Court of Appeals & Obamacare

[UNTFan23]

If you don't mandate people to purchase health insurance then many or most will not buy it. Then when they get sick, instead of getting preventative care they will show up at the Parkland emergency room with a critical situation and guess who is paying for that (you and me). So while I respect and agree with your support of the constitution I would prefer that you and others would come up with viable solutions to the health care crisis that we face.

I think a dangerous assumption that has been made with the individual mandate is that it will cause a change in behavior for those that previously didn't have insurance will suddenly go to a doctor for preventative care and not the ER for an emergency.

[Harry]

Good point but the answer lies in incentives. If you incentivize people to seek out preventative care not all but many will. Right now they'd just as well show up at the ER since it doesn't cost them anything.

[UNTFan23]

Good point but the answer lies in incentives. If you incentivize people to seek out preventative care not all but many will. Right now they'd just as well show up at the ER since it doesn't cost them anything.

If someone can't afford the co-pay even with insurance, I don't think they'll go to a doctor and will just hope the problem goes away on its own. Then if it gets bad enough, they'll go the ER.

I don't see any incentives for those that can't afford insurance now will be able to afford going to the doctor with insurance in the future. I feel it will be more of the same behaviors we have today in the future.

Another concern I have is whether or not we have the infrastructure (doctors, nurses, and facilities like hospitals and doctor offices) in place to handle an additional 30 million of previously uninsured patients. Wait times to get an appointment could increase, so if you are sick it could increase the likelihood of an ER trip due to an untreated illness because you couldn't get in to see your regular doctor.

The legislation tries to help fix a problem but I feel it falls behind to help make sure everything is in place to handle what it is attempting to fix.

[KRAM1]

KRAM, while I agree with your constitutional stance is it doesn't do anything to solve the health insurance cost problem - which if let unresolved - in fact it may push us closer to governmental health care. Can you imagine what a nightmare we would have if we didn't require drivers in Texas to purchase auto insurance? Do you realize how much the cost of our car insurance would go up for you and me without this mandate and we would be in effect subsidizing coverage for those who don't purchase it? If you don't mandate people to purchase health insurance then many or most will not buy it. Then when they get sick, instead of getting preventative care they will show up at the Parkland emergency room with a critical situation and guess who is paying for that (you and me). So while I respect and agree with your support of the constitution I would prefer that you and others would come up with viable solutions to the health care crisis that we face.

I never liked the mandate aspect of this reform until I started looking at the numbers. When you pull away the mandate guess what, the good people who do the right thing and purchase health insurance coverage get double dipped and end up paying for the ones who choose not to purchase it. I think if a VIABLE alternative was out there we wouldn't have had to go down the mandate road in the first place.

Remember, a key point to the recent Appellate court decision against Obama care was they were not dissenting against the health care reform policies in general just specifically the individual mandate. I fear if they pull the mandate away, the private insurance companies will run away from the market because they will not see any advantage to insuring only the sickest of the sick pool. This will force many of the neediest to join up in state risk pools because they will have no other place to go. The states do not have the budgets or expertise to run these plans effectively when you are looking at large numbers of participants in my opinion. Essentially we will be pushing people to join governmental sponsored and funded plans which, you guessed it we end up paying for in the end.

Harry...please stop with the auto insurance comparisons...it's night and day/apples and oranges. You will just keep this failed logic going if you don't let that analogy die. One thing that COULD solve the health insurance cost issue is to simply open health insurance up to competition across state lines and allow people and groups to buy the best policy for the best price anywhere they can find it...sort of like free enterprise. That way UnitedHealthCare, Blue Cross, etc. will not have to have large...very large...administrative staffs in every (or most states) etc. It will streamline costs in that area, and competition on price and quality is usually a very good thing in my book and tends to keep costs in line. The way it is handled today stifles competition and keeps rates artificially high.

In case you haven't noticed, Harry...mandating everyone to have auto insurance hasn't worked too well either and we continue to subsidize all those who do not buy insurance and who drive without a license or drive with a suspended license. They buy monthly policies to get a car plate and then drop the coverage if they buy it at all for any length of time.

Really, Harry? We do not have a mandate now to buy health insurance and it seems to me that plenty of people buy health insurance...heck, you might not even have a job if people were not buying health insurance without a mandate. What we are seeing in anticipation of this law is that many of the largest corporations are considering dropping their group plans and simply "allowing" people to buy their own coverage. The small firms will definitely give up group health. The "fines" being discussed cost way less than providing the health coverage in the first place.

Folks are already ending up at Parkland in the emergency room...many of which are illegal aliens...where will they go after/if Obamacare comes into effect? You actually think they will buy health insurance? Heck, they aren't even buying auto insurance now.

We, here at IPI HAVE come up with alternative plans for health care, and so have many republicans and centrists in the house and senate. None get very far with the "big brother dems and libs" and the welfare state proponents blocking the ideas from ever seeing the light of day...and in some cases special interest groups like trial lawyers and health care companies themselves. Plus, since you are in the business, why not get the folks you know in the business to help craft a plan? We have already...part of which I mentioned earlier...let's open it up to cross-boarder (state borders) competition. And, let's get rid of the massive multiple corporate structures. Another idea is obviously tort reform. Let's get the trial lawyers out of the picture and focus on actual lawsuits that have merit. After Texas instituted its limited tort reforms the number of doctors moving to Texas to practice grew big time. Check out the states who have instituted some form of medical tort reform against those who have not and see what medical malpractice rates have done. Lower the cost of malpractice insurance for doctors and hospitals and you can dramatically lower the cost of health-care nation-wide. But, it needs to done uniformly across state lines. Another idea we have proposed is to strengthen the patent and copyright laws to help drug companies recover the costs of their research over longer periods of time, and let's use tax breaks to incent companies to do that research and bring new and less expensive drugs to the market. The cost of "pirate and counterfeit" medicine is tremendously high, and it is being borne by each and every citizen in the nation. Drugs cost more in the US than just about anywhere else in the world...one reason is the cost to the firms of defending itself against lawsuits in the US. Again, tort reform. The US taxpayer and consumer "PAYS for those lawsuits and the rest of the world gets the advantage of the research being done in the US and by US drug firms. Ever wonder why so many firms are heading overseas????? How much of the cost of a hospital stay do you think is related to the costs of possible and real litigation? Fix that...costs come down.

So, Harry, as you can see, we have been suggesting alternatives...not simply finding ways to create another entitlement program.

I still see these court cases as a Constitutional issue, and not about health care, but since you basically called me out on the health care issue, I just needed to respond. You are not unlike many people who simply do not know or have not seen or have not heard about the many many proposals that have been put forward that would be multiple times better than this socialist entitlement program that Obamacare will create.

So, YES, Harry, we have come up with plans...so have many conservative and centrist congressmen and senators. Just can't get any traction due to the big government/big-spending dems and libs.

I respect your knowledge of the health care and group health industry, but find it interesting that, in knowing that about you, you could/would support Obamacare in any shape or fashion...and, yes, if the mandates are ruled unconstitutional (and the "jury" is out on that at this time...although I think it is obvious to anyone who has even so much as read the US Constitution...Obamacare is pretty much DOA. That, in my opinion, would be a great thing...then we could get down to the real task of creating a decent federally based plan that might pass Constitutional muster. It's a shame that the current administration couldn't come up with a viable plan...at least one the Congress might even read before voting on and which might, indeed, be Constitutional.

[HoustonEagle]

I believe the last piece of Health Care legislation the Republicans passed increased the size of Medicare. Is that true? How did they pay for that?

Edited August 16, 2011 by HoustonEagle

[Monkeypox]

Actually, if you want a driver's license, you have to have liability insurance.

And a driver's license is unnecessary unless you are operating a motor vehicle, in which case, you need liability insurance.

[yyz28]

So many logical fails in this thread.

First is the idea that without mandate most people won't have insurance. Well, that's an obvious fail. Before this manufactured crisis, there were roughly 15% of the population without health insurance. That means that the other 85% of us either made the choice to put a priority on our healthcare and that of our families or have it arranged for us by some other means. 85% of us are covered, and we're going to change that coverage for 85% of us to make sure the other 15% (who aren't denied medical care today mind you, they simply don't have insurance) have some sort of coverage.

I have to agree with Kram in insisting that the Auto Insurance discussion be dropped from consideration, as it is an absolute non-sequitor.

I will also echo that many plans were put forward by folks other than the ultra left leaders who were in absolute control when this was passed, including a documented several step plan released by the then Republican leaders in congress. These ideas were never given any press time, or so much as a moment on the floor of congress, and the Press just echoed the Democrat talking point that "the Republicans don't have any ideas, they are the 'Party of No!'".

...and for me, in the end, even if I like lots of the ideas within, if a measure is put in place by an unconstitutional mandate, the ends CAN NOT justify the means, as liberty is eroded and firewalls further broken down. If they can ignore the 10th amendment and the interstate commerce clause, they can just as easily ignore the first amendment.

[The Fake Lonnie Finch]

The federal government does not require the purchase of auto liability insurance, that is a requirement at the state level and is allowed as the regulation of intrastate commerce is within the purview of each state.

Also, auto liability insurance is only required of car owners...not all citizens.

Ring the bell, school's back in!

More to the point, health insurance and auto liability insurance are two separate animals.

Health insurance is bought for your own benefit. You will use its benefit, and it will protect you.

Auto liability is bought for the benefit of anyone you may hit and injure, or anyone's property you may hit and injure.

That state knows damn well that you don't have enough money in the bank to cover a loss if you put someone in the hospital or kill them while driving your car. Or, if you drive your car into their car, home, business, and anything else.

Thus, the requirement by a state for you to carry liability insurance is for the public's benefit, not yours.

The only way you can get out of it is by posting a bond with the state saying you have enough cash to cover whatever that state's law is regarding the posting of a bond in lieu of carrying liability insurance.

You'll note that the state does not require you to carry physical damage coverage for your own car. That's because the state could give less of a crap about your car. They're just wanting anyone or any property you injure or damage to be made whole - and, they know the majority of you don't have the money to do it without liability insurance.

If you want the benefit of having your own car covered, you'll buy the optional coverages as well - comprehensive, collision, and uninsured/underinsured motorist. But, you don't have to. It doesn't hurt anyone for you to drive your car around with a dent in it. That's wholly different than you putting a dent in a person.

Class dismissed!

Edited August 16, 2011 by The Fake Lonnie Finch

[The Fake Lonnie Finch]

Do you want to know what the health insurance problem is, or do you want to continue your mental masturbations?

Here are the two main problems in a nutshell:

(1) Politicians have provided cover for insurance companies within their own state borders, so that health insurance cannot be purchased across state lines. Therefore, product availability and costs vary from state-to-state.

(2) There are too many middle men in the medical manufacturing and drug producing parts of the equation.

(3) Young doctor don't care about going where health is needed. They want to set up shop where they can have enough money to buy a Mercedes or BMW, and have nice pool of secretaries, physicians assistants, and nurses they can choose among to replace the first wife - the one who put up with their sh*t through med school when they didn't have a dime to their name and were mired in debt. (And, squeezing out babies for them as a result of "comfort sex" when they were stressed out by med school and the debt and all.)

(4) Plaintiffs attorneys.

The solutions are so simply that the politicians can't figure it out...that and 137% of them have their heads stuck up the as*es:

(1) Allow the whole United States to be one marketplace for health insurance policies.

(2) Streamline the medical manufacturing processes and drug manufacturing process.

(3) Quit allowing closet pricks to become doctors.

(4) Enact federal tort reform to curb lawsuits for all but gross negligence claims, capping pain and suffering, and ending the sham of allowing chiropractors to be considered medical providers.

The fifth and final uncontrollable element at play is the Baby Boom generation. Not only have they screwed up the country's finance for decades, but they have also gotten older and need more health care. So, they've spent all the money on crap before they counted the cost of what they'd need past the age of 65.

Everyone wants a new knee, a new hip, a new this, a new that. Fine. I'm not against it. But, you've spent like drunken sailors in Bangkok nearly every single year since the end of World War II paying for social programs that bankrupted the country. So, the money's gone.

And, because the money's gone, the additional pain in the ass Baby Boomers have caused is that now we have to listen to the empty-headed libertarians and tea-party nutjobs and their seriously screwed up scorched earth bullcrap ideas every time we turn on the television radio.

I'm so sick of thinking about it that I've got to go get a Pepsi to calm me down.

Love,

The Fake Lonnie Finch

P.S. -...you filching bastards!

[KRAM1]

Do you want to know what the health insurance problem is, or do you want to continue your mental masturbations?

Here are the two main problems in a nutshell:

(1) Politicians have provided cover for insurance companies within their own state borders, so that health insurance cannot be purchased across state lines. Therefore, product availability and costs vary from state-to-state.

(2) There are too many middle men in the medical manufacturing and drug producing parts of the equation.

(3) Young doctor don't care about going where health is needed. They want to set up shop where they can have enough money to buy a Mercedes or BMW, and have nice pool of secretaries, physicians assistants, and nurses they can choose among to replace the first wife - the one who put up with their sh*t through med school when they didn't have a dime to their name and were mired in debt. (And, squeezing out babies for them as a result of "comfort sex" when they were stressed out by med school and the debt and all.)

(4) Plaintiffs attorneys.

The solutions are so simply that the politicians can't figure it out...that and 137% of them have their heads stuck up the as*es:

(1) Allow the whole United States to be one marketplace for health insurance policies.

(2) Streamline the medical manufacturing processes and drug manufacturing process.

(3) Quit allowing closet pricks to become doctors.

(4) Enact federal tort reform to curb lawsuits for all but gross negligence claims, capping pain and suffering, and ending the sham of allowing chiropractors to be considered medical providers.

The fifth and final uncontrollable element at play is the Baby Boom generation. Not only have they screwed up the country's finance for decades, but they have also gotten older and need more health care. So, they've spent all the money on crap before they counted the cost of what they'd need past the age of 65.

Everyone wants a new knee, a new hip, a new this, a new that. Fine. I'm not against it. But, you've spent like drunken sailors in Bangkok nearly every single year since the end of World War II paying for social programs that bankrupted the country. So, the money's gone.

And, because the money's gone, the additional pain in the ass Baby Boomers have caused is that now we have to listen to the empty-headed libertarians and tea-party nutjobs and their seriously screwed up scorched earth bullcrap ideas every time we turn on the television radio.

I'm so sick of thinking about it that I've got to go get a Pepsi to calm me down.

Love,

The Fake Lonnie Finch

P.S. -...you filching bastards!

1. Yes - see my earlier post

2. Yes, and too many plaintiff attorneys and too many government agencies, and too many taxes on manufacturing

3. I don't get this one...what are "closet pricks" when it comes to MD's and how do you sort them out before med school?

4. Absolutely...see my earlier post

5. Stupid - no need to even respond to this.

6. GO MEAN GREEN!

[KRAM1]

http://www.forbes.com/sites/merrillmatthews/2011/08/15/can-obamacare-survive-an-unconstitutional-mandate/

I hope the above link works for everyone. It is a piece that our (Institute for Policy Innovation) resident scholar Dr. Merrill Matthews recently wrote and was published in Forbes regarding the mandates issue.

[glick1980]

http://sickothemovie.com/_media/SiCKO_sickofactoids.pdf

[KRAM1]

Apprecite the fact the sources were listed...especially that always so friendly to the United States U.N. stuff. The vast majority of everything listed here as something "wrong" with the United States can be refuted and explained rationally. Too much effort to try to get folks to understand that this sort of "stuff" just is so biased in its research as to be comical...I suppose now you'll want to quote that famously unbiased site Snopes.com.

[glick1980]

Apprecite the fact the sources were listed...especially that always so friendly to the United States U.N. stuff. The vast majority of everything listed here as something "wrong" with the United States can be refuted and explained rationally. Too much effort to try to get folks to understand that this sort of "stuff" just is so biased in its research as to be comical...I suppose now you'll want to quote that famously unbiased site Snopes.com.

The above is a horribly failed attempt to imply that an article written with actual sources is more biased that Kram's opinion.

Edited August 17, 2011 by glick1980

[Mean Green 93-98]

http://sickothemovie.com/_media/SiCKO_sickofactoids.pdf

None of this establishes that single-payer government healthcare is the answer. All it does it establish that our healthcare has become too expensive, a fact on which we all agree. So the question is, How do we reduce the cost of healthcare without reducing its quality? Again, I don't see how single-payer government healthcare answers that question.

[glick1980]

None of this establishes that single-payer government healthcare is the answer. All it does it establish that our healthcare has become too expensive, a fact on which we all agree. So the question is, How do we reduce the cost of healthcare without reducing its quality? Again, I don't see how single-payer government healthcare answers that question.

According to the article 18,000 people die per year in America because they don't have insurance. Our healthcare is already reduced quality, high priced health care. Canadians live longer than us, obviosuly they aren't experiencing the reduced quality healthcare you refer to. Elderly in England experience less health problems than here, so once again where is the reduced quality? When you go to the doctor an he see's you for a total of 2 minutes and bills you $250 dollars do you feel like you received quality healthcare or got your money's worth?

[yyz28]

Glick, the problem is that that none of those facts can be directly linked to our healthcare system.

[KingDL1]

Actually, if you want a driver's license, you have to have liability insurance.

Well that is not true in Texas, but true if you want to register a car. You may need a social security card to get or renew your driver's license.

Edited August 18, 2011 by KingDL1

[Harry]

So many logical fails in this thread.

First is the idea that without mandate most people won't have insurance. Well, that's an obvious fail. Before this manufactured crisis, there were roughly 15% of the population without health insurance. That means that the other 85% of us either made the choice to put a priority on our healthcare and that of our families or have it arranged for us by some other means. 85% of us are covered, and we're going to change that coverage for 85% of us to make sure the other 15% (who aren't denied medical care today mind you, they simply don't have insurance) have some sort of coverage.

I have to agree with Kram in insisting that the Auto Insurance discussion be dropped from consideration, as it is an absolute non-sequitor.

I will also echo that many plans were put forward by folks other than the ultra left leaders who were in absolute control when this was passed, including a documented several step plan released by the then Republican leaders in congress. These ideas were never given any press time, or so much as a moment on the floor of congress, and the Press just echoed the Democrat talking point that "the Republicans don't have any ideas, they are the 'Party of No!'".

...and for me, in the end, even if I like lots of the ideas within, if a measure is put in place by an unconstitutional mandate, the ends CAN NOT justify the means, as liberty is eroded and firewalls further broken down. If they can ignore the 10th amendment and the interstate commerce clause, they can just as easily ignore the first amendment.

I promised I wouldn't get sucked into this but I have to make a correction. 50 Million (1 in 5) Americans are without health insurance according to the CDC, here is a Link. I just used the first link of many that came up when I googled it.

I work in this area every day and there are a LOT of good people who cannot get coverage because of preexisting conditions or cannot afford it. To say that the healthcare crisis is manufactured is just wrong. 60% of bankruptcies are due to medical bills--here's the Link for that.. There are also a lot of companies facing double digit increases from insurance carriers when they are having to lower the price of their products or services to compete in this piss poor economy.

There are some good and bad things that are coming from the patient care and protection act ie Obamacare. Good is no Pre-ex starting in 2014. Bad is they really didn't address the real issue driving costs which is providers are incentivized more by frequency of procedures versus the quality of outcomes.

Politics aside, having been in this crazy business for 20 years, and dealing with it on a daily basis, I can assure you that this is not a manufactured crisis. It is real one that should be taken very seriously regardless of your political persuasion.

[All About UNT]

Harry has spoken. Any of you Chavs dare try to retort....you shall be banned for 3 hours.

J/K ....great points Harry and thanks for the insight.

[yyz28]

I promised I wouldn't get sucked into this but I have to make a correction. 50 Million (1 in 5) Americans are without health insurance according to the CDC, here is a Link. I just used the first link of many that came up when I googled it.

I work in this area every day and there are a LOT of good people who cannot get coverage because of preexisting conditions or cannot afford it. To say that the healthcare crisis is manufactured is just wrong. 60% of bankruptcies are due to medical bills--here's the Link for that.. There are also a lot of companies facing double digit increases from insurance carriers when they are having to lower the price of their products or services to compete in this piss poor economy.

There are some good and bad things that are coming from the patient care and protection act ie Obamacare. Good is no Pre-ex starting in 2014. Bad is they really didn't address the real issue driving costs which is providers are incentivized more by frequency of procedures versus the quality of outcomes.

Politics aside, having been in this crazy business for 20 years, and dealing with it on a daily basis, I can assure you that this is not a manufactured crisis. It is real one that should be taken very seriously regardless of your political persuasion.

Well, there are 311,800,000 (roughly) Americans. Do the math on your 50 million which I'll capitulate is correct for sake of this discussion, and you've got... 16%. Yup, one percent more than my figure (which was based on 2009 numbers that the healthcare bill was shoved down our throats on) but closer to 15% than the 20% you quote. ...but even at 20%, you're destroying a system that is covering 80% of Americans by installing law that:

A. will not actually cover that many more people as we have discovered during the months since the passage (...cause we had to pass it to see what was in it after all).

B. does not provide incentive for companies to keep employees on coverage.

C. does not provide enough incentive through the mandate to force people to buy it (fine is a fraction of the cost of the insurance).

D. will lower quality and choices for the 80% who currently DO have coverage.

E. now that all the details are known is clearly a political step to single payer which the people simply wouldn't have accepted this time around.

It is interesting to note that since this president has taken office and since this bill has passed, fewer, not more, people have healthcare coverage. This isn't because of the evil health insurance companies or mean corporations, it's because unemployment is skyrocketing and many of the jobs that are available don't offer benefits.

Many of the folks filing bankruptcy for medical bills HAVE health insurance. What does Obamacare do to stop that situation? I heard it used over and over again as a reason we needed this bill, but never once have I heard it explained how this bill stops that nonsense?

You know, you say "politics aside" then you play politics. I never said, nor did the folks against THIS type of healthcare reform that the system is perfect. It is FAR from it. I run two of those companies that are facing the double digit increases. There isn't a THING in Obamacare that shows me that will stop. In fact this year AFTER the bill was passed, I had a larger than normal increase. Now that Obamacare has passed and I have a small company that won't be penalized, I could just drop coverage, say "screw my employees" and take an extra 5 figures out of here a month home with me. I'm not going to, because I think health insurance is important. ...but I don't FORCE my employees to take the coverage. I have no right. The Government can't FORCE them to take it either. They have no right.

The heavy handed measures in this bill should have been a last resort, not a first step. As has been stated in this thread over and over again, there are lots of other ideas that would help and don't include MORE government involvement, but rather less. Decrease the paperwork, red-tape and government oversight of the healthcare industry. Allow insurance companies to compete across state lines. Broaden the ease for small businesses to pool, and allow them to do so across state lines. (I have different policies for my employees in Dallas vs my employees in Chicago, both on Blue Cross/Blue Shield. How dumb is that?)

...but empowering the IRS, and creating a situation where the Federal Government blows through yet another firewall in the Constitution is not the answer to the healthcare problem in this country. It will only serve to fan the flame and turn the problem INTO the crisis it was manufactured into to get the American people to surrender a little more liberty to the federal government.

Good debate, and I appreciate you coming back into continue it.

[KRAM1]

Good discussion here folks, but...once again...the question before the courts in not about health care, it is a Constitutional issue regarding mandates. Plain and simple....repeat after me...it is a Constitutional Issue...It is a Constitutional issue.

The health care entitlement program issue will be decided at a later date with much riding on how the Supreme Court rules. And that ruling may not come for some time in the future. The Supreme Court works on its own schedule. Not the schedule Congress might like and not Obama's schedule or mine or yours.

Patience...all in good time.

Edited August 19, 2011 by KRAM1