Previously, this requirement had applied only to self-insured plans, but come the New Year, it was to apply to all non-grandfathered plans.

Just a few days before Christmas, however, the Internal Revenue Service (IRS) announced that it would not be enforcing this nondiscrimination provision, as it is called, nor levying fines. Instead, it would commence a public commentary period running through March 11, 2011.

The agency added that the provision would still be enacted at a future date, but at the start of the next insurance plan year (effectively Jan. 1, 2012, for most companies).

Employers, keep your workforces informed of relevant provisions and obligations of PPACA by purchasing and posting Personnel Concepts’ Health Care Reform Employee Information Poster.

This Final Rule takes effect Sept. 23, but it breaks little ground from the sweeping PPACA legislation other than to clarify certain provisions and mandates.

The Bill of Rights establishes that children 19 and younger cannot be denied either coverage or treatment for pre-existing conditions; health coverage once in place cannot be rescinded except in cases of applicant fraud; no lifetime limit can be set on health insurance payments; annual caps on insurance expenditures will be phased out completely by 2014; patients are free to choose their primary-care physician without restriction; and extra fees for out-of-network emergency services are barred.

Though some provisions do not apply to grandfathered policies, most take effect on Sept. 23, or on Jan. 1, 2011, when annual plan policies commencing on that date kick in.

The acceptable annual limits on health insurance expenditures (aka "essential health benefits," a term that is yet to be defined) were clarified from PPACA as being $750,000 as of Sept. 23, 2010, $1.2 million as of Sept. 23, 2011, and $2 million as of Sept. 23, 2012, for both group and individual plans. After Jan. 1, 2014, the cap is dropped and outlays become open-ended.

As of 2014, all exclusions and pre-emptions based on pre-existing conditions are outlawed.

Employers, you can easily keep your workforces informed of these new benefits and protections by acquiring and posting Personnel Concepts’ Health Care Reform Employment Information Poster. Get your copy today.

Now, as with other federal laws and regulations, states generally feel free to write more stringent rules that supersede national counterparts, so it remains to be seen if this happens with chain restaurant regulations and the known devil gets supplanted by an unknown version.

The new law tasks the Food and Drug Administration (FDA) with drawing up implementing regulations (which could take months or even a year or more given the track record on federal regulations). Stay tuned.

Meanwhile, restaurant owners can meet many other federal notification requirements by purchasing and posting Personnel Concepts’ Space Saver-3 All-On-One Foodservice Safety Poster.

Gee, once health care in America becomes subsidized at age 65, people flock to their doctors. What does that portend for our health care costs when Obama’s “public option” starts signing people up?

It doesn’t take a genius to figure out that costs will skyrocket out of control (which says a lot about the level of intelligence of those in the White House and the left side of the aisle in Congress).

I hope those making $250,000 and above won’t mind paying for all of this. (Another great farce and illusion in the whole argument, but I’ll save the topic for another time.)

Actually, there’s not much difference in the two, but Baucus reveals some juicy details about how the Obamacrats intend to enforce rationing of health care (which they still won’t admit is on the table, but they cloak it under the concept of “clinical (read: cost) effectiveness”).

In envisioning a Health Fed to run the nation’s doctors and hospitals (modeled after the Federal Reserve in both its overweening power and its so-called political independence), Baucus proposes a $10,000 fine for each instance of “medically improper or unnecessary care.”

Now, about that hip replacement you wanted to get after the age of 60, forget it. It’s unnecessary since you won’t be able to work long enough to justify the expense. (This is actually the policy in Great Britain.)

To paraphrase Al Davis, “Just suffer, baby.”

That’s why I get a good laugh everytime I read the results of a new survey. The one I came across today from the Kaiser Family Foundation and Harvard University is full of comments by everyday Janes and Joes who pine for “affordable health care.”

Now, while I sympathize with these people’s plights (I struggle too in the health care battles) and agree with the concept of affordable health care, anybody who thinks we can add 50 million to the rolls of the insured while reducing the cost of health care is seriously delusional.

The only way to do that–and this is the dirty secret and dirty word that no politician in D.C. will ever admit to or utter–is to ration health care. You know, get on a waiting list a year in advance for your next physical, or even flu shot. Then, if you’re lucky, your number may be called.

There’s another way, but it will lead to the same result as the pool of doctors shrinks up: Socialize everything and put doctors on a salary.

The biggest problem with health care as it exists in the U.S. is the payment system. Doctors perform a procedure and get paid for it from a list of payable procedures, so they try to maximize their income by performing as many procedures as possible–whether necessary or not. You’ve been through this with car mechanics no doubt: You take your car in for brakes, and suddenly five other problems are found.

So, the reality is that there really isn’t a health care system in the U.S. There is a sick care system. Very few people go to the doctor until a problem develops, so doctors have become car mechanics for the body. Which makes them very wealthy since the vast majority of Americans abuse their bodies through their diets and life-styles and are constantly in and out of doctors’ offices for maintenance of high blood pressure, diabetes, digestive problems and so on.

Now, if someone can find a middle ground between rationing and socializing, please step forward. The nearest middle ground I can think of, and it has its own set of flaws, is the Kaiser concept, in which everything you need (barring major surgery) is housed in one building and everyone is on a salary.

However, what are the odds that the D.C. brainiacs will do anything except expand Medicare and Medicaid until they squish the private insurance companies out of business? Since these two federal programs are the masters at pay-per-procedure, that leaves us stranded with the rationing option.

If Las Vegas offered odds on which direction so-called health-care reform will take over the long haul, I’d wager everything on the Medicare-Medicaid bureaucratic trump card. Can’t go wrong betting on business as usual in the nation’s capital.

The PDA folk claim that, by just extending Medicare to all Americans (thereby jettisoning, one would presume, all other current health care delivery systems), the country could–bugles blaring, drums rolling–create 2,613,495 million new, permanent, good-paying jobs; boost the economy by $317 billion in increased business and public revenues; add $100 billion in employee compensation; and infuse public budgets with $44 billion in new tax revenues.

First, as for these “new, permanent, good-paying jobs,” you don’t just pick up doctors, nurses or skilled technicians off the street, and just about every study out there shows that there is already a complete dearth of these professionals to suddenly cover the estimated 47 million Americans who lack health insurance. In Massachusetts, under its new so-called universal health care plan, most of the newly insured can’t find a doctor–and can’t afford the premiums (which the state has found itself paying or subsidizing).

But what is most disturbing about this proclamation of health heaven just over the horizon is the disingenuous financing figures–just $44 billion (or $63 billion–the distinction between these figures is not entirely clear) more than what is currently being spent on health care in America, and you get this single-payer nirvana.

Sounds like a bargain, huh? Problem is, the PDA people never say how the government will transfer the other $2.1 trillion (yes, with a T) being spent yearly on the current, mostly private system, a sum which includes insurance premiums, co-pays, deductibles, out-of-pocket expenses, and so on.

The group’s obvious point is, “How could anyone object to spending about $44 (or $63) billion when we’ve bailed out all those banking, stock market and mortgage sleazeballs for several hundred billion?”

It would be hard to so object if it were the only factor, but it would be harder still to find a way to transfer the current $2.1 trillion being spent on health care. Remember, a lot of that money is money that taxpayers are paying themselves–and which they don’t want to pay under any so-called “health care reform.” The public wants out-of-pocket expenses to disappear, and then to be able to walk into any doctor’s office on whim and get treated–without any inconvenience, waiting time or personal money spent.

The public, in short, wants a pipe dream, and sites like this, which make insuring the whole country seem like it costs less than one day in Iraq, only contribute to the daydreaming American public’s fantasies.

As the PDA site proclaims, this $63 billion–they waffle back and forth with $44 billion–is one-sixth the size of the bailout for CitiGroup and half the bailout size for AIG.

Unless my math (and PC calculator) are faulty, if you divide $2.1 trillion by 300 million people, that comes out at $7,000 per person each year. Hardly free–and certainly a lot more than $66 billion, or $220 per person per year. Hell, I’ll write a check for $220 now if I can get that seamless, faultless health care system everyone dreams of.

Unfortunately, this being the real world, it’ll cost each of us $6,780 more a year–and that’s just to get Medicare.

Wrong for all kinds of obvious reasons, most notable of which is that either you or your employer is going to have to pay for your coverage–unless you qualify under a government program because of age, disability or low income.

However, one savvy professor of health policy (and attorney) writing for the New England Journal of Medicine has figured out a quick and simple method that will provide health care for all without a huge national bureaucracy. In fact, this health care delivery vehicle already exists.

It’s called–hold the drum rolls please–Medicaid.

I can sense shivvers going up and down everyone’s spine just upon hearing the word, which bespeaks poverty and welfare. However, it could be aptly renamed and expanded at the same time. MediCure is available, as is MedAdvantage and all kinds of nifty titles.

Anyway, this is an idea that’s so sensible and easy to implement that no one in Washington, D.C., would ever consider it. After all, the whole point of health care reform is to create legions of bureaucrats (read: the politicians’ cronies and supporters) and put them into lifetime sinecures.

(One compelling, negative factor in Medicaid, as the author admits in his proposal, is its low payment schedule for doctors. In fact, many doctors refuse to accept Medicaid patients, forcing them to rely on emergency rooms, as the American Enterprise Institute points out.)

I strongly suggest reading “Medicaid and the Path to National Health Insurance” by Michael Sparer, Ph.D. and J.D. His plan cuts to the quick and solves a zillion problems in one stroke.

Problem is, practicality has nothing to do with politics. Money and power do.

John McCain (R-AZ) $2,799,156
Barack Obama (D-IL) $2,184,670
Chris Dodd (D-CT) $2,138,446
Earl Pomeroy (Blue Dog-ND) $1,735,356
Charlie Rangel (D-NY) $1,346,785
Ben Nelson (D-NE) $1,185,299
Max Baucus (D-MT) $1,171,363
Joe Lieberman (I-CT) $1,033,802
Arlen Specter (R-PA) $1,007,130
Chuck Schumer (D-NY) $943,400
Mitch McConnell (R-KY) $918,007

Said author also reports that, since 1990, insurers have donated $309,549,407, 63% of it to Republicans. Interesting since most of the people on the top-ten list are Democrats.

I’ll take this guy’s word for it even though he didn’t list any sources for this information. On its surface, the list does appear accurate, name-wise anyway.

The problem with all announced reform plans is that the reformers want to make health both more affordable and more accessible, but if you roll in another 50 million people into the ranks of the insured, the first problem is that there simply aren’t enough facilities or practitioners to handle them. So something has to give–either on the accessible side or the affordable side, or both.

Which is exactly what happened in Massachusetts–both goals got trampled under weight of the unrealistic expectations and bad modeling.

You don’t have to believe me. Fortunately, there are well-respected health care professionals who can dissect the Massachusetts mess for us. Enter Maggie Mahar, author of the 2006 book Money-Driven Medicine, and blogger at Health Beat.

I’ll provide a link to her article on Massachusetts at the end of this, but let me repeat a few points she makes.

Under the Massachusetts universal health care initiative, the percentage of uninsured in 2006 (when it was passed) fell from 6.4 to 5.7 the next year, roughly equal to the rate in the year 2000 (5.9 percent). Fewer than 500,000 Massachusetts residents are now covered who weren’t before.

Problem is, most of them can’t find a doctor and, if they’re using a state health plan, can’t afford the co-pays (20 percent) or the deductibles ($2,000 per person). That’s why use of emergency rooms is up 40 percent in Massachusetts. If you already have a doctor, the wait to see him or her has gone from an average of one month to two months since 2006–and is rising.

Plus, the plans the state offers are so expensive–about $9,000 a year for a couple in their 50s (plus the onerous co-pays and deductibles)–that tens of thousands can’t afford the policies, so the state has “exempted” 62,000 residents from the mandate to buy health insurance. Plus, the program is so costly that the state can’t afford to subsidize people who can’t pay even when they qualify under income qualification standards.

Like I said, it’s a real mess, which will soon be transplanted onto the national stage. Get ready for less (health care) for more (money).

Read Ms. Mahar’s article, “On Health Care Reform Stimulating the Economy: The Massachusetts Example.”