualified immunity. First, however, this Court has the obligation to " 'satisfy itself not only of its own jurisdiction, but also that of the lower courts in a cause under review.' " Bender v. Williamsport Area School Dist., 475 U.S. 534, 541, 106 S.Ct. 1326, 1331, 89 L.Ed.2d 501 (1986) (quoting Mitchell v. Maurer, 293 U.S. 237, 244, 55 S.Ct. 162, 165, 79 L.Ed. 338 (1934)), quoted in FW/PBS, Inc. v. City of Dallas, 493 U.S. 215, 231, 110 S.Ct. 596, 607, 107 L.Ed.2d 603 (1990). Because the courts of appeals have exclusive jurisdiction over cases challenging final orders of the Federal Aviation Administration ("FAA"), 49 U.S.C. App. § 1486, we find that the district court lacked subject matter jurisdiction over this action. Accordingly, we vacate the district judge's order and remand the case with instructions that it be dismissed for lack of subject matter jurisdiction.
The people I talk to say: "The company just changed our insurance company again." And, they have no idea what their new policy covers (and probably what their old policy covered), regarding procedures and treatments, until the provider submits a bill for services. Often, the company will not confirm authorization for tx. beforehand, and if they do you will get the message: "This authorization does not guarantee payment."
If you deal with these situations everyday, then why haven't you told the whole truth about what "really" happens? I just happen to have some knowledge about that too and the real deal is that insurance companies modify their coverages based on government recommendations. They do not arbitrarily change coverage without having the ability to defend their policy based on what the government and all it's hack boards recommend. Used to be EKGs were standard for annual physicals.... not anymore because some government sanctioned board says they are not needed. Ditto for chest x-rays, ditto for std screens, ditto for PSA blood test. And then there was mammograms but public outcry reversed that one. Oh, and let's not forget colonoscopies which used to be covered even if they found some pollips and removed them during the process. Now, it's covered if nothing is found, but if something is found the procedure is reclassified from preventive to diagnostic thus requiring higher payments to doctor as well as deductible payments from patient.
if your doctor is not ordering an EKG and a PA and lateral chest you need to vote with your feet and get a doctor who knows what they're doing. You're not clear what you mean by "standard screens", but I assume you mean routine blood profile packages called by various names by various labs (blood chemisty, a CBC, a lipid profile, and in modern times an Appolipoprotein B-A1.
It's none of my business but you seem to often focus on prostate screening, and I suggest you consult a decent urologist in the ATL if that's where you live.
I have to tell you that the urology literature has been very ambiguous about the value of a PSA during the last 5-7 years and I have journals from this past month that debate its value. I can PM you links to articles if you want them. But any urologist will check you out, get you a PSA, examine your prostate perhaps in a different way from your ATF providers, and if necessary do a TUR and an ultrasound. I was at the AUA (American Urology Association meeting)when it was in Atlanta a few months ago at the WCC, and among the most impressive exhibits were the incredible ability to do 3D prostate imaging via MRI now and ***to return to the site of the biopsied lesion(s) on re-exam which was not possible previously.
Your concept of coverage for colonoscopy doesn't comport with reality on planet earth in the real world with your whackjob perception of CPTs and ICD9s and reimbursement.
Screening for Prostate Cancer — The Controversy That Refuses to Die
http://www.nejm.org/doi/full/10.1056/NEJMe0901166
And, you are being truthful? Like when you say: "and the real deal is that insurance companies modify their coverages based on government recommendations." So, you are telling me this is the only basis upon which they change their coverages? And, they always change according to those recommendations? And, the same regarding reimbursement rates for services? I use to work for a company run by Rick Scott; you remember him don't you? So, don't try blowing smoke up my ass! 