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View Diary: Devil in the Details 3: Medicaid goes Mainstream (46 comments)

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  •  States required to cover 'essential health bene.' (4+ / 0-)
    Recommended by:
    joynow, LordMike, KenBee, Fungible Chattel

    P.412 of the senate bill says that starting in 2014 they have to cover the following:

    ‘‘(5) MINIMUM STANDARDS.—Effective January
    12 1, 2014, any benchmark benefit package under para13
    graph (1) or benchmark equivalent coverage under
    14 paragraph (2) must provide at least essential health
    15 benefits as described in section 1302(b) of the Pa16
    tient Protection and Affordable Care Act.

    Here is section 1302(b)

    4 (b) ESSENTIAL HEALTH BENEFITS.—
    5 (1) IN GENERAL.—Subject to paragraph (2),
    6 the Secretary shall define the essential health bene7
    fits, except that such benefits shall include at least
    8 the following general categories and the items and
    9 services covered within the categories:
    10 (A) Ambulatory patient services.
    11 (B) Emergency services.
    12 (C) Hospitalization.
    13 (D) Maternity and newborn care.
    14 (E) Mental health and substance use dis15
    order services, including behavioral health treat16
    ment.
    17 (F) Prescription drugs.
    18 (G) Rehabilitative and habilitative services
    19 and devices.
    20 (H) Laboratory services.
    21 (I) Preventive and wellness services and
    22 chronic disease management.
    23 (J) Pediatric services, including oral and
    24 vision care.

    It's very heavy reading in that first section on p.412. I'd appreciate it if someone else can help look through that section to make sure I'm not mistaken here.

    •  Health issues found can make people uninsurable (0+ / 0-)

      Morally, I feel strongly that we need to adjust our system to take into account the last two or three decades of science.

      We know a lot more now about why people get sick. They are pretending it doesn't exist.

      We can prevent a lot of disease. We could make serious dents in illness, especially chronic illness.

      We need to help people know what they need to do. But, they don't because (and its true) we can't go around finding lots of things and then NOT fixing them. They have made health costs in the US SO artificially high, that many things that other countries do testing wise, don't seem to get done here.

      The result is that we have no data to work with. People just show up one day really sick and scientists often have no real way of knowing what made them that way. (They won't listen to them tell them, that doesn't count)

      Do people understand what I'm getting at? if we had real universal healthcare all sorts of simple things we could do to improve health would become obvious. We would have much more epidemiological data.

      Selling Insurance across State Lines triggers NAFTA-like provisions in the GATS treaty that potentially makes affordable healthcare impossible!

      by Andiamo on Tue Mar 16, 2010 at 05:19:39 PM PDT

      [ Parent ]

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