Health Care Reform Act

[Backroads]

So... it passed.

[Just_A_Guy]

[Mod hat on for a moment]

Folks, those who know me can probably guess that I'm just itching to put in my two cents' worth on this. However, I do want to stress that the More Good Foundation's stated objectives and policies positively do not allow for the discussion of particular political candidates. I'm not going to close this thread (yet), but please limit discussion to the legislation and the Supreme Court's decision today, without branching out into discussions of the politicians who have supported or opposed the legislation. Also, beware that the moderators will be watching this thread carefully and may elect to close it without further notice.

--JAG

[pam]

As a head moderator I completely back what JAG says.

[Dravin]

As a head moderator I completely back what JAG says.

And she has this:

[Backroads]

I also back what JAG says. I tried to be at to-the-point in beginning the thread.

[skalenfehl]

"The path ahead lies in nullification. States must band together to give the federal government the political equivalent of the middle finger. Resistance must be organized, popularized, and stubbornly implemented as the last, best means of checking the federal government—an institution which historically has not restrained its own powers, as today’s ruling so obviously and alarmingly demonstrates.

Thomas Jefferson once stated that the federal government’s agents should be bound down from mischief by the chains of the Constitution. He was right, but too many have come to believe that a few judges, as part of that same government, are the most appropriate and effective means of binding legislators and bureaucurats within that same government.

This is horribly misguided: questions of constitutionality should ultimately be decided by the many, not the few.

Nullification affords that opportunity."

--Connor Boyack

[Just_A_Guy]

The two big surprises about the decision, IMHO, are a) that Roberts, not Kennedy, was the deciding vote; and b) that ACA was upheld based on Congress' power to tax, rather than Congress' power to regulate interstate commerce. (Well, the fact that it was upheld at all was a nasty shock to a lot of conservatives, myself included.)

The downside to the Court's decision that ACA falls under Congress' taxing power, is that it reinforces the principle that Congress can pretty much tax you for anything it deems politically expedient--for not buying health care or, to resurrect the old conservative saw, for "not buying broccoli". (Congres+s can't make failure to get health insurance a criminal offense, but they can pretty much use their taxing power to bludgeon a citizen into doing whatever behavior Congress deems appropriate.) The upsides are that a) Congress' power under the Interstate Commerce Clause has been seriously called into question--a majority of the Court held that that clause could not justify the individual mandate; b) it will be that much easier to eviscerate the "mandate", because Congress can just tinker with the "penalty" for not buying health care--reduce, or perhaps entirely eliminate that amount--and call it a "tax cut" to boot; and c) it is politically embarrassing for ACA's proponents who, all along, insisted that the ACA was not a tax hike.

The Court also apparently limited ACA in that states who do not want to expand Medicaid/S-CHIP--as ACA insisted that they do--can simply opt out of the expanded Medicaid/S-CHIP provisions without forfeiting their ability to participate in the programs as they existed before ACA was passed. As I recall, a big part of the reason ACA was supposedly going to be "cost-neutral" was because it was anticipated that the state governments, not the feds, would foot the bill for a lot of ACA's provisions. The Court's decision today may well make ACA such a fiscal disaster that Congress will have little choice but to pull the plug. (Liberals will accuse conservatives of sabotaging an otherwise-sound program. Conservatives will reply that the decision merely accelerates a financial Armageddon that was already coming down the tracks.)

Edited June 28, 2012 by Just_A_Guy

[Maureen]

In twenty years people are going to be wondering what all the hullabaloo was all about.

M.

[Echo2002]

I work in the healthcare field. Something needs to be done, but there are so many factors that contribute to the rise of cost in healthcare. A lot of these factors have to do with human error. I don't know that medical care is that out of reach for most Americans. I'm talking about basic care, not specialized care.

Here's some of the waste I've experienced:

Nurses not collecting specimens correctly, nurses need more training in the proper way to collect sample for lab testing. A lot of nurses (notice I did not say all), have no clue about proper collection procedures. Our lab has even made little illustrated directions and written procedures for them but they don't bother to read over them.

Ordering the wrong tests. The most common test I see ordered wrong is the pregnancy test, one test give you a number and the other is just a positive/negative answer. I don't know how many times I've seen the quantitative test ordered when all they needed is a positive or negative answer. We had one patient come through the ER that had 3 pregnancy tests done on her. All of which were negative. Why they did three I don't know, but it was a waste of money.

The over all general health of Americans is poor, due to not eating healthy and lack of physical activity. If people would eat right and exercise we wouldn't be treating as many people with diabetes, hypertension, and other illnesses related to being fat.

It's kind of scary when doctors ask lab employees about how to treat their patient. We've had that happen before. I think they are letting too many people become doctors. A friend of mine that was going through medical school said no one gets kicked out of medical school due to poor grades. They just make them take the classes over again if they fail.

I could say more but I'm beginning to ramble.

[Echo2002]

I forgot to say, one good change has come about, the doctors are going to have to order all their own tests, instead of letting the nurses do it. I think this will alleviate confusion about correct tests to order. Hopefully it will cut down on the number of incorrect tests ordered. I don't know if this new change is due to the healthcare law or not.

[beefche]

JAG, that surprised me too--that it is basically allowed under the taxation of Congress. Which means (to me), that Congress can tax the citizens on anything that is of a political agenda (both Dems and Republicans).

[Echo2002]

Yeah, people who believe they are getting "free" healthcare are going to be upset when they see their taxes increase. Only those people who don't pay taxes will get "free" healthcare. I think this will be another blow to the middle class.

[prisonchaplain]

My greater concern is that religious liberties--especially in relation to abortion--will erode even more quickly.

[Just_A_Guy]

JAG, that surprised me too--that it is basically allowed under the taxation of Congress. Which means (to me), that Congress can tax the citizens on anything that is of a political agenda (both Dems and Republicans).

Precisely. For example, if Party A ever got both houses of Congress and the Presidency, in theory they could pass legislation stating that the fiscal policy of Party B is a clear and present danger to the American way of life, and that every citizen over 21 must either contribute $500 to the Party A National Committee or else pay an additional tax of - say - $1,000. I'm not well-trained in this segment of constitutional law; but it strikes me that the only thing stopping this would be public opinion, not any constitutional provision or SCOTUS interpretation thereof. (There is, I think, a general requirement that the federal government guarantee the states a "republican" form of government; but that still gives the Congresscritters an awful lot of latitude.)

[applepansy]

If this doesn't wake up the sleeping giant I don't know what will.

(I saw the news about this earlier and didn't post because I didn't want to start a political thread. Thank you Backroads.)

[beefche]

I don't know, apple. I think too many Americans only read headlines or listen to soundbites. So, I'm guessing that most only see this as a win of a particular party and helping the poor to receive needed healthcare. I honestly don't think alot of Americans (not all, mind you) look deeper into the actual ruling and think about the implications.

[NightSG]

The most common test I see ordered wrong is the pregnancy test, one test give you a number and the other is just a positive/negative answer.

Wait...so it is possible to be just a little bit pregnant?

[Backroads]

If this doesn't wake up the sleeping giant I don't know what will.

(I saw the news about this earlier and didn't post because I didn't want to start a political thread. Thank you Backroads.)

Just taking one for the team. And wanting see polite comments.

[beefche]

My FB is lighting up with people comments for and against this new ruling. People on both sides are very, very passionate about this.

[Just_A_Guy]

b) it will be that much easier to eviscerate the "mandate", because Congress can just tinker with the "penalty" for not buying health care--reduce, or perhaps entirely eliminate that amount--and call it a "tax cut" to boot;

This just keeps getting better.

Some people are asserting that since repealing the mandate would now legally be a "tax cut", such a move wouldn't be subject to a Senate filibuster. See, e.g., here.

Chief Justice John Roberts may indeed be crazy--crazy like a fox.

Meanwhile, my wife and I have run the numbers. Covering our family would cost about $6K per annum. Our tax penalty for not carrying coverage, by 2016, would still be around $1.5K unless my pay skyrockets in the next four years. Unless I get insanely cheap coverage for work, we'll probably continue to self-insure for the short term at least.

Edited June 28, 2012 by Just_A_Guy

[annewandering]

My FB is lighting up with people comments for and against this new ruling. People on both sides are very, very passionate about this.

And may I add, most have not a clue what they are talking about.

I was very surprised by the decision for about 2 seconds. Then the sniggly thought about why Roberts, of all people, would vote for it slithered into my mind. Going to facebook and the DN's comments confirmed my fear. Ask yourself what is the number one thing you are reading and hearing? TAX. It is all about tax now. I 'wonder' how this might affect the political arena at this point in time?

I was interested in how Roberts read out the decision. Twice he stopped and added comments. Once to say that the decision does NOT say its a good law. Once to say if we want good laws we have to vote in good legislators in November.

It is hard to miss his implication.

[Echo2002]

Wait...so it is possible to be just a little bit pregnant?

lol, no. The number tells the patient how far along she is in her pregnancy.

Of course tumors can also cause a positive pregnancy test.

[Just_A_Guy]

HA! It may not even take Congress to kill this thing.

By the way, since it is a tax and the president has prosecutorial discretion, he can tell the IRS not to collect it, and the mandate goes away. Just saying.

[carlimac]

I wish someone could explain this act and it's implications to me in English...slowly! I've never been very good at understanding politics and government. I think there is a smooth spot in my brain where there should be wrinkles that would retain this info. I've been watching Fox and CNN off and on all day and the only thing I can gather is that a doctor's panel (on FOX) didn't think this was very good for the American people while our current POTUS (on CNN) thinks it's what's best for the American people. And something switched from it being a penalty to a tax? And Roberts is a hero or a villain depending on who you ask. And ...I'm lost! What does any of this have to do with Moi, my checkbook and my ability to get health care? We have good (more or less) insurance through my husband's work. Will that change?

[annewandering]

no it wont change except that they wont be able to cancel you if you have high medical bills. If you are looking for insurance they will not be able to deny you because your dad and six uncles died of cancer. Or you have already had two back surgeries. Or have been diagnosed with cancer. etc.