Proposed 2008 National
Health Care Modernization Act

This proposed Act is in two parts:

Part I - Establish the National Health Care Commission

The proposed Act requires such Commission to do the following, using the National Health Care Blue Book as its guide:

1. Establish and maintain the National Health Care Standards and Guidelines.
   
   
2. Establish and supervise the National Health Care Economic Model.
   
   
3. Establish and manage the National Health Care Administration  Corporation.
   
   
4. Annually recommend to Congress the following:
   1. Blue Book changes
   2. Economic Model changes
   3. Administrative changes
   4. Other Health Care changes such as
      1. Rationing of health care or service (as set forth in guidelines)
      2. Globalized Rx prices
      3. New economic logic as relates to the recovery of Rx research costs
      4. Changes in health care practices (practice of pharmacy and practice of nursing as an extension of the practice of medicine, e.g.).

The National Health Care Blue Book originates from and is modified as follows:

1. Recommendations to the Commission by any and all interested parties
   
   
2. Recommendations by  the Commission to Congress including suggested regulations
   
   
3. Departmental regulations.

Part II - Directed Legislation

Congress shall initially legislate the following:

1. Each state is strongly encouraged to enact a play-or-pay law where a minimum schedule of benefits is mandated. Failure for a state to enact such law would result in some federal punitive action such as the reduction in Medicaid funding which is federally-provided. Such minimum benefit shall be an HDHP with an annual maximum per covered person of $ x, adjusted for inflation; such benefit may be offered as an option; participant costs are 100%-paid by plan sponsor; covered dependent costs are shared.
   
   
2. The Blue Book shows those health conditions that will be treated in the same manner as ESRD; in exchange therefore, plan sponsors will pay a Medicare surtax of y %. Examples include serious trauma and organ transplants.
   
   
3. Any plan sponsor contributions to provide secondary benefits to any health care plan (including Medicare) shall be taxable to the beneficiary.
   
   
4. Rx benefits offered by a PBM (i.e., plastic card plan) must be offered only as a freestanding plan.
   
   
5. All plan contributions must be z % annually expended as claims, claims-related expenses or claim reserves. Amounts in excess of this threshold shall not be tax-deductible.
   
   
6. Coverage Accessibility Changes
   Three changes to existing laws which would expand coverage accessibility are as follows:
   1. Association Health Plans should be permitted.
   2. Employer-sponsored, workplace-based, employee pay-all health plans should be treated as ERISA-governed plans.
   3. Self-funded death benefits should receive IRC § 101(a) tax advantages if provided through any trust, and not just an IRC § 501(c)(9) trust.