If the health care law goes down, then what?

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snoqueen
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Re: If the health care law goes down, then what?

Postby snoqueen » Fri Mar 30, 2012 10:02 am

I am angry at liberal politicians, pundits, and constitutional experts for their hubris and narrow mindedness in not envisioning an alternative perspective.


Plenty of alternative perspectives were offered (including Canadian-style single payer, and systems modeled on various European and Asian countries' health plans) but none could pass Congress, which is not a liberal body at this time.

For my own part, I was disappointed in the healthcare law from the beginning because I too wanted single payer or possibly an extension of Medicare to cover, by increments, the rest of the people. So I'm among the small but principled percentage who are only slightly disappointed to see what's happening. The affordable care act was better than doing nothing, but it wasn't a satisfactory solution in the long run.

Quite frankly, I think the Republicans want 1) no healthcare plans at all; and 2) nothing more than to discredit Obama as much as possible. They aren't focusing at all on the needs of the people, or even pretending to do so any more.

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Re: If the health care law goes down, then what?

Postby Henry Vilas » Fri Mar 30, 2012 10:03 am

Huckleby wrote:The health care bill could have easily been crafted to protect it from the challenge we see now.

The only thing that is easy is you saying so. Care up back that up with some details?

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Re: If the health care law goes down, then what?

Postby Huckleby » Fri Mar 30, 2012 10:14 am

snoqueen wrote:
I am angry at liberal politicians, pundits, and constitutional experts for their hubris and narrow mindedness in not envisioning an alternative perspective.


Plenty of alternative perspectives were offered (including Canadian-style single payer,


I was referring specifically to the mandate. Constitutional experts and politicians assumed that because the weight of evidence indicates that a mandate is constitutional under commerce clause, that of course the health care law would pass consitutional muster with Supreme Court justices.

This was stupid and arrogant! It reflects an inability to see an issue from a different philisophical perspective.

Of course conservatives, who hate the feds paying for health care expansion, will seize upon ANY credible line of thinking to invalidate the law. Liberals would do the same if the shoe was on the other foot.

Democrats should have taken a defensive posture. They should have explicitly declared the penalty a tax, which would have closed the constitutional vulnerability. They didn't want to pay that modest political cost. They arrogantly believed they had the only reasonable way to see the issue, and were therefore on safe ground. Dummies.
Last edited by Huckleby on Fri Mar 30, 2012 10:29 am, edited 2 times in total.

Huckleby
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Re: If the health care law goes down, then what?

Postby Huckleby » Fri Mar 30, 2012 10:18 am

Henry Vilas wrote:
Huckleby wrote:The health care bill could have easily been crafted to protect it from the challenge we see now.

The only thing that is easy is you saying so. Care up back that up with some details?


Everybody knew, and it was discussed, that the mandate was home-free constitutionally if it was more explicitly included under the federal government's taxing authority. It really involved only minor. semantic changes to do so. When you think about it, instead of penalizing people for not having insurance, you could simply make them ineligible for a tax break. Or otherwise include the penalty directly in tax code.

The Dems were obsessed with claiming that the bill would not raise taxes. So they made an unwise political calculation.

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Re: If the health care law goes down, then what?

Postby Huckleby » Fri Mar 30, 2012 10:28 am

snoqueen wrote: For my own part, I was disappointed in the healthcare law from the beginning because I too wanted single payer or possibly an extension of Medicare to cover, by increments, the rest of the people.


That is going to be a tough fight, expanding medicare, and was impossible in 2009.

More to the point, and this is really painful, if the bill had included a public option, it would have helped the consitutional argument for the bill. Then people, or at least not all people, would be forced to purchase a private product.

I never saw that angle coming.

I am the rare bird who thinks that the Obamacare approach is actually much better (as a first step) than expanded medicare, and I arrive at that positition from looking at how various forms of universal healthcare are performing around the world.

But the fuckers have torpedoed Obamacare on a technicality.

snoqueen wrote: So I'm among the small but principled percentage who are only slightly disappointed to see what's happening. .

You need to get more disappointed. Regardless of how you want universal healthcare to be delivered, this is a huge setback.

snoqueen wrote: Quite frankly, I think the Republicans want 1) no healthcare plans at all; and 2) nothing more than to discredit Obama as much as possible. They aren't focusing at all on the needs of the people, or even pretending to do so any more.

Yes, this is the bitter truth. I am open-minded about alternative solutions to expanding health care, including free market, but the Republican "solutions" of tort reform, interstate insurance and high-risk pools are all shell games when examined closely.

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Re: If the health care law goes down, then what?

Postby sallybell » Fri Mar 30, 2012 8:29 pm

Huckleby wrote:
sallybell wrote:Meade: how do you feel about EMTALA? Do you think it should be repealed, or do you think it should stay?

I guess that if you walked out on the street and took a poll, 1 in 100 people could tell you what EMTALA means. I am the 99%.


Meade's got a lady friend he could ask...for the 99%, there's Wikipedia.
http://en.wikipedia.org/wiki/Emergency_ ... _Labor_Act

EMTALA is the federal law (signed by Reagan, I believe) that says hospital emergency rooms cannot turn away people who are having a medical emergency or in active labor. Or, to put it bluntly, why folks without insurance sometimes use ERs as primary care providers, which is one factor in driving up healthcare costs for all (particularly when folks can't pay for ER services and hospitals either write it off or turn it over to collections).

Particularly for folks who disagree with the individual mandate portion of the Affordable Care Act...I wonder if they support getting rid of EMTALA. That's all. It's a question that I'd love an answer to.

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Re: If the health care law goes down, then what?

Postby Huckleby » Sat Mar 31, 2012 9:01 am

I've never heard anybody suggest that we should stop treating uninsured people in emergency rooms, although I suppose there are some who think that way. Few would make such a suggestion where they can be so easily vilified.

What I have heard from some conservatives is that they want to establish low cost clinics to treat the uninsured in emergency situations. Ann Coulter suggested this, have also seen the idea put forth by conservatives in forums.

The motivation here is to take the health care issue off the table on the cheap, blunt any momentum towards universal health care. I don't think this proposal is going anywhere. For one, it might ironically morph into government run health care like in England.

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Re: If the health care law goes down, then what?

Postby Huckleby » Sat Mar 31, 2012 9:08 am

BTW, for you Obamacare skeptics who don't much care about it going down: aren't you really acting like the conservatives you criticize for putting ideology ahead of people? What about the 20M poor, single adults who lose access to medicaid, or the 10M low income who won't be subsidized to buy health insurance?


Well, enough with the lectures. I guess we are going to have to get behind medicare for all. It could be a 20-year struggle, but no time like the present to get started.

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Re: If the health care law goes down, then what?

Postby Henry Vilas » Sun Apr 01, 2012 1:25 pm

Obama's insurance requirement not the only mandate

The individual insurance requirement that the Supreme Court is reviewing isn't the first federal mandate involving health care.

There's a Medicare payroll tax on workers and employers, for example, and a requirement that hospitals provide free emergency services to indigents. Health care is full of government dictates, some arguably more intrusive than President Barack Obama's overhaul law.

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Re: If the health care law goes down, then what?

Postby DCB » Sun Apr 01, 2012 1:58 pm

Huckleby wrote:I've never heard anybody suggest that we should stop treating uninsured people in emergency rooms, although I suppose there are some who think that way. Few would make such a suggestion where they can be so easily vilified.

There have been plenty examples recently of conservatives arguing that anyone who can't afford to pay for their own health care should suffer and die.

Ron Paul at the GOP debate
Biltzer: society should just let him die?
Crowd: Yeah!
http://www.youtube.com/watch?v=irx_QXsJiao

At a protest against the healthcare law, some teabaggers mock a guy with Parkinson's Disease:
http://www.dispatch.com/content/stories ... ebate.html
http://digbysblog.blogspot.com/2010/03/ ... avior.html

Romeny on the Leno show the other night:
“If they are 45 years old and they show up and say, ‘I want insurance because I have heart disease,’ it’s like, ‘Hey guys. We can’t play the game like that. You’ve got to get insurance when you are well and then if you get ill, you are going to be covered,’” Romney said.

But if you didn't, or couldn't afford it, or if you were turned down because of pre-existing condition, then, what? you're screwed?

Huckleby
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Re: If the health care law goes down, then what?

Postby Huckleby » Sun Apr 01, 2012 2:04 pm



Ezra Klein: Individual mandate is Ryan tax credit by other name

The difference between the individual mandate and Paul Ryan's tax penalty for not having health insurance is that Ryan's plan if far more punitive.


The entire health care debate has been an endless, shrill propoganda war of semantics. One can make slippery slope arguments about ANY federal power: once you allow the feds power to wage income tax, couldn't they just take 99% of everyone's money? It was sad and low to see Supreme Court justices resorting to cheap, slippery slope arguments. More to read if you are not sufficiently pissed off:
Steven Pearlstein: Eat your broccoli, Justice Scalia

Huckleby
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Re: If the health care law goes down, then what?

Postby Huckleby » Sun Apr 01, 2012 2:17 pm

DCB wrote: There have been plenty examples recently of conservatives arguing that anyone who can't afford to pay for their own health care should suffer and die.

OK, some right wingers anonymously shouting their true feelings. I'm not hearing talk like that from politicians, pundits or even posters.

DCB wrote: Romeny on the Leno show the other night:
“If they are 45 years old and they show up and say, ‘I want insurance because I have heart disease,’ it’s like, ‘Hey guys. We can’t play the game like that. You’ve got to get insurance when you are well and then if you get ill, you are going to be covered,’” Romney said.

But if you didn't, or couldn't afford it, or if you were turned down because of pre-existing condition, then, what? you're screwed?


Romney is talking about access to health insurance, not access to emergency health care.

But he said something VERY revealing during that show: He wants to make insurers accept pre-existing conditions for people with "continuous health coverage." Well, this is a half measure that will help a percentage of people and ignores the difficult core problem.

I believe there are a large number of reasonable Republicans, and I include Romney among them, who do have a social conscience and want to do something. Here is an excellent column from a reasonable Republican at NY Times,
ROSS DOUTHAT:The Genius of the Mandate

He supports policies that will not attempt universal coverage, but still help a lot of people. I am generally all in favor of half-a-loaf solutions, as long as there is a long term plan of action to achieve the full loaf. The "good Republicans" are proposing solutions that will ease the pressure for universal health care, and stall progress indefinitely. They aren't thinking in those terms, but that is the net result.


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