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Supreme Court upholds basic idea of Romneycare
By adamg on Thu, 06/28/2012 - 10:36am
New York Times: Supreme Court Allows Health Care Law Largely to Stand.
Joe Gravellese: "Congratulations to Mitt Romney, whose signature policy achievement as governor scored a great victory today."
Prairie Rose Clayton: "Hey, hey, now, let's not forget he opened the liquor stores on Sundays."
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Comments
Jist of the ruling. The
Jist of the ruling. The mandate is unconstitutional via the commerce clause, BUT the law is still is valid as a tax in order to provide funding for medicare/medicaid to accomplish the same thing. There are a lot of state's rights and a possibility of limiting the ability of congress to dictate spending thrown in with the court's opinion too.
I don't think anyone is going to realize what this ruling effects besides the ACA law for a few weeks.
WTF
NOW IT'S ROMNEYCARE? HE CAME OUT AGAINST THE AFFORDABLE CARE ACT THAT WAS BEFORE THE SUPREMES (NOT THE SINGING GROUP).
It was always Romneycare
ACA is based on the plan adopted in Massachusetts by Romney and, yes, the legislature, which in turn is based on a plan proposed by Republicans back when Big Bad Hillary Clinton dared suggesting the government might get into the health-insurance business (unlike that nice, well run private Medicare program, of course).
Adam
How dare your discredit our messiah!
Interesting note to that
President Obama was asked a while back if this was a tax - and he said absolutely not and yet the law was upheld under Congress' authority to tax.
Huh??????
Kind of like hitting your target by missing but getting lucky with a ricochet.
Conundrum...
I believe the Solicitor General had to argue it's a tax and not a tax in the oral arguments. Guess a win is a win.
not a TAX
Not a TAX, a personal responsibility incentive for people who can afford to buy health insurance but do not: It is a tax penalty.
It will affect about 1% of the population.
Republicans were against health care freeloaders before they were for them.
Yes
It isn't a tax, but a tax penalty.
There's a huge difference, since people that don't make much won't even be penalized (have to look, but probably <150% federal poverty level)
Those that make over will have a large number of federally offered health plans to buy into that range from being almost free, to pretty damn cheap depending on their income level and family size. If it's anything like Masshealth, once you get outside of 350% FPL or so you start getting "unsubsidized" plans, but they're still much better than outright purchasing it yourself, since the pool is going to be huge.
Which leaves all but 1-2 people who for some reason have a good amount of income, but refuse to buy health insurance, driving up costs and taxes for everyone else.
Damn right they need to be penalized. (as long as our system can not turn people away).
And while I hear rumblings of a base that wants to, the GOP is not going to run on a platform to repeal treatment for those without a way to pay while they sit on a table dying.
If the base wants to make that part of their platform to fix healthcare, by all means, please do. I'll help! You'll finally push the party into the hateful, small, regional party it's been flirting with for a decade.
The insurance companies really have most of you over a barrel
Seriously, what is this perverse obsession with insurance companies? Can we stop pretending that buying insurance is the only way we can have cheaper health care for everyone? Is anybody even going to bother to read my post below about increasing the number of providers?
It's a really interesting
It's a really interesting ruling in that the law was both struck down for not being constitutional under the original justification under the commerce clause, yet upheld as still valid under congress' ability to levy taxes. So the law was both invalidated and validated at the same time. Legal scholars will be studying this ruling for a very long time.
That was politics
Anybody who thinks clearly could see that it was a tax all along.
The Supreme Court is obligated
...to find the constitutional interpretation of ambiguous clauses.
Justice Roberts wrote in his opinion:
Anyone who pays taxes in Massachusetts recognizes that it is implemented as a tax and a deduction. I'm glad that Justice Roberts was able to maintain his integrity in the face of partisanship. I cannot say the same for the other 4 "conservative" justices, who seem to be acting as Republicans in robes, not judges.
I do disagree with Roberts about his interpretation of the Commerce clause. I think he is glib to dismiss that defense because it "compels commerce" and regulates "inaction." Last time I checked, there is no Pause button on life: everyone participates in getting older and has limited control over whether they get sick or healthy. There is no "inaction" option. Either you participate in the health care system and pay your share, or you refuse to do so, and still receive treatment from hospitals while freeloading on the rest of us.
You know what solves that problem?
Permitting hospitals to refuse treatment to the insolvent. I endorse that completely.
And you get the slow clap
And you get the slow clap from Ayn Rand. Everyone else thinks that idea is inhumane and awful.
Maybe not that far
There are some good pieces to this legislation - like on pre-existing conditions.
There are some bad pieces - like putting kids on mommy and daddy's policy until they are 26 or some other adult age.
And there are some political pieces - like various exemptions for union members because it's "collective bargaining".
There are some places it didn't go far enough - like allowing insurers to operate more freely across state lines.
Let's keep the good, add the better and get rid of the bad and the political crap - we don't
Doctor payments too
There is A LOT of good stuff here. And I think we can all agree letting people die in the streets is not a good idea for a modern civil society or conducive to low crime rates and public safety and health.
My friend who is diabetic through no fault of his own (born with it) will finally be able to get insurance, and make sure costly complications don't arise. He already pays his own way out of pocket for his disease, but he's one accident away from a huge bill that others will have to pay for since he can't get insurance otherwise. Now with ACA he can.
GOP and Dems need to fix the parts of the bill that need fixing, but I'm not holding my breath.
The radical base has made it undeniably clear that they will hang any politician that crosses lines to work out bipartisan, conservative solutions.
Putting "kids" up to 26 years
Putting "kids" up to 26 years on the parents' policy means that the parents' plan is paying a little extra for these kids. However, as a rule 26 year-olds don't consume alot of medical services. This is really a way to get people who don't need insurance to get covered by insurance and thus spreading the cost around.... which is what all types of insurance really do.
It was inhumane and awful 50 years ago
Today? There's just simply too many people for me to care. I believe that our species is overpopulating the Earth. One of my most stringent ideals.
If I dropped dead tomorrow, the people who really like me (they do exist in the real world, if not in the UH comments section) would mourn me for a couple of days, then they would move on with their lives. And that's how I respond when people I like pass on.
Except you have it completely backwards
Regions like Africa and Asia that have minimal, if any, healthcare are where populations are expanding at paces never before seen. Whereas places like Europe, North America, and Latin/South America have almost completely plateaued in population.
When a society has access to good healthcare, they tend to value things like contraception and family planning that lead to better lives for the entire family. When they know that they don't need to have 6 kids to raise their cattle because you never know if one of the children is going to die from cholera or an infection from a leg break...that's when they start having only 2-3 kids because they'll live longer and be more productive because of their good quality healthcare.
So, if you don't want overpopulation, you should be arguing for better healthcare (particularly feminine healthcare) across the globe...not less of it here at home. Melinda Gates was just on the Colbert Report to explain more about this very thing.
Okay, then let's increase condom use and abortions
in Africa. Send an abortionist over to Nigeria to work. I'll chip in for that.
Ayn Rand?
The same woman who ultimately did claim her social security and socialized medicine benefits when faced with cancer?
Well, there are hypocrites
Well, there are hypocrites everywhere.
Darwin called...
...and even HE thinks you're a douchebag who likes to flaunt that fact, Will. Congrats.
Alternative...
You should be able to see the hospital a body part.
"No insurance, no credit? No problem. That's a nice looking kidney you have there... How about we swap a week's hospital stay and all the tests you can eat for it?"
Will
Please run for office on this! Please push to make it a GOP policy platform.
I'll even help you, if you need help!
Let's do this!
Well
The court said it could be interpreted both as a tax, and not as a tax.
But There's a legal precedent that when something can have two interpretations, one constitutionally unsure, the other sure; the court is to side on the side of a sure thing.
Thus, they say it's considered a tax, even if the letter of the law calls it something different.
nuanced, and does it really matter? For politics sure, but ultimately it's not a tax per say.
So, in an overpopulated world
I will now be mandated to pay to make sick people I don't know or care about not sick. Great. (Expletive) America.
Depends on how much money you make Will
You were paying for these things anyway. If you want to share how much you pay in taxes, we can probably tell you if you are paying your fair share for the services you receive in Boston, Massachusetts, USA.
Well, I know I already contribute to Medicare
But now I get to pay more for private insurance that I don't want.
As for my taxes, my total federal tax for 2011 was $4,037.
That makes you a wannabe freeloader, Will
Fact is, everyone pays taxes to support hospitals which treat people who cannot pay. They are lawfully obligated to treat all comers and cannot refuse on the basis of ability to pay.
You want to become one of the freeloaders. The rest of us don't appreciate that.
Again
I can and will pay, and I think hospitals should be allowed to refuse those who can't/won't pay.
Well, take it up with Reagan
He signed the 1986 law that requires hospitals to treat all comers.
And for the record, I and most other people in this country completely agree with that law. The last thing we need is to let people die because of a billing system malfunction.
If that gets your hackles up...
Did you know that you're also paying to send kids you don't know or care about to school? Did you know you're paying to give them water and sewer services? And their parents too?
Did you know that you're paying for the roads they drive on? You're helping to pay for the transit they use? How awful that they're wasting all your money!
I hear they're even killing people you don't know or care about in distant lands using your money. I bet you wish they'd checked with you first on that, huh?
Here we go again!
Those things don't bother me. I love when people make that counterargument against me. "You must hate education and roads!" Not at all! I like those things. I'm happy to pay to have them in my community.
It's when we start perpetuating the lives of sick people who can't afford to heal themselves with their own wealth that I have concerns. At 6 billion people, health care becomes a privilege, not a right.
Of course you know that this
Of course you know that this ruling has no effect in Massachusetts, whatsoever, other than we get to retain funding from the Federal Government, right?
Of course you know that we, as citizens and taxpayers of Massachusetts, were already paying for the health care of indigent and otherwise unable to pay users of the health care system, right?
So what you object to is a plan that lowers the total cost of the system, by putting more people in front of primary care physicians, and fewer people in the ER, right?
Last I heard we have 330 million people in the country, not 6 billion, so your logic is just 100% self serving and, if I may add, irrelevant to the actual conversation.
But of course you already knew that.
It doesn't have effect in Massachusetts
But now I can't leave the state to avoid the tax penalty for not propping up a health insurance company. That's part of my grieveance.
And just how does this put more people in front of primary care physicians? Is the agent from Blue Cross/Blue Shield going to drive Grandma to the doctor's office?
That's a pretty facile
That's a pretty fucking facile argument, Will. Avoiding primary care is literally the first thing you do when you don't have the money for health insurance. Want a study that affirms this perfectly reasonable and OBVIOUS conclusion? Fine.
Source: Healthaffairs.org
Over a population, if you have access to a doctor, you will call that doctor when you're sick.
But then you never get sick, and you wont, ever, so I can see how you'd be pissed.
Know what else would reduce emergency room costs?
More emergency rooms. That's a nice study, but it seems to forget the fact that the seller of the service (the doctors and hospitals) set the price tags.
On what planet?
How would "more emergency rooms" decrease the costs of emergency rooms? Service would get spread out and the cost increase would not be proportional to the increased income.
Unless you think this is some kind of free market utopia where, after having a heart attack, my wife and I stop to figure out which hospital current offers the most economically beneficial emergent services before she drives me there. Yeah, that makes sense.
Hunger games
Will, we are going to play some hunger games here to show how your ideas a off kilter. So here's the situation: you and your wife, or other beloved- let's call her sally - you and Sally are out for a lovely afternoon drive in your friend's sports car. it's supposed to be a quick spin around the block so Sally doesn't grab her wallet. Then, around the bend, drunky McGee hits you face on, hard. Ambulance takes you all to the hospital. You have you wallet, so they known you have insurance, and rush you in to the ER. They have no idea who the helll Sally is or if she has insurance, so no treatment for her. They throw her in the street and she dies there. How do you feel when you wake up and realize this?
what would john galt do?
what would john galt do?
Nothing.
Nothing.
That's actually a strong impasse that you have proposed
Short of tattooing all human beings with bar codes to be scanned by big-ticket merchants to gauge solvency, I really don't have an answer for that. At the moment, you've got me.
But I'm still going to hammer Obamacare for being a lazy Band-Aid that seeks the path of least resistance in improving healthcare for Americans. When is somebody going to open a medical school with a $50,000 tuition? When is somebody in this town going to finally undercut the MGH/Beth Israel/et al. monopoly and open Joe's Bargain Surgery? I would do business with that doctor, because I know his prices would be cheaper once he hung his shingle.
Emergency care is an impasse between fair market principles and the basic human desire to stop a person from imminent death. But I also believe that they're abused because a lot of people demand care outside of usual doctor's hours. Why isn't there a night doctor out there? Why aren't there more doctors, period? The high price of educating somebody to become a doctor is a big deterrent, right? So what can we do to fix this root cause?
Maybe the penalty I pay Massachusetts should be loaned to somebody who comes up with a business plan to build a cheap medical school that undercuts Harvard and all the other expensive ones out there.
You're wrong Will
every tax filer in the state has to submit a 1099-HC form to provide proof of insurance. If you were uninsured for a certain portion of the year and your income was a certain level, you paid a tax penalty in 2011. You'll do the same thing in 2012. But, yeah, ensuring that people don't die because they have no health insurance is misguided\sarcasm
http://www.massresources.org/health-reform.html
I'm aware of that
I pay taxes to the Commonwealth, and I paid the penalty for part of last year (and will pay the penalty this year.) They raised my taxes in a recession. Meanwhile, I didn't get a raise.
So you're paying the menial penalty tax for not having insurance
...but if you get hit by a bus tomorrow, John Q Taxpayer bails you out to the tune of thousands of dollars for emergency care? You sound like a freeloader to me. Oh wait, I'm sure it's the "principle" at stake, not the fact that you're too cheap to chip in your fair share
I have money
The hospital might get it over the course of a few years, but they'll get paid. I work.
I'm not sure why I even bother
But your injury could result in you not being able to work. It could also result in you needing residential services for the rest of your life. Those are expensive.
Do Not Resuscitate
If I'm injured so badly that I would need residential services for the rest of my life, I choose to be allowed to die.
Heh
That works if you're gone and you brain or heart stops.
Not if you're still alive and they can save you. Doctors aren't going to kill you cause you broke you back, but were otherwise saveable.
Paraplegic Will, saved by doctors because that's the law, screwing everyone else over.
Life ain't black and white Will. That's why we have this issue and ACA came about.
Kevorkian would have killed me
This guy should be revered as a revolutionary. He shouldn't have been treated like a criminal.
You could still leave the
You could still leave the country, though.
Well, Will,
you can always leave the country ("(Expletive) America" as you call it), but good luck finding a liveable country that doesn't have taxpayer-funded healthcare.
Why should I have to leave?
I was born here. It's my country too.
And for the 100th time, I don't oppose taxpayer-funded healthcare. What I do oppose is propping up a grossly outsized and bloated system in which a small number of health service providers relative to the market charge high prices (demanded in part by a market that doesn't wish to die or walk around with a limb hanging off). I oppose a system in which I'm legally obligated to make a wager (which is what insurance is) against whether or not I'm ever compelled to incur a five-figure bill for services, with the "house" (the insurer) taking an onerous percentage of juice. How much in premiums do you believe get paid back out to the policyholders?
Every other industry has its luxury level and its economy level. Health care is the only one where everything is high-end. There's no discount doctor. Maybe it's time to allow that. Maybe it's time for the guy who finishes last in his medical class to do surgeries out of his garage. If that were half the price of going to MGH or anything run by Partners, I would buy that service instead.
I drive a 16 year old car and I stay at Motel 6 on vacation. I seek bargains. Let's apply that to health care.
Try offering to pay cash,
Try offering to pay cash, up-front. You will be extremely happy with the result.
Seriously. Just go in and negotiate your own rate. It happens more and more frequently, and it is a valuable tool for consumers.
Will many health plans have tiers
and various other benefits that you can buy if you choose.
I don't believe some tiers are available to me, though
State wouldn't let me pay less than $117/month for Celticare. I view that as a bad wager that I don't want to make. $50 a month, I would consider.
In That Case...
Can't wait until we can all get our itemized tax bills so we can pick and choose what we pay for. Personally I'd really look forward to not paying for Abstinence Only Sex-Ed, No Child Left Behind, Corn and Oil Tax Breaks, and the War in Iraq.
Or maybe we can at least PRETEND to be adults and except that we can't get our way all the time.
As one of those people...
I'm happy to say on behalf of anyone who's ever suffered a serious illness or injury, or cared for someone who has, f**k you, Will. Enjoy your Scrooge-like rants but boy...I'm finding it hard to believe that anyone who takes this stance has much of a...well, life. No one you care about, no one in your family has ever been sick? Gotten hit by a car? Had a baby that needed a month in the hospital to thrive (and is now a happy, healthy teenaged athlete?) No one? Either you're very, very lucky or very, very sad.
As one of those people...
I'm happy to say on behalf of anyone who's ever suffered a serious illness or injury, or cared for someone who has, f**k you, Will. Enjoy your Scrooge-like rants but boy...I'm finding it hard to believe that anyone who takes this stance has much of a...well, life. No one you care about, no one in your family has ever been sick? Gotten hit by a car? Had a baby that needed a month in the hospital to thrive (and is now a happy, healthy teenaged athlete?) No one? Either you're very, very lucky or very, very sad.
Sally, I would have respected you more
If you had sworn at me without the asterisks. Disclaimer: It's 10 of 3, and I've had a few drinks:
My grandfather died in 1987 after years of living with Alzheimer's. One of my great regrets is that I was never able to know him in this life, as I was born in 1983, so my knowledge of him is limited at best. Would I have wanted for him to live a day longer with Alzheimer's so that I could know who he was? Hell no!
His wife lived the last 25 years of her life with Lou Gehrig's. At no point did she complain about her lot. She had the resources to pay for visiting nurses, and for the last 2 years of her life, nursing home residence. She was a great Vermonter, stoic and accepting of her circumstances. She accepted the end of her life with grace.
Both of my dad's parents were longtime smokers, and died in the 1990's. I was never close to them, and harbor no warm memories of them beyond playing board games in their smoky apartment on the Burlington waterfront, and an old Super 8 movie of Grandpa picking me up and holding me just before he lost use of his legs to years of tobacco use.
All of my grandparents were gone before I reached drinking age. All of them had health problems. I'm not sad about that, and I don't feel like I'm a ghoul or a monster for accepting that they've moved on to the next life.
I don't know why you imply that my circumstances are either "lucky" or "sad." At the risk of sounding like a trash TV guest, "you don't know me." I don't have that many family members in the first place...mom, dad, and my little brother are it for immediate family. That none of them are sick has more to do with statistical probability than it does with being "lucky."
And I've never viewed death as being "sad." I don't think I've cried or felt sad about death in 15 years. Hell, my family's Golden retriever died two weeks ago. I haven't shed a tear. Why does that make me somebody who doesn't have "much of a life?"
Maybe it's a male vs. female thing. You're a girl and you care about people and feel sorry for them. I'm a guy, and I feel more sorry for animals than I do for people, who are idiots who breed freely, are dishonest, and make all kinds of mistakes.
So...you have no problem
So...you have no problem paying for things you like. Everything else can sod off. Got it.
You can always move to Canada
http://www.buzzfeed.com/daves4/people-moving-to-ca...
Re: So, in an overpopulated world
Your compassion is overwhelming.
Would you feel the same way if you or someone you love were to become desperately ill and in need of a hand up, rather than losing your, insurance (under the old way of doing things) your house or going into bankruptcy? Or something like this? http://www.kevinmd.com/blog/2012/06/tragic-outcome....
Re the "overpopulated world:"
Do you consider yourself part of the surplus population?
Do you like being healthy?
Because the black plague is a shining example of your policy put into practice. The poor lived in horrible conditions in Europe. Those conditions bred disease that infected primarily the poor. Except for when it didn't...then it killed the rich and the middle class too, because disease agents don't give a shit how thick your wallet is.
Ever been introduced to herd immunity? Let the poor get diseases because they can't get vaccinated...who cares about them, right? Except one of those poor is infected with a new strain that only had the chance to mutate because you think the poor and/or sick aren't worth your consideration if they can't pay to stay healthy. That new strain can infect you because your vaccine was for the original strain. The new strain wouldn't have existed if you'd just immunized the poor too.
PUBLIC health is just that...it's everyone's health. Thus for a purely scientific/epidemiological reason alone, your argument is pure crap.
Who says Twitter is useless?
People Who Say They're Moving To Canada Because Of ObamaCare.
Comedy. Gold.
Comedy. Gold.
I wonder how many Canadians will come because our system
is now better? (Or is at least going in the right direction)
I wish I could be there
When they discover what the T in VAT stands for...
Not to mention
The first time they have to buy gas. Hoo boy, that will be fun.
Oh man...don't remind me
I didn't realize how big a difference it was and didn't fuel up before getting to Toronto. After driving around for a few days while visiting, I realized I needed to fuel up before I would be able to get back across the border.
I thought an elephant sucker-punched me in the gut when I saw the prices compared to what I was used to (my car also only takes 91+ octane).
Fresh Molson Export on draft though.
That alone might be worth it. And happy hour.
1 of 2 ain't bad
I've never been a Molson Man...but happy hour was nice...although you just have to get out of MA, not the country, to find a happy hour.
That is true
But have you tried the Export Light on draft in Canada? Much better than the bottled molson here.
Yup
The swill we have here really isn't Molson. It's Molson-American
Bbbut
It has three X's on it. Thats, like, tres equis.
Tres equis
Does anyone still sell this (or even make it)?
Not the beloved original
That hasn't been brewed since the early 70s. But there's a regional brewer of some renown in Santa Fe (Rod Tweet of Second Street Brewery) who makes a homage version of Tres Equis which has gotten a lot of gushing reviews. If I ever get down to New Mexico, I'll check it out and report back!
When visiting NM around 1980....
... we went somewhere that still had Tres Equis listed on its list of beers -- but, on ordering it, we were told they didn't have any. That was the closest my wife and I ever got to sampling Tres Equis. ;~{
Fresh Molson
Yeah, it's too bad that we can't get fresh Molson down here. Guess we'll all have to settle for fresh Berkshire Brewing, Smuttynose, Long Trail, Pretty Things, Ipswich, Allagash, Maine Brewing, Slumbrew, Mystic, Idle Hands, Cambridge Brewing, People's Pint...
(20 min later)
Otter Creek, Harpoon, Gritty McDuff's...
oh
not disagreeing there.
and for the first time since the vietnam war...
… the Canadian borders is closed.
Oh sundays...
I wish I had my Sunday back...
No more BBQs no more family fun time b/c we have to open shop.
Ii he did care about the mom and pop shop owners he would have NOT changed the law...
So sorry
But we don't serve your brand of crazy here. Come back to reality and we can talk.
You don't HAVE to do a damned thing
Just stay closed on Sundays. See how that works out for you.
Funny, most mom & pop shop owners are more than happy to take my money on Sundays and put their kids through school or pay the mortgage more quickly.
Don't blame Romney and demand for taking away your day off, blame yourself for not being able to say no and shut for the day.
um.
I wasn't aware that any liquor stores were being forced to open on Sundays.
Close on Tuesday
You could hire someone to work Sunday. Or just not open.
Really, I don't think that many people buy alcohol on Sundays anyway. They're too hung over from Saturday to be awake.
One thing that would make Obamacare more acceptable
A requirement that all health insurers list their total year-to-date premium revenue, along with the total amount paid out for health services, on their homepages. Should be clear to everybody. That's really a big part of my grieveance...why am I being forced to pay some CEO six or seven figures under threat of an income tax hike? Not my problem.
That is taken care of
The ACA requires that insurers spend at least 80% of their revenue on providing actual services and can only use 20% for things like administrative costs and CEO pay.
If they violate that rule then they have to pay their customers a rebate.
In fact, because of that, many families in Massachusetts are going to be due a rebate once that portion goes into effect.
So, is that more acceptable?