By Kathleen Sebelius
Tuesday, August 4, 2009

As the political debate about how to pay for and pass health reform grows louder and more contentious, we shouldn't lose sight of the reason we're even having this conversation: We have a huge, once-in-a-lifetime opportunity to improve the lives of all Americans, insured and uninsured alike.

Health insurance is fundamentally about peace of mind. If you have good insurance, you don't have to worry about an accident or sudden illness. You know that whatever happens, you and your family will be taken care of.

We can't eliminate all disease. But through health reform, we can give every American access to quality, affordable health insurance so that if they do get sick, they have the best chance possible of getting better without bankrupting their families.

The current health-care system gives insurance companies all the power. They get to pick and choose who gets a policy. They can deny coverage because of a preexisting condition. They can offer coverage only at exorbitant rates -- or offer coverage so thin that it's no coverage at all. Americans are left to worry about whether they'll get laid off and lose their insurance or wake up from surgery with a $10,000 bill because they didn't read the fine print on their policy.

By giving Americans choices, health reform will switch the roles. Americans will get peace of mind and insurance companies will start getting nervous. They will know that if they don't deliver a great value, their customers will flee. So they will start offering better coverage.

Reform will close the gaps in our current system. When my two sons graduated from college, I had mixed feelings. I was incredibly proud of their accomplishments, but I dreaded the fact that they would lose their health insurance when they left school. The peace of mind that comes with health reform means college graduations can go back to being the celebrations they are supposed to be.

Consider the entrepreneur sitting at her desk, dreaming about her idea for a new business. Right now, many entrepreneurs are paralyzed by our fractured health insurance system. They know that if they leave their job, they might not be able to get insurance for their families. So they, and their innovations, stay put. Health reform means unleashing America's entrepreneurs to chase their big ideas.

Without reform, we will miss out on these benefits. And our health-care system will still be a fiscal time bomb. Recent http://www.whitehouse.gov/assets/documents/CEA_Health_Care_Report.pdf - estimates indicate that by 2040, health-care costs will eat up 34 percent of our gross domestic product. By comparison, the entire federal budget today is just 20 percent of our GDP. By acting now, we have the chance to slow health-care costs in a way that doesn't slash benefits or reduce care. Instead, we can make investments in prevention, wellness and health information technology that will allow the health-care system to deliver incredible results at prices we can all afford. Imagine a system in which your doctor spends as much time trying to keep you healthy as treating you when you're sick, in which you and your doctor have all the information you need to choose the treatments that work best for you, in which you never have to fill out the same paperwork twice. Health reform is the first step in that direction.

President Obama and I are working closely with Democrats and Republicans in the House and Senate and health-care experts to make sure we get the details of health reform right. But we can't let the details distract us from the huge benefits that reform will bring. The urgency behind reform has nothing to do with the schedule of Congress and everything to do with the needs of the American people.

Nor should we let ourselves be distracted by attacks that try to use the complexity of health reform to freeze Americans in inaction. We've learned over the past 20 years that "socialized medicine" and "government-run health care" are code words for "don't change anything." With some insurers raising premiums by more than 25 percent and 14,000 people losing their health insurance every day, Americans want to hear something more from their leaders than "wait and see" and "more of the same." People have enough to worry about these days. Americans deserve the peace of mind that only health-care reform can provide.

The writer is secretary of health and human services.

DEADLY DOCTORS

O ADVISERS WANT TO RATION CARE

By BETSY MCCAUGHEY

Last updated: 1:13 am
July 24, 2009
Posted: 1:03 am
July 24, 2009

THE health bills coming out of Congress would put the de cisions about your care in the hands of presidential appointees. They'd decide what plans cover, how much leeway your doctor will have and what seniors get under Medicare.

Yet at least two of President Obama's top health advisers should never be trusted with that power.

Start with Dr. Ezekiel Emanuel, the brother of White House Chief of Staff Rahm Emanuel. He has already been appointed to two key positions: health-policy adviser at the Office of Management and Budget and a member of Federal Council on Comparative Effectiveness Research.

Emanuel bluntly admits that the cuts will not be pain-free. "Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely 'lipstick' cost control, more for show and public relations than for true change," he wrote last year (Health Affairs Feb. 27, 2008).

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).

Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Many doctors are horrified by this notion; they'll tell you that a doctor's job is to achieve social justice one patient at a time.

Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).

Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

He explicitly defends discrimination against older patients: "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years" (Lancet, Jan. 31).

The bills being rushed through Congress will be paid for largely by a $500 billion-plus cut in Medicare over 10 years. Knowing how unpopular the cuts will be, the president's budget director, Peter Orszag, urged Congress this week to delegate its own authority over Medicare to a new, presidentially-appointed bureaucracy that wouldn't be accountable to the public.

Since Medicare was founded in 1965, seniors' lives have been transformed by new medical treatments such as angioplasty, bypass surgery and hip and knee replacements. These innovations allow the elderly to lead active lives. But Emanuel criticizes Americans for being too "enamored with technology" and is determined to reduce access to it.

Dr. David Blumenthal, another key Obama adviser, agrees. He recommends slowing medical innovation to control health spending.

Blumenthal has long advocated government health-spending controls, though he concedes they're "associated with longer waits" and "reduced availability of new and expensive treatments and devices" (New England Journal of Medicine, March 8, 2001). But he calls it "debatable" whether the timely care Americans get is worth the cost. (Ask a cancer patient, and you'll get a different answer. Delay lowers your chances of survival.)

Obama appointed Blumenthal as national coordinator of health-information technology, a job that involves making sure doctors obey electronically deivered guidelines about what care the government deems appropriate and cost effective.

In the April 9 New England Journal of Medicine, Blumenthal predicted that many doctors would resist "embedded clinical decision support" -- a euphemism for computers telling doctors what to do.

Americans need to know what the president's health advisers have in mind for them. Emanuel sees even basic amenities as luxuries and says Americans expect too much: "Hospital rooms in the United States offer more privacy . . . physicians' offices are typically more conveniently located and have parking nearby and more attractive waiting rooms" (JAMA, June 18, 2008).

No one has leveled with the public about these dangerous views. Nor have most people heard about the arm-twisting, Chicago-style tactics being used to force support. In a Nov. 16, 2008, Health Care Watch column, Emanuel explained how business should be done: "Every favor to a constituency should be linked to support for the health-care reform agenda. If the automakers want a bailout, then they and their suppliers have to agree to support and lobby for the administration's health-reform effort."

Do we want a "reform" that empowers people like this to decide for us?

Why We Must Ration Health Care

Pacman -

It is called a Newspaper Merrell, specifically the NY Times.  Here let me give you an easier one.  By the way Peter Singer the author of the above article is an Obama Consultant on heath care, truly scary.

http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html - http://online.wsj.com/article/SB10001424052970204683204574358590107981718.html

The Death Book for Veterans

Ex-soldiers don't need to be told they're a burden to society.

By /search/search_center.html?KEYWORDS=JIM+TOWEY&ARTICLESEARCHQUERY_PARSER=bylineAND - JIM TOWEY

I couldn't agree more. Let's engage the other side's arguments, and let's allow Americans to decide for themselves whether the Democrats' health-care proposals should become governing law.

Some 45 years ago Ronald Reagan said that "no one in this country should be denied medical care because of a lack of funds." Each of us knows that we have an obligation to care for the old, the young and the sick. We stand strongest when we stand with the weakest among us.

We also know that our current health-care system too often burdens individuals and businesses—particularly small businesses—with crippling expenses. And we know that allowing government health-care spending to continue at current rates will only add to our ever-expanding deficit.

How can we ensure that those who need medical care receive it while also reducing health-care costs? The answers offered by Democrats in Washington all rest on one principle: that increased government involvement can solve the problem. I fundamentally disagree.

With all due respect, Americans are used to this kind of sweeping promise from Washington. And we know from long experience that it's a promise Washington can't keep.

Let's talk about specifics. In his Times op-ed, the president argues that the Democrats' proposals "will finally bring skyrocketing health-care costs under control" by "cutting . . . waste and inefficiency in federal health programs like Medicare and Medicaid and in unwarranted subsidies to insurance companies . . . ."

First, ask yourself whether the government that brought us such "waste and inefficiency" and "unwarranted subsidies" in the first place can be believed when it says that this time it will get things right. The nonpartistan Congressional Budget Office (CBO) doesn't think so: Its director, Douglas Elmendorf, told the Senate Budget Committee in July that "in the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount."

Now look at one way Mr. Obama wants to eliminate inefficiency and waste: He's asked Congress to create an Independent Medicare Advisory Council—an unelected, largely unaccountable group of experts charged with containing Medicare costs. In an interview with the New York Times in April, the president suggested that such a group, working outside of "normal political channels," should guide decisions regarding that "huge driver of cost . . . the chronically ill and those toward the end of their lives . . . ."

Given such statements, is it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by—dare I say it—death panels? Establishment voices dismissed that phrase, but it rang true for many Americans. Working through "normal political channels," they made themselves heard, and as a result Congress will likely reject a wrong-headed proposal to authorize end-of-life counseling in this cost-cutting context. But the fact remains that the Democrats' proposals would still empower unelected bureaucrats to make decisions affecting life or death health-care matters. Such government overreaching is what we've come to expect from this administration.

Speaking of government overreaching, how will the Democrats' proposals affect the deficit? The CBO estimates that the current House proposal not only won't reduce the deficit but will actually increase it by $239 billion over 10 years. Only in Washington could a plan that adds hundreds of billions to the deficit be hailed as a cost-cutting measure.

The economic effects won't be limited to abstract deficit numbers; they'll reach the wallets of everyday Americans. Should the Democrats' proposals expand health-care coverage while failing to curb health-care inflation rates, smaller paychecks will result. A new study for Watson Wyatt Worldwide by Steven Nyce and Syl Schieber concludes that if the government expands health-care coverage while health-care inflation continues to rise "the higher costs would drive disposable wages downward across most of the earnings spectrum, although the declines would be steepest for lower-earning workers." Lower wages are the last thing Americans need in these difficult economic times.

Finally, President Obama argues in his op-ed that Democrats' proposals "will provide every American with some basic consumer protections that will finally hold insurance companies accountable." Of course consumer protection sounds like a good idea. And it's true that insurance companies can be unaccountable and unresponsive institutions—much like the federal government. That similarity makes this shift in focus seem like nothing more than an attempt to deflect attention away from the details of the Democrats' proposals—proposals that will increase our deficit, decrease our paychecks, and increase the power of unaccountable government technocrats.

Instead of poll-driven "solutions," let's talk about real health-care reform: market-oriented, patient-centered, and result-driven. As the Cato Institute's Michael Cannon and others have argued, such policies include giving all individuals the same tax benefits received by those who get coverage through their employers; providing Medicare recipients with vouchers that allow them to purchase their own coverage; reforming tort laws to potentially save billions each year in wasteful spending; and changing costly state regulations to allow people to buy insurance across state lines. Rather than another top-down government plan, let's give Americans control over their own health care.

Democrats have never seriously considered such ideas, instead rushing through their own controversial proposals. After all, they don't need Republicans to sign on: Democrats control the House, the Senate and the presidency. But if passed, the Democrats' proposals will significantly alter a large sector of our economy. They will not improve our health care. They will not save us money. And, despite what the president says, they will not "provide more stability and security to every American."

We often hear such overblown promises from Washington. With first principles in mind and with the facts in hand, tell them that this time we're not buying it.

Read the Union Health-Care Label

Get ready for Detroit-style labor relations in our hospitals.

By /search/search_center.html?KEYWORDS=MARK+MIX&ARTICLESEARCHQUERY_PARSER=bylineAND - MARK MIX

Ensign receives handwritten confirmation

http://www.politico.com/static/PPM110_090925_document2.html - This doesn't happen often enough.

Sen. John Ensign (R-Nev.) received a handwritten note Thursday from Joint Committee on Taxation Chief of Staff Tom Barthold confirming the penalty for failing to pay the up to $1,900 fee for not buying health insurance.

Violators could be charged with a misdemeanor and could face up to a year in jail or a $25,000 penalty, Barthold wrote on JCT letterhead. He signed it "Sincerely, Thomas A. Barthold."

The note was a follow-up to Ensign's http://www.politico.com/livepulse/0909/Flout_the_mandate_penalty_Face_the_IRS.html?showall - questioning at the markup.

Liberals seek health-care access for illegals

Fearful that they're losing ground on immigration and health care, a group of House Democrats is pushing back and arguing that any health care bill should extend to all legal immigrants and allow illegal immigrants some access.

The Democrats, trying to stiffen their party's spines on the contentious issue, say it's unfair to bar illegal immigrants from paying their own way in a government-sponsored exchange. Legal immigrants, they say, regardless of how long they've been in the United States, should be able to get government-subsidized health care if they meet the other eligibility requirements.

"Legal permanent residents should be able to purchase their plans, and they should also be eligible for subsidies if they need it. Undocumented, if they can afford it, should be able to buy their own private plans. It keeps them out of the emergency room," said Rep. Michael M. Honda, California Democrat and chairman of the Congressional Asian Pacific American Caucus.

Mr. Honda was joined by more than 20 of his colleagues in two letters laying out the demands.

Coverage for immigrants is one of the thorniest issues in the health care debate, and one many Democratic leaders would like to avoid. But immigrant rights groups and the Democrats who sent the letters say they have to take a stand now.

President Obama has said he does not want health care proposals to cover illegal immigrants. The bill drawn up by Sen. Max Baucus, Montana Democrat and chairman of the Senate Finance Committee, excludes illegal immigrants from his proposed health care exchange.

Mr. Honda and his allies, though, say illegal immigrants should be allowed to pay for insurance if they can afford it, even if it comes through a government-established exchange. As a generally young, healthy part of the population, illegal immigrants could help reduce overall costs for those who buy into health exchange plans, the lawmakers said.

The Democrats' letters, however, do not issue ultimatums or threaten to withhold support for the bills if their requests aren't met.

The National Council of La Raza launched its own "flood their voice mail" campaign last week to put pressure on Mr. Baucus to expand coverage in his proposal to include all legal immigrants and to drop verification language in the legislation that would prevent illegal immigrants from obtaining coverage.

Mr. Honda told The Washington Times that he's not pushing for illegal immigrants to gain access to taxpayer-subsidized benefits. "That's an argument that's been done already," he said.

Rep. Steve King, Iowa Republican, said proposals that include government coverage for illegal immigrants leave him incredulous.

"If anybody can, with a straight face, advocate that we should provide health insurance for people who broke into our country, broke our law and for the most part are criminals, I don't know where they ever would draw the line," he said.

Mr. King, who opposes Democrats' health care plans in general, said illegal immigrant access in legislation "would be a poison pill that would cause health care to go down" to defeat.

Twenty-nine Democrats signed on to the letter on legal immigrants, while 21 signed the letter on covering illegal immigrants. Although the leadership of the Congressional Black Caucus signed the legal-immigrant letter in their capacity as CBC officials, they signed the other letter as individual members of Congress.

Under the 1996 welfare law overhaul, Congress restricted most federal benefits to longtime holders of green cards - those who have been in the country at least five years.

But Democrats chipped away at that rule when they reauthorized the State Children's Health Insurance Program earlier this year and allowed states to cover all immigrant children and pregnant women, regardless of how long they've been in the country.

In their letter, the Democrats said health care costs are much lower for legal immigrants than for native citizens.

"Immigrants are part of our families, our communities, our economy, and contribute to the fabric of America," they wrote. "It is simply wrong that their taxes would pay for public health insurance programs to which they are not allowed access."

Thanks for posting that video wasteful first time I've seen that.

The scary part is if they go ahead and give the illegal immigrants health care with no restrictions wouldn't that cause a major migration of illegals coming here just for the medical benefits ?

With all the procedures in place in the U.S. for having to provide proof of citizenship and showing ID's then turn around and do what they (politicians) want to do concerning illegals is beyond ridiculous.

The other day, I needed to go to the emergencyroom.

Not wanting to sit there for 4 hours, I put on my old Army fatigues and stuck a patch onto the front of my shirt that I had downloaded off the Internet.

When I went into the E.R., I noticed that 3/4 of the people got up and left. I guess they decided that they weren’t that sick after all. Cut at least 3 hours off my waiting time.

Here’s the patch. Feel free to use it the next time you’re in need of quicker emergency service.

It also works at the DMV and the laundromat.

Don’t try it at McDonald’s, the whole crew will exit and you’ll never get your order.

Get in shape or pay a price.

That's a message more Americans could hear if the health care reform bills passed by the Senate Finance and Health committees become law.

By more than doubling the maximum rewards and penalties that companies can apply to employees who flunk medical evaluations, the bills could put workers under intense financial pressure to lose weight, stop smoking or even lower their cholesterol.

The initiative, largely eclipsed in the health care debate, builds on a trend that is already in play among some corporations and that more workers will see in the packages they bring home during this month's open enrollment. Some employers offer lower premiums to people who complete personal health assessments; others offer only limited benefit packages to smokers.

The current legislative effort takes the trend a step further. It is backed by major employer groups, including the U.S. Chamber of Commerce and the National Association of Manufacturers. It is opposed by labor unions and groups devoted to combating serious illnesses, such as the American Heart Association, the American Cancer Society, and the American Diabetes Association.

A colossal loophole?
President Obama and members of Congress have declared that they are trying to create a system in which no one can be denied coverage or charged higher premiums based on their health status. The health insurance lobby has said it shares that goal. However, so-called wellness incentives could introduce a colossal loophole. In effect, they would permit insurers and employers to make coverage less affordable for people exhibiting risk factors for problems like diabetes, heart disease and stroke.

"Everybody said that we're going to be ending discrimination based on preexisting conditions. But this is in effect discrimination again based on preexisting conditions," said Ann Kempski of the Service Employees International Union.

The legislation would make exceptions for people who have medical reasons for not meeting targets.

Supporters say economic incentives can prompt workers to make healthier choices, thereby reducing medical expenses. The aim is to "focus on wellness and prevention rather than just disease and treatment," said Business Roundtable president John J. Castellani.

BeniComp Group, an Indiana company that manages incentives for employers, says on its Web site that the programs can save employers money in a variety of ways. Medical screenings will catch problems early. Employers will shift costs to others. Some employees will "choose other health care options."

Douglas J. Short, BeniComp's chief executive, said the incentives he uses focus on outcomes, not conditions.

"I can't give you an incentive based on being a diabetic or not being a diabetic, but whether you're managing your blood glucose level — I can give you an incentive based on that," Short said.

National epidemic of obesity
The incentives could attack a national epidemic of obesity. They also cut to a philosophical core of the health care debate. Should health insurance be like auto insurance, in which good drivers earn discounts and reckless ones pay a price, thereby encouraging better habits? Or should it be a safety net in which the young and healthy support the old and sick with the understanding that youth and good health are transitory?

Under current regulation, incentives based on health factors can be no larger than 20 percent of the premium paid by employer and employee combined. The legislation passed by the Health and Finance committees would increase the limit to 30 percent, and it would give government officials the power to raise it to 50 percent.

A single employee whose annual premiums cost him and his employer the national average of $4,824 could have as much as $2,412 on the line. At least under the Health Committee bill, the stakes could be higher for people with family coverage. Families with premiums of $13,375 — the combined average for employer-sponsored coverage, according to a recent survey — could have $6,687.50 at risk.

An amendment passed unanimously by the Health Committee would allow insurers to use the same rewards and penalties in the market for individual insurance, though legislative language subsequently drafted by the committee's Democratic staff does not reflect that vote, Sen. Mike Enzi (Wyo.), for the committee's ranking Republican, has said. The bill drafted by the Senate Finance Committee would set up a trial program allowing insurers in 10 states to use wellness-based incentives for individuals.

America's Health Insurance Plans, an industry lobby, has argued that insurers should be allowed to consider participation in wellness programs when setting individual premiums.

Wellness incentives voluntary
Employers and other advocates of expanded wellness incentives say taking steps to get healthier would be voluntary. Sen. John Ensign, a Nevada Republican and lead sponsor of the Finance Committee's wellness provision, said his proposal "would guarantee that the incentive is strong enough for Americans to want to participate."

Wellness incentives have been spreading rapidly in the corporate world. Unlike the legislative proposals, which address incentives based on results, the corporate programs typically compensate employees based on effort alone — for example, enrolling in smoking cessation programs even if they fail to kick the habit, or undergoing detailed medical assessments regardless of the findings. But there are exceptions: The Safeway supermarket company allows certain employees to reduce their premiums by meeting standards for body mass and other measures. Safeway chief executive Steve Burd has framed it as an issue of personal responsibility.

Valeo, a supplier of auto parts, four years ago raised the deductible on an employee health plan to $2,200 from $200 for individual coverage and to $4,400 from $400 for family coverage. Then it gave employees the opportunity to reduce the deductible to its starting point by being nonsmokers and meeting goals for blood pressure, cholesterol, and body mass index, said Robert Wade, Valeo's director of human resources for North America.

"If they don't comply they end up being penalized, if you will, but we refer to it as a Healthy Rewards program," Wade said.

Workers who choose not to submit to yearly medical assessments have been offered a different health plan that carries higher premiums, Wade said.

Results are mixed for some programs
The results are mixed. The number of employees meeting some targets in the Healthy Rewards program has risen while the number meeting others has fallen, Wade said. On average, employees have succeeded in bringing their deductibles down to about $600 in the case of individual coverage. Meanwhile, Valeo has managed to keep annual increases in health care costs per employee down to about 1 percent, he said, which is far below average.

Higher deductibles alone could explain some of the savings. They can make people more cost-conscious when deciding whether to go to the doctor or obtain other medical services.

Paychex, a payroll management company, offers incentives for participation in wellness programs but refrains from pegging them to biometric targets.

"Employees could be doing everything right and still not achieve the desired outcome. And so then you're holding them accountable for something that may not be achievable," said Jake Flaitz, the company's director of benefits.

Workers at a company called Bemis, which makes packaging, went on strike this year partly because the firm was insisting that they and their spouses submit to health risk assessments to remain eligible for their health insurance, the Workers United union said in an August news release. The union called the assessments "invasive."

North Carolina has angered some state employees by introducing a wellness program that would limit the most generous benefits package to those who meet body mass targets and don't smoke. The state would allow employees to satisfy the requirement by enrolling in weight management or smoking cessation programs.

When fully implemented, the program is projected to reduce the state health plan's medical expenses by 1.2 percent, spokeswoman Linda McCrudden said by e-mail.

The top executive at the health plan, Jack W. Walker, predicted that over the long run the federal government will pay for North Carolina's success. State workers who live longer will spend more time collecting benefits from Medicare, the federal insurance program for older Americans, he said.

URL: +url+ - '+url+'

Health care loophole would allow coverage limits

WASHINGTON – A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.

The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

Adding to the puzzle, the new language was quietly tucked away in a clause in the bill still captioned "No lifetime or annual limits."

The 2,074-page bill would carry out President Barack Obama's plan to revamp the health care system, expanding coverage to millions now uninsured and trying to slow budget-busting cost increases. A tentative deal among Senate Democrats to back away from creating a new government program to compete with private insurers appears to have overcome a major obstacle to the bill's passage.

Officials of the American Cancer Society Cancer Action Network said they were taken by surprise when the earlier ban on annual coverage limits was undercut, adding that they have not been able to get a satisfactory explanation.

"We don't know who put it in, or why it was put in," said Stephen Finan, a policy expert with the cancer society's advocacy affiliate.

Democratic officials of the Senate Health, Education, Labor and Pensions Committee would not comment publicly but said the bill contains numerous provisions that will benefit patients with cancer and other life-threatening illnesses, not to mention improvements in preventive care.

Advocates for patients say they're concerned the language will stay in the bill all the way to Obama's desk.

"The primary purpose of insurance is to protect people against catastrophic loss," Finan said. "If you put a limit on benefits, by definition it's going to affect people who are dealing with catastrophic loss." The cost of cancer treatment can exceed $100,000 a year.

Under the health care bills in Congress, the major expansion of health insurance coverage won't take place until three to four years after enactment. Democrats have touted a series of consumer protections as immediate benefits Americans will secure through the legislation. Both the Senate and House bills, for example, ban lifetime limits on the dollar value of coverage.

But Finan said the change in the Senate bill essentially invalidates the legislation's ban on lifetime limits.

"If you can have annual limits, saying there's no lifetime limits becomes meaningless," he said. A patient battling aggressive disease in its later stages could conceivably exhaust insurance benefits in the course of a year.

It's unclear how widespread such coverage limits are in the current insurance marketplace. Large employers have moved away from coverage limits, but insurers have wide discretion in designing plans for small businesses and individual customers.

In the House bill, neither annual nor lifetime limits would be allowable under an essential benefits package intended to provide comprehensive coverage.

In reference to the above post,I hope no one really thinks this "health care" over haul will do the people any real good. It's being crafted by the same idiots who vote themselves their own pay raises and then raise our taxes. All are a bunch of idiots.