The HAPI Plan
for Mandatory Wellness
 

Whenever legislation comes out of Washington DC providing programs with names like the HAPI Plan, you should know to be on high alert because whatever it is - it won’t be good. 

In January of 2007, Senator Ron Wyden introduced Senate bill S.334 titled the ‘Healthy Americans Act (HAA!)’.  On May 1, 2008, Senator Wyden issued a press release regarding a CBO and Joint Tax Committee on Taxation report saying that the act would achieve revenue neutrality by 2014 and would produce surpluses thereafter.  Since Senator Wyden was on C-Span Washington Journal this morning talking about this legislation and how it has bipartisan support - Senator Robert Bennett on the republican side, it’s safe to assume that they are going to try and move this legislation quickly now.  Watch out!  A hint on how they plan on achieving a surplus is found in the Findings:

• Americans want affordable, guaranteed private health coverage that makes them healthier and can never be taken away
• American health care provides primarily ‘sick care’ and does not do enough to prevent chronic illnesses like heart disease, stroke and diabetes.  This results in significantly higher health care costs for all Americans
• Staying as healthy as possible often requires an individual to change behavior and assume more personal responsibility for his or her health
• Personal responsibility for one’s health should include purchasing one’s own private health care coverage
• Financing this guarantee should be a shared responsibility between individuals, the Government, and employers.
• The $2,200,000,000,000 spent annually on American health care must be spent more effectively in order to meet this guarantee.
• This guarantee must include easier access to understandable information about the quality, cost, and effectiveness of health care providers, products, and services.
• The fact that businesses in the United States compete globally against businesses whose governments pay for health care, coupled with the aging of the American population and the explosive growth of preventable health problems, makes the status quo in American health care unacceptable.

This legislation doesn’t address the real problem in health care - which is that it is a profit-making industry that provides essential services.  Instead, they propose to shift the focus of health care away from “sick care” towards “wellness care”.  It’s much cheaper to treat the healthy.  “Diseased people”  will be managed and will be expected to modify their disease-producing behavior.  See Section 422.  Chronic Care Education Centers and provisions for “pay for performance” for providers -  financial incentives to “eliminate” chronic illness.  Use your imagination.   I’m not joking about this.  In a fascist, corporate controlled government such as we now have, diseased people and the elderly are an overhead cost and despite all the language of compassion, the system is being designed to eliminate the overhead.  Read the comments from different legislators on this program.  If it doesn’t make your blood run cold, then you are not understanding it.

Real ID  (by another route)

In Ron Wyden’s description of the HAA! program, there is one small paragraph that is the giveaway to another run at a national ID:  

The government, for its part, would make sure that every American has, and can afford, health insurance. Every time an individual interacts with local, state or federal government, they could be required to verify their enrollment in a private health insurance plan.

It’s important to understand that when Al Gore “reinvented” government, what that meant was that they were redesigning the computer systems of government as a major element of the redesign.  That means combining computer systems and eliminating redundancies.  The redesign dictates a national ID that is the key to all information that the government keeps on you in the new systems.  That was the impetus behind the Real ID legislation but since there has been resistance to that, the HAA Act with mandatory participation and the requirement for a unique ID by definition will become the Real ID number - only there won’t be a state DMV and a Governor to run interference to block it.  Since it will be private insurers issuing the cards, they will no doubt meet the Department of Homescam Security Real ID requirements - meaning  RFID and the number assigned will be the key to your medical records as well as all the other personal information about you that the government maintains.  If they don’t get you one way, they just came at you from a different direction. 

Mandatory Participation

The HAA! Act calls for mandatory participation in a nationally defined health insurance program with subsidies provided on a sliding scale.  The states will provide administrative guidance and rules for private insurers that will sell the plans.  The mandatory plans are called the ‘Health Americans Private Insurance’ (HAPI) plan. 

Without further ado - here's what the HAPI Plan will do for you   (I’m losing it):

“Each adult shall have the responsibility to enroll in a HAPI Plan - unless you are already covered.”  Penalty for failure to purchase a HAPI Plan - an amount totaling the retroactive payments for the HAPI Plan as if you had purchased it - plus 15%. 

Select a ‘health home’ - meaning a health care provider that will monitor your health and provide you with brochures on “wellness”.    Coverage will include “wellness checks” - which are trips to the “health home”  where they will determine if you still have a pulse and if you’ve been following their orders in terms of weight loss or whatever - because there are penalties for not following orders.   Provisions applying to Wellness:

The provider at your “health home” will - on the first visit, “determine a plan to maximize the health of the individual through wellness and prevention activities”;  

Family planning coverage will be available as a supplemental to the basic services and it will include abortion services.   (Note:  I suspect that the abortion coverage was thrown in to give republican leaders as a strawman to fight.  It is issue for compromise.  They will fight it, they will win and this legislative dog will pass into law and republicans can say, "See how good we are at family values?")     

The state will determine the premium amount and it can vary only on geography, tobacco use and family size.  So all of you drunks, druggies and fatties out there can breathe easy, they can only soak the smokers for penalty premiums.  Medicare beneficiaries however, are subject to premium adjustments depending on cooperation and/or participation in “healthy behaviors”. 

Genetic Testing - prohibits discrimination on genetic testing results; prohibits the plan from requiring a genetic test; prohibits the provider from requiring a genetic test; but does not limit a provider from requesting that the patient undergo a genetic test.

Premium Subsidy - As I read this, if your adjusted income is at the poverty line, your premium will be 100% subsidized.  If your adjusted income is less then 400% of the poverty line then your premium subsidy will be on a sliding scale.

School-based Health Centers - Section 212.  Grants will be provided to establish school-based health centers that will provide all services for children through the schools. 

Title IV - Healthier Medicare, Section 401.  Authority to Adjust Amount of Medicare Part B Premium to Reward Positive Health  Behavior (as if behavior has anything to do with aging):

“With respect to the monthly premium amount for months after December 2008, the Secretary may adjust (under procedures established by the Secretary) the amount of such premium for an individual based on whether or not the individual participates in certain healthy behaviors, such as weight management, exercise, nutrition counseling, refraining from tobacco use, designation a health home, and other behaviors determined appropriate by the secretary.  

This legislation provides for chronic disease management and chronic care education centers (Sec 422).  (It’s hard to see how they are going to run surpluses after 2014 with all these new centers they are funding - except by the elimination of “overhead”.

Part D Improvements - giving the HHS Secretary the ability to negotiate for the cheapest priced drugs (whoopie!  Drugs from China for the elderly - a little Heparin for Granny?  It might be contaminated - but what the heck… it’s cheap)

I’m only half way finished reading this legislation.  I can’t take anymore today.   The point is, Heads Up… this legislation is a bipartisan monster and the stated objectives are not the real objectives.  So what else is new in Disney's Amerika?  

The President is working to improve the adoption of health information technology.  Electronic health records show promise as a tool to help improve the efficiency and effectiveness of medical treatment.  In 2004, the President launched an initiative to make electronic health records available to most Americans within the next 10 years. Health IT systems can give citizens better access to their health information, resulting in informed decisions about their care and a better understanding of the quality of the care they are receiving.  In 2006, the President directed Federal agencies to use improved health IT systems to facilitate the rapid exchange of health information.

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