Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[nenjin]

http://www.cnn.com/2012/03/23/politics/scotus-health-care-preview/index.html?hpt=hp_c1

Most of us go about our daily business never thinking about the U.S. Supreme Court or the cases it decides. But sometimes, it gets a case so big -- and could affect your life so much -- you simply have to take notice. Next week will be one of those times.

The Supreme Court will hear oral arguments and decide on the constitutional legality of Obama's healthcare mandate. Don't know what that is?

...the "individual mandate" ... has sparked the most controversy. It requires nearly every American to purchase some level of insurance or face a tax penalty of up to about $700 a year.

SCOTUS will consider 4 questions:

1. Is the mandate even constitutional?

2. If it is constitutional, is it a "tax?" If it is a form of taxation, the court's ability to rule on the mandate is greatly diminished. That's primarily Congress's job.

3. Can the other parts of the healthcare plan survive if the individual mandate (which pays for a lot of it) is struck down?

4. Who ultimately has the right to decide on the expansion of cooperative medicaid? The Federal Government, or the States?

Even though I voted for the guy and approved of the goals of the healthcare reform, I've been against the individual mandate from the start. For the longest time, I was unemployed, had no insurance and had no place on anyone else's insurance. By choice or by circumstance, I didn't have health insurance. And they want me to penalize me for that? Do they have any idea what it costs to pay a doctor's bill without insurance? Does that money just burst into flames and disappear? Some people can't even afford to pay for the insurance or the registration or the gas or the freaking CAR so they can have a productive life. And now these people should have to walk into an insurance agent's office and hand them money they don't have?

If SCOTUS rules against the mandate and it's the death of Obama's Healthcare plan....so be it. I won't put any other labels on the plan, other than saying I already don't like being compelled to buy things by the government. You already have to have insurance for the privilege to drive, because that's fair to everyone else. But when I'm still paying to go to the hospital whether I have insurance or not....mandatory health insurance feels awfully like being taxed just for breathing, aging and being a mortal flesh bag.

So anyways, as much as I hate to see the rest of the healthcare plan go, I hope they strike it down. (Because it's pretty much the core funding mechanic.) There's plenty of precedent for the government's intrusion into the lives of citizens, but that doesn't mean that the reach of this isn't unprecedented.

(Also, European Bay12ers with your $2000 licensing fees, feel free to chime in.)

[FearfulJesuit]

Getting it struck down, as you say, would probably be a good thing. The question is, will it invalidate future stronger proposals for nationalized healthcare, which we definitely need?

[Sheb]

Wait, isn't the government paying for your insurance if you can't afford it? It seems weird to force people to pay things they can't afford.

Over here (Belgium) health insurance is provided by non-profit groups (At least mostly, dunno if for-profit insurer exist/are legal), that are mostly heir to the 19th centuries worker's co-op. It is mandatory to buy health insurance, but if you can't afford it, the state will pay for it. It works pretty good: everyone got insurance, a level of concurrence between "mutuelles" (as we call our insurers) means you avoid quite a lot of waste. And they are heavily regulated, so they can't do stuff like denying coverage for previous condition or anything. They even pay for your fees if you join a sport club, which I think is pretty cool.

[mainiac]

Even though I voted for the guy and approved of the goals of the healthcare reform, I've been against the individual mandate from the start. For the longest time, I was unemployed, had no insurance and had no place on anyone else's insurance. By choice or by circumstance, I didn't have health insurance. And they want me to penalize me for that? Do they have any idea what it costs to pay a doctor's bill without insurance? Does that money just burst into flames and disappear? Some people can't even afford to pay for the insurance or the registration or the gas or the freaking CAR so they can have a productive life. And now these people should have to walk into an insurance agent's office and hand them money they don't have?

The healthcare bill wasn't written by idiots.  They provided subsidies for people in exactly the sort of situation you describe.  Furthermore there's a decent chance that you would qualify for the exemption.  If the second least expensive plan on your state exchange costs more then 8% of your household's income, your household is exempt (and would probably be covered by medicaid.)

I just wish the ACA covered the rise in blood pressure I get from constantly seeing people be angry at it for doing things that it doesn't actually do.

[Tilla]

It's unfortunate that Republicans and DINOs forced the original bill to be neutered into this monstrosity, honestly it's probably better no bill than what they managed to slip through.

[mainiac]

It's unfortunate that Republicans and DINOs forced the original bill to be neutered into this monstrosity, honestly it's probably better no bill than what they managed to slip through.

Practically every serious health economist disagrees on that point.

Look, it's galling that the individual mandate works the way it does.  No one likes it.  But you need to see that this bill transforms us from a market that does not function as a market to a market where there is at least some competitive forces at play.  If we could replace this bill with medicare for all I would support that in a heartbeat.  But we don't have that option.  Instead we have the option between the bill that will prevent our national bankruptcy and nothing at all for the foreseeable future.

Consider this: http://www.washingtonpost.com/blogs/ezra-klein/post/we-cant-afford-another-18-years-of-health-care-drift/2011/08/25/gIQAXNjLcS_blog.html

Every journey starts with a single step.  If we slap down the only step forward we have taken on healthcare since 1964 then when exactly will we fix this thing?  And it's certainly not the most galling thing out there.  Look at the Bush Medicare part D expansion.  That was a far bigger corporate handout then the mandate and made the market more broken not less.  Go protest that.

[Knight of Fools]

I remember when Obama said that no one would lose their health insurance when 'Obama Care' went into effect.

The day it went into effect? Yeah, I lost my health insurance.

That's not my major beef with it, though. I'm all for the government helping folks out who need it, but forcing them to help themselves is a bit extreme. If someone doesn't want to save up for retirement, or is generally healthy and doesn't want to pay high prices for health insurance, then don't make that person do it.

Having the option? All for it. Having no option whatsoever? Lame.

Problem is, this is a pretty touchy issue. Lots of people are foaming at the mouth in support or opposition to it, and don't see any middle ground between their opinions.

Personally, if the bill dies, I'll be content. I probably won't get any health insurance until I'm older (And richer) because I'm pretty darn healthy, don't have any history of health problems in my family, and don't feel like spending more money for the "just in case" than I would for the actual doctor's bill. I'm frugal enough to save up for a rainy day. Shoveling over money to a company so they might give a portion of it back if I need it (If they want to) seems silly. As it stands, I don't have a choice.

[justinlee999]

I keep on misreading the title of this thread as "SCROTUS"

[zilpin]

I keep on misreading the title of this thread as "SCROTUS"

That's OK.  Unelected life-appointed people in black robes, who consider themselves the final arbiters of liberty, generally deserve it.

By the way, U.S. lawyers & legal students refer to them as "The Supremes".

I prefer SCOTUS.
Much more fitting.

[justinlee999]

Urban dictionary's fun fact on scrotus:
http://www.urbandictionary.com/define.php?term=SCROTUS

The first one.

[mainiac]

I remember when Obama said that no one would lose their health insurance when 'Obama Care' went into effect.

The day it went into effect? Yeah, I lost my health insurance.

Correlation is not causality.  And different parts of the bill came into effect at different times.  You will need a lot more information to make the case that you are implying.

That's not my major beef with it, though. I'm all for the government helping folks out who need it, but forcing them to help themselves is a bit extreme.

The government isn't doing it for your sake.  They are doing it for the community.  It's like how your country doesn't ask you to register for the draft for your sake.  It asks you to register for the draft for the sake of the country. 

The health insurance market in this country does not work.  To make it work we need to ban pre-existing conditions and legislate community rating.  But if we did those things without a mandate, insurance would become unaffordable.  The mandate keeps insurance affordable by avoiding a health insurance death spiral.  A decade back one of the states (Kentucky I think) tried to do these things without the mandate.  It didn't work.

If you want the government to insure the quality and affordability of healthcare you have to pay for it somehow.  Having the government pay for it won't work because the american people keep electing people opposed to that.  This was literally the only other way we know of to foot the bill.  Seriously.  The list of free market systems under consideration consists entirely of the individual mandate.

[Knight of Fools]

If the government really wanted me to do anything good for the community, they'd take my Internet away.

I don't really see the point you're trying to make, though. None of that really proves that we absolutely must, because we have no choice, pay for health care. The draft is necessary for national defense, but health care? Sure, health insurance in the United States is pretty ridiculous and prices are pretty high, but the best way to discourage that kind of behavior is with the free market. Is someone charging too much for a non-essential service? Then don't pay for it. What does the company do then? It either goes out of business because it's ridiculous, or, in the case of health insurance, lobbies the government to make their service seem essential and force everyone to buy it.

I understand car insurance - You're basically guaranteeing that you can pay for the damages you might cause to someone else's car. That's fine. Health insurance is all about the individual (And his/her family), though, so there's no reason to force us to pay for it, especially if it promotes people with a minor case of the cold going to the ER. The health insurance company will have to foot the bill, and if everyone's going to the hospital for their kids' runny noses, someone will have to foot the bill, and that person will be the consumer, whether or not the government pays for it.


If I ever own an orchard, I know what I'll do, though: Lobby the government to make it mandatory to buy apples because they're good for you. Never mind that people don't eat them, or some folks have a personal preference towards pears, vitamin pills, or the Atkin's Diet. I've already got an advertising theme to run with, too.

Apples! Because the law says you have to buy them.

It'll be complete with useful tips on how to make all the apples you don't eat useful. Perfume, fertilizer, entertainment, home defense... The possibilities are endless! Heck, it's a lot more useful than all the health insurance you never use. I mean, can you make a bed out of rotting health insurance?

[Frumple]

... health insurance nowadays is pretty much essential; yeah, you're a lucky SoB Knight, but luck is literally the only thing standing between you and bankruptcy or years and years of medical debt. Unless you've got a good 20k+ USD sitting in the bank, just in case.

And the people that don't have health insurance and something fraks up and they end up in the emergency room without the ability to pay for it? Guess who pays for that~

Health insurance really is kinda' like car insurance, because what happens when a person gets sick and can't pay is that either the medical provider sucks it up (which reduces quality, a net penalty for the community relying on that provider) or the taxpayers get saddled with the cost, either directly or indirectly.

Now, you could be advocating that we just let sick people who can't pay just, yanno', die off or be permanently crippled or whatev' but medical practitioners are supposed to swear that little oath (that we really want them swearing) that says they have to help those that come to them. Like you said, cost goes somewhere, so we might as well have folks paying ahead for a cost they're almost certainly going to accrue at some point.

[Bauglir]

Like car insurance, your health insurance affects others, too. Hospitals are legally required to treat patients with immediately life-threatening problems, even if they have no ability to pay and have no insurance. As a consequence, they have to offload the cost of patients who can't pay onto patients who can, making the system largely worse for everyone (the patient who can't pay has to deal with the legal work of proving they can't and the stress of trying to make whatever payments they can, remember). The money still has to come from somewhere.

I mean, I'd prefer an entirely publicly funded version in which your insurance is drawn from your taxes, because that spreads payments out to relatively tiny packets that can be anticipated and budgeted around for everyone, rather than being a single unexpected "Oh shit" that's likely to happen to everybody sooner or later. I also like to think it'd encourage people to use the system more often, since they're already paying for it, and that would also reduce the cost of the system overall (as any professional will tell you, prophylaxis is almost always cheaper than a cure, and also typically more pleasant to the patient). But that's probably implausible given today's political climate, which seems to care more about arbitrary and self-centered definitions of fairness than it does about actual results. That's not aimed at you, by the way, but is a far more general claim with plenty of exceptions (because there are likely other reasons to oppose it besides that).

[RabblerouserGT]

I don't want to be forced to buy insurance. Not a fan of that.


As for the constitutional bit, I'm a bit confused, though. We're already sort of being forced to buy insurance.
Car insurance, that is. If you drive a car, it's illegal to drive without insurance.