Read the bill

larryJ · July 28, 2009, 09:51:35 AM

I found this in today's paper and found it interesting. I will try and retype it here if my fingers hold out.

LAWMAKERS SHOULD READ A BILL BEFORE PASSING IT.
By Kevin Ferris

In 1776, the rallying cry was, "No taxation without representation." Today, it could be, "No taxation without totally clueless representation. That's what Americans got on June 26, when the House voted 219-212 for the "cap-and-tax" energy bill, as the Republicans refer to it. The bill ran more than 1,000 pages, and before members had time to digest that tome, 300 pages of amendments were added after midnight.

When Minority Leader John A. Boehner, R-Ohio, started to read the additions, bill co-sponsor Henry A. Waxman, D--California, objected. He was rebuffed. There are no time limits for comments by House leaders.

"When you file a 300-page amendment at 3:09 AM, the American people have a right to know what's in this bill," Boehner said.
Whether this bill will lessen greenhouse-gas emissions - as Democrats hope - or kill countless jobs - as Republicans hope - or ever pass the Senate, remains to be seen. But the House vote did raise a question that cuts across party and ideology.

How can lawmakers vote on something so important without a thorough understanding of what's in it?

Not the everyday "We hereby rename this post office in honor of so-and-so"or "We officially declare this Goldfish Month." The big things, like an almost $800 billion stimulus plan, or an energy package that Politico said "would transform the country's economy and industrial landscape.

Actually reading such legislation, as the founders might say, should be self-evident. But apparently not. So a little nudge is in order, especially with health-care reform looming. One nudger is Colin Hanna, a former Chester County, PA., commissioner and president of the conservative advocacy group Let Freedom Ring. He has begun a campaign (www.pledgetoread.org) that asks members of the House and Senate to promise the following:

"I___________pledge to my constituents and to the American people that I will not vote to enact an health-care reform package that: "1) I have not read, personally, in its entirety; and,

"2) Has not been available, in its entirety, to the American people on the Internet for at least 72 hours, so that they can read it too."

Let Freedom Ring isn't alone. A consortium of liberal and good-government groups is backing readthebill.org., and a group, Down-sizeDC.org., essentially wants the two planks of Hanna's pledge enacted as federal law.

Having been a commissioner, Hanna understands that lawmakers can't read every line of every bill, but he argues that in some cases it's necessary.

"There are certain issues of scope and importance that demand an extra measure of due diligence, including reading the bill in full."he said in an interview. Health care, cap-and-trade, and the stimulus all rise to that level, he says, adding that legislators dismiss this sentiment at their peril.

"There is a rising public demand that bills be read," he says, "And there is a rising public outrage against politicians who dismissively suggest that's just the way Washington works.

He is referring to a Politico story about the initial response by House Majority Leader Steny H. Hoyer, D-Md., when asked about a pledge: laughter. But then Hoyer backpedaled, saying that of course members, staff or review boards read bills, or at least "substantial portions."

Hoyer's reaction shows that the priority is not to make informed judgements and improve legislation, Hanna suggests, but to rush through bad laws before anyone can object.

"They want to completely control the entire legislative process and ram it down not only Congress' throat, but the American people's throat, and we think that's wrong." Hanna says.

If Congress hasn't the time or inclination to read the bills, let the public do it. And that's where Part 2 of the pledge comes in - allowing 72 hours for citizens to read legislation online before a vote.

"We have the technology to make complex legislation available for public and media inspection," Hanna says. "We're not being true to the ideals of democracy if we don't take advantage of that technology."

He has a point. Granted, a "read the bill" movement can come off as gimmicky, but given recent votes and the magnitude of the bills, how does one argue against citizen access to legislation? Candidate Obama had promised to post bills online before he signed them into law. He's broken the promise, so let Congress set an even higher standard.

On his website, Hanna has been tallying the number of pledge supporters. He plans to reveal the names of those backers - as well as those who rejected or ignored the offer to sign the pledge.

At which time voters will be a little better informed, even if their senators and representatives refuse to be.

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I have not looked at the sites suggested before copying this to the forum, just thought it was a good read.

Kevin Ferris is the assistant editor of the Editorial Page at The Philadelphia Inquirer.

Larryj

Anmar · July 28, 2009, 10:53:40 AM

Lots of bills get passed without being read. I think the health care bill was over 1000 pages? Generally what happens is that a member of congress hires staffers or agencies to read the bill and get an explantion.

larryJ · July 28, 2009, 01:05:35 PM

Somehow I find that scary that some staffer is making or suggesting answers and decisions which should remain solely with the congressperson. On the other hand, that person may be more in tune with what is the best way to go rather than the congressperson. Still, the article has its merits that bills should be thoroughly read before the vote and I really would like to see bills posted to the internet before voting.

Larryj

Anmar · July 28, 2009, 01:47:36 PM

Larry, you can find bills online in a number of places, including

http://www.gpoaccess.gov/bills/index.html

Teresa · July 28, 2009, 10:03:11 PM

While the dems want amnesty and free medical for illegals they want the sick..old and poor to go home and die.

Check page 425 and 430 of the Obama care bill, no matter what party you support this is BS
hey mom and dad we don't need you.

Did you notice during the presidents last Obamacare primetime commercial, he was twice asked about rationing and end of life care and he twice danced all around the question.

How could anyone be fooled by Obamacare that will eliminate all private insurance, create rationing, limit care at the end of life and punish those that don't achieve "wellness."

Any Congressman or Senator that votes for this drivel should be shot and then have to wait for care!

Just listen to this lady who has read the bill

http://fredthompsonshow.com/premiumstream?dispid20&headerDest=L3BnL2pzcC9tZWRpYS9mbGFzaHdlbGNvbWUuanNwP3BpZD03MzUxJnBsYXlsaXN0PXRydWUmY2hhcnR0eXBlPWNoYXJ0JmNoYXJ0SUQ9MzIwJnBsYXlsaXN0U2l6ZT01

pamsback · July 29, 2009, 08:26:34 AM

All I found was what anybody with any sense has been doing for YEARS me included.........living wills specifying what "heroic" measures you want taken to keep you breathin after you WOULD be better off just goin HOME. I find nothin in here about FORCING people to go home and die. I find the five year thing but it's about a CONSULTATION to make said living will and the options available to the person.

I read thru a WHOLE bunch of legal beagle crap to find this too. I HATE reading legalese........................but enough with the chicken little the sky is fallin stuff...........These people are never goin to pass this thing anyway....not unless there is MORE money for the insurance companies in it than they already get. It's ALL money talks and bullshit walks just like everything ELSE this thing we created called "government" does or doesn't do. What makes you all think ANYthing they do or DON'T do is for YOUR betterment? Get real.

SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.

(a) Medicare.--
(1) In general.--Section 1861 of the Social Security Act
(42 U.S.C. 1395x) is amended--
(A) in subsection (s)(2)--
(i) by striking ``and'' at the end of
subparagraph (DD);
(ii) by adding ``and'' at the end of
subparagraph (EE); and
(iii) by adding at the end the following
new subparagraph:
``(FF) advance care planning consultation (as defined in
subsection (hhh)(1));''; and
(B) by adding at the end the following new
subsection:

``Advance Care Planning Consultation

``(hhh)(1) Subject to paragraphs (3) and (4), the term `advance
care planning consultation' means a consultation between the individual
and a practitioner described in paragraph (2) regarding advance care
planning, if, subject to paragraph (3), the individual involved has not
had such a consultation within the last 5 years. Such consultation
shall include the following:
``(A) An explanation by the practitioner of advance care
planning, including key questions and considerations, important
steps, and suggested people to talk to.
``(B) An explanation by the practitioner of advance
directives, including living wills and durable powers of
attorney, and their uses.
``(C) An explanation by the practitioner of the role and
responsibilities of a health care proxy.
``(D) The provision by the practitioner of a list of
national and State-specific resources to assist consumers and
their families with advance care planning, including the
national toll-free hotline, the advance care planning
clearinghouses, and State legal service organizations
(including those funded through the Older Americans Act of
1965).
``(E) An explanation by the practitioner of the continuum
of end-of-life services and supports available, including
palliative care and hospice, and benefits for such services and
supports that are available under this title.
``(F)(i) Subject to clause (ii), an explanation of orders
regarding life sustaining treatment or similar orders, which
shall include--
``(I) the reasons why the development of such an
order is beneficial to the individual and the
individual's family and the reasons why such an order
should be updated periodically as the health of the
individual changes;
``(II) the information needed for an individual or
legal surrogate to make informed decisions regarding
the completion of such an order; and
``(III) the identification of resources that an
individual may use to determine the requirements of the
State in which such individual resides so that the
treatment wishes of that individual will be carried out
if the individual is unable to communicate those
wishes, including requirements regarding the
designation of a surrogate decisionmaker (also known as
a health care proxy).
``(ii) The Secretary shall limit the requirement for
explanations under clause (i) to consultations furnished in a
State--
``(I) in which all legal barriers have been
addressed for enabling orders for life sustaining
treatment to constitute a set of medical orders
respected across all care settings; and
``(II) that has in effect a program for orders for
life sustaining treatment described in clause (iii).
``(iii) A program for orders for life sustaining treatment
for a States described in this clause is a program that--
``(I) ensures such orders are standardized and
uniquely identifiable throughout the State;
``(II) distributes or makes accessible such orders
to physicians and other health professionals that
(acting within the scope of the professional's
authority under State law) may sign orders for life
sustaining treatment;
``(III) provides training for health care
professionals across the continuum of care about the
goals and use of orders for life sustaining treatment;
and
``(IV) is guided by a coalition of stakeholders
includes representatives from emergency medical
services, emergency department physicians or nurses,
state long-term care association, state medical
association, state surveyors, agency responsible for
senior services, state department of health, state
hospital association, home health association, state
bar association, and state hospice association.
``(2) A practitioner described in this paragraph is--
``(A) a physician (as defined in subsection (r)(1)); and
``(B) a nurse practitioner or physician's assistant who has
the authority under State law to sign orders for life
sustaining treatments.
``(3)(A) An initial preventive physical examination under
subsection (WW), including any related discussion during such
examination, shall not be considered an advance care planning
consultation for purposes of applying the 5-year limitation under
paragraph (1).
``(B) An advance care planning consultation with respect to an
individual may be conducted more frequently than provided under
paragraph (1) if there is a significant change in the health condition
of the individual, including diagnosis of a chronic, progressive, life-
limiting disease, a life-threatening or terminal diagnosis or life-
threatening injury, or upon admission to a skilled nursing facility, a
long-term care facility (as defined by the Secretary), or a hospice
program.
``(4) A consultation under this subsection may include the
formulation of an order regarding life sustaining treatment or a
similar order.
``(5)(A) For purposes of this section, the term `order regarding
life sustaining treatment' means, with respect to an individual, an
actionable medical order relating to the treatment of that individual
that--
``(i) is signed and dated by a physician (as defined in
subsection (r)(1)) or another health care professional (as
specified by the Secretary and who is acting within the scope
of the professional's authority under State law in signing such
an order, including a nurse practitioner or physician
assistant) and is in a form that permits it to stay with the
individual and be followed by health care professionals and
providers across the continuum of care;
``(ii) effectively communicates the individual's
preferences regarding life sustaining treatment, including an
indication of the treatment and care desired by the individual;
``(iii) is uniquely identifiable and standardized within a
given locality, region, or State (as identified by the
Secretary); and
``(iv) may incorporate any advance directive (as defined in
section 1866(f)(3)) if executed by the individual.
``(B) The level of treatment indicated under subparagraph (A)(ii)
may range from an indication for full treatment to an indication to
limit some or all or specified interventions. Such indicated levels of
treatment may include indications respecting, among other items--
``(i) the intensity of medical intervention if the patient
is pulse less, apneic, or has serious cardiac or pulmonary
problems;
``(ii) the individual's desire regarding transfer to a
hospital or remaining at the current care setting;
``(iii) the use of antibiotics; and
``(iv) the use of artificially administered nutrition and
hydration.''.
(2) Payment.--Section 1848(j)(3) of such Act (42 U.S.C.
1395w-4(j)(3)) is amended by inserting ``(2)(FF),'' after
``(2)(EE),''.
(3) Frequency limitation.--Section 1862(a) of such Act (42
U.S.C. 1395y(a)) is amended--
(A) in paragraph (1)--
(i) in subparagraph (N), by striking
``and'' at the end;
(ii) in subparagraph (O) by striking the
semicolon at the end and inserting ``, and'';
and
(iii) by adding at the end the following
new subparagraph:
``(P) in the case of advance care planning
consultations (as defined in section 1861(hhh)(1)),
which are performed more frequently than is covered
under such section;''; and
(B) in paragraph (7), by striking ``or (K)'' and
inserting ``(K), or (P)''.
(4) Effective date.--The amendments made by this subsection
shall apply to consultations furnished on or after January 1,
2011.
(b) Expansion of Physician Quality Reporting Initiative for End of
Life Care.--
(1) Physician's quality reporting initiative.--Section
1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2))
is amended by adding at the end the following new paragraphs:
``(3) Physician's quality reporting initiative.--
``(A) In general.--For purposes of reporting data
on quality measures for covered professional services
furnished during 2011 and any subsequent year, to the
extent that measures are available, the Secretary shall
include quality measures on end of life care and
advanced care planning that have been adopted or
endorsed by a consensus-based organization, if
appropriate. Such measures shall measure both the
creation of and adherence to orders for life-sustaining
treatment.
``(B) Proposed set of measures.--The Secretary
shall publish in the Federal Register proposed quality
measures on end of life care and advanced care planning
that the Secretary determines are described in
subparagraph (A) and would be appropriate for eligible
professionals to use to submit data to the Secretary.
The Secretary shall provide for a period of public
comment on such set of measures before finalizing such
proposed measures.''.
(c) Inclusion of Information in Medicare & You Handbook.--
(1) Medicare & you handbook.--
(A) In general.--Not later than 1 year after the
date of the enactment of this Act, the Secretary of
Health and Human Services shall update the online
version of the Medicare & You Handbook to include the
following:
(i) An explanation of advance care planning
and advance directives, including--
(I) living wills;
(II) durable power of attorney;
(III) orders of life-sustaining
treatment; and
(IV) health care proxies.
(ii) A description of Federal and State
resources available to assist individuals and
their families with advance care planning and
advance directives, including--
(I) available State legal service
organizations to assist individuals
with advance care planning, including
those organizations that receive
funding pursuant to the Older Americans
Act of 1965 (42 U.S.C. 93001 et seq.);
(II) website links or addresses for
State-specific advance directive forms;
and
(III) any additional information,
as determined by the Secretary.
(B) Update of paper and subsequent versions.--The
Secretary shall include the information described in
subparagraph (A) in all paper and electronic versions
of the Medicare & You Handbook that are published on or
after the date that is 1 year after the date of the
enactment of this Act.

sixdogsmom · July 29, 2009, 08:56:09 AM

Thanks for posting this Pam, an opportunity for the truth. How nice for a Wednesday morning!

larryJ · July 29, 2009, 08:59:00 AM

I listened to some, not all, of the interview and decided this woman is reading between the lines. It is like Pam said, all this section is for is to make seniors aware of their options such as living wills, advance directives, etc. There is nothing in the bill that says go home and die. I have always been a fan of Fred Thompson, so maybe I will go back and listen to the whole thing later. I am hoping he would set her straight.

Larryj

larryJ · July 29, 2009, 10:25:08 AM

Been reading the health care bill, (yawn) and I will continue to do so, but have noticed one paragraph that states, "No federal money should be paid to undocumented aliens." and the following copy and paste. Read especially the 'followup counseling visit' (c) as it pertains to the counseling subject

SEC. 1236. DEMONSTRATION PROGRAM ON USE OF PATIENT DECISIONS AIDS.

(a) In General.--The Secretary of Health and Human Services shall
establish a shared decision making demonstration program (in this
subsection referred to as the ``program'') under the Medicare program
using patient decision aids to meet the objective of improving the
understanding by Medicare beneficiaries of their medical treatment
options, as compared to comparable Medicare beneficiaries who do not
participate in a shared decision making process using patient decision
aids.
(b) Sites.--
(1) Enrollment.--The Secretary shall enroll in the program
not more than 30 eligible providers who have experience in
implementing, and have invested in the necessary infrastructure
to implement, shared decision making using patient decision
aids.
(2) Application.--An eligible provider seeking to
participate in the program shall submit to the Secretary an
application at such time and containing such information as the
Secretary may require.
(3) Preference.--In enrolling eligible providers in the
program, the Secretary shall give preference to eligible
providers that--
(A) have documented experience in using patient
decision aids for the conditions identified by the
Secretary and in using shared decision making;
(B) have the necessary information technology
infrastructure to collect the information required by
the Secretary for reporting purposes; and
(C) are trained in how to use patient decision aids
and shared decision making.
(c) Follow-up Counseling Visit.--
(1) In general.--An eligible provider participating in the
program shall routinely schedule Medicare beneficiaries for a
counseling visit after the viewing of such a patient decision
aid to answer any questions the beneficiary may have with
respect to the medical care of the condition involved and to
assist the beneficiary in thinking through how their
preferences and concerns relate to their medical care.
(2) Payment for follow-up counseling visit.--The Secretary
shall establish procedures for making payments for such
counseling visits provided to Medicare beneficiaries under the
program. Such procedures shall provide for the establishment--
(A) of a code (or codes) to represent such
services; and
(B) of a single payment amount for such service
that includes the professional time of the health care
provider and a portion of the reasonable costs of the
infrastructure of the eligible provider such as would
be made under the applicable payment systems to that
provider for similar covered services.

Larryj

larryJ · July 29, 2009, 10:49:39 AM

I went back and listened to the whole interview. My thoughts?

1) I still think Betsy is reading more into this than what is actually there.

2) Fred didn't disagree with her.

3) I am not such a big fan of Fred's anymore. (it was a mediocre thing anyway).

4) I now have a headache.

5) I going to get off the forum for a while and take my wife some coffee and wish her Happy Anniversary (#35).

Larryj

Read the bill

pamsback