Osler's Razor

But Canada (and every other industrialized nation with single payer plans) are barren, irradiated wastelands thanks to the ruin brought by their socialized health care systems!
 

My grandfather was a physician Boston University med School Class of 1920 - - I dont even think BAND AIDS had been invented yet... and his ENTIRE LIFE he yelled and screamed about how SOCIALIZED MEDICINE IS COMING WATCH OUT ITS GOING TO RUIN THIS COUNTRY. My parents heard it from him. I heard it from him in the 70s, 80s etc. He lived to be 98 years old. I think his last words were something about "Do you really want to wait three years for a mammogram?"
My Dad was also a doctor and he was freaked out about it too... "You DONT WANT US TO TURN INTO CANADA!!!"

WHAT THE HELL is so wrong with OBAMA CARE??? OR at least a thing where everyone has acess to affordable healthcare??? I do not think it is OWED to me But I dont think I should have to rearrange my LIFE around trying to find insurance...

I think it is all too expensive anyway and maybe the prices SHOULD come down?

I have a friend who just had a heart transplant He has pills he has to take that are like 3000 dollars a dose or something...


I used to have a CPAP machine for snoring at night I do not need it anymore since I got my tonsils out but honestly they sell the parts for it on Amamzon for like 19 dollars. The same exact parts for it cost my ins co 150 dollars. For a little piece of plastic!

People, or companies or whatever - someone - is making money Right and left out of the system we have now... Have you ever looked at an itemized bill from a hospital stay? A C section can cost like $30K easily. It was $18K to get my tonsils out...

I guess the price is so high because we have to pay for all of the people who do not have insurance??? Maybe if almost everyone was insured then the prices woudl come down? I dont know...

I do know my husband is self employed and that is a freaking nightmare health insurace wise. Seven Hundred dollars a month to insure just he and my 7 year old.

We have a friend who also has his own business He has worked hard to really build it up and get this He has this thing... fibromyalgia... HE cannot EVEN GET A POLICY!!!! He owns his own company, and he cannot get a policy because of his preexisting condition. NO amount of money will buy him coverage. If he gets into a car accident or something his house his business is GONE.

I know another family where the wife has MS. THe husband has an MBA from Pepperdine but he cannot leave his weird job at some TIRE STORE because if he does he does not knwo if his wife will ever have insurance again...

I am NOT EVEN PRETENDING to know what the answer is to this problem but the thing we have now is so stupid.

I know that people SMOKE and eat crap and abuse their bodies and Maybe they shoudl pay more? Would be an incentive to take better care of themselves? We seem to take care of a lot of people who just SHOW UP at an ER but then what are you going to do? turn them away??? We have all of these Veterans coming back from this ten year long pointless war with no legs no arms.. or they had serious head injuries and they go and kill their entire families..

I do not knwo what the exact solution is but what we have now is NOT working.

More people need to be able to afford decent overage. It does not have to be FREE, but it shoudl be available based on income etc. HOW to pay for it? I do not know... maybe you charge extra for donuts and bad food... and cigarettes... ? A governemnt run casino? Put all of the Lottery ticket money into it? I have no idea...

I do not have the answers but I know what we have now is comepletely insane.
 

I'm not sure how the mandate will be found constitutional without creating new law. I haven't been able to find any precedent for the government being able to require you to enter into a contract with another private party without some kind of prerequisite. In other words, they can make you buy car insurance if you want to drive, but I can't see how they can make you buy health insurance just for living in the United States. I mean even taxation is predicated on earning some kind of income, and if you don't earn any income, you don't owe the government any money. It's hard for me to see how the court can say that it's constitutional for Congress to require you to purchase something you don't want for no reason other than that you happen to live in the U.S. I definitely support a public option health care plan, but I really dislike being told that I have to buy insurance whether I like it or not.
 

The issue is not about government power to force individuals to do something, it is about whether the federal government has that power. There is question a state government could enact such a mandate (see, e.g., Massachusetts health care law, which does exactly that).
As to whether the federal government has the power - I agree with Mark - the necessary and proper clause gives Congress the ability to enact the mandate because it is an essential part of the overall plan, which clearly is within Congress' power.
 

For me, the most important part of this is individual liberty. I have a hard time understanding why people are so willing to just hand over their liberty and their sovereignty to the federal government. Why should the government have the right to force me to buy insurance? And as tydwbleach begins to hint, when this fails to bring costs down it will become "well, smokers and fat people cost too much, so lets ban cigarettes and cheeseburgers." And when that doesn't bring costs down it will be something else. And when they come to take away something you care about it will be too late to complain because we would have already bought into the idea that the federal government has the right to do these kind of things.

I'm not ready to live in a country where the federal government has the right to arbitrarily tell me I have to buy insurance, or that I can't eat a steak when I want to, or that I have to go to church because it is good for me.

Smoke 'em if you got 'em.

Also, Scruffy Murphy's rules.
 

This is going to sound like the acme of ridiculous ignorance--or a satire on conservatism--but I assure you it is not the latter (you can be the judge of the former).

The problem with Obamacare is that it is just not American. That is, for many, the assumptions necessary to make socialized medicine on a national scale work are not present in our unique political culture.

That is the resistance.
 

WF--

I think you are right in identifying the central objection in its essence. It tears against individualism. Of course, so does insurance in the first place, but this extends that idea to the extreme.

Sadly, though, our current system of half-measures is a terrible mess.
 

RRL-

The cost-cutting inherent in a national health system would hurt most two politically powerful groups: Big Pharma and doctors.

Also, the slippery slope argument doesn't work so well when you extend it to church... the constitution does cover that explicitly!
 

The necessary and proper clause is not an independent basis for the Constitutionality of the ACA, it has to attach to another provision of the Constitution. In this case, the DOJ is claiming is the Commerce Clause allows it. The question seems to be a definitional one. Is everyone in the health care market unique in that everyone is in it because we are human or can people be outside the market and the ACA is forcing us in. If the former, then the ACA is probably constitutional in that the health care marketplace affects interstate commerce. If the latter, unconstitutional because a single person outside the marketplace does not affect interstate commerce. It is an interesting question.
 

All this ACA, Commerce Clause, market place, definitional, provisional talk etc. cause a great deal of confusion to a great number of regular people, the kind of people that are not below poverty line, but just a hair or even a little more than a hair above. The current system will implode at some point, given the abysmal abuses some of which tydwbleach points out, but (at the risk of breaking out in hives) I have to agree in part with RRL. I say in part because there’s ample precedent where “freedom” has become a relative term. Smoke ‘em if you got ‘em indeed, but if you pay a huge tax to smoke ‘em I don’t see why you shouldn’t be joined in sharing that kind of tax by your Cheetos gobblin’ , soda swiggin’ fellow Americans.
 

I'd rather eat seal fat than cinnamon ice cream.
 

CNN just presented another program comparing our health care system with other industrialized countries systems. They spent the most time on countries that changed from dysfunctional models like ours to a more functional system. They were all different but had common elements. They all had private and public roles.These countries spent a great amount of time looking at what works and doesn't work in other countries. We too often arrogantly reject this approach. We could learn a lot. Instead we are discussing the possible restrictions to progress in our constitution of 1787. Since 1787 we have had, to our benefit, a history of trading our civil liberties when the opportunity for a better life for all Americans presented itself. We have ended slavery,passed safety and environmental laws, and have compulsory education, etc.

We now spend twice as much on heath care per person, yet are less healthy and live shorter lives than any other industrialized nation. Facts are facts. We know what works and what doesn't work. We should get on with it.

We will eventually have single payer, we will end pay for fee, and we will let the health givers make decisions on value and quality of heath care. We will join the other nations that have preceded us, but only by looking forward not always backwards for directions.

Having worked with the auto companies for years I am aware of the many times the companies campaigned against progress on the grounds of that liberties would be trampled and that the imposed actions would drive them out of business. They claimed that air bags, cafe standards, catalytic converters, and seat belts would be rejected by the consumers and promoted the dire results the changes would bring. The polls showed that people bought in and didn't like the changes. Fortunately there were more mature voices and we have benefited.

We are now in the hands of nine robed folks who in their questions stressed the law's harm to the insurers)and those who choose not to be insured , and seldom, if ever, how their decision would effect those who need assured and modern health care.
Incredibly, this court could decide
that we will have to wait for a more forward looking court before we catch up to the world in affordable health care for all.
 

How does insurance “tear[] against individualism”? I would argue the opposite, that insurance largely upholds individualism, allowing us to contract to provide for ourselves in the event difficult circumstances. In my view, a major problem with our health care system is that real insurance is not offered to consumers. Governments mandate what we can purchase, and then hospitals are mandated to provide care.

I would also argue that we already have national health insurance. Over 40% of health care expenditures are already made by governments…do we really need more?

Even with the mess of a health care system we have, for the vast majority of families (at least in Texas) health care can work pretty well. I paid about $300/month through law school for a high deductible private policy for my wife, our kids, and me. And normal c-sections do not cost $30k. I’m sure hospitals mark up the bills to insurers to cover the costs for patients who don’t pay and to cover the lower rates paid to government insurers. Lawyers are primary beneficiaries of these disputes between hospitals and insurance companies.

I also think some health care is just expensive. For example, from personal experience, I know that an hour visit to a pediatric cardiologist's office costs about $500. But are lawyers any different? I've heard of big firm attorneys billing $1000 for a phone call, regardless of the time spent on the call. So why should we be shocked when professionals want to get paid? If anything, the medical profession is much better than attorneys at providing charity to those who need it. If you disagree, try visiting Scottish Rite hospital in Dallas.

The “uninsured” problem should really not be so complicated. Those with pre-existing conditions can be helped without fundamentally changing the system for everyone. And then just give healthy young people the same tax incentives that businesses have to purchase insurance.

And wouldn’t the best cost-cutting measure possible, be to allow individuals to purchase coverage across state lines? I don’t understand the resistance to this idea.

As to the constitutionality of BHO-care, I’m with JT. Though, it sounds like the left is throwing the solicitor general under the bus. I’m not sure whether he’s incompetent or whether it’s just an indefensible position (I mean we had “to pass the bill to see what’s in it”, right?)…but it’s been fun to watch!
 

Like Tyd, I grew up in a family where Socialized Medicine equaled communism. My Dad wanted to be a Doctor, but the bars to entry to Med School were high, he got drafted, etc. etc.

And my experience with health insurance companies continues to be maddening. I have a stack of papers behind me that I need to deal with, but I don't have an hour to set aside to sit on perma hold and then run to the fax machine to resubmit claims.

As far as I can tell Insurance companies do two things-- they raise rates and they deny coverage. I pay $1600 a month to insure my family. There's a group rate thru my firm, but since I am a Partner, I pay, not the firm.

It's ridiculous. The layers of bureaucracy amaze me. We're paying billions for people to analyze bills instead of provide medical care.

I GET the individual liberty argument and No, I don't want the government telling me I have to buy something.... but the Commonwealth of Virginia makes me buy auto insurance.. or pay a fee. Although I guess I could choose not to have a car. It regulates alcohol sales and many other things, as do the Feds. But yes, its true, there is nothing else the government requires me to BUY.

Even so, Health insurance has become the standard. The only people who don't WANT health insurance are outliers, members of very extreme and small religous groups or nuts. It's a highly regulated industry. Economic reality calls for some sort of attempt to bring sense to it all.

I really do not like the new healthcare law -- I think it was a half -measure and it will end up costing taxpayers billions. Unless and until the insurance companies are brought to heel, this is going to be a problem.

Even so, I think the individual mandate is Constitutional. Like former Soliciter General Fried (SG for Reagan), it's my view that Congress has the power to regulate commerce. This is commerce. Regulate it.

--and once my Dad started his own business and had to get health insurance for himself and employees and pay and pay and pay, his views changed too.
 

My c section was 30 k eight years ago. Maybe some of that was spencer in the nicu for No Reason At All for 11 days..

For Six years i had this concierge physician. I paid an extra Amount every year and for that he paid very close attention to me. I hated this in your face thing with him..making me get tested all of the time for everything... but he was thorough...then last year i gave him up. Willing to pay for health care...willing to pay more for better care also, but when there seems to be so much waste, corruption, and so many people who burden the system i dont know....it is hard to justify the high cost.....yes i could get a policy that is cheap monthly but if ihave to be hospitalized i will automatically owe like 7k right off the bat? That is not smart, or practical or affordable....that is kind of risky...trading financial healtj for physical health and the purpose of insurance is risk management! Wth?


I want to stay healthy and not have a panic attack every time my kid goes onthe soccer field. I want to pay for decent insurance. Insurance where if i am in a car accident, i will not go into like all kinds of debt...
 

They can argue all they want, but the insurance company's want to make a PROFIT and that is made at the expense of the consumer. We have a home in 2 states and carry our insurance in 1 state. If I move the policy to the other state our premiums go up close to $500/quarter. Our health status hasn't changed. The whole thing is BS.

Like Tyd - I have a friend who has high BP, but is a runner, healthy weight, etc... She can not get insurance. They refuse to look at the person, lifestyle, etc... She has high BP, therefore she must live an unhealthy lfiestyle - BS....

If you don't have employer provided insurance at the present time it is like playing roulette trying to get a policy. That is something the people in DC don't get since they all have insurance provided by us - the tax payers.
 

Yeah, I’d say $30k for a c section and 11 days in the nicu is a steal of a deal. What tyd experienced sounds like defensive medicine, so you can blame the lawyers…. And my deductible in law school was $2500 (of course without maternity coverage). I now have a little higher deductible at my firm, but with an HSA contribution. The point is, if we treated auto insurance like health insurance, insurance companies would pay for our gas…absurd, expensive, and not insurance. I probably pay about $7k a year in gas, but I don’t need an insurance company to do that for me.

I agree with the arguments about the inefficiencies of health insurance, but it’s the product of government regulation. Only large companies can manage the regulations so we all deal with large bureaucracies. Do you really think we will reduce "waste and corruption" by having the largest bureaucracy in the history of the world manage our health care? Everybody wants a profit...even government bureaucrats.
 

The ACA is essentially the end of health insurance. The business model which existed prior to the passage of ACA is totally unworkable and untenable. Insurance company CEO's will tell you that. Universal health care systems are straining under rising costs; some would even say that they are going broke. Still, people in Canada and in W Europe are generally very satisfied with the care they receive. People in these countries do not go bankrupt because they do not have insurance, they do not worry about how they are going to pay when they need to go to the doctor, nor do they mind paying taxes to pay for their care and that of their fellow countrymen. With the rising costs globally, our costs in USA are still far far higher than in any other country and are individual results are no way near as good.

The ACA is not perfect, what system is, but if the conservative justices succeed in overturning the law, or in overturning the individual mandate, which essentially makes the system unworkable, the political backlash will lead to Medicare for all. Many Americans have said that they wish to see ACA repealed, but when you look at the polls closely, you will find that an overwhelming majority believe that ACA did not go nearly far enough, and thus, they oppose the law.

It will be interesting to see how they rule in June.

Scott Davis
 

Scott, I may be wrong and it may not even come close to being the reason why W Europeans are generally satisfied with their healthcare coverage or even free education, but the majority of those Nordic “socialists” starting with Sweden and ending with Iceland pay between 45% up to 55% in income tax, not to mention at least another 10 to 20% in VATs. Germany and France shell out a meager 45% and 41% respectively. Italy, Spain, Greece and Portugal are in the same bracket but they are notorious tax evaders and it actually shows (in fact, I read an article about Portugal called “A Nation of Dropouts Shakes Europe” interesting insight not just on education).
 

Is there any constitutional precedent for the federal government forcing a person to buy something from a private entity merely because that person lives in the United States? I am not familiar with any but I would love to read any cases that suggest the government has this power. This is what I do not understand, on what basis is the government claiming that it has this authority, especially when there appears to be no direct precedent on point?
 

"The ACA is essentially the end of health insurance."

That's quite the admission. I actually agree with the statement, and those who claim the bill was designed as a backdoor to single payer. This just highlights the misrepresentations by those who voted for the bill...without even reading it.

I'm not sure about the political analysis by Mr. Davis re: backlash. If he is correct, I guess it would be the backlash to the backlash, since the bill's passage caused the historic defeats for Democrats in 2010.