FT 4-11: Medical Care Act

[Kamala]

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The Chair calls the Prime Minister.

[Unconditional Surrender Truman]

I give my thanks to the speaker, and my apologies to the House for the delay in my reply; it has been a very busy weekend off the forum, and I wanted to give this bill the time and attention it deserves.

The proposal before us is a bill to complete the reformation of Atlasian medical care and insurance begun two months ago by the Reforming and Regionalizing Public Healthcare Act, a federal law drafted by Senator Scott (PPT) and Representative Yankee this past summer. Under that law, all existing medical insurance programs (Medicare, Medicaid, and Veterans' care services) were consolidated under AtlasCare to form what is effectively a federally-funded public option available to all citizens. This bill — the People's Medical Care and Insurance Act — will bring the reform process full circle by establishing a regional Insurance Exchange where citizens may choose between AtlasCare and a number of approved private plans that meet federal and regional requirements for minimum care and benefits. (Currently, the Fremontian Exchange is being run by the federal Department of Internal Affairs; this bill will bring the exchange under regional administration.) The Exchange will be governed by a special Commission chosen by the eighteen state governors and the prime minister, who will be empowered to make such rules and regulations as described by Section 2(iii) of this bill.

To be blunt, this is perhaps the most important piece of legislation to be considered by the House of Commons this session, and I am sure all of our members will engage and act accordingly. Have at it!

[Cactus Jack]

I see no cause for objection within the current text of the bill. I support this legislation completely, without reservation or hesitation.

[Pericles]

This looks like a good bill that will improve choice and access to affordable healthcare for Fremontians and increase coverage. I see no faults in it and I think FremontCare would be a great thing for Fremont.

[Kamala]

I guess in order to keep things interesting, I will oppose this bill from the left.

As a member of the Peace Party, I believe in putting people before profit. And the problem with the legislation is that it still maintains the deepest, most important issue: that health is a for-profit industry, but it shouldn't be.

I oppose Trumancare not because it's a step backward, but because it simply takes one step forward instead of the potential for leaps and bounds. I am in the process (I guess you could say) of drafting a competing legislation, one that nationalizes all non-cosmetic healthcare providers in the Commonwealth and consolidates them as a Commonwealth System of Health run by the regional government. It's time we take a stand against the creeping influence of capitalism in everything; healthcare is a right, not something to be bought and sold.

I hope my fellow members will stand with me and realize that an even better tomorrow is possible.

[Unconditional Surrender Truman]

Trumancare

I have to say, I like the name.

[Kamala]

Trumancare

I have to say, I like the name.

Not as good as Kamalacare.

[Pericles]

A possible amendment would add all those over 60 into the AtlasCare program.

[Unconditional Surrender Truman]

A possible amendment would add all those over 60 into the AtlasCare program.

Do you plan to introduce such an amendment?

As the bill now stands, all Fremontians have the option of enrolling in AtlasCare; the poor and disable, persons over the age of 65, and veterans of the armed services are enrolled automatically and do not pay a premium, while the rest of the population may enroll voluntarily and do pay a premium. I assume you intend to add persons between the ages of 60 and 65 to the former group?

[Pericles]

A possible amendment would add all those over 60 into the AtlasCare program.

Do you plan to introduce such an amendment?

As the bill now stands, all Fremontians have the option of enrolling in AtlasCare; the poor and disable, persons over the age of 65, and veterans of the armed services are enrolled automatically and do not pay a premium, while the rest of the population may enroll voluntarily and do pay a premium. I assume you intend to add persons between the ages of 60 and 65 to the former group?

Yes.

[Pericles]

Amended. I decided to go for 57 instead of 60.

AN ACT
to provide for the health and well-being
of the Fremontian people

Section 1 (Title and definitions)
i. The long title of this Act shall be, the "People's Medical Care and Insurance Act of 2017." It may be cited as the "Medical Care Act" or as "FremontCare."
ii. For the purposes of this legislation, "Federal Act" shall refer in particular to the Reforming and Regionalizing Public Healthcare Act of 2017.

Section 2 (Fremontian Healthcare Exchange)
i. The Fremontian Healthcare Exchange, and all matters pertaining to its administration, shall be henceforth the prerogative of the Commission on Health and Insurance.
ii. The membership of the Commission shall be nominated by the executives of the several constituent states, such that each state shall be represented by a single Commissioner; and the Prime Minister of Fremont shall themself nominate an Executive Commissioner and two Deputy Commissioners. The Commissioners so chosen shall serve terms of six years, while the Deputy Commissioners and the Executive Commissioner shall serve for three years; by no person shall be seated as a member of the Commission who has not been confirmed by a vote of the House of Commons.
iii. The Commission shall have full power to administer and direct the activities of the Exchange; to make all regulations for minimum coverage; to license private insurers to sell on the Exchange; and to pass sanctions against any insurer who should fail to comply with the regulations so established.
iv. AtlasCare shall be made available on the Exchange for enrollment by all citizens and permanent residents of the Commonwealth of Fremont.

Section 3 (Insurance Mandates)
i. All licensed private insurers must provide those services laid out by Section 2.1(b) of the Federal Act.
ii. Both AtlasCare and private insurers must provide transition-related services to all people diagnosed with Gender Dysphoria including; but not limited to; psychiatric services, cosmetic procedures that affirm an individuals gender, and follow-up medical care deemed necessary by an individuals Doctor
iii. Any medical professional or facility not willing to provide services under the second clause of this Section may decline the procedure, provided that an alternative facility or professional able to provide such services be available within a reasonable distance of the patient, and provided that a professional or facility refers the patient to that available alternative
iv. All licensed private insurers must provide coverage of to the dependent children of the policy holder until said children are twenty five years of age.
iv. Dependent children being fewer than twenty five years of age shall be eligible to receive coverage through their parent or legal guardian, and all licensed private insurers shall be required to provide the same.
v. All citizens and permanent residents of the Commonwealth of Fremont, being at least twenty seven years to fifty-seven of age, and not being insured either by AtlasCare or by a licensed private insurer, shall be charged an annual duty of $500, and an additional $500 for every uninsured dependent in their care; proceeds from which shall be appropriated by the Commission for the treatment of persons with severe medical conditions.


Section 4 (Implementation)
i. Section 2(ii) of this Act shall go into effect immediately; and all other provisions of this Act shall become operative on January 1, 2018.
ii. The Fremontian government shall appoint a nonpartisan commission of former government officials and healthcare policy experts to recommend improvements, if any are needed, to the healthcare system of Fremont. Said commission shall be named the Fremontian Commission on Affordable Healthcare for all, and shall be tasked with the two mandates of maximizing insurance coverage and affordability of said coverage for Fremontians.
iii. The recommendations of the commission will be submitted no later than January 1, 2021(barring a request for an extension by a majority of the commission that is approved by the Prime Minister, provided said extension has an end date no later than 5 years after the request for the extension was approved), which will go for an up-down vote on the Fremont House of Commons.
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[Unconditional Surrender Truman]

Unless I'm misreading something, the amendment to Section 3 merely exempts persons age 57 and over from the Individual Mandate. I guess we can have that discussion if y'all want to, but I was under the impression the honorable member wanted to add persons 57/60 years and older to AtlasCare, which the amendment does not appear to do.

With regards to the FCACA: I presume this to be a non-playable commission?

[Unconditional Surrender Truman]

I thank the Commons for their patience.

Having reviewed the provisions of the federal health law, I found no provision by which Nyman may be induced to offer full subsidy on basis of age to recipients of AtlasCare over the age of 57. This, of course, does not mean that we cannot make such an offer; but it does mean that the monies necessary to pay for the expansion would need to come out of the regional treasury.

I would encourage the honorable Member to seek an estimate from the Game Moderator with regards to how much such an expansion would cost the region. Depending on how long it takes the GM to prepare such an estimate, we can then either consider it as an amendment to the present bill, or as separate legislation.

Thoughts or questions?

[Pericles]

I thank the Commons for their patience.

Having reviewed the provisions of the federal health law, I found no provision by which Nyman may be induced to offer full subsidy on basis of age to recipients of AtlasCare over the age of 57. This, of course, does not mean that we cannot make such an offer; but it does mean that the monies necessary to pay for the expansion would need to come out of the regional treasury.

I would encourage the honorable Member to seek an estimate from the Game Moderator with regards to how much such an expansion would cost the region. Depending on how long it takes the GM to prepare such an estimate, we can then either consider it as an amendment to the present bill, or as separate legislation.

Thoughts or questions?

I'll allow a cost estimate to be done and accept separate legislation may need to be drafted. However I will push for keeping the commission in the bill, in order for further improvements to the Fremontian health system to be made in a non-partisan manner.

[Unconditional Surrender Truman]

I'm happy to accept FCACA; will this suffice for a compromise amendment?

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I gave the special commission its own section and tinkered with the word order a bit (for example, putting "former public officials" after "healthcare policy experts" so the bill does not appear to mandate the appointment of "former policy experts"), but I don't think I made any changes to the substance of the proposal. Thoughts?

[Pericles]

Support this.

[Unconditional Surrender Truman]

Seeing no objection, the amendment has been adopted.

[Pericles]

Motion to move to a vote. This bill should be passed as soon as possible, and we shouldn't let the legislative process bog us down and lead to gridlock and a failure to meet the needs of the Fremontian people.

[Unconditional Surrender Truman]

I second the motion.

[Kamala]

We will now move to voting see as there were no objections.

AYE.

[Unconditional Surrender Truman]

AYE!

[Cactus Jack]

AYE

[Pericles]

AYE

[Kamala]

With a vote of 4-0-2 not voting, this bill does pass. It moves to the Prime Minister's desk for further action.

[Unconditional Surrender Truman]

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