Forgive the departure from my usual verbosity. I’m on my way to a meeting, and I don’t have the time. Today I’ll report disturbing content found in health care bills that are competing for passage in Washington. Thanks to Linda Rosa for keeping our attention on language in one of the Senate bills: “S.1679 – Affordable Health Choices Act,” sponsored by (guess who?) Senator Tom Harkin (D-IA). According to Linda, Harkin and supporters will attempt to merge his bill with Baucus’s. Here are some of the choice passages in Harkin’s 800+ page bill (emphasis added):
A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.
…(4) ensure that the health team established by the entity includes an interdisciplinary, interprofessional team of health care providers, as determined by the Secretary; such team may include medical specialists, nurses, nutritionists, dieticians, social workers, behavioral and mental health providers (including substance use disorder prevention and treatment providers), doctors of chiropractic, licensed complementary and alternative medicine practitioners, and physicians’ assistants;
…(c) Requirements for Health Teams- A health team established pursuant to a grant under subsection (a) shall–
(1) establish contractual agreements with primary care providers to provide support services;
(2) support patient-centered medical homes, defined as mode of care that includes–
(A) personal physicians;
(B) whole person orientation;
…(F) provide coordination of the appropriate use of complementary and alternative (CAM) services to those who request such services;
…(H) provide local access to the continuum of health care services in the most appropriate setting, including access to individuals that implement the care plans of patients and coordinate care, such as integrative health care practitioners;
(1) HEALTH CARE WORKFORCE- The term ‘health care workforce’ includes all health care providers with direct patient care and support responsibilities, such as physicians, nurses, nurse practitioners, primary care providers, preventive medicine physicians, optometrists, ophthalmologists, physician assistants, pharmacists, dentists, dental hygienists, and other oral healthcare professionals, allied health professionals, doctors of chiropractic, community health workers, health care paraprofessionals, direct care workers, psychologists and other behavioral and mental health professionals (including substance abuse prevention and treatment providers), social workers, physical and occupational therapists, certified nurse midwives, podiatrists, the EMS workforce (including professional and volunteer ambulance personnel and firefighters who perform emergency medical services), licensed complementary and alternative medicine providers, integrative health practitioners, public health professionals, and any other health professional that the Comptroller General of the United States determines appropriate.
(2) HEALTH PROFESSIONALS- The term ‘health professionals’ includes–
(A) dentists, dental hygienists, primary care providers, specialty physicians, nurses, nurse practitioners, physician assistants, psychologists and other behavioral and mental health professionals (including substance abuse prevention and treatment providers), social workers, physical therapists, public health professionals, clinical pharmacists, allied health professionals, doctors of chiropractic, community health workers, school nurses, certified nurse midwives, podiatrists, licensed complementary and alternative medicine providers, the EMS workforce (including professional and volunteer ambulance personnel and firefighters who perform emergency medical services), and integrative health practitioners;
(B) national representatives of health professionals;
(C) representatives of schools of medicine, osteopathy, nursing, dentistry, optometry, pharmacy, chiropractic
Notice that these sections mean that all other references to “licensed health care practitioners,” of which there are many, stipulate quacks.
The following passage reveals the ignorance of its authors:
…(B)(ii) has a license or certification in a State to practice allopathic medicine, osteopathic medicine, psychology, school psychology, psychiatric nursing, social work, school social work, marriage and family therapy, school counseling, or professional counseling;
Also in this bill is the following:
‘SEC. 3103. PROGRAM DESIGN.
…(D) The essential benefits provided for in subparagraph (A) shall include a requirement that there be non-discrimination in health care in a manner that, with respect to an individual who is eligible for medical or surgical care under a qualified health plan offered through a Gateway, prohibits the Administrator of the Gateway, or a qualified health plan offered through the Gateway, from denying such individual benefits for religious or spiritual health care, except that such religious or spiritual health care shall be an expense eligible for deduction as a medical care expense as determined by Internal Revenue Service Rulings interpreting section 213(d) of the Internal Revenue Code of 1986 as of January 1, 2009
Thanks also to Billy London, who called our attention to that passage after having his own attention called to it by Rita Swan of CHILD. What it means, of course, is that this bill would require Administrators to pay Christian Science “Practitioners,” among others (Scientologists, perhaps?), fees for their “services.” Since there is to be non-discrimination, we might presume that such fees would be comparable to those paid to legitimate practitioners. Ms. Swan found similar language in House Bill HR 3200, sponsored by John Dingell (D-MI):
Section 125. PROHIBITION OF DISCRIMINATION IN HEALTH CARE SERVICES BASED ON RELIGIOUS OR SPIRITUAL CONTENT.
Neither the Commissioner nor any health insurance issuer offering health insurance coverage through the Exchange shall discriminate in approving or covering a health care service on the basis of its religious or spiritual content if expenditures for such a health care service are allowable as a deduction under 213(d) of the Internal Revenue Code of 1986, as in effect on January 1, 2009.
Most people will never read these voluminous bills, but as politicians love to say, “the devil’s in the details.” Even politicians don’t seem to understand their own creations. According to Rita Swan:
It is bizarre that the IRS allows bills for prayers to be deducted from income tax and it’s even more bizarre for the federal government to be forcing insurers to pay bills for prayer. I don’t think Congress understands what they’re doing. Congressional staffers [whom] CHILD officers have talked to at first denied that anybody would be paying for prayer, and even after we cite the specific bill sections, they don’t know what religious “health care” the IRS allows deductions for and therefore don’t understand that the federal government will be forcing insurance companies to pay purely for prayer.
Ms. Swan, a former Christian Scientist, knows of what she speaks:
Christian Science founder Mary Baker Eddy directed her “practitioners” to make their charges for prayers equal to physicians’ charges for medical care. These practitioners set their own rates, but sometimes their charges are indeed comparable to medical bills. In 1989 Christian Science healer Mario Tosto charged parents $446 for two days of prayer-treatment for Ian Lundman, an 11-year-old Minnesota boy with diabetes. The boy died.
In Michigan an insurance company balked at paying a Christian Science practitioner’s bill of $1,775 for her prayers on top of medical bills for the patient. The couple sued the company. Stephenson v. State Farm, 48th District Court, as reported in Michigan Trial Lawyers Association newsletter, October 1986, page 22.
A friend just told us about Oregon media begging the public for donations to cover medical care for a soldier seriously wounded in Afghanistan–medical care that the Army won’t pay for. And yet Congress wants to force insurance companies to pay $223 a day for prayer for a child who is dying of diabetes because his mother refuses insulin for him?
CHILD members and friends, please call or e-mail your Congressperson and U.S. Senators this week. Ask to speak to their health staffers or leave a message and oppose a government mandate that insurers pay bills for prayer. If they deny the existence of such a mandate, please cite the sections of the health care reform bills we gave above.
Amen to that.