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http://www.latimes.c...,0,423592.story

 

 

Justices signal possible trouble for health insurance mandate

 

"Are there any limits," asked Justice Anthony Kennedy, one of three conservative justices whose votes are seen as crucial to the fate of the unprecedented insurance mandate.

Chief Justice John G. Roberts Jr. suggested that the government might require Americans to buy cellphones to be ready for emergencies. And Justice Antonin Scalia asked if the government might require Americans to buy broccoli or automobiles.

 

"If the government can do this, what else can it ... do?” Scalia

 

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http://www.latimes.c...,0,423592.story

 

 

Justices signal possible trouble for health insurance mandate

 

"Are there any limits," asked Justice Anthony Kennedy, one of three conservative justices whose votes are seen as crucial to the fate of the unprecedented insurance mandate.

Chief Justice John G. Roberts Jr. suggested that the government might require Americans to buy cellphones to be ready for emergencies. And Justice Antonin Scalia asked if the government might require Americans to buy broccoli or automobiles.

 

"If the government can do this, what else can it ... do?” Scalia

Yep, it's gonna be struck down.

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CNN's reporter called today a "train wreck" for the Obama Administration.

 

I haven't been this encouraged since I heard John Clayton say Mario Williams left Buffalo without a contract in hand.

 

You sons-a-bitches are gonna pay when you get my hopes up, and they rule that the law is constitutional. :devil:

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http://www.latimes.c...,0,423592.story

 

 

Justices signal possible trouble for health insurance mandate

 

"Are there any limits," asked Justice Anthony Kennedy, one of three conservative justices whose votes are seen as crucial to the fate of the unprecedented insurance mandate.

Chief Justice John G. Roberts Jr. suggested that the government might require Americans to buy cellphones to be ready for emergencies. And Justice Antonin Scalia asked if the government might require Americans to buy broccoli or automobiles.

 

"If the government can do this, what else can it ... do?” Scalia

 

 

 

That's very interesting coming from Scalia. He was considered the swing vote, given his historically broad interpretation of "interstate commerce".

 

He must hate women, and want to kill grandma.

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That's very interesting coming from Scalia. He was considered the swing vote, given his historically broad interpretation of "interstate commerce".

 

He must hate women, and want to kill grandma.

 

 

By any chance do you know how long will they be arguing this case?

 

 

Also, if it does get "Blow'd up" I think that helps Romney.

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By any chance do you know how long will they be arguing this case?

 

 

Also, if it does get "Blow'd up" I think that helps Romney.

 

I vaguely recall hearing one or two weeks for oral arguments on the radio down here. Decision due in June.

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By any chance do you know how long will they be arguing this case?

 

According to the NYT here:

 

The justices have broken the case into four discrete issues, scheduling a separate session for each, for a total of six hours, the most in one case in more than 40 years. Mr. Clement, like his principal adversary, Solicitor General Donald B. Verrilli Jr., will be arguing three times.

 

Also, if it does get "Blow'd up" I think that helps Romney.

 

You could argue it helps Obama, in that the moment it's busted up, companies will give serious thought to expanding their companies again. Probably not enough between June and the election, but still...

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You could argue it helps Obama, in that the moment it's busted up, companies will give serious thought to expanding their companies again. Probably not enough between June and the election, but still...

 

 

And there's the whole "The Republicans took away your health care" campaign angle, which would be dishonest but effective.

 

It's too bad we can't just get a bipartisan agreement on the fact that the law is an empty feel-good gesture that as legislation is complete and utter ****, and needs to have a stake driven through its heart and replaced with real health care reform.

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He just gave the libs their next great idea. Someone will be drafting that bill by day's end.

After Obama's "last election " he will have more "flexibility" to move on idea's like this.

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And there's the whole "The Republicans took away your health care" campaign angle, which would be dishonest but effective.

 

It's too bad we can't just get a bipartisan agreement on the fact that the law is an empty feel-good gesture that as legislation is complete and utter ****, and needs to have a stake driven through its heart and replaced with real health care reform.

 

The system will continue to limp along with high prices and the same core issues as it did prior to the ACA being passed... Prices are not likely to go down anytime soon, it is simple a matter of better technolgies being adaopted everyday and people living much longer than they did even 50 years ago. We are also seeing a massive brick and sticks expansion as we try to make room for a large surge in demand, building although partly funded by private donation also take a very large chuck out of our hospital cash flow.

 

Until the notion that we treat "everybody" regardless of ability to pay or have insurance, we will be in the same predicament. We wrote off 150 million in unreimbursed care last year, alot of it was indigent care but an even larger portion was just on people who failed to maintain insurance coverage. Until we are by law able to shut the door in the faces of those who cannot pay, we will continue to raise prices on testing and billiables to insurance compaines (not federal programs)to help offset the costs...

 

It all get spaid for, directly or indirectly. We as a nation have decide whether we are going to hold each indivdual American to account, or simply whine when costs gets shifted onto the paying crowd.

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If it is ruled unconstitutional, what's the historical impact vis-a-vis it being the cornerstone Obama legislation?

 

Has an issue as central to a presidency (like this is) and with so much tonnage behind it ever been struck down? They might try to shrug it off, but does a presidency really recover?

 

Not to mention it would be an albatross around Obama's neck going from the summer into November when independents and the average American busy with work/family/entertainment and/or who generally disdain politics finally starts to pay a little more attention. 'He tried to pass a law that was pretty blatantly unconstitutional in its federal over-reach.'

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If it is ruled unconstitutional, what's the historical impact vis-a-vis it being the cornerstone Obama legislation?

 

Has an issue as central to a presidency (like this is) and with so much tonnage behind it ever been struck down? They might try to shrug it off, but does a presidency really recover?

 

Not to mention it would be an albatross around Obama's neck going from the summer into November when independents and the average American busy with work/family/entertainment and/or who generally disdain politics finally starts to pay a little more attention. 'He tried to pass a law that was pretty blatantly unconstitutional in its federal over-reach.'

 

The message will be formed that progress on the issue of healthcare has gone backwards. Some will hold that to be very true, others will be glad we are back to square one. The important questions are:

 

1. What do independent voters think?

2. If this is struck down and ACA is basically gone, what is the GOP answer to replace it with? I think that will be important, because there are alot of Americans that were happy something got done.... they will need to come up with some sort of plan.

3. What do small/medium business owners think? with the ACA, they could basically absolve themselves from having to provide healthcare to their employees through a group plan... they could simple give a stipend for employees to go an buy insurance on exchanges. This puts them in a position again for have two options, one not so great the other expensive.

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That's very interesting coming from Scalia. He was considered the swing vote, given his historically broad interpretation of "interstate commerce".

 

He must hate women, and want to kill grandma.

I kept hearing Kennedy was considered the swing vote. Looks like they're both going to vote against it.

The system will continue to limp along with high prices and the same core issues as it did prior to the ACA being passed... Prices are not likely to go down anytime soon, it is simple a matter of better technolgies being adaopted everyday and people living much longer than they did even 50 years ago. We are also seeing a massive brick and sticks expansion as we try to make room for a large surge in demand, building although partly funded by private donation also take a very large chuck out of our hospital cash flow.

 

Until the notion that we treat "everybody" regardless of ability to pay or have insurance, we will be in the same predicament. We wrote off 150 million in unreimbursed care last year, alot of it was indigent care but an even larger portion was just on people who failed to maintain insurance coverage. Until we are by law able to shut the door in the faces of those who cannot pay, we will continue to raise prices on testing and billiables to insurance compaines (not federal programs)to help offset the costs...

 

It all get spaid for, directly or indirectly. We as a nation have decide whether we are going to hold each indivdual American to account, or simply whine when costs gets shifted onto the paying crowd.

Prices were going to increase faster under Obamacare than they are now. Again the problem is that the mandate allows for people to purchase insurance when they need it and drop it when they don't, because there is no pre-existing condition exclusion. And the penalty is so low, it makes fiscal sense to not have it.

 

Scrap the law and start over. Begin with tort reform and opening competition across state lines.

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We as a nation have decide whether we are going to hold each indivdual American to account, or simply whine when costs gets shifted onto the paying crowd.

Most rational people understand what you're saying, but simultaneously understand that while Obamacare does a lot of things, it does nothing to address the problem it claims to address. It simply adds another ridiculous layer to a massively inept body of lawyers who somehow think that forcing people to buy something they don't want simply because they live in this country is a horrible precedent to set.

 

Had the president chosen to address the issue and not get caught up in "being the guy who brought universal health care to America," we wouldn't be in this spot. He tried for single-payer, got immediately shot down, and unlike effective leaders, instead of re-grouping and re-thinking a new strategy, plan or law, he began to compromise his initial plan. By the time he was bribing congressman with kickbacks and special deale, and handing out waivers like gumdrops to every union group he could reach, it became nothing but a watered-down embarrassment of a law which is so unpopular that you can barely keep track of all the Democrats who have chosen not to run for re-election this year because of this albatross.

 

Should the mandate be found unconstitutional, it will collapse the law. If this does take place, there are many ways people will try to paint this as a failure, but the most accurate way is to show just how clueless Obama is as a leader. A follower? Sure. An organizer? Maybe. But a leader. Not even close.

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I kept hearing Kennedy was considered the swing vote. Looks like they're both going to vote against it.

 

Prices were going to increase faster under Obamacare than they are now. Again the problem is that the mandate allows for people to purchase insurance when they need it and drop it when they don't, because there is no pre-existing condition exclusion. And the penalty is so low, it makes fiscal sense to not have it.

 

Scrap the bill and start over. Begin with tort reform and opening competition across state lines.

 

That is the biggest issue, you can buy it when you get sick, I have never liked that portion of the bill.

 

Insurance compaines can do business in any State they wish, the competition across State lines really holds little merit as a way to decrease costs- and cost is not dictated from the insurance company, it is dicated as a billable from the hospital/ provider- and much of that starts as a percentage of Federal Payor reimbursement. again is goes back to the fact that we inflate prices to the carrier because we have so many unreimbursed costs... that is why the ACA attempted to fix the underlying issue, everybody paying their own bills, and not shifting the burden

 

As far as litigation, I agree that the outlandish amount of lawsuits against compaines and providers does little to help the system, but we do want to make sure patients to do have realistic ways to get compensationed for malpractice.

 

The real issue, from my study of the subject and years in Healthcare Administration, is shaping the expectation of Americans that healthcare is expensive, and we will not be able to acheive the Walmart cost model many Americans have come to expect. We have the best Machines, Minds and Meds of anywhere in the world (even though our outcomes are not always better, can you imagine Americans spending more to get less!!!!)so we need to cnvery to people if you want the best, it is a pretty penny- In my expereince, people don't like that..... they feel like it should be cheap, just like any product or service... it just isnt the reality.

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That is the biggest issue, you can buy it when you get sick, I have never liked that portion of the bill.

 

Insurance compaines can do business in any State they wish, the competition across State lines really holds little merit as a way to decrease costs- and cost is not dictated from the insurance company, it is dicated as a billable from the hospital/ provider- and much of that starts as a percentage of Federal Payor reimbursement. again is goes back to the fact that we inflate prices to the carrier because we have so many unreimbursed costs... that is why the ACA attempted to fix the underlying issue, everybody paying their own bills, and not shifting the burden

 

As far as litigation, I agree that the outlandish amount of lawsuits against compaines and providers does little to help the system, but we do want to make sure patients to do have realistic ways to get compensationed for malpractice.

 

The real issue, from my study of the subject and years in Healthcare Administration, is shaping the expectation of Americans that healthcare is expensive, and we will not be able to acheive the Walmart cost model many Americans have come to expect. We have the best Machines, Minds and Meds of anywhere in the world (even though our outcomes are not always better, can you imagine Americans spending more to get less!!!!)so we need to cnvery to people if you want the best, it is a pretty penny- In my expereince, people don't like that..... they feel like it should be cheap, just like any product or service... it just isnt the reality.

 

And this has happened because healthcare is practically the only industry where the consumer has no idea of what the real cost of service is. The costs are hidden in the insurance that most people don't pay on their own.

 

Yet the administration is trying to paint the picture that the system can be fixed by eliminating insurance companies, while not addressing the expectation of service and the actual cost.

 

And then their feathers are ruffled when somebody calls them clueless.

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Most rational people understand what you're saying, but simultaneously understand that while Obamacare does a lot of things, it does nothing to address the problem it claims to address. It simply adds another ridiculous layer to a massively inept body of lawyers who somehow think that forcing people to buy something they don't want simply because they live in this country is a horrible precedent to set.

 

Had the president chosen to address the issue and not get caught up in "being the guy who brought universal health care to America," we wouldn't be in this spot. He tried for single-payer, got immediately shot down, and unlike effective leaders, instead of re-grouping and re-thinking a new strategy, plan or law, he began to compromise his initial plan. By the time he was bribing congressman with kickbacks and special deale, and handing out waivers like gumdrops to every union group he could reach, it became nothing but a watered-down embarrassment of a law which is so unpopular that you can barely keep track of all the Democrats who have chosen not to run for re-election this year because of this albatross.

 

Should the mandate be found unconstitutional, it will collapse the law. If this does take place, there are many ways people will try to paint this as a failure, but the most accurate way is to show just how clueless Obama is as a leader. A follower? Sure. An organizer? Maybe. But a leader. Not even close.

 

But America has always been about compromise, thats what make Democracies special. as far as Leadership, don't leaders set goals and get them accomplished? If the contetnion is sticking to single payor that has zero chance passing no matter what, unwavering, and continuing the bang ones head against the wall leadership, well then we should keep doing the same thing. I woudld argue that Obama was bold in his leadership of getting the ACA passed, now if your point of view is not from his idealogy, then I understand the questioning of leadership, its all relative to your politics, right?

 

So he and the democratic congress bent, bent, bent and bent... and that is why you got a bills that was way more compicated than it had to be.

 

From the beginning I have held the belief that we should not in absolute hold healthcare to the principles of market economics unless we are making sure 100% of Americans are partipcating, because at some point no matter how much we expercise, everybody uses it, no expections... by we continue to try to apply marketing priciples to a system where some people can play, and not pay.

 

Look, I tend believe Americans need to be left alone, purchase what they want, and if they want to smoke and eat and get real big and fat and get cancer, that is their protected right to do so... but don't expect the rest of us to bail you out, when you are crying about not having the mean to pay for your healthcare... cry to someone else.

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That is the biggest issue, you can buy it when you get sick, I have never liked that portion of the bill.

That is the centerpiece of the bill. The mandate theoretically is how Obamacare will be funded. But if you make exceptions for millions of people and have such a weak penalty that it still makes sense to not carry insurance, you basically get the sick/sickest people paying for insurance and dropping it when they don't need it. It's like being able to buy car insurance after you've had an accident and then dropping it after the car has been fixed. To me, it was a transparent attempt for the Dems to get private insurance companies to go out of business, forcing the government to have to step in.

Insurance compaines can do business in any State they wish, the competition across State lines really holds little merit as a way to decrease costs- and cost is not dictated from the insurance company, it is dicated as a billable from the hospital/ provider- and much of that starts as a percentage of Federal Payor reimbursement. again is goes back to the fact that we inflate prices to the carrier because we have so many unreimbursed costs... that is why the ACA attempted to fix the underlying issue, everybody paying their own bills, and not shifting the burden

I don't know if I buy that selling across state lines won't have a positive effect. I have limited choices for health care in my area. More choices means more competition.

As far as litigation, I agree that the outlandish amount of lawsuits against compaines and providers does little to help the system, but we do want to make sure patients to do have realistic ways to get compensationed for malpractice.

Victims should get compensation for malpractice. But there should be caps and there should be a review panel that allows certain cases to proceed or not.

The real issue, from my study of the subject and years in Healthcare Administration, is shaping the expectation of Americans that healthcare is expensive, and we will not be able to acheive the Walmart cost model many Americans have come to expect. We have the best Machines, Minds and Meds of anywhere in the world (even though our outcomes are not always better, can you imagine Americans spending more to get less!!!!)so we need to cnvery to people if you want the best, it is a pretty penny- In my expereince, people don't like that..... they feel like it should be cheap, just like any product or service... it just isnt the reality.

I agree that expectations need to be changed. Health care is like a buffet. You pay one price and expect to get your money's worth. So you use/eat more than you should. HDHP's/HSA's are the way to go. It puts you in control of your medical care and expenditures. I had a patient, who had a HDHP/HSA say "I don't like it because I don't like keeping track of that stuff." Yes, because caring about your health and health care dollars shouldn't be a concern to you. :rolleyes:

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