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Posted by Gunnar Emilsson (+18345) 10 years ago
That's what I'm feeling, as the U.S. Supreme Court listens to arguments that Congress lacks authority under the Commerce Clause of the Constitution to require individuals to get health insurance.

It would seem to be a pretty simple matter based on previous court decisions that settled this issue in 1942, but nothing is certain with the Roberts court. I will make a bold prediction: The Supremes will rule against the Commerce Clause by a 5-4 decision.

What's next for the Supremes to roll back? I'm thinking they will re-visit the Dred Scott decision, and suddenly African Americans will find their vote is worth 3/5 of a Caucasian's vote (although re-visiting Dred Scott might cause Clarence Thomas to finally grow a pair).
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Posted by Bob Netherton II (+1908) 10 years ago
Wrong, Gunnar! Roe v Wade is next. THEN Dred Scott.
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Posted by Buck Showalter (+4452) 10 years ago
I heard they'll quit after suffrage.
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Posted by Richard Bonine, Jr. (+15405) 10 years ago
5 reasons ObamaCare is already good for you

Read more: http://www.foxnews.com/op...z1qQ6o4pUV

This week, the nine Justices of the Supreme Court have been listening to oral arguments about the constitutionality of the Patient Protection and Affordable Care Act.
According to polls, 56% of Americans favor repealing the health care reform law. Then again, a decision on fundamental rights and constitutionality should not be a popularity contest. What's more, according another poll, 1 in 7 Americans believes the Supreme Court has already repealed the Affordable Care Act. So much for polling.

How's about, instead, we look at some facts:

1. Millions of Americans have already benefited from ObamaCare

In 2011, an estimated 86 million Americans used provisions in the Affordable Care Act to get preventative care through their insurance plans, care that insurance companies previously subjected to co-pays or deductibles but now must provide for free. Over 2.5 million seniors have saved an estimated $1.5 billion thanks to prescription drug discounts included in health care reform.
At least 2.5 million young people now can stay on their parents' health insurance until age 26. And 4 million small businesses can now claim a tax deduction for providing health insurance to their employees, which so far over a quarter-million small businesses have claimed, providing insurance for 2 million workers.

2. The law won't fully take effect until 2014

It's amazing all the pre-emptive attacks on a law that, for the most part, hasn't gone into effect yet. You can check out this timeline of the various provisions of the Affordable Care Act and when they will take effect.

The controversial "individual mandate" at the center of the Supreme Court arguments this week doesn't kick in until 2014. What this means is that the cost containment provisions in the Affordable Care Act haven't gone into effect yet either, and meanwhile critics are attacking the law based largely on hypothetical future predictions.

In fact, on Monday, the Supreme Court considered whether interest groups or individuals can file suit against a provision in the law that hasn't even been enforced yet.

3. The individual mandate was originally a Republican idea.

Recently, President Obama's senior adviser David Plouffe called Republican presidential candidate Mitt Romney "the godfather of the individual mandate." At a GOP primary debate in 2011, Romney said, "We got the idea of an individual mandate.from [Newt Gingrich], and [Newt] got it from the Heritage Foundation."

In fact, the idea of requiring businesses or individuals to provide and pay for health insurance traces at least as far back as Richard Nixon, who in 1974 proposed a mandate that "every employer would be required to offer all full-time employees the Comprehensive Health Insurance Plan," the insurance plan Nixon was pushing.

In 1989, Stuart Butler of the Heritage Foundation shifted the conservative frame from an employer mandate to an individual mandate, writing:

If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services-even if that means more prudent citizens end up paying the tab.. A mandate on households certainly would force those with adequate means to obtain insurance protection, which would end the problem of middle-class "free riders" on society's sense of obligation.
Incidentally, Butler has recently tried to renounce his invention of the individual mandate, but it appears to me that his reasoning reads something like, "I was for it when it was a Republican idea and am against it now that Democrats embraced it."

4. The Congressional Budget Office recently cut health care reform's cost estimates.

Conservatives have relied on apples-to-oranges accounting gimmicks to suggest the Congressional Budget Office (CBO) recently doubled the cost estimates for the Affordable Care Act.
In fact, the CBO adjusted its estimates to say the Affordable Care Act will cost less than originally projected. Moreover, the CBO has said that repealing the Affordable Care Act would increase the deficit by $210 billion.

5. Something had to be done about health care

The fact is, almost three-quarters of Americans saw health care reform as an urgent priority in the fall of 2009. President Obama had a plan. Republicans did not.

Still today, the president is trying to adapt and confirm the implementation of the Affordable Care Act to meet the needs of all Americans while keeping costs down. Republicans are simply putting forward another budget that slashes Medicare and middle class benefits while giving more tax breaks to the rich.
At the end of the day, while Americans are still on the fence about the Affordable Care Act as a blanket concept, when asked about particular remedies that the law includes, the public is overwhelmingly supportive.

This suggests that the president has a messaging problem, not a policy problem --- whereas the Republicans simply lack any substantive alternative, let alone a popular one.
All of the above suggests that the current fight over health care reform has nothing to do with the Affordable Care Act and everything to do with the president who signed it.

Never mind the fact that the law already shows promising and valuable impact even before it's fully in effect. Never mind the fact that cost estimates are dropping and, starting in 2014, the law will contain overall health care costs that are crippling our household budgets.

Never mind the fact that the central component of the law was a Republican idea. Conservative ideologues are willing to sacrifice much-needed health care reform and the well-being of millions of Americans who don't have health insurance or are being denied care because of pre-existing conditions, lifetime caps on spending or other injustices -- all for the sick goal of undermining President Obama.

Fortunately, about a third of the country -- moderate and swing voters -- haven't made up their mind and are ready to listen to the president, who needs to a better job in the 2012 campaign of defining the benefits of his health care reform. But especially when faced with the alternative -- a Republcan Party increasingly concerned only with the health and well-being of the 1% -- voters will back the president and their own best interest to have health and prosperity for all Americans.
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Posted by Bridgier (+9506) 10 years ago
http://www.balloon-juice....gislation/

When the debate over health care reform got underway in earnest in 2009, Frank Luntz and other GOP pollsters/strategists warned the party that Americans expected improvements to the dysfunctional system, and Republicans couldn't simply say "no" to everything.

Three years later, that's effectively where the party has ended up: wanting to go back to the mess "Obamacare" is cleaning up.

But what about McConnell's main idea? It's one of the GOP's favorite talking points: we don't need real reform; we just need to let consumers buy across state lines. President Obama and the Affordable Care Act allow this, but set minimum standards that states must abide by. McConnell and his party want to go further, removing, or at least severely weakening, those standards.

This is generally called the "race to the bottom." Under McConnell's vision, state policymakers would tell insurers that if they were to set up shop in their state the rules would be written in the industry's favor. The industry would go with the state that offered the sweetest deal-which is to say, the most lax oversight with the fewest restrictions-and before long, it would be consumers' only choice. Why? Because every insurer would move to that state, leaving Americans with no other coverage to buy.

That's exactly what happened with the credit card industry, and it's a model to be avoided, not followed.



But tossing us all into The Nothing is what the GOP wants. They "want to give the power to the states" because it's FREEDOM and junk, and instead we'll get the same awful abuses that the credit card industry has been perpetrating on consumers for years, only far worse because this time it will involve health insurance and health care itself. The cheapest, meanest policies that cover the least in health care and have massive deductibles will be the only ones left for the vast majority of Americans and the insurance industry will pocket the difference. Can't afford it? There's Nothing you can do about it. Keen observers will note that the Nothing applies to any social government functions: Medicare, Medicaid, Social Security and retirement, environmental protections, education, food safety, financial products, everything. You can't provide it yourself because you can't afford it? You get Nothing.

So no, I don't believe for a second that the GOP will have to replace HCR with something. That would be something, after all. What they want is Nothing.


Perhaps one of our esteemed commentors from the right would care to join us in a cordial disputation regarding the cost of health care in America.
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Posted by Amorette F. Allison (+1908) 10 years ago
When I was a child, I somehow thought that the Supreme Court was above politics, that they looked things up in big books and decided objectively what was legal and what was not. It broke my heart--and it still does--when I realized that all the justices do is decide what political leanings they agree with and rule that way.

Sigh.

I hope they keep the colonoscopy benefit for a while at least. Someone in my family keeps putting it off and I hope to get that done this summer come hell or lots of laxative.
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Posted by Gunnar Emilsson (+18345) 10 years ago
Perhaps one of our esteemed commentors from the right would care to join us in a cordial disputation regarding the cost of health care in America.


Why, we all know, Bridgier, that if we got rid of the trial lawyers, the cost of health care will go down by 50 to 75%.
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Posted by Hal Neumann (+10304) 10 years ago
Argument recap: It is Kennedy's call
Lyle Denniston
SCOTUSblog
March 27th, 2012
http://www.scotusblog.com...edys-call/
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Posted by Gunnar Emilsson (+18345) 10 years ago
Nice update, Hal. Thanks for the link.

I was just at the local tavern, and the general consensus was that if the SCOTUS rules against Obamacare, the health care issue is dead for another generation.

By which time, I will be a senior and on Medicare, so I will fight all you youngsters tooth and nail against socialized health care, as your apathy in 2012 means you are buttmunches and deserve to live a subservient life that is controlled by the rich.
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Posted by Levi Forman (+3716) 10 years ago
Gunnar -

Did you expect to benefit in some way from Obamacare? I don't see how it addresses the price of health insurance. If you're very poor it might pick yours up, but the very poor aren't paying for health care right now anyway.

Bringing this to the supreme court now is just a political move to get the bases riled up. Whether it is struck down or not we are just kicking the can down the road.
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Posted by Gunnar Emilsson (+18345) 10 years ago
Yes, I do expect Obamacare to lower my insurance rates when it fully kicks in, Levi. As in all things, it will take time.

As Senator Baucus pointed out yesterday, the average Montana family carrying health insurance pays an extra $2,000 a year to pay for those who don't carry insurance, yet occasionally require emergency treatment. These people aren't paying cash.

As the article Richard cites, the CBO expects the cost of health insurance to go down, and thus the deficit to go down in the lobg run.

I have no reasons to doubt any of those sources. I have every reason to doubt every lame GOP proposal that has been floated out there. Not a single one can withstand independent scrutiny of the unbiased.

Of course, in your world, its one giant conspirancy by the media and the major parties, so there probably isn't much reason to continue this debate.

Next?
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Posted by Bridgier (+9506) 10 years ago
Whether it is struck down or not we are just kicking the can down the road.

An interesting assertion. What, in your estimation, would not kicking the can down the road look like?
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Posted by Levi Forman (+3716) 10 years ago
You're assuming that the free market is going to kick in. I think that insurance company profits are just going to go up. They have no incentive to lower rates, only some new unwilling customers who now have no option to vote with their feet.

As far as my solution, I don't have one, but this plan is half-assed. If you're going to go with mandatory participation (which may or may not be a good idea) you have to have rate controls of some kind or you have basically given insurance companies a license to levy taxes, a right previously reserved for the government.
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Posted by Gunnar Emilsson (+18345) 10 years ago
I agree that requiring individuals to contract with for-profit insurance companies is a very troubling part of the law. (which is why I prefer Hillarycare, but that's another debate....(as is how we ended up with this negotiated mess which is a Republican idea in the first place)).

But, it is at least a step in the right direction. If its Obamacare or the 2010 status quo, I'll chose Obamacare anyday.
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Posted by austin orr (+16) 10 years ago
The real tradgedy is that this country has turned into a bunch yellow bellied snivlers who believe they are entitled tofree healthcare and expect others to take care of every aspect of their lives whether it be obama care,medicare or any other govt benefits.....this is not what this country was founded on...what happened to paving your own way and being responsible for you and yours...all these govt programs do is create a large. voting block that dosnt give a damn what happens to america as long as they continue to recieve there free benefits...worth thousands.....at the detriment of others...it leaves these people unmotivated,and uninspired...they will never be more than they are now.......subservant to our govt and the offshore banks that contrll our govt
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Posted by MilesCity.com Webmaster (+10023) 10 years ago
Is that you Mr. Potter?
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Posted by Amorette F. Allison (+1908) 10 years ago
Right. Only the rich should have health care. The poor should just die and be buried in a potter's field. Heaven knows a heathy workforce that has money to spend on something besides doctor's bills would be bad for the economy.
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Posted by David Schott (+18387) 10 years ago
I'm just glad someone finally came and gave us the GOP plan for health care in America. I was worried you elitists had frightened them away.
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Posted by Dillpickle (+37) 10 years ago
I find it really hard to support the law. Most everything that this bill required of the insurance industry I think are things that should have been expected over the past 50 years anyway. And it's called reform? AND I'm forced to participate in a system of profit? Yes, there are caps included for corporate profit, but years of observation tell me there are other ways they would make up the difference.

Let's go for real reform. Start over. This bill bombed, for good reason. Let's go back to the drawing board and start with the public option. It would certainly rally the bases and get people involved before the next election. 'Insurance' has shown itself unable and unworthy of participating in healthcare in a reasonable way.
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Posted by Amorette F. Allison (+1908) 10 years ago
This is the Bob Dole making money for the big insurance companies version of healthcare. Better than nothing but not by much.
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Posted by Denise Selk (+1674) 10 years ago
The problem I've had a hard time trying to wrap my mind around, and I've tried until my brain aches (which may not take much), is the notion that just because you earn/are worth more, means you worked harder or are somehow a better/smarter person. I've seen this idea advanced here many, many times, but this sentiment seems to pervade our culture.

If you can't afford health insurance coverage, and would welcome the assistance the government could provide, you are labeled a "yellow bellied snivler", a drain on society, a welfare whore, lazy, worthless, and so on.

Yet, in what world does an NBA star who makes $30 million a year work harder than a roofer? In what world does an actor who makes $20 million a picture work harder than a farmer? What about a CEO? Does he work harder than a hairdresser? Everyone is born with their own skill set. Just because of nature's blessings, should the model who scores millions in endorsements deserve the ability to afford healthcare coverage, while the garbageman who minds our putrid masses struggles with the same?

Our sense of who works "harder" in this world is truly perplexing. It's not a matter of go to school, get yourself a degree and make lots of money. What about all of those positions needed to be filled in this world not meant for the college set? The ones that come without the great pay and benefits, yet we seem to be unable to live without? The hairdressers, the baristas, the waitresses, the maids, the cooks, the cashiers. We want them doing their jobs. We need them doing their jobs. We want (and demand) excellent service from them. But, we want to leave them a $1.00 tip on a minimum wage income. Yet, when they could use help, we want to label them Cadillac-driving, steak-eating welfare cheats.

I'd like just one person to show me that these individual recipients of government assistance cost our country more than those corporate welfare recipients of the same. Perhaps, then, I would be more comfortable condemning those less fortunate than myself with the ease others seem to muster. I don't know.

I do know I love Daniel Radcliffe,

"I think, if you make a lot more money than most people -- like I do -- you should pay more tax and subsidise people who work just as hard as you, but don't earn as much."


but that could simply be my HP obsession.
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Posted by Buck Showalter (+4452) 10 years ago
27,000 pages and the dumbass SCOTUS is focused on about three lines. This whole thing is creepier than you can imagine - your private information will be shared with government agencies regardless of if you use Medicare or Medicaid or give consent - your healthcare provider will be penalized in reimbursement if patients don't receive suggested interventions, tests, vaccines, etc. (regardless if that treatment conflicts with the patient's religion or foil hat beliefs). They are already proposing an easing of reporting requirements for the first stages because they're hopelessly impossible to meet while hospitals try to adopt new technology (NCLB for hospitals), but it's hard to imagine the end game is better patient care.

It would save us all a fortune if the Feds and State could get on the same page and agree on a standard for claims, as it is you've got people who handle MCD, people who hand MCR, people who handle private payers, people who handle Work Comp. The real impact of this is going to be measured in doctors who retire or stop seeing MCR and MCD patients altogether because it's too big a hassle.

[This message has been edited by Buck Showalter (3/29/2012)]
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Posted by Levi Forman (+3716) 10 years ago
^^This is why I'm skeptical about a public option. It seems like a great way to force competition except for the fact that the government is terrible at everything. As someone who worked 10 years for a DOE contractor and who deals with various Dept. of Agriculture agencies regularly now, it's an exception to find something that is run by the government that isn't ridiculously slow, inefficient, irrational, and wastes massive amounts of cash. I'm afraid whatever the public option would wind up being would be a beauraucratic mess that the very poor will wind up stuck in and no one else will want to use.
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Posted by Wendy Wilson (+6168) 10 years ago
I think that the answer to Denise's conundrum is, in part, a reflection of our Judeo-Christian heritage. Many churches actively promote the idea that if you are good enough, God will bless you with prosperity. Therefore, those who are rich must be somehow better than those who are poor. The dogma of many fundamentalist Baptist churches as well as the LDS faith often contain veiled (and not so veiled) references to this principle. It's not sound logic but since when was religion logical?

[This message has been edited by Wendy Wilson (3/29/2012)]
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Posted by cj sampsel (+483) 10 years ago
I voted for Obama and will again. I do think he should not have
pushed national health care with the economy the way it is and fighting two wars. I am all for national healthcare, however.
One issue left out of this thread is that, this is the catch,
if done properly it will reduce medical expenses.
I have worked at two small Montana hospitals and now work at the VA.
Seven and a half years ago when I left North Valley Hospital in Whitefish to come here they wrote off over twp million dollars in debt. Last year St.Pete's here in Helena wrote off over $12,000,000.
Montana hospitals last year wrote off more than $100,000,000.
Guess who pays for that? People with insurance or who pay their bills. Of course this causes rates to increase. National Health Insurance would make a huge dent in these figures.
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Posted by Buck Showalter (+4452) 10 years ago
Oh yeah, we wrote off about $10 million last year (you get sent to collections, we call it "charitable giving"). I'll be voting Obama this go round, but this isn't his finest work.
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Posted by Amorette F. Allison (+1908) 10 years ago
Before the Supremes overturn Roe Vs. Wade, they also need to knock down Griswold v. Connecticut. That is the decision in 1965 which granted "marital privacy" and said grown-ups, in the privacy of their bedroom, could use birth control. I know Rick Santorum wants to see that gone.
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Posted by jabba (+16) 10 years ago
If you don't have health insurance, maybe our EMS and ER providers ought to leave you on the sidewalk or at least wait for an irrevocalbe letter of credit before treating you. That would be the least socialist way to handle it all, since otherwise the many of us that do have insurance and do use the health care system end up paying the bills for those who don't have insurance.
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Posted by howdy (+4947) 10 years ago
The key is to get the insurance companies out of it entirely and just let all the monies collected go toward the medical bills...my hubby and I would glad pay our 800 per month toward it as that is what we already pay the insurance companies..if we didn't have to pay a profit, it would be a lot cheaper for all concerned...
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Posted by Bob Netherton II (+1908) 10 years ago
If you're against profits, you're against Jesus.
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Posted by Bridgier (+9506) 10 years ago
Unfortunetly for jabba's very christian solution, ER's are required to provide care for any and all who come through the door.
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Posted by Jeri Dalbec (+3264) 10 years ago
Today, State Senator, Jim Shockley, who is running for the Attorney General's office, was a guest on "Voices of Montana". He stated that he is against "Obama Care" and if people who can afford Health Care but do not buy it...then, go to the ER and do not pay...they should have a lien put on their home, car or anything they may have of value. A gentleman called in to say that he wanted to buy insurance but his wife has had Lupus for 7 years, therefore, NO COMPANY will sell him insurance and he is definitely for "Obama Care". After he hung up, Sen. Shockley said that there was Medicaid that could help him????

He did say that any hospital that accepts Government money has to treat people in ER. Those that do not, do not have to.
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Posted by Maryann McDaniel (+253) 10 years ago
The use of the emergency rooms for routine and other care by illegals along the Texas border is killing our health care in Texas. Many hospitals have had to close. Those who live further from the border do not understand what is happening.
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Posted by Amorette Allison (+12504) 10 years ago
In big cities, most poor people use the emergency room instead of a family doctor. Kids with earaches get in line, clogging services for emergencies and costing the hospital a fortune. It has nothing to with "illegals." It has to do with poverty.

If either Teddy Roosevelt or Richard Nixon had had their way, this stupid argument would have been settled generations ago and we would have better health care at less cost. They lost. We suffer. It will probably take another generation at least to get to where we should have been a hundred years ago.
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