Duke University Prof Explains Parts Of The Health Care Bill

I also heard this on the radio. The writer is a professor of classics at Duke U. He decided to try to answer a few questions about the health care bill, at least one version of it.

What does the bill, HR 3200, short-titled ‘‘America’s Affordable Health Choices Act of 2009,” actually say about major health care issues? I here pose a few questions in no particular order, citing relevant passages and offering a brief evaluation after each set of passages.

This bill is 1017 pages long. It is knee-deep in legalese and references to other federal regulations and laws. I have only touched pieces of the bill here. For instance, I have not considered the establishment of (1) “Health Choices Commissio0ner” (Section 141); (2) a “Health Insurance Exchange,” (Section 201), basically a government run insurance scheme to coordinate all insurance activity; (3) a Public Health Insurance Option (Section 221); and similar provisions.

This is the evaluation of someone who is neither a physician nor a legal professional. I am citizen, concerned about this bill’s effects on my freedom as an American. I would rather have used my time in other ways—but this is too important to ignore.

We may answer one question up front: How will the government will pay for all this? Higher taxes, more borrowing, printing money, cutting payments, or rationing services—there are no other options. We will all pay for this, enrolled in the government “option” or not.

(All bold type within the text of the bill is added for emphasis.)

This is what the bill says, pages 284-288, SEC. 1151. REDUCING POTENTIALLY PREVENTABLE HOSPITAL READMISSIONS:

‘(ii) EXCLUSION OF CERTAIN READMISSIONS.—For purposes of clause (i), with respect to a hospital, excess readmissions shall not include readmissions for an applicable condition for which there are fewer than a minimum number (as determined by the Secretary) of discharges for such applicable condition for the applicable period and such hospital.

and, under “Definitions”:

‘‘(A) APPLICABLE CONDITION.—The term ‘applicable condition’ means, subject to subparagraph (B), a condition or procedure selected by the Secretary . . .


‘‘(E) READMISSION.—The term ‘readmission’ means, in the case of an individual who is discharged from an applicable hospital, the admission of the individual to the same or another applicable hospital within a time period specified by the Secretary from the date of such discharge.


‘‘(6) LIMITATIONS ON REVIEW.—There shall be no administrative or judicial review under section 1869, section 1878, or otherwise of— . . .

‘‘(C) the measures of readmissions . . .


1. This section amends the Social Security Act

2. The government has the power to determine what constitutes an “applicable [medical] condition.”

3. The government has the power to determine who is allowed readmission into a hospital.

4. This determination will be made by statistics: when enough people have been discharged for the same condition, an individual may be readmitted.

5. This is government rationing, pure, simple, and straight up.

6. There can be no judicial review of decisions made here. The Secretary is above the courts.

7. The plan also allows the government to prohibit hospitals from expanding without federal permission: page 317-318.

I. Am. Appalled.

Check out the rest. The link I provided, which publishes the letter in full, also links to the Professor’s webpage.

- Aggie


  1. Martino said,

    August 12, 2009 @ 2:58 pm

    So “the Secretary” decides all these things. Let’s hope “the Secretary” isn’t having a bad day when I need a doctor.

  2. Bob said,

    August 12, 2009 @ 3:29 pm

    This interpretation draws wild conclusions from what is very clear legal language in this draft of the bill. First of all, understand that this is not the final bill and lots of things will still get cleared up. However, the passage “Preventable Hospital Readmissions” should clue readers in that this is about keeping little Timmy’s mom from bringing him back 30 times for a skinned knee and wasting all of our money… a practice that is perfectly OK under today’s regulation and a practice that drives up all of our premiums. That’s how easy this interpretation is to debunk and that took me all of 2 seconds to see. I shudder to think the rounds that this will make and how many people will misinterpret this professor’s credentials as meaning that he has some unbiased ability to present the law here. His interpretation is clearly that of someone looking not for the best outcome for all of us, but just to scare people into disapproving of the bill before they even use common sense to understand what it says.

  3. Bloodthirsty Liberal said,

    August 12, 2009 @ 3:35 pm

    To BTL Readers:

    We’ve hit the big time! All those grass-roots summer jobs that we found advertised on Craigs List – the ones that pay up to $16/hour to advocate for the President’s health care plan – some of those resources are being focused on our little site! Isn’t that cool?

    Bob – quick question. Did you read the pdf I posted written by Ezekiel Emmanuel? The one where he explains that dementia is a condition that wouldn’t be guaranteed treatment because a demented person can no longer be a contributing member to society? How do you know that little Timmy’s mom would go back to the hospital 30 times with a skinned knee? Maybe instead, Little Timmy has cystic fibrosis, muscular dystrophy, juvenile diabetes, or leukemia. Let’s just say that I know lots of moms and kids and have yet to meet a single one that went to the hospital 30 times for a skinned knee. Not one, Bob.

    - Aggie

  4. Martino said,

    August 12, 2009 @ 3:44 pm

    Let’s hope Timmy doesn’t have to answer to “the Secretary” for that skinned knee. In Obama’s world, he might just get it amputated so he can’t bring it back 30 times.

  5. Bloodthirsty Liberal said,

    August 12, 2009 @ 4:09 pm

    You’re right! Why do I bother to try to seriously answer those clowns?

    - Aggie

  6. judi said,

    August 13, 2009 @ 9:17 am

    While Bob is hardly worth responding to, I have this question. It is true that by a stretch of an imagination such as Bob’s, you could believe the conclusion that he has come to about the meaning of the language stated. However, there are many other, and even more likely conclusions to be drawn as well. Should language so easy to misinterperet be written into a bill? If the letter of the language was intended to be followed wouldn’t it be better for that language to be clear? One may draw the conclusion that it is purposfeully vague so a person may interperet it in a way that suits their cause, such as, say, a judge.

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