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Liberal Utopia

What your world would be if everything liberals wanted, they got. Open the door at the bottom of its Elysium façade and take a glimpse of hell.

Health Choices Administration

 

A bureaucracy that makes health choices for you.


I

suppose calling it the "Shut Up & Do Whatever We Tell You Administration" was too long for the letterhead or something. Although it would've been more accurate, given that no administrative or judicial review of anything the Health Choices Commissioner ever does is expressly allowed in the bill.

That's what you self-blinded supporters of Øfascist"Care" are mindlessly supporting. Solely because someone else told you you ought to support it. Not because you, you know, like read it or anything and said, "Hey, that sounds like a pretty good idea."

Or maybe you actually want someone else making all "your" health choices for you. So long as its your beloved worshipped Der Führer making them, right? When its President Sarah Palin appointing the next Health Choices Commissioner, no doubt you'll still be cool with that.

In that case, let's see what other things, yes, President Palin's healthcare appointees can do without ever having to worry about any of those nasty administrative or judicial reviews:

SEC. 223(f) LIMITATIONS ON REVIEW.–There shall be no administrative or judicial review of a payment rate or methodology established under this section [for the public health insurance option for services and health care providers] or under section 224 ["innovative" payment mechanisms and policies to determine payments for items and services under the public health insurance option].


President Palin's healthcare appointees are just going to loooove setting payment rates that you betchya will leave you squealing "she's stealing from the poor to give to the rich!11!!!11ONE!" or some other incoherent nonsense. But squeal is all, yes, you can do, because this bill requires every agency and court in the land to flat-out ignore you. Mwwahahhaa hahahaha ha

SEC. 1123 [adding new subsection (x) to section 1833 of the Social Security Act]... "[(x)(2)](C) LIMITATION ON REVIEW.–There shall be no administrative or judicial review under section 1869, 1878, or otherwise, respecting (i) the identification of a county or other area under subparagraph (A) [i.e., which counties are among 'lowest fifth percentile of utilization based on per capita spending' for services provided in accordance with a government-specified 'physician fee schedule']; or (ii) the assignment of a postal ZIP Code to a county or other area under subparagraph (B) [i.e., the 'dominant county' in that ZIP code]."


Oops. President Palin's healthcare appointees could only identify counties in Red States eligible fur al dis heer extree "free" health care, by golly (paid for mostly by you Blue Statists, of course). What's that? You're gonna sue them? Sorry. Better commence with your futile squealing again. 'Cause that's the only relief you have any standing to seek.

SEC. 1151 [adding new subsection (p) to section 1886 of the Social Security Act]... "[(p)](6) LIMITATIONS ON REVIEW.–There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of (A) the determination of base operating DRG [Diagnosis Related Group of a hospital's patients for which a flat rate is paid regardless of the actual services provided] payment amounts; (B) the methodology for determining the adjustment factor under paragraph (3) [i.e., the greater of 1 minus ratio of 'aggregate payments for excess readmissions' and 'aggregate payments for all discharges', or 0.99, 0.98, 0.97, or 0.95 for fiscal years 2012, 2013, 2104, 2015+, respectively], including excess readmissions ratio under paragraph (4)(C) [i.e., ratio (but not less than 1.0) of 'risk adjusted readmissions' to 'risk adjusted expected readmissions'], aggregate payments for excess readmissions under paragraph (4)(A) [i.e., 'applicable conditions' sum of the product of 'base operating DRG payment amount,' number of admissions, and 'excess readmissions ratio' minus 1], and aggregate payments for all discharges under paragraph (4)(B) [sum of 'base operating DRG payment amounts' for all conditions], and applicable periods and applicable conditions under paragraph (5); (C) the measures of readmissions as described in paragraph (5)(A)(ii) [i.e., 'endorsed' readmissions that 'have appropriate exclusions' unrelated to prior discharge]; and (D) the determination of a targeted hospital under paragraph (8)(B)(i) [i.e., one that received or was eligible to receive at least $10 million in estimated 'disproportionate share payments'], the increase in payment under paragraph (8)(B)(ii) ['for transitional care activities designed to address the patient noncompliance issues that result in higher than normal readmission rates'], the aggregate cap under paragraph (8)(C)(i) [i.e., 5 percent of the estimated difference in spending with and without application of the 'adjustment factor' mentioned above], the hospital-specific limit under paragraph (8)(C)(ii) [i.e., the full estimated difference in spending with and without application of the 'adjustment factor'], and the form of payment made by the Secretary under paragraph (8)(D) [i.e., 'a lump sum basis, a periodic basis, a claim by claim basis, or otherwise']."


For some strange reason, hospitals in Red States have been faring far better financially and otherwise under the Palin Administration than they had under the Øfascist Tyrannical Dictatorship. It's really just too bad there's no legal recourse for bed-wetting liberals(birm) to do anything about it, even if they could find out why Red State hospitals are now literally rolling in dough. Boo-flickin'-hoo. (Time for another round of pointless squealing.)

SEC. 1156(a) [adding new subsection (i) to section 1877 of the Social Security Act]... "[(i)(2)](H) LIMITATION ON REVIEW.–There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of the exception process under this paragraph [for lifting the prohibition on expansion of a hospital's capacity], including the establishment of such process, and any determination made under such process."


My, my, how nearly every Red State hospital has been expanding like a herd of caribou around the Alaskan pipeline since President Palin took office! But it's a complete mystery the same can't be said about very many Blue State Stasis ones. Gee whiz, that right there is some mighty potent prima facie evidence for a heckuva abuse-of-power case... Huh? Oh, that's right. Never mind. (Cue squealing)

SEC. 1301 [adding new section 1866D to Title XVIII of the Social Security Act]... "[SEC. 1866D(e)](4) LIMITATIONS ON REVIEW.–There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of (A) the elements, parameters, scope, and duration of the pilot program ['to test different payment incentive models']; (B) the selection of qualifying ACOs ['accountable care organizations'] for the pilot program; (C) the establishment of targets, measurement of performance, determinations with respect to whether savings have been achieved and the amount of savings; (D) determinations regarding whether, to whom, and in what amounts incentive payments are paid; and (E) decisions about the extension of the program under subsection (g), expansion of the program under subsection (h) or extensions under subsection (i)."


Don't be surprised when President Palin's healthcare appointees select Dick Cheney's own Conservative Death Beast Blood-for-Oil Evil Tonsillectomy Services & Amputation Supplies® company as one of the ACOs qualifying for all the neat "incentive payments".... Wait a minute, I can't hear a word you're saying with all that squealing going on. Tell that angry mob of yours to take it outside.

SEC. 1303 [adding a new subsection (p) to section 1833 of the Social Security Act]... "[(p)](4) LIMITATION ON REVIEW.–There shall be no administrative or judicial review under section 1869, section 1878, or otherwise, respecting (A) any determination or designation under this subsection [relating to 'primary care payment incentives' (i.e., a 5 to 10 percent bonus for doctors serving in 'primary care health professional shortage areas')]; (B) the identification of services as primary care services under this subsection; and (C) the identification of a practitioner as a primary care practitioner under this subsection."


President Palin especially likes this one. So many Republican-donor physicians, so little time (for "spreading the wealth incentives around a bit"™). Don't like it? Well, by golly, then sue! ...uh, er... I mean, let's start up that chant again. "What are we only doing? Squealing!1!!!! When are we doing it? Now Always!!!111!!!ONE!!1" OK. Again. But this time with political terrorist-size feeling....

SEC. 1631 [adding new section 1128G to Title XI of the Social Security Act]... "[1128G(a)(1)]... Actions taken and determinations made under this subsection [relating to punishment imposed on a whole 'category of providers of services or suppliers of items or services' which Der Sekretär 'determines' feels poses a 'significant risk of fraudulent activity' (without any regard for those providers or suppliers that have never themselves engaged in any), where such universal punishment includes invasive, unannounced, and blackballing-intended 'screenings,' arbitrary periods of 'enhanced oversight,' and an unlimited 'moratorium on enrollment' (so long as Der Sekretär 'determines' feels it wouldn't 'adversely impact access of individuals to care')] shall not be subject to review by a judicial tribunal."


Lovely. Certainly every liberal is comfortable with the fact that one of President Palin's healthcare appointees has such massive, unreviewable power to punish an entire category of predominantly Demoqrat-donating and/or unionized companies "providers or suppliers" while never having to stop or even slow down once to bother with any kind of messy, inconvenient trial. And, no, I don't want to hear any more of your squealing. The most effective time for that was before this bill ever got to the House floor, not after it had to spend only a half day on your Der Führer's desk waiting for him to again break his "five days of sunlight before signing" promise.

SEC. 1741(a)(2) [striking "regard to" and all that follows through the period in section 1927(k)(1)(B) of the Social Security Act, and inserting]... "(v) ...Such a determination [relating to a non-inhalation, non-infusion drug's 'average manufacturer price' obtained by 'necessary' inclusion of 'its sales directly to, or rebates, discounts, or other price concessions provided to, hospitals, clinics, and physicians'] shall not be subject to judicial review...."


Another official act obtained from the bribery of Half-Whitey Former Junior Senotard Baracketeer al-Hussein Øfascist by the Pharmaceutical Researchers and Manufacturers Association (PhRMA)? As the Democorrupt Speaker of the Hate "Nan Sees Swastikas" Peloseri would say: You be the judge.®

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