Friday, August 14, 2009

HR 3200: A Text Hegelian in its Girth* and Obscurantism

(*I refer to the "girth" of Hegel's texts not Hegel's personal girth. I'm sure he was an averaged sized, and fit German Philosopher. Neither is the obscurantism of HR 3200 that of the philosophic variety, but that of the legal professional's variety. But, nevertheless..)

The PDF document is 1017 pages long. To read any two to 10 page section of the document trying to glean understanding is like..well..reading Derrida, or Hegel with the added burden of about a half dozen references to other parts of the bill, or already existing legislation. Through the tangle of legalize, we mere mortals are supposed to get a handle on this thing, that is, if we chose to read it, something that was apparently optional for senators and representatives.

And there was a rush to pass this thing before August?

Here's a taste(without the line numbers) This part of the bill has to do with the duties of someone called the "Health Choices Commissioner," (hereafter referred to as "Der Kommissar" in memory of Mr. Falco) who heads up something called the "Health Choices Administration," the agency that would manage the new program:


(a) In General- There is hereby established, as an independent agency in the executive branch of the Government, a Health Choices Administration (in this division referred to as the `Administration').

(b) Commissioner-

(1) IN GENERAL- The Administration shall be headed by a Health Choices Commissioner (in this division referred to as the `Commissioner') who shall be appointed by the President, by and with the advice and consent of the Senate.

(2) COMPENSATION; ETC- The provisions of paragraphs (2), (5), and (7) of subsection (a) (relating to compensation, terms, general powers, rulemaking, and delegation) of section 702 of the Social Security Act (42 U.S.C. 902) shall apply to the Commissioner and the Administration in the same manner as such provisions apply to the Commissioner of Social Security and the Social Security Administration.


(a) Duties- The Commissioner is responsible for carrying out the following functions under this division:

(1) QUALIFIED PLAN STANDARDS- The establishment of qualified health benefits plan standards under this title, including the enforcement of such standards in coordination with State insurance regulators and the Secretaries of Labor and the Treasury.

(2) HEALTH INSURANCE EXCHANGE- The establishment and operation of a Health Insurance Exchange under subtitle A of title II.

(3) INDIVIDUAL AFFORDABILITY CREDITS- The administration of individual affordability credits under subtitle C of title II, including determination of eligibility for such credits.

(4) ADDITIONAL FUNCTIONS- Such additional functions as may be specified in this division.

(b) Promoting Accountability-

(1) IN GENERAL- The Commissioner shall undertake activities in accordance with this subtitle to promote accountability of QHBP offering entities in meeting Federal health insurance requirements, regardless of whether such accountability is with respect to qualified health benefits plans offered through the Health Insurance Exchange or outside of such Exchange.


(A) IN GENERAL- The commissioner shall, in coordination with States, conduct audits of qualified health benefits plan compliance with Federal requirements. Such audits may include random compliance audits and targeted audits in response to complaints or other suspected non-compliance.

(B) RECOUPMENT OF COSTS IN CONNECTION WITH EXAMINATION AND AUDITS- The Commissioner is authorized to recoup from qualified health benefits plans reimbursement for the costs of such examinations and audit of such QHBP offering entities.

(c) Data Collection- The Commissioner shall collect data for purposes of carrying out the Commissioner's duties, including for purposes of promoting quality and value, protecting consumers, and addressing disparities in health and health care and may share such data with the Secretary of Health and Human Services.

(d) Sanctions Authority-

(1) IN GENERAL- In the case that the Commissioner determines that a QHBP offering entity violates a requirement of this title, the Commissioner may, in coordination with State insurance regulators and the Secretary of Labor, provide, in addition to any other remedies authorized by law, for any of the remedies described in paragraph (2).

(2) REMEDIES- The remedies described in this paragraph, with respect to a qualified health benefits plan offered by a QHBP offering entity, are--

(A) civil money penalties of not more than the amount that would be applicable under similar circumstances for similar violations under section 1857(g) of the Social Security Act;

(B) suspension of enrollment of individuals under such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Commissioner is satisfied that the basis for such determination has been corrected and is not likely to recur;

(C) in the case of an Exchange-participating health benefits plan, suspension of payment to the entity under the Health Insurance Exchange for individuals enrolled in such plan after the date the Commissioner notifies the entity of a determination under paragraph (1) and until the Secretary is satisfied that the basis for such determination has been corrected and is not likely to recur; or

(D) working with State insurance regulators to terminate plans for repeated failure by the offering entity to meet the requirements of this title.

(e) Standard Definitions of Insurance and Medical Terms- The Commissioner shall provide for the development of standards for the definitions of terms used in health insurance coverage, including insurance-related terms.

(f) Efficiency in Administration- The Commissioner shall issue regulations for the effective and efficient administration of the Health Insurance Exchange and affordability credits under subtitle C, including, with respect to the determination of eligibility for affordability credits, the use of personnel who are employed in accordance with the requirements of title 5, United States Code, to carry out the duties of the Commissioner or, in the case of sections 208 and 241(b)(2), the use of State personnel who are employed in accordance with standards prescribed by the Office of Personnel Management pursuant to section 208 of the Intergovernmental Personnel Act of 1970 (42 U.S.C. 4728).


(a) Consultation- In carrying out the Commissioner's duties under this division, the Commissioner, as appropriate, shall consult with at least with the following:

(1) The National Association of Insurance Commissioners, State attorneys general, and State insurance regulators, including concerning the standards for insured qualified health benefits plans under this title and enforcement of such standards.

(2) Appropriate State agencies, specifically concerning the administration of individual affordability credits under subtitle C of title II and the offering of Exchange-participating health benefits plans, to Medicaid eligible individuals under subtitle A of such title.

(3) Other appropriate Federal agencies.

(4) Indian tribes and tribal organizations.

(5) The National Association of Insurance Commissioners for purposes of using model guidelines established by such association for purposes of subtitles B and D.

(b) Coordination-

(1) IN GENERAL- In carrying out the functions of the Commissioner, including with respect to the enforcement of the provisions of this division, the Commissioner shall work in coordination with existing Federal and State entities to the maximum extent feasible consistent with this division and in a manner that prevents conflicts of interest in duties and ensures effective enforcement.

(2) UNIFORM STANDARDS- The Commissioner, in coordination with such entities, shall seek to achieve uniform standards that adequately protect consumers in a manner that does not unreasonably affect employers and insurers.


(a) In General- The Commissioner shall appoint within the Health Choices Administration a Qualified Health Benefits Plan Ombudsman who shall have expertise and experience in the fields of health care and education of (and assistance to) individuals.

(b) Duties- The Qualified Health Benefits Plan Ombudsman shall, in a linguistically appropriate manner--

(1) receive complaints, grievances, and requests for information submitted by individuals;

(2) provide assistance with respect to complaints, grievances, and requests referred to in paragraph (1), including--

(A) helping individuals determine the relevant information needed to seek an appeal of a decision or determination;

(B) assistance to such individuals with any problems arising from disenrollment from such a plan;

(C) assistance to such individuals in choosing a qualified health benefits plan in which to enroll; and

(D) assistance to such individuals in presenting information under subtitle C (relating to affordability credits); and

(3) submit annual reports to Congress and the Commissioner that describe the activities of the Ombudsman and that include such recommendations for improvement in the administration of this division as the Ombudsman determines appropriate. The Ombudsman shall not serve as an advocate for any increases in payments or new coverage of services, but may identify issues and problems in payment or coverage policies.

Mind you, this is but 9 pages or so from the ten-hundred and seventeen page behemouth. By my calculations, that would be (9/1017)... less than one percent of the bill. Eight tenths of one percent, if I'm correct.

So, what's the damn hurry? Congress: Read the thing, argue and discuss, and scrap it if you have to, but whatever you do, read it. The chicken little routine isn't fair or necessary.

Followup to the Tweeting and Time Constraint Post

That previous post is here.

A case in point: Human Rights Watch comes out with a report claiming IDF intentionally shot Gazan civilians during their 08-09 operations, civilians who were waving white flags, in areas IDF had control of, and which were relatively peaceful/non-kinetic. The reporters find no evidence that Hamas was using these civilians as human shields.

IDF responded, albeit, sometime afterward, and under provocation from the HRW report. The response include the video (below), and a general debunking.

In addition to the efforts of the IDF, other blogs have 'researched the researchers' as it were:


NGO Monitor

NGO Monitor's bullet-list of questionable aspects of the report, and its sourcing is as follows:

HRW had no presence in Gaza during the conflict. Therefore, the organization's Gaza ‘reports’, including “White Flag Deaths” are based entirely on unverifiable claims wrapped in a fa├žade of research.
The report’s co-author Joe Stork is a veteran anti-Israel political activist and the antithesis of a professional legal analyst. Before joining HRW, he was a leader of MERIP (Middle East Research and Information Project), whose publications have carried laudatory interviews with terrorist leaders and urged socialists to “comprehend the achievements” of the 1972 Munich Olympics massacre.
HRW’s publication fails to investigate incidents in which "white flags", ambulances and hospitals were used by Hamas to hide military activity. Instead, the entire report is designed to provide "evidence" of alleged Israeli war crimes (a term used 15 times).
This publication relies on Palestinian ‘eyewitness’ testimony, such as the claims of Khalid Abd Rabbo. But Abd Rabbo's testimony in other reports is highly inconsistent, and fails to provide the information necessary for a serious analysis.
Six of the seven alleged incidents are based on the unprovable ‘evidence’ from journalists or NGOs with highly biased agendas, including Breaking the Silence, Al Mezan and Palestinian Center for Human Rights (PCHR).
“White Flag Deaths”, like other HRW "research reports" goes out of its way to reject the well-documented utilization of human shields by Hamas. (In contrast, in an interview with the Jerusalem Post, Bill Van Esveld acknowledged this evidence. This glaring inconsistency further demonstrates the framework of HRW's activities with respect to Israel.)
The report cites medical and ballistic records as ‘evidence’ of alleged white flag incidents, but these claims provide no information on the circumstances of the injuries, and are irrelevant to HRW's claims.

To state things minimally, this point by point answer to the report should be grounds for doubting its objectivity, if not its veracity. It should at least give pause.

Now, if such counters were possible in real time, as the conflict was unfolding, and were backed up by video from the scene, I think, as payoff for the inconveniences and difficulties this would introduce, IDF would have bought some more time for Operation Cast Lead. A more thorough rooting out and defeat of Hamas forces would have been in the offing.

This Web v2 informational aspect to projection of force should become a part of IDF military operations. The question then becomes, how to bring it about. Three options present themselves. We can rely on sympathetic indigenous folks, as the world has in the case of the Iranian uprising, or we can rely on embeds, or soldiers themselves

Given that the locals voted Hamas into power, and have been poisoned by years of propaganda, we can assume that indigenous support would not likely be offered by Gazans. So, IDF would have to go the embed route, or rely on its own personnel. This introduces operational security issues, and other difficulties. But, it seems to me the trade-off would be worth it.

"Pallywood" must be countered, in kind, on an ongoing basis, with saturation coverage, if Israel is to be able to defend itself without worrying about time compression effects of world media coverage, that is too often manipulated by its enemies.