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Kennedy: Individual Mandate Fundamentally Changes Relationship of Govt

There isn't going to be any single payer system. That was killed long ago.

No it's not, it's really inevitable if this bill gets struck down. The status-quo can't last forever, and change is needed.
 
No it's not, it's really inevitable if this bill gets struck down. The status-quo can't last forever, and change is needed.
I doubt people are going to be very enthusiastic about another major tax and spend program until we do something significant about the current debt situation, which will undoubtedly turn critical again after the election.
 
I doubt people are going to be very enthusiastic about another major tax and spend program until we do something significant about the current debt situation, which will undoubtedly turn critical again after the election.

It is still inevitable.
 
It is still inevitable.
Not really, we could see a slow-growth expansion of the two-tier system and still provide "universal coverage" without going single payer. Single-payer couldn't even pass with heavy house and senate Democrat majorities and a Democratic president with health care reform his primary goal.
 
It is fantastic to hear this. It would be even better if it's not a 5-4 Decision to strike the mandate, but I don't think that's going to be likely.

The way the lib judges coached the attorney for the government, picked him up when he fell down and threw him softball questions I think a 5-4 decision is a forgone conclusion.
 
It is still inevitable.
When democrats manage to get that once-in-a-generation supermajority in the house and senate and whitehouse and own the courts, maybe. But I doubt that's going to happen anytime soon.
 
No it's not, it's really inevitable if this bill gets struck down. The status-quo can't last forever, and change is needed.

that is true. but I find your belief that "change" means "only in the direction of increased government control" interesting.

given that in about 10 years we will no longer be able to fund social security and medicare, where do you imagine we are going to get the money to fund UHC?
 
that is true. but I find your belief that "change" means "only in the direction of increased government control" interesting.

given that in about 10 years we will no longer be able to fund social security and medicare, where do you imagine we are going to get the money to fund UHC?
Lack of money is but a mere nuisance to the government.

Ok, seriously, I believe single-payer is an inevitability, also. Don't mistake that as meaning it would be the best option. I didn't say that. I mean the option that I believe will happen.

I would (hope?) think that single-payer would eliminate medicare, so that would account for part of the funding, but not all of it. But, as I type this another thought jumps in my head that kind of scares me. We might end up with both. Government is loathe to eliminate ANY program, ever, and we usually end up with needless duplication.
 
a public option should have been the compromise, not a mandate to buy insurance from for-profit insurance companies.

it's past time to start looking at what other first world nations are doing about this problem. step one is to uncouple health insurance coverage from employment. then we can consider how many for-profit middlemen we really need between the patient and the healthcare solution.
 
Lack of money is but a mere nuisance to the government.

..... i will admit, i'm not even sure where to go with this. the inability to actually afford something doesn't mean we can't buy it....

are you suggesting we will simply print the money, and accept the destruction of wealth inherent in high inflation?

Ok, seriously, I believe single-payer is an inevitability, also. Don't mistake that as meaning it would be the best option. I didn't say that. I mean the option that I believe will happen.

I would (hope?) think that single-payer would eliminate medicare, so that would account for part of the funding, but not all of it. But, as I type this another thought jumps in my head that kind of scares me. We might end up with both. Government is loathe to eliminate ANY program, ever, and we usually end up with needless duplication.

Democrats barely pushed through Obamacare with a supermajority in the Senate, ownership of the House, and the White House. It was a hair-thin vote, they were forced to resort to parliamentary tricks, and many were subsequently relieved of the burden of public service by that a public no longer interested in their services.

There is simply no way UHC passes. You may get universal subsidization of health insurance in the form of refundable tax credits a'la the Ryan Plan. But Obamacare pretty much established the left lateral limit for the politically possible health care reform.
 
step one is to uncouple health insurance coverage from employment.

in most cases, certainly. but one-size-fits-all typically doesn't.

then we can consider how many for-profit middlemen we really need between the patient and the healthcare solution.

for the vast majority of cases, only one - the health care provider. insurance is only feasible for catastrophic costs.
 
Here are what I consider the most telling comments from Kennedy:

“Assume for the moment that this is unprecedented, this is a step beyond what our cases have allowed, the affirmative duty to act to go into commerce. If that is so, do you not have a heavy burden of justification? I understand that we must presume laws are constitutional, but, even so, when you are changing the relation of the individual to the government in this, what we can stipulate is, I think, a unique way, do you not have a heavy burden of justification to show authorization under the Constitution?”

“I think it is true that, if most questions in life are matters of degree . . . the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries. That’s my concern in the case.”

Kennedy is not going to strike the law, but he is going to impose a high burden of proof for similar laws in the future, and he is going to make it clear that the healthcare/insurance industry and this particular situation is very unique. I think Roberts may join with him as well.

JMO.
 
..... i will admit, i'm not even sure where to go with this. the inability to actually afford something doesn't mean we can't buy it....

are you suggesting we will simply print the money, and accept the destruction of wealth inherent in high inflation?
My point was semi-facetious, but in all seriousness I'm not suggesting we do. I am suggesting that saying we can't buy something if we don't have the money would mean more if we didn't have such a history of government deficits and debt. We're obviously not being fiscally responsible as it is.


Democrats barely pushed through Obamacare with a supermajority in the Senate, ownership of the House, and the White House. It was a hair-thin vote, they were forced to resort to parliamentary tricks, and many were subsequently relieved of the burden of public service by that a public no longer interested in their services.

There is simply no way UHC passes. You may get universal subsidization of health insurance in the form of refundable tax credits a'la the Ryan Plan. But Obamacare pretty much established the left lateral limit for the politically possible health care reform.
You're presuming opinions never change. If the mandate is struck down... as I think it should be, btw... then pretty much nothing changes. If pretty much nothing changes then people will continue to feel stuck. I'm not sure that that "hair-thin" majority was accurately representative of the population as a whole. I believe public sentiment will increase over time and our legislators will feel they have no other choice, regardless how they personally believe.
 
My point was semi-facetious, but in all seriousness I'm not suggesting we do. I am suggesting that saying we can't buy something if we don't have the money would mean more if we didn't have such a history of government deficits and debt. We're obviously not being fiscally responsible as it is.

You're presuming opinions never change. If the mandate is struck down... as I think it should be, btw... then pretty much nothing changes. If pretty much nothing changes then people will continue to feel stuck. I'm not sure that that "hair-thin" majority was accurately representative of the population as a whole. I believe public sentiment will increase over time and our legislators will feel they have no other choice, regardless how they personally believe.

Passing the Affordable Health Care Act is anything but fiscally responsible.

Second, there are heavy clamps on competition in insurance. Due to state licensing and restrictions on licensing and selling, companies have increased costs on a state by state basis. There also is decreased competition because of this cost, not to mention the extra red tape.

The solutions are basic and will only work slowly. Insurance needs to be severed from employment, the tax breaks inherent in group insurance need to phased out OR passed along to individual consumers. Health Insurance should not cover basic health maintenance. It should be for catastrophic coverage, hospital stays, surgery etc etc. Not for a checkup. If people had to start paying cash for basic procedures, you can bet that cost would be watched more closely. High risk pools that are state regulated could be created but the unfortunate fact is that most people with those conditions cannot afford what their actual cost should be. We do need a solution for that. But I dont think the current law does this in the right way.

There are a number of side avenues as well: HSAs, very basic coverage for younger people, cash only clinics that do very basic health maintenance etc. All of which would be illegal under AHCA. Yet those kinds of things do drive costs down and let people be independent of expensive health insurance if they are already healthy.
 
Passing the Affordable Health Care Act is anything but fiscally responsible.

Second, there are heavy clamps on competition in insurance. Due to state licensing and restrictions on licensing and selling, companies have increased costs on a state by state basis. There also is decreased competition because of this cost, not to mention the extra red tape.

The solutions are basic and will only work slowly. Insurance needs to be severed from employment, the tax breaks inherent in group insurance need to phased out OR passed along to individual consumers. Health Insurance should not cover basic health maintenance. It should be for catastrophic coverage, hospital stays, surgery etc etc. Not for a checkup. If people had to start paying cash for basic procedures, you can bet that cost would be watched more closely. High risk pools that are state regulated could be created but the unfortunate fact is that most people with those conditions cannot afford what their actual cost should be. We do need a solution for that. But I dont think the current law does this in the right way.

There are a number of side avenues as well: HSAs, very basic coverage for younger people, cash only clinics that do very basic health maintenance etc. All of which would be illegal under AHCA. Yet those kinds of things do drive costs down and let people be independent of expensive health insurance if they are already healthy.
I don't disagree with the part in red, but part of the reason health costs are so high now is to cover people who currently can't and/or don't pay their bills. How would this change for the better?
 
I don't disagree with the part in red, but part of the reason health costs are so high now is to cover people who currently can't and/or don't pay their bills. How would this change for the better?

Because the costs are high even for regular procedures. A battery of comprehensive blood tests goes for around $500.00. Do you really think if people had to pay cash out of pocket for that procedure that it wouldn't go down? CAT Scan--3400, MRI---1000, XRays---500 to 1500 depending on location and numbers. Insurance companies dont create as much competition as individual consumers and the cost pushback will be greater. Lower costs= MORE people able to pay.

The idea that people are not able to pay bills and it drives costs higher is essentially correct, but the affordable health care act will increase those numbers not decrease them.
 
I don't disagree with the part in red, but part of the reason health costs are so high now is to cover people who currently can't and/or don't pay their bills. How would this change for the better?

What percent of health care spending in the U.S. in not reimbursed because of people not having insurance?
 

I see it talked to "full hospital bills". So if a hospital charges an insurance company $10 for a service but an individual walking in without insurance $50 that would account for nearly all of these "costs" you describe.

It seems that the basis for the mandate is a number that is pretty hard to get our arms around. Let's remember that health care is a $2.7 trillion industry, so even the number mentioned would only be 2% of total costs. Also remember that illegal immigrants that go to the hospital could still fall into this category, as well as people who will still not sign up for insurance even with the mandate.
 
I see it talked to "full hospital bills". So if a hospital charges an insurance company $10 for a service but an individual walking in without insurance $50 that would account for nearly all of these "costs" you describe.

It seems that the basis for the mandate is a number that is pretty hard to get our arms around. Let's remember that health care is a $2.7 trillion industry, so even the number mentioned would only be 2% of total costs. Also remember that illegal immigrants that go to the hospital could still fall into this category, as well as people who will still not sign up for insurance even with the mandate.
Would the fine from the mandate (i.e.: not purchasing insurance) be cheaper for someone with an incredibly expensive condition such as cancer? Would they then be entitled to the same treatment because they paid their fine? They did "participate" in the system one way or another, after all. If I'm understanding this correctly, for some it may be a wise decision to not have insurance.
 
Would the fine from the mandate (i.e.: not purchasing insurance) be cheaper for someone with an incredibly expensive condition such as cancer? Would they then be entitled to the same treatment because they paid their fine? They did "participate" in the system one way or another, after all. If I'm understanding this correctly, for some it may be a wise decision to not have insurance.

The fine will be cheaper than buying insurance for just about everyone as I understand it. Even after paying the fine, they would not get the same treatment as if they had bought insurance.
 
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