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V338 - Health Bill 2010 Watch

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    As many are of the opinion, Aye
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    Please note the commencement section has changed between Third Reading and vote.

    B338 - Health Bill 2010, Government
    An Act to reduce healthcare burden on the government in the United Kingdom, cutting the most regressive taxes and subsidising healthcare insurance for the poorest to ensure a universal healthcare system remains, while giving people the freedom to choose how they spend their own money.

    BE IT ENACTED by The Queen's most Excellent Majesty, by and with the advice and consent of the Commons in this present Parliament assembled, in accordance with the provisions of the Parliament Acts 1911 and 1949, and by the authority of the same, as follows:

    1 Sale of NHS Assets
    (1) The National Health Service Act 2006 (c.41) is hereby repealed.
    (2) The following quasi-autonomous non-governmental organisations (QUANGOs) are hereby disbanded:
    (a) National Patient Safety Agency
    (b) The Independent Reconfiguration Panel
    (c) National Treatment Agency
    (d) Connecting for Health
    (e) NHS Appointments Commission
    (f) The NHS Litigation Authority
    (3) The NHS Asset Allocation Commission shall be set up and;
    (a) It shall decide the best way of grouping NHS assets for sale.
    (b) It shall make sure no more than 20% of any type of asset is owned by one company.
    (4) The NHS Asset Allocation Commission shall sell NHS assets with the following objectives:
    (i) Maximise revenue from the sale of assets.
    (ii) Enable competition by different health providers.
    (iii) Minimise disruption from the transition of provision of health services to private individuals and companies.
    (5) The NHS Asset Allocation committee shall report to the Health select committee every 6 months until the completion of the process.
    (6) Once the process of the sale of NHS assets is complete, the NHS Asset Allocation Committee shall be disbanded.

    2 Medical Savings Accounts
    (1) Each person aged 16 years and above shall have a medical savings account (MSA); and
    (2) Each person shall save a portion of their earnings into this account according to Schedule 1.
    (3) Money in an MSA may only be used for spending on Health Services.
    (4) For the purposes of this Act, "Health Services" are defined as "All services dealing with the diagnosis and treatment of disease, or the promotion, maintenance and restoration of health; all medicines (as designated by the Medicines and Healthcare products Regulatory Agency) designed for the treatment or prevention of a disease; all dental care (including cosmetic); cosmetic surgery, and care for the elderly."
    (5) In the case where a person contributes less than the amounts as set out in Schedule 2 in any given tax year, the government shall top it up to this level.
    (6) In the case that a person has saved the amount as set out in Schedule 3 that tax year, they are not obliged to save more money to their MSA that tax year.
    (7) People may transfer responsibility of their Medical Savings Account to another person or organisation; and
    (8) In the case that responsibility has been transferred, money in the MSA can be spent only on the original owner of that MSA.

    3 Insurance & Risk Equalisation
    (1) It shall be mandatory to purchase catastrophe health insurance.
    (2) In the case that someone does not have catastrophe insurance cover, they are liable to a fine of up to £2000; and
    (a) Any fine imposed shall take into account ability to pay.
    (b) Courts may order community service instead of a fine in the case of those unwilling or unable to pay.
    (c) Courts may pardon someone in exceptional circumstances, including but not limited to poverty.
    (3) Catastrophe health insurance is defined for the purposes of this bill as "Insurance, with a very high deductible, covering an injury or illness with medical expenses that are above the normal parameters of basic health cover."
    (4) A risk equalisation pool shall be created and operated by the Department for Health; and
    (5) It shall be used to equalise risk through "risk taxes" and "risk subsidies" including, but not limited to the following factors:
    (a) Gender
    (b) Health Status
    (c) Age
    (d) Socio-economic Status
    (6) A price level will be determined for a decent level of catastrophe insurance by the Department of Health and this shall be added to the basket of goods covered by the Poverty Abolition Act.

    4 Insurance Claims & Arbitration
    (1) It is the responsibility of the health company, not the patient to claim for the cost under health insurance.
    (2) No hospital shall be permitted to refuse inpatient care to anyone on the grounds of a lack of health insurance.
    (3) Hospitals shall be permitted to use the courts in order to extract payment in the case of someone not having health insurance.
    (4) The Court of Health Arbitration shall be set up and shall arbitrate in the following circumstances:
    (a) Ordering payment where an individual does not have catastrophe health insurance.
    (b) Ordering payment where an insurance company refuses to pay the health services company.
    (5) The Court of Health Arbitration shall use the same criteria as set out in Section 3.2.a, 3.2.b and 3.2.c of this Act when ordering payment where the person does not have health insurance.
    (6) In the case that the court orders that an individual or insurance company is not liable to the full cost of their treatment, the government shall pay the health company the remaining cost directly.

    5 Information Dissemination
    (1) Department for Health shall publish the 50th and 90th percentile bill size for a range of treatments by different companies annually.
    (2) Department for Health shall publish risk-adjusted survival rates for a range of diseases as treated by different companies annually.
    (3) The information contained within sections 4(1) and 4(2) of this Act shall be available on the Department for Health website.
    (4) The fact that catastrophe insurance is mandatory, and the relevant sanctions shall be advertised on TV, radio and billboards by the Department of Health.

    6 Abolition of Council Tax
    (1) Local Government Finance Act 1992 (c.14) is hereby repealed; and
    (a) any shortfall in tax revenue due to this shall be met by central government funding to councils.

    7 Reduction in VAT
    (1) In section 2(1) of Value Added Tax Act 1994 (rate of VAT), for “20 per cent” substitute “15 per cent”.
    (2) Sections 1(6) and 1(7) of Federal Act 2010 (Funding) are hereby repealed.

    8 Reduction in Alcohol Duties
    (1) Alcohol Liquor Duties Act 1979 is amended as follows:
    (2) In section 5 (rate of duty on spirits), for “£23.80” substitute “£11.90”.
    (3) In section 36(1AA)(a) (standard rate of duty on beer), for “£17.32” substitute “£8.66”.
    (4) In section 62(1A) (rates of duty on cider)—
    (a) in paragraph (a) (rate of duty per hectolitre in the case of sparkling cider of a strength exceeding 5.5 per cent), for “£217.83” substitute “£108.96”,
    (b) in paragraph (b) (rate of duty per hectolitre in the case of cider of a strength exceeding 7.5 per cent which is not sparkling cider), for “£54.04” substitute “£27.02”, and
    (c) in paragraph (c) (rate of duty per hectolitre in any other case), for “£36.01” substitute “£18.00”.
    (5) In section 62(1A) (as amended by subsection (4))—
    (a) in paragraph (b), for “£25.11” substitute “£12.55”, and
    (b) in paragraph (c), for “£16.73” substitute “£8.36”.
    (6) For the table in Schedule 1 substitute—


    9 Reduction in Tobacco Duties
    (1) For the table in Schedule 1 to Tobacco Products Duties Act 1979 substitute—


    10 Reduction In Income Tax
    (1) In section 3.1 of the Poverty Abolition Act 2009 for "thirty-seven" substitute "thirty-two and a half".

    11 Commencement
    (1) Sections 1.3, 1.4. 1.5 and 1.6 of this Act shall come into force on the day upon which this Act has been passed.
    (2) All other provisions contained within this Act shall come into force on the upon which the process set out in section 1.4 has been completed.

    12 Short Title
    (1) Upon receipt of Royal Assent this Act may be cited as the Health Act 2010

    Schedule 1
    Those aged 16 to 35 years: 6.5%
    Those aged 35 to 45 years: 7.5%
    Those aged 45 to 60 years: 8.5%
    Those aged 60 years and above: 9%

    Schedule 2
    Those aged 16 to 35 years: £1250
    Those aged 35 to 45 years: £1500
    Those aged 45 to 60 years: £1650
    Those aged 60 years and above: £1750

    Schedule 3
    Those aged 16 to 35 years: £2500
    Those aged 35 to 45 years: £3000
    Those aged 45 to 60 years: £3300
    Those aged 60 years and above: £3500

    The Short VersionThis bill replaces the NHS with a system of Medical Savings Accounts that people can use to spend on any Health Services, and risk equalised, compulsory catastrophe health insurance, to cover costs that are exceptional (due to an accident), or large bills. The money for catastrophe health insurance is provided for by extra payments through the PAA, and medical savings accounts are topped up for the poorer in society.

    The money saved then goes into a package of tax cuts. This is a program designed to both reduce the cost of living for the poorest, to reduce health externality taxes, since the externality is now internalised, and to let those working keep more of their money. It takes VAT down to 15%, which will help the poorest. Likewise the scrapping of council tax is a huge burden off the shoulders of the poor. We have halved all alcohol and tobacco duties, since government spending on health is around halved, and we have reduced income tax by 4.5p in the pound to a new rate of 32.5%.

    Changes For Second ReadingA couple, some SPAG. Then, I've split off Section 4 and changes that a bit, meaning there is now a Court of Health Arbitration to deal with non-payment by insurance companies and expands on the case where the individual has failed to purchase health insurance.

    I've also put in another variable to equalise risk on, since I thought it might be relevant, socio-economic status. It should be noted that risk equalisation is not limited to those four factors, but must include them.

    Changes For Third ReadingNot much here, just two things. On the reduction of VAT which now abolishes Federal Saes Tax from when the Federal Act would have come into play.

    The second thing is the change of the criteria that the NHS Asset Allocation Committee would use to sell off assets. It now takes into account disruption to services and competition concerns in the allocation of assets, not just revenue. Further to that, I've fleshed this out a bit with some detail on how often the committee reports to parliament, and set out that it shall no longer exist once it's done it's job.


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    What he said ^^
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    A difficult decision.
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    I believe that I supported this as well so will continue to do so. Agreeing with the government on this and their new amendment, I think I have to sit down for a minute .
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    The fundamental problems with this bill have not been altered throughout the readings, and while i appreciate the amount of time spent on this bill, i have to vote against it.
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    As the primary author (obviously with contributions from various people throughout its creation & development) I shall of course be voting Aye.
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    I only have had time to skim this, but about this part:

    medical savings accounts are topped up for the poorer in society.
    I imagine this would be part of the budget. I only have skimmed it so forgive me if the answer is in the bill, but say the government pays into the poorer accounts, how much would be set aside nationally for this?

    As far as the government topping up said accounts for the poor, where does the government draw the line in that sense?

    What if someone who is middle class/lower middle class can afford to pay into their account but doesn't want to because they prefer the current health system?

    What is the difference between a middle class persons contribution to the NHS from their tax and what they would be contributing from a section of their pay packet?

    That's all I can do for now.
    Again apologies if those answers are in the bill, I haven't had enough time to read it.
    I know I should have asked these in the readings but I haven't had time to read the entirity of any of the readings.
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    (Original post by thunder_chunky)
    I only have had time to skim this, but about this part:



    I imagine this would be part of the budget. I only have skimmed it so forgive me if the answer is in the bill, but say the government pays into the poorer accounts, how much would be set aside nationally for this?

    As far as the government topping up said accounts for the poor, where does the government draw the line in that sense?

    What if someone who is middle class/lower middle class can afford to pay into their account but doesn't want to because they prefer the current health system?

    What is the difference between a middle class persons contribution to the NHS from their tax and what they would be contributing from a section of their pay packet?

    That's all I can do for now.
    Again apologies if those answers are in the bill, I haven't had enough time to read it.
    I know I should have asked these in the readings but I haven't had time to read the entirity of any of the readings.
    It's taken automatically as a portion of wages (varying with age, as set out in Schedule 3) into their own medical savings account, in that respect it acts somewhat like a tax - but it is then theirs to spend with whichever provider they wish. The government tops up to the amount in Schedule 1 for any given year, so it is dependent on there not being enough saved through the contribution.

    The total government health spend on this should be around £60bn, about half of the current health budget, of that, £42bn is from topping up MSA accounts and £18bn is for catastrophe insurance through the PAA. The reason that taxes can be cut by seemingly more than that it because there was an element of tax churn before, in that because the PAA is determined by the prices of goods, taxes on spending increased the amount government had to pay out, to then get it back in those taxes. Reducing VAT, for example, means those prices are good, and although the government gets less back, it also has to pay less out in PAA payments.

    As for contributions to health, well, I did a calculation for one person here: http://www.thestudentroom.co.uk/show...8&postcount=47

    I hope that answers your questions with regards how the Bill works. For the bits you've asked about, Section 2 and the three Schedules are the bits to answer your questions in Bill form.
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    Is it me or did the Prime Minister abstain against his own government's Bill?
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    (Original post by Stricof)
    Is it me or did the Prime Minister abstain against his own government's Bill?
    Well spotted.
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    (Original post by Stricof)
    Is it me or did the Prime Minister abstain against his own government's Bill?
    Yes.

    And?

    We don't whip in government, members of it are free to vote as they wish.
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    In the interests of the nation and the people I vote nay triumphantly!
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    (Original post by simontinsley)
    Yes.

    And?

    We don't whip in government, members of it are free to vote as they wish.
    Yes, but you would have thought that the prime minister would have voted for his own government's Bill. Shame that there isn't a rule here about ministers who vote against government Bills being sacked as may happen to some Lib Dem ministers in the coalition with the tuition fee rises.
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    I believe that the NHS is an important aspect of Great Britain. Although I do believe it needs reform the conditions set out by this bill would, I believe, not be in the interests of the British people.
    With “catastrophe health insurance,” what would happen if one cannot afford this? It is wrong that then they are fined but the fine is conditional on ones ability to pay when of course if they have a reduced fine because they cannot pay then surely this would apply to the health insurance?

    Therefore at the moment I am leaning towards a nay
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    (Original post by jakemittle)
    Therefore at the moment I am leaning towards a nay
    Please do so. This Bill is totally idealogical and is not in the interests of the people.
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    (Original post by jakemittle)
    I believe that the NHS is an important aspect of Great Britain. Although I do believe it needs reform the conditions set out by this bill would, I believe, not be in the interests of the British people.
    With “catastrophe health insurance,” what would happen if one cannot afford this? It is wrong that then they are fined but the fine is conditional on ones ability to pay when of course if they have a reduced fine because they cannot pay then surely this would apply to the health insurance?

    Therefore at the moment I am leaning towards a nay
    One is [i]given/i] the money to buy it, as set out in section 3.6. To then argue that anyone cannot afford something they have been given the money to purchase is impossible at best, and so therefore that renders the rest of the point invalid.
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    (Original post by simontinsley)
    One is [i]given/i] the money to buy it, as set out in section 3.6. To then argue that anyone cannot afford something they have been given the money to purchase is impossible at best, and so therefore that renders the rest of the point invalid.
    Does it?
    What are the conditions of having an insurance paid for? and I imagine it would be progressive?
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    Although I am an Orange Booker, this is the one part of the book I was not fully sold on. I think this far too radical, I also believe that public opinion is strongly against this bill.
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    (Original post by jakemittle)
    Does it?
    What are the conditions of having an insurance paid for? and I imagine it would be progressive?
    There is no condition. It is added to the goods on the PAA list, and thus the money for it comes through, with that, to everyone, regardless of circumstance.
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    (Original post by spidergareth)
    Although I am an Orange Booker, this is the one part of the book I was not fully sold on. I think this far too radical, I also believe that public opinion is strongly against this bill.
    The first bit, fair enough - I do wonder what your qualms with it are, though.

    The second bit - well, it is true, but is that a reason? Public opinion also believes we should give no international aid, slash immigration, leave the EU, reintroduce capital punishment and so forth. There's a reason we have representative democracy, not direct.
 
 
 
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