SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386, 590]

Kandahar said:

My ultimate goal is to have everyone covered under a federal plan which would provide, at the very least, catastrophic coverage and free preventative care.

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Catastrophic is anything life-threatening or permanently disabling right? And preventive is pretty much everything else. Unless you'd care to specify what is altogether excluded from these two categories, I think we have to assume it's all-inclusive.

And they'd pay premiums for this insurance, if they could afford it. Otherwise they'd get subsidies to pay for it, which would be paid for out of the general tax revenue.

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This is all going in the same direction, which is what I articulated. Over time, fewer and fewer people are responsible for more and more of the funding responsibility, leaving people poorer, more desperate/helpless and more reliant on the contributions of others to meet their needs. Meanwhile, nothing is implemented to suppress the actual cost of medical care.

People aren't going to care any more or less just because they're on a government plan. What's important, as far as getting people to care about the costs, is the deductible. And I would support higher deductibles for government plans (although I'd waive them for people who couldn't afford them).

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You make people pay pricier and pricier premiums, as well as larger deductibles, until they can't afford it and then you waive the requirement. This is exactly as I described in my previous post. "Make them poor enough to need us."

Is there any conceivable scenario in which a person would be denied care? Of any kind? If not, this sounds like universal care, which we already have by virtue of our promise to treat anyone who shows up, and the glaring problem with universally guaranteed care is that it inherently fails to control for the rising cost of medical care, and heaps the burden onto an ever smaller group of people.

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

teamosil said:

Well obviously removing the public option is the hugest concession to the GOP and the corporations. Oddly, the mandate was another one. But also things like raising the caps on price increases.

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They didnt make that concession to the GOP, they made it to fellow democrats. The GOP played no role, ZERO, in the crafting of the legislation that came out of the House. The concessions made were made to get 218 democratic votes.

Kandahar said:

I find it's better to see the world as it actually is, rather than as one might want it to be. This is especially important when forming political policy. And ranting about the "****ing political system" doesn't change the fact that it does, in fact, exist, and the only way to get to universal health care is to work through it.

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But is it not clear that both the Dems and the GOP work together to create political tension and opposition, so the system stays in power, and no third way is possible? In Virginia, it is illegal to have a third political party. Same sort of deal in other states. Campaigns are financed by corporations. The political establishment generates controversy and opposition between the two entrenched parties.

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

reefedjib said:

Why do you keep bringing up AUTO insurance? All that is required is liability insurance...minus the medical side, because Medicare for all will solve the medical problem, all that is left is property damage insurance, Since cars/trucks are optional, if you don't have a vehicle you have no need for liability insurance. Medical coverage, on the other hand, is inescapable. We each have our bodies and our health to deal with.

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You duck the POINT. Why is "single payer" good for ONLY medical care? You fail to see that the SAME argument can be made for any "need", that it can either be attained by trading a prtion of YOUR wages for it, or supplied to ALL by taxation and the gov't doling it out. This is no more, or less, true for food, sheter and clothing, than for medical care. You dance all around the issue; we all have as much "ACCESS" to the doctor as we do for the grocery store, it is just that BOTH expect to be paid for their goods and services upon check-out.

The idea that since medical care is important, it somehow should be made into a "common right", instead of remaining an individual responsibility, applies equally to food, shelter and clothing. You either believe that one should work and provide for themselves (and their dependents) or that ALL "needs" should be guaranteed by the gov't, and that work is a mere option, needed only to secure luxuries, beyond that "needed" for simply sustaining life, which are "guaranteed" to all, just for existing in the USA.

We now have MANY gov't programs to "give away" things, but is that REALLY a good thing? In our "war on poverty" we have NOT eliminated poverty, we still have a steady 12% to 15% of the U.S. population defined as "poor people", they simply happen to be supported BY THE GOV'T (we the WORKING sheeple) at a standard of living well above 75% of the world, yet ever more is STILL demanded of the 52% that must pay income taxes.

Neomalthusian said:

Catastrophic is anything life-threatening or permanently disabling right? And preventive is pretty much everything else. Unless you'd care to specify what is altogether excluded from these two categories, I think we have to assume it's all-inclusive.

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Any medical expenses beyond a certain relatively high deductible (maybe $4,000)...plus a few annual checkups, cancer screenings, etc. Ideally, the patient's first $4,000 of care (excluding those preventative services) would be out-of-pocket if he/she could afford it.

This is all going in the same direction, which is what I articulated. Over time, fewer and fewer people are responsible for more and more of the funding responsibility, leaving people poorer, more desperate/helpless and more reliant on the contributions of others to meet their needs.

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Not at all. Everyone who could afford it would be paying for their own premiums and out-of-pocket expenses under such a system.

Meanwhile, nothing is implemented to suppress the actual cost of medical care.

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The Affordable Care Act established the IPAB to help control costs. Additionally, as the government covers more people, its bargaining power with health care providers will increase and it will be better able to keep costs down.

Is there any conceivable scenario in which a person would be denied care? Of any kind? If not, this sounds like universal care,

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Correct, universal care.

and the glaring problem with universally guaranteed care is that it inherently fails to control for the rising cost of medical care, and heaps the burden onto an ever smaller group of people.

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Every single country in the world with universal health care does a better job control the costs of medical care than the United States does.

reefedjib said:

But is it not clear that both the Dems and the GOP work together to create political tension and opposition, so the system stays in power, and no third way is possible? In Virginia, it is illegal to have a third political party. Same sort of deal in other states. Campaigns are financed by corporations. The political establishment generates controversy and opposition between the two entrenched parties.

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If that's the case, what makes you think that it's remotely realistic to scrap the Affordable Care Act and go straight to universal health care?

Neomalthusian said:

Catastrophic is anything life-threatening or permanently disabling right? And preventive is pretty much everything else. Unless you'd care to specify what is altogether excluded from these two categories, I think we have to assume it's all-inclusive.



This is all going in the same direction, which is what I articulated. Over time, fewer and fewer people are responsible for more and more of the funding responsibility, leaving people poorer, more desperate/helpless and more reliant on the contributions of others to meet their needs. Meanwhile, nothing is implemented to suppress the actual cost of medical care.



You make people pay pricier and pricier premiums, as well as larger deductibles, until they can't afford it and then you waive the requirement. This is exactly as I described in my previous post. "Make them poor enough to need us."

Is there any conceivable scenario in which a person would be denied care? Of any kind? If not, this sounds like universal care, which we already have by virtue of our promise to treat anyone who shows up, and the glaring problem with universally guaranteed care is that it inherently fails to control for the rising cost of medical care, and heaps the burden onto an ever smaller group of people.

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From each according to their ability (to pay taxes), to each according to their need (for free stuff).

Yes they can!

Kandahar said:

If that's the case, what makes you think that it's remotely realistic to scrap the Affordable Care Act and go straight to universal health care?

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Get the Tea Party and Occupy Wall Street leadership together in a room and agree to basic principles and basic policies...UHC is one of them, and removing corporate interests from government is another. Balanced budget is a third one. Remove entitlements from teh federal budget and make them state level is a fourth. Ending drug prohibition is a fifth one. Financial regulation is a sixth one. Then talk to various candidates, or supply their own, and pull together a new political party, in the shadows, as some will be Dems and some will be GOP. Get representation in Congress and get the Presidency. Enact the agreed policies.

Kandahar said:

Any medical expenses beyond a certain relatively high deductible (maybe $4,000)...plus a few annual checkups, cancer screenings, etc. Ideally, the patient's first $4,000 of care (excluding those preventative services) would be out-of-pocket if he/she could afford it.



Not at all. Everyone who could afford it would be paying for their own premiums and out-of-pocket expenses.



The Affordable Care Act established the IPAB to help control costs. Additionally, as the government covers more people, its bargaining power with health care providers will increase and it will be better able to keep costs down.



Correct, universal care.



Every single country in the world with universal health care does a better job control the costs of medical care than the United States does.

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Controlling costs by gov't mandate is INSANE. Apply that concept to food; we now have a variety of restaurants from places offering filet mignon, with all the trimmings, served on fine china, while seated at linen covered tables to drive-through joints offering tacos in a paper bag. If you start controlling prices, what you end up with is less and less choice until ALL restaurants offer only tacos, as more and more are forced to close.

reefedjib said:

Get the Tea Party and Occupy Wall Street leadership together in a room and agree to basic principles and basic policies...UHC is one of them, and removing corporate interests from government is another. Balanced budget is a third one. Then talk to various candidates, or supply their own, and pull together a new political party, in the shadows, as some will be Dems and some will be GOP. Get representation in Congress and get the Presidency. Enact the agreed policies.

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First of all, there is no "Tea Party leadership" or "Occupy Wall Street leadership" outside of the Republican and Democratic Party. There is absolutely zero chance you're going to get a herd of right-wing conservatives to agree to universal health care. And even if you did, they would turn on it the instant it was introduced as legislation, as they did with the Affordable Care Act. The individual mandate had 20 years of conservative intellectual groundwork, but that didn't stop them from abandoning it the minute a guy with a (D) after his name signed on to it. So what makes you think that a vastly more liberal policy which has never had any conservative support would enjoy a better fate?

If you want to get to universal health care, you take big steps when you can (i.e. the Affordable Care Act), and you take smaller steps when you can't (i.e. incrementally raising Medicaid eligibility).

ttwtt78640 said:

Controlling costs by gov't mandate is INSANE.

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Except it works just fine for every other developed nation.

Apply that concept to food; we now have a variety of restaurants from places offering filet mignon, with all the trimmings, served on fine china, while seated at linen covered tables to drive-through joints offering tacos in a paper bag. If you start controlling prices, what you end up with is less and less choice until ALL restaurants offer only tacos, as more and more are forced to close.

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Well, we don't need to apply it to food.

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

ttwtt78640 said:

You duck the POINT. Why is "single payer" good for ONLY medical care? You fail to see that the SAME argument can be made for any "need", that it can either be attained by trading a prtion of YOUR wages for it, or supplied to ALL by taxation and the gov't doling it out. This is no more, or less, true for food, sheter and clothing, than for medical care. You dance all around the issue; we all have as much "ACCESS" to the doctor as we do for the grocery store, it is just that BOTH expect to be paid for their goods and services upon check-out.

The idea that since medical care is important, it somehow should be made into a "common right", instead of remaining an individual responsibility, applies equally to food, shelter and clothing. You either believe that one should work and provide for themselves (and their dependents) or that ALL "needs" should be guaranteed by the gov't, and that work is a mere option, needed only to secure luxuries, beyond that "needed" for simply sustaining life, which are "guaranteed" to all, just for existing in the USA.

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The issue is that except for the really poor, food, shelter and clothing are affordable to most Americans. There are programs to help the poor with food, shelter and clothing, although more could be done. But the cost for these things are not prohibitive and they are constant, recurring, affordable costs.

In the case of healthcare it is completely different. Your average doctor visit is affordable, but hospitalization, surgery, advanced tests, and the latest drugs are not affordable, even to a middle class family, much less a poor one. There are regular doctor visits but there is also the unexpected visit and the costly consequences if a problem is found. So, we have a basic need, healthcare, whose cost is prohibitive and unpredictable. Unlike those other needs, the solution to healthcare to deal with these qualities of prohibitive cost and unpredictable occurrence, is to treat it as insurance. Unfortunately, this insurance is tied to employment and if you are not poor, you have to pay a huge amount for COBRA. Plus the administration of all this is Byzantine.

Solution to healthcare, and not food, shelter and clothing? Make it single payer, universal.

The reason why this does not apply to auto, renters or life insurance is that those are not needs.

Kandahar said:

First of all, there is no "Tea Party leadership" or "Occupy Wall Street leadership" outside of the Republican and Democratic Party. There is absolutely zero chance you're going to get a herd of right-wing conservatives to agree to universal health care. And even if you did, they would turn on it the instant it was introduced as legislation, as they did with the Affordable Care Act. The individual mandate had 20 years of conservative intellectual groundwork, but that didn't stop them from abandoning it the minute a guy with a (D) after his name signed on to it. So what makes you think that a vastly more liberal policy which has never had any conservative support would enjoy a better fate?

If you want to get to universal health care, you take big steps when you can (i.e. the Affordable Care Act), and you take smaller steps when you can't (i.e. incrementally raising Medicaid eligibility).

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I know for a fact that there is Tea Party leadership not attached to a particular politician. There is also serious Occupy Wall Street folks trying to be involved in the government discussions on regulation of financial markets. Bring then together for a weekend. Immediately table disagreements and focus on common ground.

Healthcare is only one issue, and if it got tabled while other principles and policies were agreed to, I would take that in a DC power outage.

Kandahar said:

Except it works just fine for every other developed nation.



Well, we don't need to apply it to food.

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Then buy "the poor" a first class ticket to Morroco if they are sick. ;-)

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

reefedjib said:

The issue is that except for the really poor, food, shelter and clothing are affordable to most Americans. There are programs to help the poor with food, shelter and clothing, although more could be done. But the cost for these things are not prohibitive and they are constant, recurring, affordable costs.

In the case of healthcare it is completely different. Your average doctor visit is affordable, but hospitalization, surgery, advanced tests, and the latest drugs are not affordable, even to a middle class family, much less a poor one. There are regular doctor visits but there is also the unexpected visit and the costly consequences if a problem is found. So, we have a basic need, healthcare, whose cost is prohibitive and unpredictable. Unlike those other needs, the solution to healthcare to deal with these qualities of prohibitive cost and unpredictable occurrence, is to treat it as insurance. Unfortunately, this insurance is tied to employment and if you are not poor, you have to pay a huge amount for COBRA. Plus the administration of all this is Byzantine.

Solution to healthcare, and not food, shelter and clothing? Make it single payer, universal.

The reason why this does not apply to auto, renters or life insurance is that those are not needs.

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OK, then let's END SNAP, DOEd and welfare (in all of its many forms), and place that "savings" into medicaid and expand that coverage. There is NO extra in the federal "budget" as we now spend 40% more than we dare ask for in direct taxation. It is time to set PRIORITIES not simply add ever more "nice" things that the gov't can think of. We must FIRST have our gov't learn to live within its means, only THEN talk of adding things. ;-)

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

reefedjib said:

You don't think corporations use the commerce clause to raise the barriers of entry into an industry, to limit the players?

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Sure, that happens sometimes. Like I say 1 out of 100 uses of the commerce clause is pro-corporate. But the extent to which it happens is wildly exaggerated. For example, you hear a lot of talk about small businesses being driven out of business by overwhelming regulatory burdens. I worked at a three person start up as it grew into a 75 person company. The only regulatory burden we really had was paying taxes once a year. The first year, the CEO did the taxes himself. The next two years he hired an accountant to work on it for a couple days. Then once it got bigger, the CFO did them himself. That was it. It's hype. In fact, most regulations don't even affect small businesses at all. For example, most employment regulations don't kick in until a business has 50 or 200 employees. Financial reporting requirements don't kick in until a company is publicly traded on a major exchange with over 2,000 shareholders of record (which usually means at least 50,000 actual shareholders, since most investors, their brokerage is the "shareholder of record". So, you could have only one shareholder of record- etrade, but have a million shareholders).

What the barrier to entry argument is is just spin from big businesses that want to push their externalities on to the general public freely.

reefedjib said:

That is the difference between corporate interests and propaganda. Who do you think makes money on the drug war, especially with the artificial retail price of drugs?

• Cartels?
• Police?
• Federal Law Enforcement?
• Arms manufacturers?
• Communications and military/survillance industries?
• Banks and financial institutions?
• Real Estate?
• Politicians?

What the hell do they do with all the money that flows through the artificial black market?
What authoritarian governments with offensive federal police powers are supported by Drug War aid?

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I mean, I'm sure some manufacturers and whatnot lobby in favor of the war on drugs. But I don't buy that that is the main motivation behind it. Seems more driven by the politics to me. Again, I'm strongly anti-war-on-drugs. And I'm for legalization at least of non-physically-addictive drugs. But, I think it's a bit of a stretch to blame the war on drugs on the corporations. There was, and to a lesser extent, there still is, an enormous amount of public hysteria about it. It is very similar to the immigration hysteria today IMO.

reefedjib said:

All because of propaganda and misuse of the commerce clause?

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No that is not accurate at all. The commerce clause has played a fairly minor role in the war on drugs. The war in general is conducted by states, who don't need any constitutional justification. For federal law enforcement, actual interstate, or international drug trafficking the federal government would have authority over regardless of the commerce clause. The only place they really need it is in the scenario you referenced- somebody who is growing their own drugs for consumption within the same state. So, trying to pin the war on drugs on the commerce clause isn't very reasonable IMO.

reefedjib said:

This is my fundamental point. The two groups dissatisfied with the country are the Tea Party and the Occupy Wall Street folks. It must be made clear to both groups that they share the same fundamental principle: government is beholden to corporate interests.

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I agree there are some similarities- they both want corporations to have less control over government. But they differ radically on the other side of the equation. OWS wants government to force corporations into line. The Tea Party wants government to let corporations off the leash to do whatever they want to us.

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Fletch said:

They didnt make that concession to the GOP, they made it to fellow democrats. The GOP played no role, ZERO, in the crafting of the legislation that came out of the House. The concessions made were made to get 218 democratic votes.

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No lol. That isn't how politics works. The right went bezerk over it. That has a huge impact. Democrats in swing states couldn't take the heat and they caved. That's what all those tea parties were about- trying to force democrats in swing states to cave.

reefedjib said:

I know for a fact that there is Tea Party leadership not attached to a particular politician.

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It doesn't matter. Virtually all of them are driven by the same tribal mentality that drives their fierce opposition to the Affordable Care Act, despite the fact that there was almost no opposition (let alone outrage) to these kind of ideas among conservatives prior to 2009.

There is also serious Occupy Wall Street folks trying to be involved in the government discussions on regulation of financial markets. Bring then together for a weekend. Immediately table disagreements and focus on common ground.

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Health care would most certainly not be common ground. In fact it's possibly the single most intractable issue between them.

Healthcare is only one issue, and if it got tabled while other principles and policies were agreed to, I would take that in a DC power outage.

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Then I think you're in the wrong thread.

ttwtt78640 said:

Then buy "the poor" a first class ticket to Morroco if they are sick. ;-)

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Other nations, understandably, aren't particularly fond of paying for health care for the citizens of deadbeat nations like ours. It's why I had to buy international health insurance policies when I was in college, whenever I traveled abroad (even to nations with universal health care).

Kandahar said:

Except it works just fine for every other developed nation.



Well, we don't need to apply it to food.

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How much do these other nations spend (% of GDP) on their military, education, agricultural subsidies and other "social programs"? These other nations made different CHOICES than the U.S. and allocate their tax money on those things in different proportions than we do. Perhaps if the U.S. spent the SAME dollar amount, per patient/citizen, as they did, then we would have that same "quality" of care. Using apples to moonrocks comparisons is insane.

Kandahar said:

Other nations, understandably, aren't particularly fond of paying for health care for the citizens of deadbeat nations like ours. It's why I had to buy international health insurance policies when I was in college, whenever I traveled abroad (even to nations with universal health care).

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We treat illegal aliens for free, under the PPACA, why should they not do so?

ttwtt78640 said:

How much do these other nations spend (% of GDP) on their military, education, agricultural subsidies and other "social programs"? These other nations made different CHOICES than the U.S. and allocate their tax money on those things in different proportions than we do.

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Sounds like a good argument for spending less on military and agricultural subsidies, and reforming our education system so that we can spend less there too.

Perhaps if the U.S. spent the SAME dollar amount, per patient/citizen, as they did, then we would have that same "quality" of care. Using apples to moonrocks comparisons is insane.

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No, see, that's the thing. We *ALREADY* spend far more than any other country in the world on our health care. Yet we STILL get results that are, at best, average. Obviously the countries with universal health care are doing something right, and obviously we are doing something wrong.

ttwtt78640 said:

We treat illegal aliens for free, under the PPACA, why should they not do so?

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Because believe it or not, other nations have sovereign governments where they set their own policies, rather than merely acting as foils to the US policies on various issues.

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

teamosil said:

Sure, that happens sometimes. Like I say 1 out of 100 uses of the commerce clause is pro-corporate. But the extent to which it happens is wildly exaggerated. For example, you hear a lot of talk about small businesses being driven out of business by overwhelming regulatory burdens. I worked at a three person start up as it grew into a 75 person company. The only regulatory burden we really had was paying taxes once a year. The first year, the CEO did the taxes himself. The next two years he hired an accountant to work on it for a couple days. Then once it got bigger, the CFO did them himself. That was it. It's hype. In fact, most regulations don't even affect small businesses at all. For example, most employment regulations don't kick in until a business has 50 or 200 employees. Financial reporting requirements don't kick in until a company is publicly traded on a major exchange with over 2,000 shareholders of record (which usually means at least 50,000 actual shareholders, since most investors, their brokerage is the "shareholder of record". So, you could have only one shareholder of record- etrade, but have a million shareholders).

What the barrier to entry argument is is just spin from big businesses that want to push their externalities on to the general public freely.

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I take it your company was not in the agriculture, defense, pharmaceutical, energy, telecom or financial industries. Were you working for a designer label?

teamosil said:

I mean, I'm sure some manufacturers and whatnot lobby in favor of the war on drugs. But I don't buy that that is the main motivation behind it. Seems more driven by the politics to me. Again, I'm strongly anti-war-on-drugs. And I'm for legalization at least of non-physically-addictive drugs. But, I think it's a bit of a stretch to blame the war on drugs on the corporations. There was, and to a lesser extent, there still is, an enormous amount of public hysteria about it. It is very similar to the immigration hysteria today IMO.

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Drug War: Propaganda
How Cannabis was Criminalised | Cannabis Information

Once opium and marijuana were illegal, it was simple to extend the drug war industry to all other illicit drugs and the US federal government was the prime mover in the UN making drugs internationally illegal. The Drug War is a vast industry.

teamosil said:

No that is not accurate at all. The commerce clause has played a fairly minor role in the war on drugs. The war in general is conducted by states, who don't need any constitutional justification. For federal law enforcement, actual interstate, or international drug trafficking the federal government would have authority over regardless of the commerce clause. The only place they really need it is in the scenario you referenced- somebody who is growing their own drugs for consumption within the same state. So, trying to pin the war on drugs on the commerce clause isn't very reasonable IMO.

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The states and the feds conduct the war on drugs. The states' war on drugs is funded by the feds.

Ok, I am with you. The commerce clause has not played a fundamental role in drug criminalization, but it is not a minor role either, at least in the case of marijuana. Otherwise, I could grow for personal consumption. See Gonzales v. Raich.