Universal Health Care

Here in America, we are supposed to be a country that is for the people, so why don't we take care of our people? What I am referring to is our health care crisis. Maybe not all people see this, but many do. Take Hilary Clinton for example; she proposed a system of universal health care for us here in the U.S because she too noticed the deficiency of the current system that we do have. It might not have been carried out, but at least she opened the eyes of many Americans who knew little about other health care options.
If you believe that the system we have now is just fine, I would like you to explain your reasoning. Then I would like to ask you: If we have such a great health care program, then why are we going to have to watch over 18,000 people die this year alone due to the fact that they don't have, and can't afford, health care? And why are we going to have to witness hundreds more who will lose a limb or be severely wounded, and all they can do is attempt to patch themselves up and hope for the best? This right here is not an example of the government supposedly looking out for its peoples.
So why don't we give universal health care a try? What is there to be afraid of? Socialism, right? This is just an opinion, but that sounds to me like an excuse for the wealthy - the CEO's and major executives of health care companies - to keep the things that they have and not have to worry about those who live in poverty. Even men and women who have spent their entire lives working aren't fully covered with the health care that's provided now-a-days. Just recently I was able to watch Michael Moore's video “SiCKO” which is about universal health care, and on it were many peoples' stories of how they live with little to no insurance. One of the stories was about an elderly couple who were forced to move in with one of their children after one of them were diagnosed with cancer; they had two options, pay the mortgage and go without treatment, or treat the cancer and go without their own home. This isn't a decision that we should have to live with, and with universal health care, we wouldn't have to.
Fact: the United States ranks 37th in the world's health systems. This is 11 behind Saudi Arabia, a country that we view inferior to ourselves. The top two countries on the list are France and Italy, two countries that provide universal health care and one that even pays for their citizens to obtain a college education. (You may find the ranking for the world's health systems at www.photius.com/rankings/healthranks.html)
I would like to get all of your opinions on this matter, if you believe that we should stick with the health care provided or switch to universal health care. My opinion: universal health care is the way to go. Let us provide for all, not for some!
For more ways to help in the petitioning of universal health care, check out Michael Moore's website: http://www.michaelmoore.com/sicko/what-can-i-do.





Here Is A Copy Of What We Are Being Offered:

I
108TH CONGRESS
1ST SESSION H. R. 676
To provide for comprehensive health insurance coverage for all United States
residents, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
FEBRUARY 11, 2003
Mr. CONYERS (for himself, Mr. MCDERMOTT, Mr. KUCINICH, Mrs.
CHRISTENSEN, Mr. SCOTT of Virginia, Ms. LEE, Ms. NORTON, Mr.
DAVIS of Illinois, Mr. OWENS, Mr. JACKSON of Illinois, Mr. HINCHEY,
Mr. PAYNE, Mr. CUMMINGS, Ms. KILPATRICK, Mr. HASTINGS of Florida,
Mr. FATTAH, Mr. GRIJALVA, Mr. TOWNS, Mr. LEWIS of Georgia, Mr.
GUTIERREZ, Mr. THOMPSON of Mississippi, Ms. CARSON of Indiana, Mr.
PASTOR, Ms. WOOLSEY, Mr. CLAY, and Mr. RANGEL) introduced the following
bill; which was referred to the Committee on Energy and Commerce,
and in addition to the Committees on Ways and Means, Resources,
and Veterans’ Affairs, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To provide for comprehensive health insurance coverage for
all United States residents, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘United States National Health Insurance Act (or the Ex-
panded and Improved Medicare for All Act)’’.
(b) TABLE OF CONTENTS.—The table of contents of
this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions and terms.
TITLE I—ELIGIBILITY AND BENEFITS
Sec. 101. Eligibility and registration.
Sec. 102. Benefits and portability.
Sec. 103. Qualification of participating providers.
Sec. 104. Prohibition against duplicating coverage.
TITLE II—FINANCES
Subtitle A—Budgeting and Payments
Sec. 201. Budgeting process.
Sec. 202. Payment of providers and health care clinicians.
Sec. 203. Payment for long-term care.
Sec. 204. Mental health services.
Sec. 205. Payment for prescription medications, medical supplies, and medically
necessary assistive equipment.
Sec. 206. Consultation in establishing reimbursement levels.
Subtitle B—Funding
Sec. 211. Overview: funding the USNHI Program.
Sec. 212. Appropriations for existing programs for uninsured and indigent.
TITLE III—ADMINISTRATION
Sec. 301. Public administration; appointment of Director.
Sec. 302. Quality and cost control.
Sec. 303. Regional and State administration; employment of displaced clerical
workers.
Sec. 304. Confidential Electronic Patient Record System.
Sec. 305. National Board of Universal Quality and Access.
TITLE IV—ADDITIONAL PROVISIONS
Sec. 401. Treatment of VA and IHS health programs.
Sec. 402. Public health and prevention.
Sec. 403. Reduction in health disparities.
TITLE V—EFFECTIVE DATE
Sec. 501. Effective date.
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SEC. 2. DEFINITIONS AND TERMS.
In this Act:
(1) USNHI PROGRAM; PROGRAM.—The terms
‘‘USNHI Program’’ and ‘‘Program’’ mean the pro-
gram of benefits provided under this Act and, unless
the context otherwise requires, the Secretary with
respect to functions relating to carrying out such
program.
(2) NATIONAL BOARD OF UNIVERSAL QUALITY
AND ACCESS.—The term ‘‘National Board of Uni-
versal Quality and Access’’ means such Board estab-
lished under section 305.
(3) REGIONAL OFFICE.—The term ‘‘regional of-
fice’’ means a regional office established under sec-
tion 303.
(4) SECRETARY.—The term ‘‘Secretary’’ means
the Secretary of Health and Human Services.
(5) DIRECTOR.—The term ‘‘Director’’ means,
in relation to the Program, the Director appointed
under section 301.
TITLE I—ELIGIBILITY AND
BENEFITS
SEC. 101. ELIGIBILITY AND REGISTRATION.
(a) IN GENERAL.—All individuals residing in the
United States (including any territory of the United
States) are covered under the USNHI Program entitling
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them to a universal, best quality standard of care. Each
such individual shall receive a card with a unique number
in the mail. An individual’s social security number shall
not be used for purposes of registration under this section.
(b) REGISTRATION.—Individuals and families shall
receive a United States National Health Insurance Card
in the mail, after filling out a United States National
Health Insurance application form at a health care pro-
vider. Such application form shall be no more than 2 pages
long.
(c) PRESUMPTION.—Individuals who present them-
selves for covered services from a participating provider
shall be presumed to be eligible for benefits under this Act,
but shall complete an application for benefits in order to
receive a United States National Health Insurance Card
and have payment made for such benefits.
SEC. 102. BENEFITS AND PORTABILITY.
(a) IN GENERAL.—The health insurance benefits
under this Act cover all medically necessary services, in-
cluding—
(1) primary care and prevention;
(2) inpatient care;
(3) outpatient care;
(4) emergency care;
(5) prescription drugs;
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(6) durable medical equipment;
(7) long term care;
(8) mental health services;
(9) the full scope of dental services (other than
cosmetic dentistry);
(10) substance abuse treatment services;
(11) chiropractic services; and
(12) basic vision care and vision correction
(other than laser vision correction for cosmetic pur-
poses).
(b) PORTABILITY.—Such benefits are available
through any licensed health care clinician anywhere in the
United States that is legally qualified to provide the bene-
fits.
(c) NO COST-SHARING.—No deductibles, copay-
ments, coinsurance, or other cost-sharing shall be imposed
with respect to covered benefits. 17
SEC. 103. QUALIFICATION OF PARTICIPATING PROVIDERS.
(a) REQUIREMENT TO BE PUBLIC OR NON-PROF-
IT.— 20
(1) IN GENERAL.—No institution may be a par-
ticipating provider unless it is a public or not-for-
profit institution. 23
(2) CONVERSION OF INVESTOR-OWNED PRO-
VIDERS.—Investor-owned providers of care opting to
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participate shall be required to convert to not-for-
profit status.
(3) COMPENSATION FOR CONVERSION.—The
owners of such investor-owned providers shall be
compensated for the actual appraised value of con-
verted facilities used in the delivery of care.
(4) FUNDING.—There are authorized to be ap-
propriated from the Treasury such sums as are nec-
essary to compensate investor-owned providers as
provided for under paragraph (3).
(5) REQUIREMENTS.—The conversion to a not-
for-profit health care system shall take place over a
15-year period, through the sale of US Treasury
Bonds. Payment for conversions under paragraph
(3) shall not be made for loss of business profits,
but may be made only for costs associated with the
conversion of real property and equipment.
(b) QUALITY STANDARDS.—
(1) IN GENERAL.—Health care delivery facili-
ties must meet regional and State quality and licens-
ing guidelines as a condition of participation under
such program, including guidelines regarding safe
staffing and quality of care.
(2) LICENSURE REQUIREMENTS.—Participating
clinicians must be licensed in their State of practice
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and meet the quality standards for their area of
care. No clinician whose license is under suspension
or who is under disciplinary action in any State may
be a participating provider.
(c) PARTICIPATION OF HEALTH MAINTENANCE OR-
GANIZATIONS.—
(1) IN GENERAL.—Non-profit health mainte-
nance organizations that actually deliver care in
their own facilities and employ clinicians on a sala-
ried basis may participate in the program and re-
ceive global budgets or capitation payments as speci-
fied in section 202.
(2) EXCLUSION OF CERTAIN HEALTH MAINTE-
NANCE ORGANIZATIONS.—Other health maintenance
organizations, including those which principally con-
tract to pay for services delivered by non-employees,
shall be classified as insurance plans. Such organiza-
tions shall not be participating providers, and are
subject to the regulations promulgated by reason of
section 104(a) (relating to prohibition against dupli-
cating coverage).
(d) FREEDOM OF CHOICE.—Patients shall have free
choice of participating physicians and other clinicians,
hospitals, and inpatient care facilities.
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SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.
(a) IN GENERAL.—It is unlawful for a private health
insurer to sell health insurance coverage that duplicates
the benefits provided under this Act.
(b) CONSTRUCTION.—Nothing in this Act shall be
construed as prohibiting the sale of health insurance cov-
erage for any additional benefits not covered by this Act,
such as for cosmetic surgery or other services and items
that are not medically necessary.
TITLE II—FINANCES
Subtitle A—Budgeting and
Payments
SEC. 201. BUDGETING PROCESS.
(a) ESTABLISHMENT OF OPERATING BUDGET AND
CAPITAL EXPENDITURES BUDGET.—
(1) IN GENERAL.—To carry out this Act there
are established on an annual basis consistent with
this title—
(A) an operating budget;
(B) a capital expenditures budget;
(C) reimbursement levels for providers con-
sistent with subtitle B; and
(D) a health professional education budget,
including amounts for the continued funding of
resident physician training programs.
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(2) REGIONAL ALLOCATION.—After Congress
appropriates amounts for the annual budget for the
USNHI Program, the Director shall provide the re-
gional offices with an annual funding allotment to
cover the costs of each region’s expenditures. Such
allotment shall cover global budgets, reimbursements
to clinicians, and capital expenditures. Regional of-
fices may receive additional funds from the national
program at the discretion of the Director.
(b) OPERATING BUDGET.—The operating budget
shall be used for—
(1) payment for services rendered by physicians
and other clinicians;
(2) global budgets for institutional providers;
(3) capitation payments for capitated groups;
and
(4) administration of the Program.
(c) CAPITAL EXPENDITURES BUDGET.—The capital
expenditures budget shall be used for funds needed for—
(1) the construction or renovation of health fa-
cilities; and
(2) for major equipment purchases.
(d) PROHIBITION AGAINST CO-MINGLING OPER-
ATIONS AND CAPITAL IMPROVEMENT FUNDS.—It is pro-
hibited to use funds under this Act that are earmarked—
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(1) for operations for capital expenditures; or
(2) for capital expenditures for operations.
SEC. 202. PAYMENT OF PROVIDERS AND HEALTH CARE CLI-
NICIANS.
(a) ESTABLISHING GLOBAL BUDGETS; MONTHLY
LUMP SUM.—
(1) IN GENERAL.—The USNHI Program,
through its regional offices, shall pay each hospital,
nursing home, community or migrant health center,
home care agencies, or other institutional provider
or pre-paid group practice a monthly lump sum to
cover all operating expenses under a global budget.
(2) ESTABLISHMENT OF GLOBAL BUDGETS.—
The global budget of a provider shall be set through
negotiations between providers and regional direc-
tors, but are subject to the approval of the Director.
The budget shall be negotiated annually, based on
past expenditures, projected changes in levels of
services, wages and input, costs, and proposed new
and innovative programs.
(b) THREE PAYMENT OPTIONS FOR PHYSICIANS AND
CERTAIN OTHER HEALTH PROFESSIONALS.—
(1) IN GENERAL.—The Program shall pay phy-
sicians, dentists, doctors of osteopathy, psycholo-
gists, chiropractors, doctors of optometry, nurse
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practitioners, nurse midwives, physicians’ assistants,
and other advanced practice clinicians as licensed
and regulated by the States by the following pay-
ment methods:
(A) Fee for service payment under para-
graph (2).
(B) Salaried positions in institutions re-
ceiving global budgets under paragraph (3).
(C) Salaried positions within group prac-
tices or non-profit health maintenance organiza-
tions receiving capitation payments under para-
graph (4).
(2) FEE FOR SERVICE.—
(A) IN GENERAL.—The Program shall ne-
gotiate a simplified fee schedule with clinician
representatives, after close consultation with the
National Board of Universal Quality and Access
and regional and State directors.
(B) CONSIDERATIONS.—In establishing
such schedule, the Director shall take into con-
sideration regional differences in reimburse-
ment, but strive for a uniform national stand-
ard.
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(C) FINAL GUIDELINES.—The regional di-
rectors shall be responsible for promulgating
final guidelines to all providers.
(D) BILLING.—Under the Act physicians
shall submit bills to the regional director on a
simple form, or via computer. Interest shall be
paid to providers whose bills are not paid within
30 days of submission.
(E) NO BALANCE BILLING.—Licensed
health care clinicians who accept any payment
from the USNHI Program may not bill any pa-
tient for any covered service.
(F) UNIFORM COMPUTER ELECTRONIC
BILLING SYSTEM.—The Director shall make a
good faith effort to create a uniform computer-
ized electronic billing system, including in those
areas of the United States where electronic bill-
ing is not yet established.
(3) SALARIES WITHIN INSTITUTIONS RECEIVING
GLOBAL BUDGETS.—
(A) IN GENERAL.—In the case of an insti-
tution, such as a hospital, health center, group
practice, community and migrant health center,
or a home care agency that elects to be paid a
monthly global budget for the delivery of health
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care as well as for education and prevention
programs, physicians employed by such institu-
tions shall be reimbursed through a salary in-
cluded as part of such a budget.
(B) SALARY RANGES.—Salary ranges for
health care providers shall be determined in the
same way as fee schedules under paragraph (2).
(4) SALARIES WITHIN CAPITATED GROUPS.—
(A) IN GENERAL.—Health maintenance or-
ganizations, group practices, and other institu-
tions may elect to be paid capitation premiums
to cover all outpatient, physician, and medical
home care provided to individuals enrolled to
receive benefits through the organization or en-
tity. 15
(B) SCOPE.—Such capitation may include
the costs of services of licensed physicians and
other licensed, independent practitioners pro-
vided to inpatients. Other costs of inpatient and
institutional care shall be excluded from capita-
tion payments, and shall be covered under insti-
tutions’ global budgets.
(C) PROHIBITION OF SELECTIVE ENROLL-
MENT.—Selective enrollment policies are pro-
hibited, and patients shall be permitted to en-
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roll or disenroll from such organizations or enti-
ties with appropriate notice.
(D) HEALTH MAINTENANCE ORGANIZA-
TIONS.—Under this Act—
(i) health maintenance organizations
shall be required to reimburse physicians
based on a salary; and
(ii) financial incentives between such
organizations and physicians based on uti-
lization are prohibited.
SEC. 203. PAYMENT FOR LONG-TERM CARE.
(a) ALLOTMENT FOR REGIONS.—The Program shall
provide for each region a single budgetary allotment to
cover a full array of long-term care services under this
Act. 15
(b) REGIONAL BUDGETS.—Each region shall provide
a global budget to local long-term care providers for the
full range of needed services, including in-home, nursing
home, and community based care.
(c) BASIS FOR BUDGETS.—Budgets for long-term
care services under this section shall be based on past ex-
penditures, financial and clinical performance, utilization,
and projected changes in service, wages, and other related
factors.
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(d) FAVORING NON-INSTITUTIONAL CARE.—All ef-
forts shall be made under this Act to provide long-term
care in a home- or community-based setting, as opposed
to institutional care.
SEC. 204. MENTAL HEALTH SERVICES.
(a) IN GENERAL.—The Program shall provide cov-
erage for all medically necessary mental health care on
the same basis as the coverage for other conditions. Li-
censed mental health clinicians shall be paid in the same
manner as specified for other health professionals, as pro-
vided for in section 202(b).
(b) FAVORING COMMUNITY-BASED CARE.—The
USNHI Program shall cover supportive residences, occu-
pational therapy, and ongoing mental health and coun-
seling services outside the hospital for patients with seri-
ous mental illness. In all cases the highest quality and
most effective care shall be delivered, and, for some indi-
viduals, this may mean institutional care.
SEC. 205. PAYMENT FOR PRESCRIPTION MEDICATIONS,
MEDICAL SUPPLIES, AND MEDICALLY NEC-
ESSARY ASSISTIVE EQUIPMENT.
(a) NEGOTIATED PRICES.—The prices to be paid
each year under this Act for covered pharmaceuticals,
medical supplies, and medically necessary assistive equip-
ment shall be negotiated annually by the Program.
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(b) PRESCRIPTION DRUG FORMULARY.—
(1) IN GENERAL.—The Program shall establish
a prescription drug formulary system, which shall
encourage best-practices in prescribing and discour-
age the use of ineffective, dangerous, or excessively
costly medications when better alternatives are avail-
able.
(2) PROMOTION OF USE OF GENERICS.—The
formulary shall promote the use of generic medica-
tions but allow the use of brand-name and off-for-
mulary medications when indicated for a specific pa-
tient or condition.
(3) FORMULARY UPDATES AND PETITION
RIGHTS.—The formulary shall be updated frequently
and clinicians and patients may petition their region
or the Director to add new pharmaceuticals or to re-
move ineffective or dangerous medications from the
formulary. 18
SEC. 206. CONSULTATION IN ESTABLISHING REIMBURSE-
MENT LEVELS. 20
Reimbursement levels under this subtitle shall be set
after close consultation with regional and State Directors
and after the annual meeting of National Board of Uni-
versal Quality and Access.
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Subtitle B—Funding
SEC. 211. OVERVIEW: FUNDING THE USNHI PROGRAM.
(a) IN GENERAL.—The USNHI Program is to be
funded as provided in subsections (b) and (c).
(b) ANNUAL APPROPRIATION FOR FUNDING OF
USNHI PROGRAM.—There are authorized to be appro-
priated to carry out this Act such sums as may be nec-
essary.
(c) INTENT.—Sums appropriated pursuant to sub-
section (b) shall be paid for—
(1) by vastly reducing paperwork;
(2) by requiring a rational bulk procurement of
medications;
(3) from existing sources of Federal govern-
ment revenues for health care;
(4) by increasing personal income taxes on the
top 5 percent income earners;
(5) by instituting a modest payroll tax; and
(6) by instituting a small tax on stock and bond
transactions.
SEC. 212. APPROPRIATIONS FOR EXISTING PROGRAMS FOR
UNINSURED AND INDIGENT.
Notwithstanding any other provision of law, there are
hereby transferred and appropriated to carry out this Act,
amounts equivalent to the amounts the Secretary esti-
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mates would have been appropriated and expended for
Federal public health care programs for the uninsured and
indigent, including funds appropriated under the Medicare
program under title XVIII of the Social Security Act,
under the Medicaid program under title XIX of such Act,
and under the Children’s Health Insurance Program
under title XXI of such Act.
TITLE III—ADMINISTRATION
SEC. 301. PUBLIC ADMINISTRATION; APPOINTMENT OF DI-
RECTOR.
(a) IN GENERAL.—Except as otherwise specifically
provided, this Act shall be administered by the Secretary
through a Director appointed by the Secretary.
(b) LONG-TERM CARE.—The Director shall appoint
a director for long-term care who shall be responsible for
administration of this Act and ensuring the availability
and accessibility of high quality long-term care services.
(c) MENTAL HEALTH.—The Director shall appoint a
director for mental health who shall be responsible for ad-
ministration of this Act and ensuring the availability and
accessibility of high quality mental health services.
SEC. 302. OFFICE OF QUALITY CONTROL.
The Director shall appoint a director for an Office
of Quality Control. Such director shall, after consultation
with state and regional directors, provide annual rec-
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ommendations to Congress, the President, the Secretary,
and other Program officials on how to ensure the highest
quality health care service delivery. The director of the Of-
fice of Quality Control shall conduct an annual review on
the adequacy of medically necessary services, and shall
make recommendations of any proposed changes to the
Congress, the President, the Secretary, and other USNHI
program officials.
SEC. 303. REGIONAL AND STATE ADMINISTRATION; EM-
PLOYMENT OF DISPLACED CLERICAL WORK-
ERS.
(a) USE OF REGIONAL OFFICES.—The Program
shall establish and maintain regional offices. Such regional
offices shall replace all regional Medicare offices.
(b) APPOINTMENT OF REGIONAL AND STATE DIREC-
TORS.—In each such regional office there shall be—
(1) one regional director appointed by the Di-
rector; and
(2) for each State in the region, a deputy direc-
tor (in this Act referred to as a ‘‘State Director’’)
appointed by the governor of that State.
(c) REGIONAL OFFICE DUTIES.—
(1) IN GENERAL.—Regional offices of the Pro-
gram shall be responsible for—
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(A) coordinating funding to health care
providers and physicians; and
(B) coordinating billing and reimburse-
ments with physicians and health care providers
through a State-based reimbursement system.
(d) STATE DIRECTOR’S DUTIES.—Each State Direc-
tor shall be responsible for the following duties:
(1) Providing an annual state health care needs
assessment report to the National Board of Uni-
versal Quality and Access, and the regional board,
after a thorough examination of health needs, in
consultation with public health officials, clinicians,
patients and patient advocates.
(2) Health planning, including oversight of the
placement of new hospitals, clinics, and other health
care delivery facilities.
(3) Health planning, including oversight of the
purchase and placement of new health equipment to
ensure timely access to care and to avoid duplica-
tion.
(4) Submitting global budgets to the regional
director.
(5) Recommending changes in provider reim-
bursement or payment for delivery of health services
in the State.
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(6) Establishing a quality assurance mechanism
in the State in order to minimize both under utiliza-
tion and over utilization and to assure that all pro-
viders meet high quality standards.
(7) Reviewing program disbursements on a
quarterly basis and recommending needed adjust-
ments in fee schedules needed to achieve budgetary
targets and assure adequate access to needed care.
(e) FIRST PRIORITY IN RETRAINING AND JOB
PLACEMENT.—The Program shall provide that clerical
and administrative workers in insurance companies, doc-
tors offices, hospitals, nursing facilities and other facilities
whose jobs are eliminated due to reduced administration,
should have first priority in retraining and job placement
in the new system.
SEC. 304. CONFIDENTIAL ELECTRONIC PATIENT RECORD
SYSTEM.
(a) IN GENERAL.—The Secretary shall create a
standardized, confidential electronic patient record system
in accordance with laws and regulations to maintain accu-
rate patient records and to simplify the billing process,
thereby reducing medical errors and bureaucracy.
(b) PATIENT OPTION.—Notwithstanding that all bill-
ing shall be preformed electronically, patients shall have
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the option of keeping any portion of their medical records
separate from their electronic medical record.
SEC. 305. NATIONAL BOARD OF UNIVERSAL QUALITY AND
ACCESS.
(a) ESTABLISHMENT.—
(1) IN GENERAL.—There is established a Na-
tional Board of Universal Quality and Access (in
this section referred to as the ‘‘Board’’) consisting
of 15 members appointed by the President, by and
with the advice and consent of the Senate.
(2) QUALIFICATIONS.—The appointed members
of the Board shall include at least one of each of the
following:
(A) Health care professionals.
(B) Representatives of institutional pro-
viders of health care.
(C) Representatives of health care advo-
cacy groups.
(D) Representatives of labor unions.
(E) Citizen patient advocates.
(3) TERMS.—Each member shall be appointed
for a term of 6 years, except that the President shall
stagger the terms of members initially appointed so
that the term of no more than 3 members expires
in any year.
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(4) PROHIBITION ON CONFLICTS OF INTER-
EST.—No member of the Board shall have a finan-
cial conflict of interest with the duties before the
Board.
(b) DUTIES.—
(1) IN GENERAL.—The Board shall meet at
least twice per year and shall advise the Secretary
and the Director on a regular basis to ensure qual-
ity, access, and affordability.
(2) SPECIFIC ISSUES.—The Board shall specifi-
cally address the following issues:
(A) Access to care.
(B) Quality improvement.
(C) Efficiency of administration.
(D) Adequacy of budget and funding.
(E) Appropriateness of reimbursement lev-
els of physicians and other providers.
(F) Capital expenditure needs.
(G) Long-term care.
(H) Mental health and substance abuse
services.
(I) Staffing levels and working conditions
in health care delivery facilities.
(3) ESTABLISHMENT OF UNIVERSAL, BEST
QUALITY STANDARD OF CARE.—The Board shall
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specifically establish a universal, best quality of
standard of care with respect to—
(A) appropriate staffing levels;
(B) appropriate medical technology;
(C) design and scope of work in the health
workplace; and
(D) best practices.
(4) TWICE-A-YEAR REPORT.—The Board shall
report its recommendations twice each year to the
Secretary, the Director, Congress, and the Presi-
dent.
(c) COMPENSATION, ETC.—The following provisions
of section 1805 of the Social Security Act shall apply to
the Board in the same manner as they apply to the Medi-
care Payment Assessment Commission (except that any
reference to the Commission or the Comptroller General
shall be treated as references to the Board and the Sec-
retary, respectively):
(1) Subsection (c)(4) (relating to compensation
of Board members).
(2) Subsection (c)(5) (relating to chairman and
vice chairman)
(3) Subsection (c)(6) (relating to meetings).
(4) Subsection (d) (relating to director and
staff; experts and consultants).
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(5) Subsection (e) (relating to powers).
TITLE IV—ADDITIONAL
PROVISIONS
SEC. 401. TREATMENT OF VA AND IHS HEALTH PROGRAMS.
This Act provides for health programs of the Depart-
ment of Veterans’ Affairs and of the Indian Health Serv-
ice to initially remain independent for the 5-year period
that begins on the date of the establishment of the
USNHI program, but after such period those programs
shall be integrated into the USNHI program.
SEC. 402. PUBLIC HEALTH AND PREVENTION.
It is the intent of this Act that the Program at all
times stress the importance of good public health through
the prevention of diseases.
SEC. 403. REDUCTION IN HEALTH DISPARITIES.
It is the intent of this Act to reduce health disparities
by race, ethnicity, income and geographic region, and to
provide high quality, cost-effective, culturally appropriate
care to all individuals regardless of race, ethnicity, sexual
orientation, or language.
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TITLE V—EFFECTIVE DATE
SEC. 501. EFFECTIVE DATE.
Except as otherwise specifically provided, this Act
shall take effect on January 1, 2005, and shall apply to
items and services furnished on or after such date.
Æ

Lesson 8: Being Pushed Away....

Sometimes it's hard to see past the blinders in life. Sometimes it's impossible to admit when your wrong. And it always takes a life time to finally see the truth. By then, it's usually too late. The important people in your life won't be there anymore because you've pushed them away. They've left you because you can't get over yourself and your insecurities. It's a shame when this happens, and you never realize how bad you messed up until you do get over these irritating problems that you cause so many people. And it never bothers you, because you don't see it in time.
I have a few people in my life who are like this. It's terrible really. They know I'd do anything for them but in return I get treated like something they could lie down and walk over, like they do.
It amazes me how some people can so easily treat others like this. Especially others that actually care about them, others who have actually been there and would usually be there under any circumstance , but how can someone be there if you don't let them? If you don't want them? All in all, it may hurt you at first to let them go because they push you away, but that's not a choice that's ours. And in the end, maybe they'll realize that they did wrong, that it's their fault and they missed out. And if they do, hopefully they hurt as bad as you did when they were pushing you away.