Free Markets, Free People

health care reform

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Observations: The QandO Podcast for 11 Aug 13

This week, Michael, and Dale discuss many things.

The direct link to the podcast can be found here.

Observations

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Unions on Obamacare: "This vision has come back to haunt us"

File this under "Cry Me A River". Union bigwigs James Hoffa, Joseph Hansen, and Donald "D" Taylor have written a strongly worded note to Harry Reid and Nancy Pelosi begging them to reform the Affordable Care Act—Obamacare—that the unions so strongly supported.

When you and the President sought our support for the Affordable Care Act (ACA), you pledged that if we liked the health plans we have now, we could keep them. Sadly, that promise is under threat. Right now, unless you and the Obama Administration enact an equitable fix, the ACA will shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.

Yes. It will. Many of us said it would. Repeatedly. But the Unions were big-time supporters of it. Now they are whining about the very things we predicted before the law was passed.

We have been strong supporters of the notion that all Americans should have access to quality, affordable health care. We have also been strong supporters of you. In campaign after campaign we have put boots on the ground, gone door-to-door to get out the vote, run phone banks and raised money to secure this vision.

Now this vision has come back to haunt us.

Ah ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha! Woo hoo hoo hoo hoo hoo! Ah, Whew! Huh. Oh. Ho. Ho ho. Ho ho ho ho. Oh ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho ho! Ha ha ha ha ha ha ha ha ha ha ha ha ha ha ha!

(Rubbing my thumb against my fingertips.) You know what this is? It’s the world’s smallest string quartet playing "My heart cries for you", you dolts. You poltroons. You microcephalic dunces.

You guys are so stupid, I honestly don’t know why you don’t just fall down more.

On behalf of the millions of working men and women we represent and the families they support, we can no longer stand silent in the face of elements of the Affordable Care Act that will destroy the very health and wellbeing of our members along with millions of other hardworking Americans.

We believe that there are common-sense corrections that can be made within the existing statute that will allow our members to continue to keep their current health plans and benefits just as you and the President pledged.

Good luck with that, Stupids. You wanted Obamacare. You campaigned for it. So, you deserve to get it. Good and hard.

I hope your members thank you for selling them down the river with your support of Obamacare by dragging you naked and screaming out of your offices for a good tar and feathering. I’ve never wanted to see some union thuggery more in my life than I do right now, directed at you.

I now truly understand the German concept of schedenfreude. Indeed, I embrace it.

~
Dale Franks
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Observations: The QandO Podcast for 25 Nov 12

This week, Bruce, Michael, and Dale discuss Israel and Obamacare.

The direct link to the podcast can be found here.

Observations

As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2010, they can be accessed through the RSS Archive Feed.


“You can keep your plan…”

…for as long as your health care plan exists, anyway. Which, for retirees of the 3M corporation, it no longer will. It seems that the passage of Obamacare has prompted 3M to join the rush for the door in terms of providing health care coverage.

As we’ve noted repeatedly here, the claims that you could keep your health care plan and physician could not possibly be true, as the “reform” package set up perverse incentives. What we are seeing is precisely what we predicted. Corporations and insurers are responding to Obamacare’s  incentives by getting out of the health insurance business. Because that’s what the law’s incentives urge them to do.

It really is one of the most basic principles of economics: people respond to incentives.


Waxman cancels CEO hearing, ObamaCare remains unpopular (update)

I guess after he finally read the health care bill he’d voted for, Rep. Henry Waxman (D-Never Never Land), chair of the House Energy and Commerce committee, decided it wouldn’t be a good idea to grill CEOs whose companies had apparently read it and complied with its provisions:

The cancellation came after they realized what everyone already knew – that the companies were required to do what they did because of accounting rules. Waxman and others had reacted with outrage and accused the companies of doing it – in essence, to make health care reform look bad.

Right.  Companies normally take $1 billion dollar hits against their profits just to “make health care look bad”.   And, of course, it must have been a conspiracy, since so many did it, right Mr. Waxman?

House Minority Leader John Boehner issued a statement which gets to the crux of Waxman’s now cancelled plan:

“Chairman Waxman thought he could intimidate businesses into keeping quiet about this new job-killing health care law, but when they called his bluff by continuing to speak out, he chose to pull the plug.”

Sounds about right.  Meanwhile another poll shows the specific health care legislation recently passed and signed into law, remains deeply unpopular to a majority of Americans:

Fifty-eight percent of Americans (96 percent of Republicans, 10 percent of Democrats and 54 percent of Independents) support repealing the health care reform legislation that was signed into law by President Barack Obama in March, according to a new national survey conducted April 6 – 10 by researchers from Indiana University’s Center for Health Policy and Professionalism Research (CHPPR).

Americans 18 to 34 years of age were most supportive of repealing the legislation with more than 70 percent supporting its repeal.

“This is somewhat surprising given that some of the most vocal opposition to reform in the past came from older Americans while younger individuals seemed less opposed,” said Aaron Carroll, M.D., director of CHPPR.

Despite claims that this sort of opposition would quickly and quietly fade away after passage,  it doesn’t appear that’s the case.  The last demographic quoted in the poll is interesting, because it means that younger people are aware of the impact the legislation will have on them (mandate) and the vast majority don’t support it at all.  These sorts of numbers, and the fact that few of the so-called “benefits” this bill provides don’t start till 2014, make repeal more “doable” than if the benefits had already begun to take hold – a cost of gaming the CBO numbers in an effort to claim this monstrosity decreases the deficit.

GOP – can you say “silver platter?”

UPDATE: Even AP has noticed:

Opposition to President Barack Obama’s health care law jumped after he signed it — a clear indication his victory could become a liability for Democrats in this fall’s elections.

A new Associated Press-GfK poll finds Americans oppose the health care remake 50 percent to 39 percent. Before a divided Congress finally passed the bill and Obama signed it at a jubilant White House ceremony last month, public opinion was about evenly split. Another 10 percent of Americans say they are neutral.

Disapproval for Obama’s handling of health care also increased from 46 percent in early March before he signed the bill, to 52 percent currently — a level not seen since last summer’s angry town hall meetings.

~McQ


So are we in “death panel” territory here?

David Leonhardt spends about a 1,000 words in the New York Times banging around the edges of what has to be done by government to cut health care costs. Or, as he calls it “In Medicine, the Power of No”. He wonders if we can every really learn to say “no”. And, of course, he’s talking about saying no to sick people, to patients – denying them care.

From an economic perspective, health reform will fail if we can’t sometimes push back against the try-anything instinct. The new agencies will be hounded by accusations of rationing, and Medicare’s long-term budget deficit will grow.

So figuring out how we can say no may be the single toughest and most important task facing the people who will be in charge of carrying out reform. “Being able to say no,” Dr. Alan Garber of Stanford says, “is the heart of the issue.”

Maybe I’m reading to much into this, but what is being said here is “the new agencies” which will be “in charge of carrying out reform” need to learn to “say no”.

Huh? I thought all this reform was about leaving such decisions about treatment between your doctor and yourself and not those evil, mean insurance companies. Who are these agencies – these “new” agencies – and why are they in they charged with “saying no?” If they’re “new” they’re a creation of the HCR monstrosity and if they have the ability to say “no” aren’t they strangely like the supposed mythical “death panels” Sarah Palin commented on?

Of course any sane person reviewing the claims of those pushing this piece of garbage known as health care reform knew that to drive down costs, rationing and the denial of care was not only possible but absolutely necessary. And, like so many other aspects of this bill, what was promised to gain support is almost the opposite of what was passed in the legislation.

Leonhardt knows where he’s going with his piece, but he is loath to actually say it. So he dances all around it, but if you read carefully you understand that despite all the rigmarole about bringing patients in on the decision and his belief that if they’re informed they’ll choose the least costly methods, he understands that as he says in his title that someone in authority is going to ultimately have to say “no” to make this work. And that pretty much means, much to the chagrin of the left, that Sarah Palin was right.

~McQ


NOW they tell us…

John Cassidy, writing in one of the blogs at that hotbed of reactionary conservatism, the New Yorker, notes the following about the BFD.  First, he writes that the individual mandate is likely to prompt rather different behavior than the law assumes:

Consider the so-called “individual mandate.” As a strict matter of law, all non-elderly Americans who earn more than the poverty line will be obliged to obtain some form of health coverage. If they don’t, in 2016 and beyond, they could face a fine of about $700 or 2.5 per cent of their income—whichever is the most. Two issues immediately arise.

Even if the fines are vigorously enforced, many people may choose to pay them and stay uninsured. Consider a healthy single man of thirty-five who earns $35,000 a year. Under the new system, he would have a choice of enrolling in a subsidized plan at an annual cost of $2,700 or paying a fine of $875. It may well make sense for him to pay the fine, take his chances, and report to the local emergency room if he gets really sick. (E.R.s will still be legally obliged to treat all comers.) If this sort of thing happens often, as well it could, the new insurance exchanges will be deprived of exactly the sort of healthy young people they need in order to bring down prices. (Healthy people improve the risk pool.)

He then moves on to note that employers may respond in a rather unexpected fashion as well:

Take a medium-sized firm that employs a hundred people earning $40,000 each—a private security firm based in Atlanta, say—and currently offers them health-care insurance worth $10,000 a year, of which the employees pay $2,500. This employer’s annual health-care costs are $750,000 (a hundred times $7,500). In the reformed system, the firm’s workers, if they didn’t have insurance, would be eligible for generous subsidies to buy private insurance. For example, a married forty-year-old security guard whose wife stayed home to raise two kids could enroll in a non-group plan for less than $1,400 a year, according to the Kaiser Health Reform Subsidy Calculator. (The subsidy from the government would be $8,058.)

In a situation like this, the firm has a strong financial incentive to junk its group coverage and dump its workers onto the taxpayer-subsidized plan. Under the new law, firms with more than fifty workers that don’t offer coverage would have to pay an annual fine of $2,000 for every worker they employ, excepting the first thirty. In this case, the security firm would incur a fine of $140,000 (seventy times two), but it would save $610,000 a year on health-care costs. If you owned this firm, what would you do?

I assume that final question is rhetorical.

Too bad no one could explain this prior to the bill’s passage.

If only there was some intellectual discipline that tried to predict how people respond to incentives in a world of scarce resources!


The BFD – its first week

So, how is ObamaCare being greeted by the real world since it was signed into law Tuesday?  Well, pretty much as expected by those who were paying attention (and that wouldn’t include the unicorns and moon pony crowd).  For instance, employees at Verizon were greeted with a statement by the company explaining its interpretation of the law and what that would mean in terms of future coverage:

In an email titled “President Obama Signs Health Care Legislation” sent to all employees Tuesday night, the telecom giant warned that “we expect that Verizon’s costs will increase in the short term.” While executive vice president for human resources Marc Reed wrote that “it is difficult at this point to gauge the precise impact of this legislation,” and that ObamaCare does reflect some of the company’s policy priorities, the message to workers was clear: Expect changes for the worse to your health benefits as the direct result of this bill, and maybe as soon as this year.

You may recall that Caterpillar said that the bill would cost them $100 million more in health care coverage in the first year alone. That ought to make them highly competitive.

Verizon is also being punished for offering retirees health benefits:

Mr. Reed specifically cited a change in the tax treatment of retiree health benefits. When Congress created the Medicare prescription drug benefit in 2003, it included a modest tax subsidy to encourage employers to keep drug plans for retirees, rather than dumping them on the government. The Employee Benefit Research Institute says this exclusion—equal to 28% of the cost of a drug plan—will run taxpayers $665 per person next year, while the same Medicare coverage would cost $1,209.

In a $5.4 billion revenue grab, Democrats decided that this $665 fillip should be subject to the ordinary corporate income tax of 35%. Most consulting firms and independent analysts say the higher costs will induce some companies to drop drug coverage, which could affect about five million retirees and 3,500 businesses. Verizon and other large corporations warned about this outcome.

Or, instead of discouraging employers from dumping retirees on the government, the new plan encourages it and essentially punishes those who don’t. In fact, you could say that the entire bill encourages companies to dump employee coverage. If they’re of a certain size and don’t offer coverage, they are fined $750 per employee. Compare that to the thousands of dollars in cost for coverage plus the expense of administering an employee health insurance program. If you’re running a company in an economy mired in recession, what is one of the primary things you try to do? Cut costs. You have 50 employees and you’re spending $5,000 each on health insurance or $250,000 plus the cost of administration of the program. You can dump it all and pay a fine of $37,500. What would you do?

Oh, and there’s this little goodie to encourage companies to act quickly:

U.S. accounting laws also require businesses to immediately restate their earnings in light of the higher tax burden on their long-term retiree health liabilities. This will have a big effect on their 2010 earnings.

Of course it will. And that will have a significant impact on the economy and first quarter earnings.

Some companies, however, have an alternate plan:

Consumers Energy, a Michigan gas and electric company with 2.9 million customers, said it will not take a big first-quarter charge because, like most utility companies, it can try to recover the added costs from its customers through rate hikes.

The increased costs are going to be paid by someone – customer, taxpayers – it’s all the same in the end.

And that’s pretty much where the states are right now as well. South Carolina just tallied up its new unfunded mandate:

The expansion represents a 4.4 percent increase in the $20.9 billion the state would have spent on Medicaid during that nine-year period, adding roughly $100 million a year to the state’s costs.

The state is looking at a 1 billion dollar shortfall next year – the unfunded mandate adds $914 million to the shortfall over the next 10 years. Any guess who will end up paying for that?

It should be clear, given the Verizon info that the intent is to move people off employer based insurance and on to something else. I’ve always been a proponent of individual health insurance purchased by families individually in a free and competitive insurance market like we do any other insurance product. It immediately solves the portability problem and it drives cost down. What we’re seeing here is a manipulation of tax code pointed at effectively ending employer insurance programs but with a different aim in mind – single-payer government run insurance.

The intent to again offer legislation to establish an public option, voiced by Harry Reid and House Democrats makes that point rather clearly. Democrats will try to pass that before November – bet on it. Should they succeed, then all the parts would be in place to move in that desired direction. Meanwhile, unsurprisingly the promise of “if you like your plan and if you like your doctor you can keep them” appears to be a hollow one. The law incentivizes drastic changes in plans to avoid costs and taxes and in many cases, it is clearly smarter for a business to dump health care coverage altogether.

As for 95% of us not seeing a dime in new taxes – that too was a load of nonsense as most of us knew. Unless you live in the 57th state where none of this has any impact, the new unfunded mandates promise increased taxes – states, unlike the federal government can’t print money and thus have to either cut spending or increase taxes. Since the increased spending is being mandated, it leaves them little choice, does it?

~McQ


Perhaps HCR is a jobs bill

I do love it when government simplifies things. Like all these new boards and commissions in the new law:

1. Grant program for consumer assistance offices (Section 1002, p. 37)
2. Grant program for states to monitor premium increases (Section 1003, p. 42)
3. Committee to review administrative simplification standards (Section 1104, p. 71)
4. Demonstration program for state wellness programs (Section 1201, p. 93)
5. Grant program to establish state Exchanges (Section 1311(a), p. 130)
6. State American Health Benefit Exchanges (Section 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (Section 1311(i), p. 150)
8. Grant program for state cooperatives (Section 1322, p. 169)
9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (Section 1322(d), p. 177)
11. State basic health plan programs (Section 1331, p. 201)
12. State-based reinsurance program (Section 1341, p. 226)
13. Program of risk corridors for individual and small group markets (Section 1342, p. 233)
14. Program to determine eligibility for Exchange participation (Section 1411, p. 267)
15. Program for advance determination of tax credit eligibility (Section 1412, p. 288)
16. Grant program to implement health IT enrollment standards (Section 1561, p. 370)
17. Federal Coordinated Health Care Office for dual eligible beneficiaries (Section 2602, p. 512)
18. Medicaid quality measurement program (Section 2701, p. 518)
19. Medicaid health home program for people with chronic conditions, and grants for planning same (Section 2703, p. 524)
20. Medicaid demonstration project to evaluate bundled payments (Section 2704, p. 532)
21. Medicaid demonstration project for global payment system (Section 2705, p. 536)
22. Medicaid demonstration project for accountable care organizations (Section 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care (Section 2707, p. 540)
24. Grant program for delivery of services to individuals with postpartum depression (Section 2952(b), p. 591)
25. State allotments for grants to promote personal responsibility education programs (Section 2953, p. 596)
26. Medicare value-based purchasing program (Section 3001(a), p. 613)
27. Medicare value-based purchasing demonstration program for critical access hospitals (Section 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing facilities (Section 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies (Section 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (Section 3012, p. 688)
31. Grant program to develop health care quality measures (Section 3013, p. 693)
32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712)
33. Medicare shared savings program (Section 3022, p. 728)
34. Medicare pilot program on payment bundling (Section 3023, p. 739)
35. Independence at home medical practice demonstration program (Section 3024, p. 752)
36. Program for use of patient safety organizations to reduce hospital readmission rates (Section 3025(b), p. 775)
37. Community-based care transitions program (Section 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory tests (Section 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (Section 3140, p. 850)
40. Independent Payment Advisory Board (Section 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board (Section 3403, p. 1027)
42. Grant program for technical assistance to providers implementing health quality practices (Section 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (Section 3502, p. 1048)
44. Grant program to implement medication therapy management (Section 3503, p. 1055)
45. Grant program to support emergency care pilot programs (Section 3504, p. 1061)
46. Grant program to promote universal access to trauma services (Section 3505(b), p. 1081)
47. Grant program to develop and promote shared decision-making aids (Section 3506, p. 1088)
48. Grant program to support implementation of shared decision-making (Section 3506, p. 1091)
49. Grant program to integrate quality improvement in clinical education (Section 3508, p. 1095)
50. Health and Human Services Coordinating Committee on Women’s Health (Section 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (Section 3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s Health (Section 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s Health (Section 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (Section 3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council (Section 4001, p. 1114)
56. Advisory Group on Prevention, Health Promotion, and Integrative and Public Health (Section 4001(f), p. 1117)
57. Prevention and Public Health Fund (Section 4002, p. 1121)
58. Community Preventive Services Task Force (Section 4003(b), p. 1126)
59. Grant program to support school-based health centers (Section 4101, p. 1135)
60. Grant program to promote research-based dental caries disease management (Section 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid beneficiaries (Section 4108, p. 1174)
62. Community transformation grants (Section 4201, p. 1182)
63. Grant program to provide public health interventions (Section 4202, p. 1188)
64. Demonstration program of grants to improve child immunization rates (Section 4204(b), p. 1200)
65. Pilot program for risk-factor assessments provided through community health centers (Section 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity (Section 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (Section 4305, p. 1238)
68. National Health Care Workforce Commission (Section 5101, p. 1256)
69. Grant program to plan health care workforce development activities (Section 5102(c), p. 1275)
70. Grant program to implement health care workforce development activities (Section 5102(d), p. 1279)
71. Pediatric specialty loan repayment program (Section 5203, p. 1295)
72. Public Health Workforce Loan Repayment Program (Section 5204, p. 1300)
73. Allied Health Loan Forgiveness Program (Section 5205, p. 1305)
74. Grant program to provide mid-career training for health professionals (Section 5206, p. 1307)
75. Grant program to fund nurse-managed health clinics (Section 5208, p. 1310)
76. Grant program to support primary care training programs (Section 5301, p. 1315)
77. Grant program to fund training for direct care workers (Section 5302, p. 1322)
78. Grant program to develop dental training programs (Section 5303, p. 1325)
79. Demonstration program to increase access to dental health care in underserved communities (Section 5304, p. 1331)
80. Grant program to promote geriatric education centers (Section 5305, p. 1334)
81. Grant program to promote health professionals entering geriatrics (Section 5305, p. 1339)
82. Grant program to promote training in mental and behavioral health (Section 5306, p. 1344)
83. Grant program to promote nurse retention programs (Section 5309, p. 1354)
84. Student loan forgiveness for nursing school faculty (Section 5311(b), p. 1360)
85. Grant program to promote positive health behaviors and outcomes (Section 5313, p. 1364)
86. Public Health Sciences Track for medical students (Section 5315, p. 1372)
87. Primary Care Extension Program to educate providers (Section 5405, p. 1404)
88. Grant program for demonstration projects to address health workforce shortage needs (Section 5507, p. 1442)
89. Grant program for demonstration projects to develop training programs for home health aides (Section 5507, p. 1447)
90. Grant program to establish new primary care residency programs (Section 5508(a), p. 1458)
91. Program of payments to teaching health centers that sponsor medical residency training (Section 5508(c), p. 1462)
92. Graduate nurse education demonstration program (Section 5509, p. 1472)
93. Grant program to establish demonstration projects for community-based mental health settings (Section 5604, p. 1486)
94. Commission on Key National Indicators (Section 5605, p. 1489)
95. Quality assurance and performance improvement program for skilled nursing facilities (Section 6102, p. 1554)
96. Special focus facility program for skilled nursing facilities (Section 6103(a)(3), p. 1561)
97. Special focus facility program for nursing facilities (Section 6103(b)(3), p. 1568)
98. National independent monitor pilot program for skilled nursing facilities and nursing facilities (Section 6112, p. 1589)
99. Demonstration projects for nursing facilities involved in the culture change movement (Section 6114, p. 1597)
100. Patient-Centered Outcomes Research Institute (Section 6301, p. 1619)
101. Standing methodology committee for Patient-Centered Outcomes Research Institute (Section 6301, p. 1629)
102. Board of Governors for Patient-Centered Outcomes Research Institute (Section 6301, p. 1638)
103. Patient-Centered Outcomes Research Trust Fund (Section 6301(e), p. 1656)
104. Elder Justice Coordinating Council (Section 6703, p. 1773)
105. Advisory Board on Elder Abuse, Neglect, and Exploitation (Section 6703, p. 1776)
106. Grant program to create elder abuse forensic centers (Section 6703, p. 1783)
107. Grant program to promote continuing education for long-term care staffers (Section 6703, p. 1787)
108. Grant program to improve management practices and training (Section 6703, p. 1788)
109. Grant program to subsidize costs of electronic health records (Section 6703, p. 1791)
110. Grant program to promote adult protective services (Section 6703, p. 1796)
111. Grant program to conduct elder abuse detection and prevention (Section 6703, p. 1798)
112. Grant program to support long-term care ombudsmen (Section 6703, p. 1800)
113. National Training Institute for long-term care surveyors (Section 6703, p. 1806)
114. Grant program to fund State surveys of long-term care residences (Section 6703, p. 1809)
115. CLASS Independence Fund (Section 8002, p. 1926)
116. CLASS Independence Fund Board of Trustees (Section 8002, p. 1927)
117. CLASS Independence Advisory Council (Section 8002, p. 1931)
118. Personal Care Attendants Workforce Advisory Panel (Section 8002(c), p. 1938)
119. Multi-state health plans offered by Office of Personnel Management (Section 10104(p), p. 2086)
120. Advisory board for multi-state health plans (Section 10104(p), p. 2094)
121. Pregnancy Assistance Fund (Section 10212, p. 2164)
122. Value-based purchasing program for ambulatory surgical centers (Section 10301, p. 2176)
123. Demonstration project for payment adjustments to home health services (Section 10315, p. 2200)
124. Pilot program for care of individuals in environmental emergency declaration areas (Section 10323, p. 2223)
125. Grant program to screen at-risk individuals for environmental health conditions (Section 10323(b), p. 2231)
126. Pilot programs to implement value-based purchasing (Section 10326, p. 2242)
127. Grant program to support community-based collaborative care networks (Section 10333, p. 2265)
128. Centers for Disease Control Office of Minority Health (Section 10334, p. 2272)
129. Health Resources and Services Administration Office of Minority Health (Section 10334, p. 2272)
130. Substance Abuse and Mental Health Services Administration Office of Minority Health (Section 10334, p. 2272)
131. Agency for Healthcare Research and Quality Office of Minority Health (Section 10334, p. 2272)
132. Food and Drug Administration Office of Minority Health (Section 10334, p. 2272)
133. Centers for Medicare and Medicaid Services Office of Minority Health (Section 10334, p. 2272)
134. Grant program to promote small business wellness programs (Section 10408, p. 2285)
135. Cures Acceleration Network (Section 10409, p. 2289)
136. Cures Acceleration Network Review Board (Section 10409, p. 2291)
137. Grant program for Cures Acceleration Network (Section 10409, p. 2297)
138. Grant program to promote centers of excellence for depression (Section 10410, p. 2304)
139. Advisory committee for young women’s breast health awareness education campaign (Section 10413, p. 2322)
140. Grant program to provide assistance to provide information to young women with breast cancer (Section 10413, p. 2326)
141. Interagency Access to Health Care in Alaska Task Force (Section 10501, p. 2329)
142. Grant program to train nurse practitioners as primary care providers (Section 10501(e), p. 2332)
143. Grant program for community-based diabetes prevention (Section 10501(g), p. 2337)
144. Grant program for providers who treat a high percentage of medically underserved populations (Section 10501(k), p. 2343)
145. Grant program to recruit students to practice in underserved communities (Section 10501(l), p. 2344)
146. Community Health Center Fund (Section 10503, p. 2355)
147. Demonstration project to provide access to health care for the uninsured at reduced fees (Section 10504, p. 2357)
148. Demonstration program to explore alternatives to tort litigation (Section 10607, p. 2369)
149. Indian Health demonstration program for chronic shortages of health professionals (S. 1790, Section 112, p. 24)*
150. Office of Indian Men’s Health (S. 1790, Section 136, p. 71)*
151. Indian Country modular component facilities demonstration program (S. 1790, Section 146, p. 108)*
152. Indian mobile health stations demonstration program (S. 1790, Section 147, p. 111)*
153. Office of Direct Service Tribes (S. 1790, Section 172, p. 151)*
154. Indian Health Service mental health technician training program (S. 1790, Section 181, p. 173)*
155. Indian Health Service program for treatment of child sexual abuse victims (S. 1790, Section 181, p. 192)*
156. Indian Health Service program for treatment of domestic violence and sexual abuse (S. 1790, Section 181, p. 194)*
157. Indian youth telemental health demonstration project (S. 1790, Section 181, p. 204)*
158. Indian youth life skills demonstration project (S. 1790, Section 181, p. 220)*
159. Indian Health Service Director of HIV/AIDS Prevention and Treatment (S. 1790, Section 199B, p. 258)*
[*Section 10221, page 2173 of H.R. 3590 deems that S. 1790 shall be deemed as passed with certain amendments.]

So get those resumes ready for submission – maybe you too can be a part of the “Indian youth telemental health demonstration project”.

~McQ

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