Court rRuling on Obamacare

[flabbybody]

The US Supreme Court has 2 monumental rulings regarding the constitutionality of The Affordable Care Act signed into law in 2010:

1) Does the Federal government have the authority to require its citizens
to purchase health insurance, the so-called mandate?
2) Does the federal government have the authority to require states to
expand Medicaid as a condition of receiving federal health care funding, the so-called all or none coercion doctrine?

Item 2 is far reaching. AFA will provide millions of low income adults with health insurance and not cost any state a dime until 2017. If you're rooting for the Court to overturn Obamacare you probably already have insurance for your family and don't give a shit about anyone but yourself.
But I don't want to stifle debate with my opinion.

http://thirdbranch.update.crooksandliars.com/susie-madrak/legal-challenge-aca-says-all-or-nothi

[Silcc69]

This ought to be interesting...........

[Faldur]

If you're rooting for the Court to overturn Obamacare you probably already have insurance for your family and don't give a shit about anyone but yourself.

Pathetic, no its not about giving a shit about anyone its a little thing called the Constitution of The United States. And how NO party has the right to trample on it the way this administration has attempted and successfully done.

The founding documents of this country supersede the need of any special interest. Get your head out of your ass, and discover what made this country what it is.

[Stavros]

This item was on the news here in the UK this morning, it will make for fascinating reading this side of the Atlantic too, as our own coalition government has just passed into law yet another Health Reform Act, parts of which give private enterprise an entry into the national service which diehards don't approve of -frankly because the Govt doesn't have, or can't -or won't- find the money to fund the whole of the national health service.

That aside, Faldur, when you refer to a 'special interest' I don't understand what or who you mean. Is health care really a 'special interest', or is it not of strategic importance to the population of the USA as a whole? I mean, its not like transexual porn, for example, which I would consider a 'special interest'.

I see this as part of a global debate about the growth of the elderly as a segment of the population with the health implications, medically and financially.

[Silcc69]

If Obamacare is indeed overturned what will become of the car insurance mandate?

[hippifried]

1) Does the Federal government have the authority to require its citizens
to purchase health insurance, the so-called mandate?
2) Does the federal government have the authority to require states to
expand Medicaid as a condition of receiving federal health care funding, the so-called all or none coercion doctrine?

Is that second issue even part of this particular case? Because that's pretty weak. Of course the feds have the authority to put conditions on receiving federal funding.

There's another issue they have to look at. One whole day's arguments were dedicated to severability. The real question here, the big one, is whether the funding mechanism can be dealt with as an entirely separate matter. This is where the Obama administration has pushed the hardest, because the Republican mandate is the only part of the law that can be seriously challenged. Get it severed & & I don't think the administration cares whether they win or lose because they never wanted the individual mandate in the first place. Personally, I'm all for dumping it, & I hope it's far reaching enough to get rid of all mandatory insurance laws. Losing the Republican mandate ju8st means that the public option is back in play.

[buttslinger]

I think the same Supreme Court that gave you Bush in 2000 will take poor people's health insurance in 2012.

[Faldur]

Is health care really a 'special interest', or is it not of strategic importance to the population of the USA as a whole?

In this country Stavros, health care insurance is something responsible citizens buy for themselves, or negotiate into their employment. It ensures various levels of there health care costs are covered. The majority of Americans support the continuation of this in the private sector.

"Special Interests", I probably miss-used the term. Here lately we call the small groups of people screaming for free items, and demanding everyone else pay for it, "special interests".

[buttslinger]

people screaming for free items, and demanding everyone else pay for it

They're screaming because the ambulance just bought them to the ER, and if they don't have any money, you and I pay for it.

[hippifried]

The "special interest" here is the insurance companies. I don't see why anybody owes them a damn thing. Since they managed to take full control of the healthcare industry in the '80s, costs have risen exponentially until it's now 1/6 of the entire US economy. None of this is ever going to come under control until we stop treating the insurance industry as if it has an entitlement.

[onmyknees]

The US Supreme Court has 2 monumental rulings regarding the constitutionality of The Affordable Care Act signed into law in 2010:

1) Does the Federal government have the authority to require its citizens
to purchase health insurance, the so-called mandate?
2) Does the federal government have the authority to require states to
expand Medicaid as a condition of receiving federal health care funding, the so-called all or none coercion doctrine?

Item 2 is far reaching. AFA will provide millions of low income adults with health insurance and not cost any state a dime until 2017. If you're rooting for the Court to overturn Obamacare you probably already have insurance for your family and don't give a shit about anyone but yourself.
But I don't want to stifle debate with my opinion.

http://thirdbranch.update.crooksandliars.com/susie-madrak/legal-challenge-aca-says-all-or-nothi


Another sweeping generalization...good job.

And if you're contention is correct, and it's not........nearly 60% of citizens are selfish scum bags. My health care premiums have gone up 15% since the bill passed, and my deductible went from 0 to 1500 for the same coverage...so there's noting affordable about The "Affordable" Health Care Act. And that's just the start....there was so much budget trickery in the original bill to keep it under a billion it was a joke... Now the CBO has revised it's original number and it's a budget buster. Check it out...you might need CPR ! I hope you have the proper coverage. lol


Ultimately it's the same old shit...the producers pay the freight for the non producers...and don't give me that liberal bilge about a safety net...we all get that.

And if that's not enough....there's the Constitution, as Faldur properly pointed out. You act like it's some small militant, uncaring minority who opposed it. Wake up and read the papers dude...it's 26 states !

And if this was just about covering the uninsured, he wasted a year of super majorites in Congress and enormous political capitol and put the country through a twisted, corrupt process when if he sat at a table across from Paul Ryan they could have modified Medicare and Medicaid and increase coverage thresholds. This is about the liberals endless appetite to run every aspect of your life from a bloated, inefficient central government.

[Faldur]

The "special interest" here is the insurance companies. I don't see why anybody owes them a damn thing. Since they managed to take full control of the healthcare industry in the '80s, costs have risen exponentially until it's now 1/6 of the entire US economy. None of this is ever going to come under control until we stop treating the insurance industry as if it has an entitlement.

You really think the government can do a better job of managing health care than private industry? Ya, there track record with running programs efficiently is outstanding.

How about we look at the "models" liberals like so much. Canada is bleeding so much money from health care they are looking to reverse the government run aspect of it. And England, well that place speaks for itself.

[Odelay]

The founding documents of this country supersede the need of any special interest. Get your head out of your ass, and discover what made this country what it is.
One of the things that contributed to making this country what it is is slave labor from 1605 to 1865. Most of the founders were definitely hip to that and even the ones who weren't looked the other way.

[flabbybody]

I understand why Brits think we're fucked up.
It's amazing. 9 people sit on the US Supreme Court. We know 4 will vote to uphold and 4 will vote to overturn. So the law that ultimately determines how most of us regular folk get the medical care we need to live (or die) will come down to one person's decision.

I don't think this is what George Washington and Alex Hamilton had in mind when they created the American government. But they never needed to wait for their insurance company to approve their MRI and authorize their hip replacement surgery.

[hippifried]

You really think the government can do a better job of managing health care than private industry? Ya, there track record with running programs efficiently is outstanding.

How about we look at the "models" liberals like so much. Canada is bleeding so much money from health care they are looking to reverse the government run aspect of it. And England, well that place speaks for itself.
Canada? Pfffft! We already have a working model. It's a real good one. It covers the largest group of healthcare consumers in the country, & costs pennies on the dollar (if that much) compared to private insuranbce. It's called Medicare. So yeah, the government can do a better job of managing health care than private industry.

[Prospero]

If Obamacare is indeed overturned what will become of the car insurance mandate?

A very pertinent observation. To drive in the US (and most anywhere) you MUST have car insurance. So is your government ignoring the constitution when it insists on this?

[Faldur]

Canada? Pfffft! We already have a working model. It's a real good one. It covers the largest group of healthcare consumers in the country, & costs pennies on the dollar (if that much) compared to private insuranbce. It's called Medicare. So yeah, the government can do a better job of managing health care than private industry.

Thats actually a great example of governments incompetence. $60 billion dollars a year in fraud. A program that is projected to go bankrupt in 2024. And what does this marvelous program provide? Medicare provides health insurance to 46 million elderly and disabled americans. And lets not forget the fine example of medicaid, another 53 million lower income families are recipients of this program.

So 99 million americans benefit from the medicare/medicaid program, thats almost 1/3 of our countries population. At an annual cost of $835 billion dollars. Thats the example you want to use? I am not disagreeing that this is a viable and needed service. But come one, were talking $8.4 million per recipient. At last check my health insurance didn't quite cost that much.

Anything the federal government does, it does extremely poorly. We spend 4% more annually in medicare/medicaid than we do for defense. And that number is only growing at a rate that is unsustainable. If thats your example of how well our government will run our health care system, no thanks count me out.

[Faldur]

Arggh.. corrections.. $8,434 per recipient.. my bad. Look at the zeros.. still an equal amount to what my health care costs me.

[Stavros]

In this country Stavros, health care insurance is something responsible citizens buy for themselves, or negotiate into their employment. It ensures various levels of there health care costs are covered. The majority of Americans support the continuation of this in the private sector.

I think that you provide precisely one side of the argument to balance with the other. The balance of argument, on the principles, is whether or not you want a health care system for the whole country paid for out of a special tax, or health care provision based on personal insurance plans, which you advocate.

I cannot agree with you because my experience of the NHS in the UK, which I use and once worked in. I am aware that the NHS is flawed, that successive governments have tried to reform it, which is code for making it less expensive than it might be, just as I am aware that the quality of healthcare, particularly in the hospital sector, varies from one part of the country to another. But right now I get my medicine free of charge (because of my age), and if I fall ill or am involved in an accident, I am treated. I paid for it for years when I was fit and healthy, and it doesn't bother me that I have been subsidising the NHS which treats people who are sick because of the way they live -smoking cigarettes, for example, creating cancers and heart disease to name but two consequences of that bad habit. The NHS belongs to all of us, drug addicts, smokers, the obese, children who fall out of trees, pregnant mothers, and so on; it is as strategic a resource to the country as the military, and certain industries. People here are also free to, and do buy private health insurance. Its also known as queue jumping.

Two issues: what happens to people in the USA who cannot organise the day ahead, quite apart from the rest of their lives? And haven't there been families in the US which went bankrupt because of medical bills?

I agree there are horrendous cost issues and poor management, on both sides of the Atlantic, but I don't see these as problems that cannot be solved.

[hippifried]

Faldur, you're full of shit. Where to start...

1st) Medicare is not an insurance policy & never has been. It's not a savings account either.

2nd) You lumped Medicare & Medicaid together. Not the same thing at all. If you're going to add all government healthcare programs together, you have to add the VA. Wow! We just went over 1/3 of the population. Dollars to donuts says that just those 3 programs account for more than half of the healthcare services used. I don't have the figures in front of me, but I'm thinking that statement could apply to Medicare alone.

3rd) & the #1 stupid argument in here is... The comparison of a single premium paid into a minor piece of the total to the payout per recipient of the biggest consumers of the services. What? You didn't think anybody'd notice that you don't know the difference between in & out? You really should try taking a second look at all the crap you parrot. Make the real comparison. If you have a job, your paystub lists your payment into Medicare. Hold that up next to your private insurance premium. By the way, were you figuring in your employer's contribution? If so, less than 8.5M per annum wont get you much private coverage these days.

4th) $60 billion in fraud? & that # comes from ...? No matter though. You understand what Medicare fraud is, right? It ain't somebody lying about their age. It's over billing & double billing by the industry, & most of that's by the insurance companies. It happens all through the private market too, but they have ways to make it all look like losses so it can re written off taxes. There's your private industry at work. You pay more. You get less. They're ripping off the taxpayers, so you're paying even more for less. Providing you actually pay taxes. Meanwhile, the government's providing more services for less money than the whole private insurance industry combined. But they can't do anything right, right? Hope you're enjoying that idiotlogue fantasy world you live in.

[Maxwell]

A very pertinent observation. To drive in the US (and most anywhere) you MUST have car insurance. So is your government ignoring the constitution when it insists on this?

Well, that's certainly an original argument. I mean it's not as though the Obama administration tried to coin it--and failed miserably in doing so.

Auto insurance is not subject to a federal mandate. It's a state by state issue. And there's a co-pay to boot. People don't have to rely on a government run insurance organization. Driving is, after all, a voluntary act. As such, that's why it covers damage done to the person you hit, and not to yourself--which establishes a wide margin of difference between the two issues. This isn't even mentioning that insurance is priced to risk. Depending on your location and history, premiums go up or down. That's not correlative to a fixed single payer system.

[buttslinger]

Nobody believes the insurance companies are going to reduce their rates if Obamacare is overturned. If millions of people drop health insurance because it gets too expensive, the taxpayers will foot the ER bills, not them.

[onmyknees]

Nobody believes the insurance companies are going to reduce their rates if Obamacare is overturned. If millions of people drop health insurance because it gets too expensive, the taxpayers will foot the ER bills, not them.



Curious then why the Health Insurance Companies were either silent, or came out in favor of ObamaCare. I'm inclined to think they got a backroom deal from Sebilius and Obama just like the "Corn husker Kickback".

Yes...you're correct ...which is all the more reason why ObamaCare is illegitimate. You can't pass the most profound piece of social legislation in 100 years with zero input or zero votes from the opposition party representing 45-49% of the electorate. There has to be consensus. This is why Obama is neither a statesman nor a leader in the spirit of Slick Willie.
Speaking of social issues, here's a conundrum for you progressives...you tell me that the majority of citizens now are in favor of gay marriage and you want legislation to reflect that, and you want it now. Yet when I tell you 60 % of Americans oppose Obamacare for a variety of reasons, you either have no answer...or dismiss them as selfish know nothings. You can't have it both ways, yet you continue to try.

[trish]

I'm inclined to think...Neither an argument nor the truth.


...zero input ... from the opposition partyNot so. If it weren't for GOP input we'd have single payer instead of a mandate.

[onmyknees]

Neither an argument nor the truth.

Not so. If it weren't for GOP input we'd have single payer instead of a mandate.


Wrong ( as usual) Obama caved on that on his own. Do the research....he didn't get any GOP votes, and he didn't need any. He would have never got Ben Nelson and Landreaux had there been single payer.

Remember that sham of a health care summit that was televised ? He assured the country he would consider Republican suggestions. When asked weeks later had anyone from the Obama Admin had ever contacted any of the GOP representitives at the meeting.....every one said the meeting was the first and last time they ever discussed health care with Obama or his team . The evidence of that would be the final draft. Not one Republican idea made it. It's his ...he owns it...thus it is rightly named "Obamacare"

[trish]

Wrong again. You are not inclined to think. Moreover you're forgetting about the bipartisan Senate committee on healthcare reform.

[onmyknees]

Have you noticed the absolute incredulity of liberal pundits over the seemingly rough time Obamacare got at the High Court ? Tingles Matthews was in shock, turned dilusion...CNN's Jeffery Tobin was melting down right before our eyes, Nina Totenberg..., The NYT....it's mass hysteria. It's fall down funny....really it is..

John Podhoretz writes about the psychic shock when The Cocoon falls apart. (http://www.nypost.com/p/news/opinion/opedcolumnists/supreme_shock_for_la_la_libs_LkWBvHWTzeCs4gvA3hdHK J)

They’re so convinced of their own correctness — and so determined to believe conservatives are either a) corrupt, b) stupid or c) deluded — that they find themselves repeatedly astonished to discover conservatives are in fact capable of a) advancing and defending their own powerful arguments, b) effectively countering weak liberal arguments and c) exposing the soft underbelly of liberal self-satisfaction as they do so.
That’s what happened this week. There appears to be no question in the mind of anyone who read the transcripts or listened to the oral arguments that the conservative lawyers and justices made mincemeat out of the Obama administration’s advocates and the liberal members of the court.
This came as a startling shock to the liberals who write about the court.

[trish]

No, haven't noticed. Apparently incredulity is in the eye of the beholder. We all knew the court would split down party lines and the conservative judges are well known assholes.

[Prospero]

Onmyknees describes Obamacare as "....the most profound piece of social legislation in 100 years."

What about civil rights legislation? I guess to the Conservatives the only legislation they feel to be genuinely earthshaking is that which might challenge big business?

[BluegrassCat]

Onmyknees describes Obamacare as "....the most profound piece of social legislation in 100 years."

What about civil rights legislation? I guess to the Conservatives the only legislation they feel to be genuinely earthshaking is that which might challenge big business?

He just compulsively sodomizes the truth. Prohibition, Ending Prohibition, Women's Suffrage, Social Security, Medicare, the Civil Rights Act, the Voting Rights Act, all less important than Obamacare, apparently.

And of course either party can pass new laws with 0 out-party support. It's ridiculous on its face to say otherwise.

The most absurd thing is that Obamacare is a conservative idea! Developed by the ultra right-wing Heritage Foundation, advocated by the GOP leadership a decade ago, and implemented by a Republican governor at the state level. We've always known that the SCOTUS is ideological but this tests how partisan they are. Will they vote against a conservative plan to spite a Democratic president? I still have some hope that Kennedy and maybe even Roberts care enough about the legitimacy of the Court to rule on principle but we'll see. After all this is an extremely conservative Court; 4 of the 5 most conservative justices of the past 80 years are on this bench while none of the justices are in the top 5 of liberal justices (Ginsburg is ranked 10).

The law is plainly constitutional. Congress has the power to regulate interstate commerce (which Healthcare clearly is) and has the power to levy taxes (which is how the mandate is enforced). End of story. Anyone who brings up broccoli is uninformed or intellectually dishonest.

[BluegrassCat]

The "Affordable" Health Care Act. And that's just the start....there was so much budget trickery in the original bill to keep it under a billion it was a joke... Now the CBO has revised it's original number and it's a budget buster. Check it out...you might need CPR ! I hope you have the proper coverage. lol


Yes, indeed you should check it out, which you clearly haven't. Here are the side by side comparisons of estimates from 2010 and now of both gross and net costs. As you can see net costs have FALLEN. So much for your right-wing fairy tale. Try pushing that shit over at Stormfront where you have a sympathetic audience.

The sad thing is that while you say "I hope you have the proper coverage," you actually don't hope that at all. You support denying people coverage and letting them die for a lack of it. It's nothing new, but it is worth noting every now and then that morally, you're an utter monster.

[flabbybody]

We should take comfort in the most recent polls that show the President surging in a head to head contest with Romney. It's as if the prospect of the Court overturning AHC is energizing support for Obama's reelction. People claim to be against Obamacare in principle, but at the end of the day they know they'll be better off under the new law

[flabbybody]

OK folks. I want to go on record with my prediction as we get close to crunch time. It's pretty simple arithmetic. 9 Justices total... 5 Republicans, 4 Dems. The 4 Dems are rock solid with the President but one or more of the Republicans will cave in and vote with the Democratic minority. Kennedy will certainly be one of them and there could be another. The vote may actually be 6-3 in favor.

The US Supreme Court will rule that Obamacare is constitutional in its entirety.

The law stands as written and will be fully implemented by the end of 2014.
You've heard it here first !

[Odelay]

Hope you're right, flabby, but I have my doubts. It is a fact (using OMK phraseology here) that to overturn this law, Scalia and Kennedy will have to ignore other rulings and opinions that they have made which support the commerce clause. It's a rogue court. They use precedent where it supports a decision that they personally favor, and they ignore precendent where it doesn't match up with their personal wants and desires.

This is a final chance for Kennedy to look like anything other than a complete partisan hack. Does he hold onto the final shred of dignity over a long career? I wouldn't place real money on it.

[buttslinger]

Tecnically, It's 5 Conservatives, and 5 Liberals, But I hope Flabbybody is right and this is the first step to the greatest Healthcare System in the World. (Hillarycare)

WASHINGTON — Supreme Court Justice Clarence Thomas hit a milestone Tuesday by not asking a single question during the morning's oral arguments. It has been five years since Thomas uttered a question to a lawyer arguing a case.

[trish]

Poor old Clarence, he's way out of his league and he knows it. He too afraid to emit so much as a squeak for fear of being humiliated. That or his mind is so closed he feels no need to probe, test or inquire.

[Prospero]

I tend to think that Ronald Dworkin is a considerably greater and more reliable authority on whether Obama's health care plans are constitutional or not than Faldur and certainly than our own pocket demagogue, OMK - the jailbird.

This is a very cogent argument published recently in the NY Review of books.

http://www.nybooks.com/articles/archives/2012/may/10/why-mandate-constitutional-real-argument/?pagination=false

[flabbybody]

Tecnically, It's 5 Conservatives, and 5 Liberals, But I hope Flabbybody is right and this is the first step to the greatest Healthcare System in the World. (Hillarycare)

WASHINGTON — Supreme Court Justice Clarence Thomas hit a milestone Tuesday by not asking a single question during the morning's oral arguments. It has been five years since Thomas uttered a question to a lawyer arguing a case.
I never had Clarence as one of the potential Republican defectors.

[Odelay]

Sounds like from the comments of Scalia's forthcoming book that we can rule out him siding with the 4 liberal justices. It's really down to Kennedy, although some analysts still rate Roberts as an extreme longshot on a vote to uphold.

Personally, I think the ACA is a kludge of a law. I think it's better than nothing with a provision preventing denial of coverage based on pre-existing conditions. But I'm guessing this gets struck down and things will have to get a lot worse before critical mass is reached and real health care reform is passed. My favorite remedy would be a movement to demand that Congress strip themselves of health care coverage. Could work too if voters had the 'nads to vote out the incumbent and for the guy/girl who is willing to forgo coverage until universal coverage is passed.

[buttslinger]

One of my doctors was Chief Justice Rehnquist's endocrinologist when he had thyroid cancer. He was my buddy and made "the phone call" for me. It's good to have friends in high places.

[flabbybody]

Sounds like from the comments of Scalia's forthcoming book that we can rule out him siding with the 4 liberal justices. It's really down to Kennedy, although some analysts still rate Roberts as an extreme longshot on a vote to uphold.

Personally, I think the ACA is a kludge of a law. I think it's better than nothing with a provision preventing denial of coverage based on pre-existing conditions. But I'm guessing this gets struck down and things will have to get a lot worse before critical mass is reached and real health care reform is passed. My favorite remedy would be a movement to demand that Congress strip themselves of health care coverage. Could work too if voters had the 'nads to vote out the incumbent and for the guy/girl who is willing to forgo coverage until universal coverage is passed.
It's certainly far from perfect, but it's all we got. Ironically the idea of forcing young healthy adults to purchase health coverage was the conservative Republican idea in order to bring on board the insurance industry. Insurers crave low risk customers because actuarially they are the most profitable. Obama made it the centerpiece of the law because he knew Canadian style single payer was dead on arrival. So the pragmatic compromise is the very issue the Court may rule against.

[broncofan]

To my knowledge there has never been an opinion issued respecting the difference between positive and negative regulation under the Commerce Clause. The article Prospero linked is a very good primer on the subject. I didn't read all of it but Scalia, though an originalist, has in the past already extended the Commerce Clause beyond what Clarence Thomas, for instance, would be willing to do.

Anyhow, the other Commerce Clause opinions have quibbled more over the definition of "interstate" in interpreting the commerce clause. Does it have to involve an interstate operation that federal law is restricting? Past decisions have said no; if it is an entirely instate operation but the regulation of the business activity in question would have a substantial effect on interstate commerce, the federal government can pass laws regulating it under its commerce clause power.

If the Commerce Clause were read in the way Clarence Thomas thinks it should be read, there would be very little the federal government could legislate under it. For seventy or so years, the clause has been interpreted in such a way that the federal government is given fairly broad power to regulate commercial activity where the states are unable to come up with a workable solution because of collective action problems and race to the bottom mentality. In fact, our health insurance quagmire seems like the exact reason it makes sense for the federal government to have such power.

[broncofan]

In other opinions, Scalia has respected precedent regarding Commerce Clause jurisprudence. In order to justify departing from that precedent he has to find a basis for distinguishing this case from other cases such as Wickard v. Filburn that were litigated under the Commerce Clause. The article Prospero linked makes the great point that forcing someone to buy does not justify a slippery slope argument and thus the invocation of a limiting principle any more than a restrictive regulation does. There is nothing inherently more tyrannical or threatening about forcing people to engage in activity than preventing them from so doing. One could hypothetically be regulated out of existence by being prevented from eating broccoli (and other foods) just as it would be burdensome to force them to eat this vegetable, the stuff that cruciferous nightmares are made of.

The check on regulation is the due process clause, and there's no reason it could not be applied to anything forcing an individual to purchase something if it was excessively burdensome. One can read the article linked by OMK and the one linked by Prospero to see the difference between empty rhetoric on the one hand and substantive analysis on the other. I cannot be sure that Kennedy will decide in the way that Dworkin expects, but his reasoning is very convincing.

[broncofan]

It's certainly far from perfect, but it's all we got. Ironically the idea of forcing young healthy adults to purchase health coverage was the conservative Republican idea in order to bring on board the insurance industry. Insurers crave low risk customers because actuarially they are the most profitable. Obama made it the centerpiece of the law because he knew Canadian style single payer was dead on arrival. So the pragmatic compromise is the very issue the Court may rule against.
This is a good point. I also think the mandate as it's called is necessary to make the whole thing work. Insurance companies would go bankrupt if only those who were at risk got insurance. So, the plan was to make the young and healthy subsidize the old and infirm. The truth is that the young and healthy, if they're lucky, eventually become old and infirm. Also, disability and illness are not doled out based on merit, so it is naive for those fortunate enough to have good health to believe it is the result of their virtue.

[flabbybody]

I would be astounded if the Court ruled against the mandate and let the rest of the law stand. I think most of us think the decision will be all or nothing.
We''ll know soon enough... this Thursday

[broncofan]

I would be astounded if the Court ruled against the mandate and let the rest of the law stand. I think most of us think the decision will be all or nothing.
We''ll know soon enough... this Thursday
I agree. And though I'm guessing, I don't think it would be consistent with congressional intent to let it stand since the bill probably doesn't work as a coherent whole without the mandate. Scalia is very big on the idea of the legislature voting on the text of the bill (not the legislative history or only parts of the bill) and so he would probably not sign off on anything that kept part of the legislation but not the rest. He would argue, quite eloquently as he is a very good writer for (insert pejorative), that what remains in the bill after part is struck down for constitutional reasons has not been voted on and passed.

[robertlouis]

I found this on Facebook. Is what it says true? If it is, it's a scandal.

[Prospero]

Thomas will vote against affordable care. it's a given. It's really all down to one judge who flips to the right more often than not. Don't hold your breath for a good outcome..

[robertlouis]

Thomas will vote against affordable care. it's a given. It's really all down to one judge who flips to the right more often than not. Don't hold your breath for a good outcome..


I realise that. But against such a flagrant conflict of interest? That's shameful.

[Stavros]

I realise that. But against such a flagrant conflict of interest? That's shameful.

The only shame Republicans are aware of is other people's...

[Prospero]

A very powerful article in the Sunday Times of London by Andrew Sullivan entitled "A Very American Coup - By The Judges" showing how the US Supreme Court has now become a key political player on the side of the Republicans - (for instance yesterday refusing to even re-examine the Citizens First ruling and on thursday poised to strike down the affordable care package.) The court was stacked with Conservatives under Reagan and George W Bush. I can't link to the Times article here because of the News Corp pay wall but it is worth seeking out. It is succinct where other deeper analysis such as those in NY Times and the New Yorker are very long reads.

[Prospero]

Here is a well argued piece from the Economist that examines the slippery slope argument.

Obamacare and the Supreme court
I am starting to hate broccoli
Mar 28th 2012, 16:05 by M.S.

CAN someone point me to a conservative who resolutely opposes Obamacare, but thinks it is constitutional? There are probably still a few out there (as of just a few weeks ago there were quite a few conservative legal scholars who believed the court would confirm the law's constitutionality by a wide margin), but I'm not hearing much from them today. Nor am I hearing from any liberals who support universal health insurance, but think the mandate is unconstitutional. Partisan identification is overwhelmingly the easiest means of determining where anyone will come down on any question with a political valence—on the street, in Congress, and to all appearances (and for the umpteenth time this century) on the Supreme Court.

So, that's life. Because partisan identification so overwhelms principled commitments on this question, there is, at this stage, very little point in writing anything about the Supreme Court's deliberations on Obamacare that is addressed to both those who think the law is constitutional, and those who don't. It is, of course, my belief that it is supporters of the unconstitutionality argument who have managed to convince themselves of transparently absurd distinctions in their zeal to have the law struck down; but at this point in the trajectory of the political argument, they think the same of me. There might be some readers out there in America who are still amenable to persuasion one way or the other, but they are probably low-information observers who are unlikely to be reading this publication.

Even so, I've decided to look for something to say about the second day of testimony that could actually be read without a sneer of dismissal by someone who, unlike me, thinks the law is bad policy and unconstitutional to boot. I think there's actually a slight window of opportunity in the question Anthony Kennedy posed to solicitor general Donald Virelli: "Can you identify any limits on the commerce clause?" At various points in the oral arguments yesterday, justices raised the concern that if the government can require people to buy health insurance, it could also require people to buy any other good on the private market; specifically mentioned were broccoli and cell phones. It's a slippery slope, the judges were saying. What principle could limit Congress's power to make people buy things?

One such limiting principle might be that a measure had to be necessary as part of a reasonable piece of legislation intended to achieve a major, legitimate public end. I think this would be sufficient to rule out idiotic measures such as requiring Americans to buy broccoli or (in most cases) cell phones. Try, for example, to think of a major public goal that could be reasonably addressed by a programme which would entail the government ordering people to buy broccoli. What could such a goal possibly be? Increasing the public's intake of vitamin B so as to reduce public health-care costs and improve public health? But mandatory private broccoli purchases would be completely ineffective at achieving this goal; the government might order people to buy broccoli, but it can't force them to eat it. It would obviously be more effective (and incontestably constitutional) to subsidise broccoli so that those who do have some inclination to eat broccoli, rather than Big Mac's or what have you, would be more likely to do so. Ordering people to buy broccoli would be an arbitrary, irrational and ineffective means to accomplish any public health goal, and for that reason such a law could be ruled unconstitutional.

How about cell phones? Try to imagine what kind of legitimate public goal might be achieved by requiring everyone to buy cell phones. Imagine, for example, that we wanted to enhance public safety by ensuring that all victims or witnesses of crimes could immediately call 911. Obviously many people can't afford cell phones, so the government would have to provide subsidies for those who couldn't, while also means-testing to ensure the subsidies aren't handed out to people who would have bought cell phones anyway. This starts to seem possibly reasonable. But does universal cell-phone possession really enhance crime reporting? That seems doubtful; so many people already own cell phones that the number of witness reports seems unlikely to rise by much if some of the few people who don't yet own them acquire them. And, as with the broccoli example, requiring people to buy cell phones doesn't mean the federal government has the power to require people to carry them; and people who currently can afford cell phones but choose not to buy them—ie, those who might suffer from a law forcing them to make commercial decisions they have the power to make but don't want to—would be those least likely to actually carry them. This suggests the law is an irrational means of achieving the objective, and could be ruled unconstitutional.

But these examples also suggest that under some circumstances, requiring people to buy things besides health insurance on the private market might be a reasonable or necessary means to achieve an objective. Imagine, for example, that America decided to eliminate its standing army and go back to a model of pure territorial defence based on a "people's war" guerrilla strategy, with required militia service for all able-bodied citizens. This seems pretty unlikely, but it's not utterly impossible. Having made that decision, would it be constitutional for the government to order everyone subject to militia service to buy an assault rifle on the private market, providing subsidies for those who can't afford one? This seems like it might be a reasonable means to achieve a legitimate public goal. It's much more likely that the government would simply buy everyone a rifle for reasons of standardisation, and you'd have to allow exceptions for reasons of religion or conscience, just as we do with the draft. But in principle ordering everyone to buy a rifle doesn't seem like an unconstitutional way to achieve the goal of national defence, if we decided to go the home-militia route.

The standard outline above, obviously, is the "necessary and proper" standard laid down in McCullough v Maryland. I am not a lawyer, and there are a whole lot of incredibly smart lawyers in America who don't think this clause is a sufficient limit. But I don't really understand why.

Put it this way: None of the slippery-slope examples I outlined above really quite make sense in the world as it stands today. Other than health insurance, I can't actually think of a single example of any other type of good that the government might rationally or reasonably order citizens to buy on the private market. Whether or not you think they're a good idea, individual mandates are clearly a rational-seeming way to solve problems in the health-insurance market, rational enough that they appealed to the Heritage Foundation, Republicans in Congress, Mitt Romney and so on, and eventually (and reluctantly) to Democrats. But I can't think of any other area of the economy or society where having the federal government order every citizen to buy a good from a private provider seems like a reasonable solution to a problem, or has seemed so to anyone else, Democrats, Republicans, or what have you. And this is why the slippery slope argument that Mr Kennedy is worried about seems inconsequential to me. I just can't imagine where such a slope could slip to. I'm hoping is that this is a genuinely helpful explanation of how I see things, for people who disagree with me about whether Obamacare is good policy.

[Stavros]

Prospero I think you have to accept that many Americans have a concept of health care that is quite different from what we have in the UK; even if we don't agree with it. In some of the coverage of the debate you can hear people arguing with someone saying Why should I pay for your health care?

In the UK we have a national service that not only provides the full range of health care from cradle to grave, but also trains doctors, nurses and the ancillary staff from radiographers through to occupational therapists, haematologists, dentists and so on and so on. Yes, the result is the largest government department, a multiplicity of health authorities and so on: but it is paid for from our taxes, it belongs to us.

The difficulty for me is in trying to separate out all the possible different scenarios when -according to that American- I should resent paying for your health care -examples:
I am paying for the consequences of someone's smoking habit when they fall ill with cancer -I am paying for surgeons to repair someone's broken bones because he drove his car into a tree when drunk or high on drugs; I am paying for someone's SRS because they are convinced they are a woman trapped in a man's body.

BUT, the treatment of someone's cancer is part of a pool of science theory and practice that has many other applications and which may benefit me when I fall ill with another disease; the orthopaedic knowledge gained from patching up drunken idiots who should not be driving may help me if I need a hip or knee replacement operation when I am 75; the SRS may benefit my significant other.

There are always scientific and social benefits to medicine and surgery, the benefits are available to all, so why not create national systems which are funded from modest taxation and which guarantees treatment at a general level across all age groups, and without regard to the ability to pay, or any other qualifying rule? Americans pay for their national security, what could be more important than the 'nations' health? I sometimes wonder if the Americans opposed to health care think of themselves as being part of the USA...

[Prospero]

I sometimes wonder if the Americans opposed to health care think of themselves as being part of the USA...

I think the crisis currently facing the US goes deeper than simply the issue of health care. This is of crucial importance but it is the frontline in a deeper and more disturbing battle.

And of course i understand the US attitude to health care. Half my family live there.

[Stavros]

Could you be more specific about the issues that you are thinking of? Is it similar to the attempt that is being made in the Uk to 'roll back the state' from its presence in the market place and in terms of social policy (and in the UK, education)?

[Prospero]

Find and read the Andrew Sullivan piece Stavros - or any number of lucid explications of the hijacking of the US political process by big money with the collusion of a Right wing dominated Supreme Court. I've posted a few from the NYRB.

[buttslinger]

Should be a CNN kind of day tomorrow.....

[flabbybody]

It should be fascinating. In the event the Court overturns the mandate (currently a 50-50 proposition on the eve of the announcement), I'll be most interested in how Obama's people spin this. No matter what the President says it will be colossal setback to his first term resume. No one can say if it will cost him re- election but I'd be very excited if I were a Romney speech writer.

[buttslinger]

Hey Flabbybody, the RNC wrote this script a few months ago, or maybe some guy in a chalet in Switzerland or something. Roberts thinks what they want him to think, that's why he's in there. You think the powers that be are going to let the goddam PRESIDENT fuck with their game?????? When Obama loses, WE lose. These charts ain't no accident.

[flabbybody]

stavros said it best. When it comes to your wealth class, cancer is a disease of equal opportunity

[Prospero]

Cancer is an equal opportunity disease - how you get to treat it is where class divisions become sharly visibile.

Oh and i thought I'd preempt OMK...."LMAO You Liberal losers lost ha ha ha..." (abrasive laughter with clouds of sulphur and a wiggling of a jailbirds scaly posterior)

[robertlouis]

I wonder just how many Americans have this response to the whole issue of government funded medical care.

[Prospero]

Very good rl.....

[flabbybody]

apparently Chief Justice Roberts was OK with Obamacare as long as the uninsured pay a 'tax' as opposed to a 'penalty'. Lawyers and judges love their words.
whatever.... you heard it here first when I predicted mandate would stand.

[Prospero]

Is that breaking news Flabby?

[Prospero]

Great news.... just reading it now

http://www.reuters.com/article/2012/06/28/us-usa-healthcare-court-idUSBRE85R06420120628

[Prospero]

Full text of the SCOTUS decision

http://www.washingtonpost.com/wp-srv/politics/documents/supreme-court-health-care-decision-text.html

[robertlouis]

Great news.... just reading it now

http://www.reuters.com/article/2012/06/28/us-usa-healthcare-court-idUSBRE85R06420120628

Commonsense and decency prevail. OK, it's based on legal interpretation, but the effect will be profound, and should assist Obama's re-election chances.

[Prospero]

Republicans have pledged to repeal it if elected.
The challenges ahead - from the Washington post.

The Supreme Court just upheld the Affordable Care Act as constitutional, affirming Congress’ authority to require Americans to purchase health insurance coverage.
It’s no doubt an understatement to describe this as a huge victory for the law, and the Obama administration. The Affordable Care Act – after spending two years in legal limbo – now has the court’s backing to move forward. That does not, however, mean the law has smooth sailing ahead. Many obstacles still stand in the law’s way, ones that could derail its success nearly as much as an adverse legal ruling. Here’s a rundown of what the law faces in coming months.
The 2012 elections. Former governor Mitt Romney (R) has repeatedly pledged that, if elected, he would repeal Obamacare on his first day in office. While Congressional procedure pretty much makes that impossible, there is still a lot a Republican president could do to impede or slow the implementation of the Affordable Care Act – especially if he happens to be working with a Republican-controlled Congress.
“This definitely raises the stakes for November,” says Cheryl Smith, a director at health consulting firm Leavitt Partners. “That would be the last opportunity to elect a Congress that could put this back in the hands of a state.”
Repeal isn’t exactly easy: There would be a lot of procedural hurdles to overcome for a President Romney who wasn’t working with a supermajority in the Senate, and had to use reconciliation (more on that here). Administratively though, there’s decent leeway to move slowly on implementing the Affordable Care Act, or devote fewer resources to making sure it works than an Obama administration may have.
The states. States hold a huge amount of sway with what happens with the Affordable Care Act. They’re the ones doing the heavy lifting in setting up health insurance exchanges, the marketplaces where an estimated 32 million Americans will purchase health coverage beginning in 2014. How well those health insurance exchanges work is nearly certain to impact the size of the insurance expansion, with an easier-to-use system likely leading to bigger numbers.
Some have moved aggressively on implementation; others have refused to do anything. Today’s decision could encourage states to move faster, as many have said they were waiting for the Supreme Court to rule before devoting resources to implementation. There’s also the possibility though that states could wait for the results of the November election. And that would mean less prep work for the law’s big launch in 2014 – that’s when pre-existing conditions end and the individual mandate starts – and a less solid foundation.
Public opinion. The Affordable Care Act has been divisive since it became law, with public opinion polls regularly finding the American public leaning against the overhaul. With the law’s least popular provision left standing – the individual mandate – that’s unlikely to change anytime soon.
That could become a roadblock for the law’s biggest goal: Getting Americans to sign up for health coverage. In Massachusetts, where the individual mandate was very effective in increasing coverage, the law had a broad base of public support. Jonathan Gruber, the M.I.T. economist who worked on both the Massachusetts and federal laws, says that negative public opinion has the potential to make the federal experience less smooth.
“There’s certainly a risk that a large opposition could mitigate the effects of the mandate,” says MIT health care economist Jonathan Gruber, who worked on both the Massachusetts and the federal law. “I could see some resistance, where people decide to pay the fine.”
That would be bad news for the Affordable Care Act: The whole point of the mandate isn’t to raise revenue, but to make sure that healthy people buy insurance. If only those who anticipate high medical needs enroll, premiums could spike.

[Stavros]

Smart call, Flabbybody...

A few thoughts:

1) Having lost the case at this juncture, the Tea Party must now either campaign on an 'opt out' provision that Romney says he will introduce if elected; or turn their attention to something else in revenge;

2) I note in the report in The Guardian just now this note on the case against:
"... lawyers for 26 US states challenging the legislation said Congress went beyond its powers by, for the first time in its history, requiring people to buy a product from the private sector."
-Surely all US citizens are obliged to buy car insurance? Doesn't this therefore mean that there is a law which obliges US citizens who drive to buy a product from the private sector?

3) Does the concept of 'interstate commerce' mean insurance? I do understand that health is big business, in the UK as well as everywhere else, but to me my first reaction is to call it a service: surely it cannot be health-care in the US that is considered 'interstate commerce'? Apologies for my ignorance on this.

Perhaps Obamacare should now become Obama Cares...?

[Prospero]

The car insurance one doesn't fly. You only have to by that if you have a car.

[robertlouis]

I still shake my head at the popular opposition to all this. It has to be the most successful con trick of all time, getting people to vote against something that is surely in their own best interest in both the short and long term.

[robertlouis]

The car insurance one doesn't fly. You only have to by that if you have a car.

What's the insurance like on a flying car then? ;)

[Stavros]

But if you do drive/own a car, you are still legally obliged to buy the insurance from the private sector, no? And consider the proportion of Americans who do own a car...that may not be universal but it must be a high % of the population.

[Prospero]

True but it's not the same as arguing that everyone must buy something. you have a right not to own a car. You are legally obliged to "own" your body.

[robertlouis]

Stand by.....

[buttslinger]

apparently Chief Justice Roberts was OK with Obamacare as long as the uninsured pay a 'tax' as opposed to a 'penalty'. Lawyers and judges love their words.
whatever.... you heard it here first when I predicted mandate would stand.

I wonder if Bush would have been elected President in 2000 if Roberts had been in charge...............

Nice call, flabbybody.

[loren]

I can't speak for anyone else, my major objection to obamacare is the Federal usurpation of power. Health care is not a Federal issue, it is an issue that should be left to the individual State's. Many people (I see a lot of foreigners) have argued that it is perfectly okay for the government to demand that everyone buys health insurance because people who drive cars have to have insurance. Firstly, drivers have to have insurance for their automobile, not for themselves. Secondly, the laws regarding car insurance are determined by each individual State.

Fortunately for me, the State of Missouri voted on and passed an ammendment to the State's constitution. We soundly rejected the individual mandate. However if the Governor or State legislation were to try to go back on that; or if obama were to try to force it on us, I will NEVER submit to it.

[Prospero]

We "foreigners" as opposed to a gun packin' TV have an interest in this because it has a direct know-on effect on the wider issues of US politics. And that of course has a wide impact on global politics. So your slur is innappropriate. Your last Republican presidency inflicted immense damage on the world and on the US. We across the water pray another will not be in office in the near future.

On a personal level half my family live in the US - an ALL support the affordable Care act. But then they don't live in Missouri... with its stone age political views.

[AmandaA]

... my major objection to obamacare is the Federal usurpation of power. Health care is not a Federal issue, it is an issue that should be left to the individual State's. ...

...However if the Governor or State legislation were to try to [mandate a healthcare policy]; or if obama were to try to force it on us, I will NEVER submit to it.

So...you'll go without any health insurance policy in order to show them how stubborn you are?

[loren]

We "foreigners" as opposed to a gun packin' TV have an interest in this because it has a direct know-on effect on the wider issues of US politics. And that of course has a wide impact on global politics. So your slur is innappropriate. Your last Republican presidency inflicted immense damage on the world and on the US. We across the water pray another will not be in office in the near future.

On a personal level half my family live in the US - an ALL support the affordable Care act. But then they don't live in Missouri... with its stone age political views.

It wasn't ment as a slur, I ment it more as a joke. I just get a little annoyed at people from another country telling me how I should vote and who I should or should not support. I haven't told anyone across the pond that they should support Scottish independence or that they should drive out the Hanoverian swine.

If everyone in my State dranke obama's kool-aid, would we still have stone age political views?

[robertlouis]

If everyone in my State dranke obama's kool-aid, would we still have stone age political views?

No, you'd still have stone-age political views no matter what you drink lol.

[robertlouis]

Fortunately for me, the State of Missouri voted on and passed an ammendment to the State's constitution. We soundly rejected the individual mandate. However if the Governor or State legislation were to try to go back on that; or if obama were to try to force it on us, I will NEVER submit to it.

So just what exactly would you do if your insurance didn't meet your personal health needs? Applaud the free market and die?

[BluegrassCat]

Fortunately for me, the State of Missouri voted on and passed an ammendment to the State's constitution. We soundly rejected the individual mandate. However if the Governor or State legislation were to try to go back on that; or if obama were to try to force it on us, I will NEVER submit to it.

Fortunately for you and the people of Missouri, you can take as many votes against it as you like but thanks to the Supremacy Clause Missouri is bound by the individual mandate (tax). Enjoy.

[broncofan]

I can't speak for anyone else, my major objection to obamacare is the Federal usurpation of power. Health care is not a Federal issue, it is an issue that should be left to the individual State's. Many people (I see a lot of foreigners) have argued that it is perfectly okay for the government to demand that everyone buys health insurance because people who drive cars have to have insurance. Firstly, drivers have to have insurance for their automobile, not for themselves. Secondly, the laws regarding car insurance are determined by each individual State.

Fortunately for me, the State of Missouri voted on and passed an ammendment to the State's constitution. We soundly rejected the individual mandate. However if the Governor or State legislation were to try to go back on that; or if obama were to try to force it on us, I will NEVER submit to it.
You don't have a choice. As Bluegrass said, the Supremacy clause says that federal law, when constitutional, trumps state law. The mandate was passed under the Commerce Clause, and as many predicted the fine if you do not pay into it is considered a tax. So it implicates the tax and spending clause. If you would like to evade taxes, you can find yourself a nice federal prison to go to.

[broncofan]

Mitt Romney has recently said that while the Court has said that the PPAPA is constitutional, they did not say it was a good law. Could you imagine if they did? Talk about judicial activism; it would be some interesting dicta if the Court decided they wanted to talk about the merits of every bill whose constitutionality they ruled on.

But Mitt has promised that if he's elected President, he will repeal the PPAPA. I think he means the legislature will, but it is a very interesting campaign strategy to advertise that you are going to deprive Americans of the first comprehensive health care bill ever passed into law. I really think this will backfire.

With this decision, Scalia has distinguished himself as an unprincipled turd who has contradicted his previous Commerce Clause decisions by attempting to create a distinction that has no meaning. Kennedy has distinguished himself as a mental lightweight who apparently didn't understand the previous decisions he's issued on the subject, and Clarence Thomas has been consistent as he has never had respect for precedent on the Commerce Clause. What a bold and courageous decision by Justice Roberts. I agree that elements of the mandate, insofar as they "create commerce" have the effect of a tax, and so are not a usurpation of the states' power by the legislature. But any federal regulation intended to fix a broken and inconsistent state by state system of regulation are going to have to restructure that system entirely. There's no point in making artificial distinctions in order to limit their ability to do so when the Due Process clause already does.

[broncofan]

Smart call, Flabbybody...

3) Does the concept of 'interstate commerce' mean insurance? I do understand that health is big business, in the UK as well as everywhere else, but to me my first reaction is to call it a service: surely it cannot be health-care in the US that is considered 'interstate commerce'? Apologies for my ignorance on this.

Perhaps Obamacare should now become Obama Cares...?
I know this isn't addressed to me so I apologize if I am speaking out of turn. In previous cases, below are a couple of examples of things that have been considered interestate commerce. Marijuana someone was growing on his property in one state. Wheat that someone grew for his own personal consumption. In this latter case, the wheat that someone grew for his own consumption was said to have a substantial effect on interstate commerce because the federal government was attempting to fix the price of wheat. If many farmers were to grow wheat for their own consumption, it would greatly reduce the demand for wheat in interstate commerce and thwart the purpose of the legislation.

The Commerce Clause has been interpreted very broadly because actions that are taken intra-state exert effects far beyond the borders of that state. In fact, the Civil Rights Act was passed under the Commerce Clause because if businesses discriminated based on prohibited factors such as race, sex, national origin, etc. it would have an effect on interstate commerce because people from various ethnic backgrounds would not be able to do business where such practices were prevalent.

So, even though it's counter-intuitive, the Commerce Clause gives the Federal government broad authority to create a comprehensive program to regulate certain types of commercial activity when states cannot because of political pressures. States have individual pressures to attract insurance business for instance by having the most permissive laws. They also have pressure to discriminate against out of staters, which is prohibited by the so-called dormant commerce clause which limits a state's ability to create laws that would interfere with the federal government's ability to regulate interstate commerce even in the absence of federal legislation. For instance if a state wanted to make it illegal to drive a tractor trailer on their highways, it would violate the dormant commerce clause. Even though there may be no federal law on point, it would exert a negative effect on interstate commerce that would usurp the federal government's authority.

But the most important issue is that the Supreme Court usually respects precedent. The principle of stare decisis says that previous interpretations by a court are controlling on issues said to fall within that holding. So, Justices such as Scalia, have pressure to find artificial distinctions to claim they are not breaking with precedent.

Finally, many Republicans like to quote the state's rights argument, claiming that activities that have traditionally been carried out by the states are powers exclusively held by them. However, our 10th amendment says that those powers that the constitution does not delegate to the federal government reside in the states. So, if it falls within the ambit of an enumerated power given to the federal government, then federal law trumps state law.

[loren]

Fortunately for you and the people of Missouri, you can take as many votes against it as you like but thanks to the Supremacy Clause Missouri is bound by the individual mandate (tax). Enjoy.

According to the Tenth Ammendment: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. " The Supremacy Clause says that the U.S. Constitution, and laws passed within the boundries set up in the Constitution. is the supreme law of the land. Medical insurance is not a power granted to the Federal government, therefore is left as a State issue.


You don't have a choice. As Bluegrass said, the Supremacy clause says that federal law, when constitutional, trumps state law. The mandate was passed under the Commerce Clause, and as many predicted the fine if you do not pay into it is considered a tax. So it implicates the tax and spending clause. If you would like to evade taxes, you can find yourself a nice federal prison to go to.

It was passed as being under the authority of the Commerce Clause. However, it was argued as a tax. In fact the Supreme Court said that Congress does not have the power to demand that people take part a=in any market, but they do have the power to levy tax. A "tax" I will not pay!

[broncofan]

That's funny, I was just talking about the 10th amendment. The Supreme Court just ruled today that the federal law was constitutional. So, it was passed pursuant to the federal government's constitutionally enumerated authority. So, there is no power left to reside in the states as they cannot pass a law that expressly or implicitly contradicts a federal law that does not violate the Constitution (according to the highest court in the land; not you dimwit).

The mandate is passed pursuant to the Commerce Clause. The fine if you do not get insurance is covered I presume by the Taxing and Spending Clause. As the Supreme Court ruled on the constitutionality of the mandate and the fine for violating the mandate, you have no choice but to comply or violate the law.

There's a place for people who do that. It's called prison. :)

[robertlouis]

So just what exactly would you do if your insurance didn't meet your personal health needs? Applaud the free market and die?

Bump.

Well, are you going to respond, Loren?

[broncofan]

That's funny, I was just talking about the 10th amendment. The Supreme Court just ruled today that the federal law was constitutional. So, it was passed pursuant to the federal government's constitutionally enumerated authority. So, there is no power left to reside in the states as they cannot pass a law that expressly or implicitly contradicts a federal law that does not violate the Constitution (according to the highest court in the land; not you dimwit).

The mandate is passed pursuant to the Commerce Clause. The fine if you do not get insurance is covered I presume by the Taxing and Spending Clause. As the Supreme Court ruled on the constitutionality of the mandate and the fine for violating the mandate, you have no choice but to comply or violate the law.

There's a place for people who do that. It's called prison. :)
Actually I just read my first news article on it. Roberts' majority opinion apparently predicated the constitutionality of the mandate on the Taxing and Spending Clause. Either way, the mandate is constitutional. Do what you like Loren.

[loren]

Bump.

Well, are you going to respond, Loren?

Point of fact, I don't have any health insurance since I was unduly fired from my job.

[loren]

That's funny, I was just talking about the 10th amendment. The Supreme Court just ruled today that the federal law was constitutional. So, it was passed pursuant to the federal government's constitutionally enumerated authority. So, there is no power left to reside in the states as they cannot pass a law that expressly or implicitly contradicts a federal law that does not violate the Constitution.

It is only considered "Constitutional" just because 5 people said it is. I bet I can find five people who say the Earth is flat or that the sun revolves around the Earth; does it make it true. There is NOWHERE in the Constitution that empowers Congress to effect a major overhaul of the health care industry.

[flabbybody]

Smart call, Flabbybody...

A few thoughts:

1) Having lost the case at this juncture, the Tea Party must now either campaign on an 'opt out' provision that Romney says he will introduce if elected; or turn their attention to something else in revenge;

2) I note in the report in The Guardian just now this note on the case against:
"... lawyers for 26 US states challenging the legislation said Congress went beyond its powers by, for the first time in its history, requiring people to buy a product from the private sector."
-Surely all US citizens are obliged to buy car insurance? Doesn't this therefore mean that there is a law which obliges US citizens who drive to buy a product from the private sector?

3) Does the concept of 'interstate commerce' mean insurance? I do understand that health is big business, in the UK as well as everywhere else, but to me my first reaction is to call it a service: surely it cannot be health-care in the US that is considered 'interstate commerce'? Apologies for my ignorance on this.

Perhaps Obamacare should now become Obama Cares...?
thank you sir.
I'd love to know how George W feels right about now over his 2005 choice for Chief Justice. and Senator Obama voted against the Roberts nomination. delicious irony

[broncofan]

It is only considered "Constitutional" just because 5 people said it is. I bet I can find five people who say the Earth is flat or that the sun revolves around the Earth; does it make it true. There is NOWHERE in the Constitution that empowers Congress to effect a major overhaul of the health care industry.
"We must remember it is a constitution we are expounding". It is not supposed to have the "prolixity of a legal code." These words were spoken by Chief Justice Marshall in McCullough v. Maryland. The Constitution gives the federal government enumerated powers. It does not specifically list activities the federal government is allowed to partake in.

When it comes to the issue of the constitutionality of federal law, ever since Marbury v. Madison, it only matters what the Supreme Court says. You can find five people, ten people, a billion people. But can you find five people on the Supreme Court? No. So you must pay the tax, or go where everyone else who makes frivolous tax evasion arguments go.

Many people every day assert that the federal gov. doesn't have jurisdiction over them, can't force them to pay taxes, that they choose to opt out of any program the gov. enacts with tax money etc. Such justifications of per se violations of the law end up being completely disregarded in court. Will you go before a judge and make such an argument?

[onmyknees]

Well fortunately we had founders smart enough for us to remedy even bad Supreme Court Decisions.....it's called elections, and one is coming soon. I would say two things to you libs and progressives who are dancing behind your keyboards in your tighty whities...

1. We now live in a country where the central government can tax you for something you choose not to partake in. ( Health insurance) And where the President assures us something is not a tax, and the Supreme Court rewrites the law to say it is. If you're good with all that....by all means gloat.
2. Be careful what you wish for and what you find momentary political satisfaction in. All this precedent and use of Executive Privilege, Executive Orders used to skirt laws ranging from DOMA to immigration, and the use of reconciliation and vote buying to pass Obama Care will be at the disposal of the next Conservative President. And being the even minded crew you are....I'm sure you won't mind when on day 1 Romney indulges in the same practices as Obama. Or if we should be fortunate enough to win the Senate, I'm sure you'll see it as fair and just when we begin to pass legislation without any input or dare I say votes from the minority party. Surely all's fair in love and politics...right?

[buttslinger]

well fortunately we had founders smart enough for us to remedy even bad supreme court decisions.....it's called elections, and one is coming soon. I would say two things to you libs and progressives who are dancing behind your keyboards in your tighty whities...

1. We now live in a country where the central government can tax you for something you choose not to partake in. ( health insurance) and where the president assures us something is not a tax, and the supreme court rewrites the law to say it is. If you're good with all that....by all means gloat.
2. Be careful what you wish for and what you find momentary political satisfaction in. All this precedent and use of executive privilege, executive orders used to skirt laws ranging from doma to immigration, and the use of reconciliation and vote buying to pass obama care will be at the disposal of the next conservative president. And being the even minded crew you are....i'm sure you won't mind when on day 1 romney indulges in the same practices as obama. Or if we should be fortunate enough to win the senate, i'm sure you'll see it as fair and just when we begin to pass legislation without any input or dare i say votes from the minority party. Surely all's fair in love and politics...right?

lmao!!!!

[Odelay]

All credit to Flabby in this thread for his predictions. I was pretty pessimistic.

I don't get the conserv-a-hate on Roberts, though. Granted, this was a pet cause for the GOP but that's exactly it - it was a pet cause, not a core cause. This wasn't about big money in politics, union power, class action lawsuits, or any of the countless pro-corporation decisions that the court has rammed down our throats. Roberts was on the "right" side there. And when it comes to overturning Roe v Wade, Roberts will side with his tribe. The long term objective of the GOP to dismantle the safety net is still on course. This was a minor bump in the road. I think, in the end, Roberts saw that he'd be Chief Justice for another 20+ years and decided this was one he could go against the grain on without upsetting the over all objectives of the far right agenda which is keeping taxes low on the rich, shredding the safety net, keeping big money in politics to keep Republicans in control, and voter restriction activities to counterbalance the coming demographic disadvantage.

I disagree with 95% of modern conservative causes, but I have to admit that the people behind this agenda are smart in the ways that they're able to win.

[BluegrassCat]

Well fortunately we had founders smart enough for us to remedy even bad Supreme Court Decisions.....it's called elections, and one is coming soon. I would say two things to you libs and progressives who are dancing behind your keyboards in your tighty whities...

1. We now live in a country where the central government can tax you for something you choose not to partake in. ( Health insurance) And where the President assures us something is not a tax, and the Supreme Court rewrites the law to say it is. If you're good with all that....by all means gloat.
2. Be careful what you wish for and what you find momentary political satisfaction in. All this precedent and use of Executive Privilege, Executive Orders used to skirt laws ranging from DOMA to immigration, and the use of reconciliation and vote buying to pass Obama Care will be at the disposal of the next Conservative President. And being the even minded crew you are....I'm sure you won't mind when on day 1 Romney indulges in the same practices as Obama. Or if we should be fortunate enough to win the Senate, I'm sure you'll see it as fair and just when we begin to pass legislation without any input or dare I say votes from the minority party. Surely all's fair in love and politics...right?

Let's see, the Constitution was upheld, millions of Americans have healthcare and we made serious efforts to control healthcare costs so of course the Tea-bagger is pissed. Butthurt punk, lmao.

[loren]

[QUOTE=broncofan;1163288]"We must remember it is a constitution we are expounding". It is not supposed to have the "prolixity of a legal code." These words were spoken by Chief Justice Marshall in McCullough v. Maryland. The Constitution gives the federal government enumerated powers. It does not specifically list activities the federal government is allowed to partake in.

When it comes to the issue of the constitutionality of federal law, ever since Marbury v. Madison, it only matters what the Supreme Court says. You can find five people, ten people, a billion people. But can you find five people on the Supreme Court? No. So you must pay the tax, or go where everyone else who makes frivolous tax evasion arguments go.QUOTE]
If you believe in a living Constitution, that can simply be changed by any judge or polition on a whim; then there is not a list of activities that the Federal government is prohibited from. In fact, there is absolutely no limit to the Federal government's authority. (Which begs the question, why even have State governments?) However, if you believe that the original intent Constitution was to establish a legal foundation for all future Federal laws to be built upon and within the limits described by the Constitution; then there is a clear limit to the activities and issues the Federal government is allowed to participate in.

According to inJustice Roberts, The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness. By this logic, the law is still unconstitutional. Granted in Article 1 section 8 (first paragraph) it says, "The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises,..." They have rebilled the individual mandate as a tax, and there is the rub. Because Article 1 section 7 (first paragraph) says, "All Bills for raising Revenue shall originate in the House of Representatives; but the Senate may propose or concur with Amendments as on other Bills.". obamacare, individual mandate, (which they are now saying is a tax) originated in the Senate and therefore according to the supreme law of the land is invalid.

Furthermore, if the obama shows as much zeal in enforcing this "law" as he has shown in enforcing other laws or provisions, I have nothing to worry about. "I don't see any voter intimidation - they just happen to peacefully assemeble in front of the polling place, Congress - I don't really need them if I want to go to war, who needs due process anyway, hey you didn't pay your taxes but you're qualified to tell everyone else they should pay theirs, illegal immigration - they are just misunderstood not criminals, immigration policy - hey I'm not going to do anything to stop them from coming and to hell with any state that wants to do anything about it." Half of obama's cabinet and a good share of the scumbags on Capitol Hill hasn't paid their taxes. I mean Warren Buffett hasen't paid the taxes he has owed for the past ten years and he got the President Medal of Freedom. So, as far as tax evasion is concernned, it looks like I'd be in good company.

[Stavros]

Many people (I see a lot of foreigners) have argued that it is perfectly okay for the government to demand that everyone buys health insurance because people who drive cars have to have insurance. Firstly, drivers have to have insurance for their automobile, not for themselves. Secondly, the laws regarding car insurance are determined by each individual State.


I raised the point about car insurance -and I admit it was a weak one- because of the argument that for the first time your Federal govt was forcing US citizens to buy a product from the private sector.

In the UK our health service is paid for by a tax that is deducted at source, ie from wages -but it is first and foremost a service not a business, even if there are billions of £ circulating in the 'health industry- -what also concerns us in the UK are the policies of a coalition government that seek to dismantle the health service we have and make it more commercial, as the US health care 'industry' is perceived to be. Defenders of the UK system who have been arguing for years that the US road is one we don't want to go down on, can now argue that if anything, the US is waking up to the benefits of a European model. No system is perfect, and they all have in-built tendencies to bureaucratic muddle, but morally a service available to all that is free at the time of need is a human right, not a market choice.

As for Hanoverian Swine -is this supposed to be a reference to the Royal Family? That dynasty died in 1901 with the Queen-Empress Victoria. Her son and successor, Edward VII was the son of Albert, whose royal line passed through Saxe-Coburg und Gotha, a name that was changed to Windsor in July 1917 for obvious political reasons (just as many towns in the US and Canada named after German places were re-named).

[Stavros]

I know this isn't addressed to me so I apologize if I am speaking out of turn. In previous cases, below are a couple of examples of things that have been considered interestate commerce. Marijuana someone was growing on his property in one state. Wheat that someone grew for his own personal consumption. In this latter case, the wheat that someone grew for his own consumption was said to have a substantial effect on interstate commerce because the federal government was attempting to fix the price of wheat. If many farmers were to grow wheat for their own consumption, it would greatly reduce the demand for wheat in interstate commerce and thwart the purpose of the legislation.

The Commerce Clause has been interpreted very broadly because actions that are taken intra-state exert effects far beyond the borders of that state. In fact, the Civil Rights Act was passed under the Commerce Clause because if businesses discriminated based on prohibited factors such as race, sex, national origin, etc. it would have an effect on interstate commerce because people from various ethnic backgrounds would not be able to do business where such practices were prevalent.

So, even though it's counter-intuitive, the Commerce Clause gives the Federal government broad authority to create a comprehensive program to regulate certain types of commercial activity when states cannot because of political pressures. States have individual pressures to attract insurance business for instance by having the most permissive laws. They also have pressure to discriminate against out of staters, which is prohibited by the so-called dormant commerce clause which limits a state's ability to create laws that would interfere with the federal government's ability to regulate interstate commerce even in the absence of federal legislation. For instance if a state wanted to make it illegal to drive a tractor trailer on their highways, it would violate the dormant commerce clause. Even though there may be no federal law on point, it would exert a negative effect on interstate commerce that would usurp the federal government's authority.

But the most important issue is that the Supreme Court usually respects precedent. The principle of stare decisis says that previous interpretations by a court are controlling on issues said to fall within that holding. So, Justices such as Scalia, have pressure to find artificial distinctions to claim they are not breaking with precedent.

Finally, many Republicans like to quote the state's rights argument, claiming that activities that have traditionally been carried out by the states are powers exclusively held by them. However, our 10th amendment says that those powers that the constitution does not delegate to the federal government reside in the states. So, if it falls within the ambit of an enumerated power given to the federal government, then federal law trumps state law.

Thanks for the clarification Broncofan, although we are aware of 'state's rights' sometimes the legal arguments people make don't appear to make sense without an explanation. Perhaps health care in the US should be viewed in the same way as defence...whatever happens I suspect this issue has still some way to go even if, as The Guardian reported yesterday, John Boehner and some other House Republicans now feel they should move on to other issues.

[loren]

As for Hanoverian Swine -is this supposed to be a reference to the Royal Family? That dynasty died in 1901 with the Queen-Empress Victoria. Her son and successor, Edward VII was the son of Albert, whose royal line passed through Saxe-Coburg und Gotha, a name that was changed to Windsor in July 1917 for obvious political reasons (just as many towns in the US and Canada named after German places were re-named).

I thought that the Hanovererians had renamed their own house and then changed it to Windsor in 1917. Thanks for clearing that up for me.

[Prospero]

Salon has analysis piece that suggests that - despite yesterday's ruling - SCOTUS has now swung further to the Right with Kennedy's decision to vote with the Conservatives.

http://www.salon.com/2012/06/29/anthony_kennedy_joins_the_radicals/

[Ben]

Michael Moore: Supreme Court Healthcare Ruling a Victory on the Path to Single-Payer - YouTube (http://www.youtube.com/watch?v=hvuPYRSN2Xk)

[Ben]

I can't speak for anyone else, my major objection to obamacare is the Federal usurpation of power. Health care is not a Federal issue, it is an issue that should be left to the individual State's. Many people (I see a lot of foreigners) have argued that it is perfectly okay for the government to demand that everyone buys health insurance because people who drive cars have to have insurance. Firstly, drivers have to have insurance for their automobile, not for themselves. Secondly, the laws regarding car insurance are determined by each individual State.

Fortunately for me, the State of Missouri voted on and passed an ammendment to the State's constitution. We soundly rejected the individual mandate. However if the Governor or State legislation were to try to go back on that; or if obama were to try to force it on us, I will NEVER submit to it.

In Canada it started out as a provincial &/or state issue, as it were.
First adopted by Tommy Douglas in Saskatchewan. Until it was universally adopted by the federal government.
And, too, it's what most Americans want. If you look at polls/surveys. You can't say socialized medicine. Because that word scares us -- ha ha! ha! (And, too, health care costs are the leading cause of bankruptcy in America.)
So denying Americans single-payer is really an attack on democracy, meaningful democracy....
And, too, universal health care goes against what we've been taught since infancy. Ya know, why should I care about anyone else? (In neoclassical economics you're what's defined as a: rational wealth maximizer. Ya know, no one else matters but me.
So, global warming or trashing the environment or pollution simply don't matter. Future generations don't matter. Because I'm strictly rational; I care about maximizing my own wealth. And who cares about anyone else.
So, a universal system of care and caring goes AGAINST everything we've been taught.
So an unwillingness to embrace single-payer does make sense. It's very rational. Again, why should anyone else matter but me.
But it certainly goes against what Adam Smith said: the core of being a human being is a concern for others.)

Tommy Douglas CCF 50th Anniversary Speech on Health Care - YouTube (http://www.youtube.com/watch?v=SBIGTfJSwgI)

Paul Krugman on health care: it's a social responsibility. - YouTube (http://www.youtube.com/watch?v=9ow9YDLliy8)

[NYBURBS]

Smart call, Flabbybody...

A few thoughts:

1) Having lost the case at this juncture, the Tea Party must now either campaign on an 'opt out' provision that Romney says he will introduce if elected; or turn their attention to something else in revenge;

2) I note in the report in The Guardian just now this note on the case against:
"... lawyers for 26 US states challenging the legislation said Congress went beyond its powers by, for the first time in its history, requiring people to buy a product from the private sector."
-Surely all US citizens are obliged to buy car insurance? Doesn't this therefore mean that there is a law which obliges US citizens who drive to buy a product from the private sector?

3) Does the concept of 'interstate commerce' mean insurance? I do understand that health is big business, in the UK as well as everywhere else, but to me my first reaction is to call it a service: surely it cannot be health-care in the US that is considered 'interstate commerce'? Apologies for my ignorance on this.

Perhaps Obamacare should now become Obama Cares...?

Traditionally, insurance was not thought to be commerce, and has been regulated at the state level. As for being forced to buy car insurance, that is done under the Police Powers that each state retained, it's a much broader power than anything granted to the federal government. So the states have always been able to mandate that you buy car insurance or health insurance, the issue here was whether Congress could do the same under it's commerce clause power. Obviously, the decision was that they could not, but that they can tax you (a distinction without too much meaning though lol).

[Prospero]

....

[buttslinger]

American children win, Republican children lose. Roberts saves dignity of SCROTUS.

[onmyknees]

You libs are a sad lot....when a conservative justice votes with the 4 predictably liberal justices, you shower him with accolades...similar to your post about the dignity. Yet when a liberal justice votes with the predictably conservative justices..................oh wait....... That never happens so we don't know quite how you'd react !! LMFAO. As Roberts said in his comments....it's up to the electorate to resolve all this. And we will. This thing was a disgrace from the sleezy vote buying to pass it to Nancy Pelosi famously suggesting we had to pass it to find out what was in it. You can't pass legislation that fundementally changes the 1/6 of the economy by ramming it through with no opposition votes....none. Not one.... it has to be consencious. It's still unpopular. Deal with that fact. It's never been about universal coverage...ever. It's about moving towards the liberal goal of government controled health care.

Now please tell me why children will be so much better off under Obama Care.

[flabbybody]

not so much better off, just a little better off. which is reason enough to be happy that the law was upheld. does it mean every little kid in America will see a dentist at least once before the age of 10 ? No. you guys would never pay a few extra dollars in taxes for that. just as long as your kids can afford braces.
Obamacare is all we could get. so we'll take it.

[BluegrassCat]

Now please tell me why children will be so much better off under Obama Care.

Google it, you sad bitter troll.

I'll get ya started: The American Academy of Pediatrics supported Obamacares, as did the Children Defense Fund.
Obamacares provides for copay-less preventive pediatric services, it says insurance companies can't deny care to children for pre-existing conditions, it extends CHIP, it provides extensions for nursing mothers and allows adult children to remain on their parents insurance until 26.

Of course your man Mitt thinks prayer and magic underwear will keep children from getting sick. How embarrassing for you. LMAO!

[robertlouis]

You libs are a sad lot....when a conservative justice votes with the 4 predictably liberal justices, you shower him with accolades...similar to your post about the dignity. Yet when a liberal justice votes with the predictably conservative justices..................oh wait....... That never happens so we don't know quite how you'd react !! LMFAO. As Roberts said in his comments....it's up to the electorate to resolve all this. And we will. This thing was a disgrace from the sleezy vote buying to pass it to Nancy Pelosi famously suggesting we had to pass it to find out what was in it. You can't pass legislation that fundementally changes the 1/6 of the economy by ramming it through with no opposition votes....none. Not one.... it has to be consencious. It's still unpopular. Deal with that fact. It's never been about universal coverage...ever. It's about moving towards the liberal goal of government controled health care.

Now please tell me why children will be so much better off under Obama Care.

Serious, simple question for you, OMK. If state-sponsored medical care is intrinsically evil, can you explain how every other developed western democracy has a system which involves to a greater or lesser degree healthcare provided for from taxes and free or heavily subsidised at the point of demand without the need for costly, indeed often unaffordable personal insurance? Is the rest of the western world wrong and the Republican right correct?

[flabbybody]

Stavros observed how strange it is in the American debate over universal coverage to hear people say: "why should I pay for your health care?"
This just doesn't come up in other places.

[robertlouis]

Stavros observed how strange it is in the American debate over universal coverage to hear people say: "why should I pay for your health care?"
This just doesn't come up in other places.

Taking community responsibility for those less fortunate is the hallmark of a civilised society. It's also a core principle of Christianity. Given that the US, at least at the level of professed faith and church attendance is arguably the most Christian of all the developed western societies, this seems like a remarkable contradiction.

As I said in my question to OMK, is the American right correct in its approach to healthcare and the rest of the civilised world wrong?

[NYBURBS]

Taking community responsibility for those less fortunate is the hallmark of a civilised society. It's also a core principle of Christianity. Given that the US, at least at the level of professed faith and church attendance is arguably the most Christian of all the developed western societies, this seems like a remarkable contradiction.

As I said in my question to OMK, is the American right correct in its approach to healthcare and the rest of the civilised world wrong?

Well, you also need to realize that there are various reasons why this was opposed, and not all conservatives share the same reasons for that opposition. Government can provide whatever services people deem necessary, be it police, fire, or even universal health care. The problem some of us have, is that the federal government was not set up to do this, is far removed from the people at large, and there was an attempt at grossly stretching the enumerated powers of Congress to accomplish this.

I will grant you that for some, the issue is simply about not wanting another "welfare" program, but for others it is about maintaining an equilibrium between central and local government. If there is sufficient support for a single payer/universal/mandatory insurance effort then pass an amendment, much like was done for prohibition, women's suffrage, the income tax, etc. It's a somewhat moot point now, though I think there will continue to be several decades worth of litigation to come out of this (such as more clearly defining when a tax becomes a regulatory effort rather than a revenue raising measure).

[robertlouis]

Well, you also need to realize that there are various reasons why this was opposed, and not all conservatives share the same reasons for that opposition. Government can provide whatever services people deem necessary, be it police, fire, or even universal health care. The problem some of us have, is that the federal government was not set up to do this, is far removed from the people at large, and there was an attempt at grossly stretching the enumerated powers of Congress to accomplish this.

I will grant you that for some, the issue is simply about not wanting another "welfare" program, but for others it is about maintaining an equilibrium between central and local government. If there is sufficient support for a single payer/universal/mandatory insurance effort then pass an amendment, much like was done for prohibition, women's suffrage, the income tax, etc. It's a somewhat moot point now, though I think there will continue to be several decades worth of litigation to come out of this (such as more clearly defining when a tax becomes a regulatory effort rather than a revenue raising measure).

I understand and appreciate that, and I have a high regard for the esteem that you rightly hold for your Constitution, but over here, it's much more the iniquities of this dreadful evil being foisted on an unwilling populace that we hear about. From the perspective of almost anyone in another western democracy where state-funded and governed healthcare functions pretty well, that sort of opposition is simply inexplicable.

[Prospero]

I wonder why there is such a deep loathing of this on the right when, leaving aside the issue of how it is paid for, almost all of its provisions for extending health care are positive ones eg. preventing insurance companies from denying cover to those with pre-existing medical conditions. Why is something designed to enhance the health coverage for the nation so loathed by those whose primary concern seems to be to avoid paying tax?

[Silcc69]

WASHINGTON -- Republicans have said repeatedly that the landmark health care reform law, upheld as constitutional by the Supreme Court last week, must be repealed and replaced. But the GOP leader in the U.S. Senate gave a surprising answer on "Fox News Sunday" when asked how Republicans would provide health care coverage to 30 million uninsured Americans.

"That is not the issue," Sen. Mitch McConnell said. "The question is how to go step by step to improve the American health care system. It is already the finest health care system in the world."

"Fox News Sunday" host Chris Wallace interrupted, "You don't think 30 million uninsured is an issue?"

"We're not going to turn the American health care system into a western European system," McConnell said. "That's exactly what is at the heart of Obamacare. They want to ... have the federal government take over all American health care. The federal government can't handle Medicare or Medicaid."

Wallace pressed McConnell, noting that the Affordable Care Act will prohibit insurance companies from not offering plans to individuals with pre-existing health conditions. "If you repeal Obamacare, how will you protect those people with pre-eexisting conditions?"

"Over the half of the states have high-risk pools that deal with that issue," McConnell said, assuring Wallace that the state programs could cover the tens of millions of uninsured Americans who have pre-existing health conditions.

Thirty-five states now have high-risk pools, covering about 208,000 people. Those policies are open to individuals with pre-existing health issues but often come with high premiums, waiting periods and coverage exclusions for certain conditions.

The Affordable Care Act included a new federal high-risk pool (modeled on the state plans) called the Pre-Existing Condition Insurance Plan. So far, only 67,000 Americans have enrolled. The program will be phased out in 2014 when the law's broader provisions kick in.

There are as many as 25 million Americans who lack insurance and have pre-existing conditions and altogether there are 50 million uninsured, according to the Government Accountability Office.

http://www.huffingtonpost.com/2012/07/01/mitch-mcconnell-uninsured-obamacare_n_1641033.html

[Odelay]

You libs are a sad lot....when a conservative justice votes with the 4 predictably liberal justices, you shower him with accolades...similar to your post about the dignity. Yet when a liberal justice votes with the predictably conservative justices..................oh wait....... That never happens

Happens a lot. In fact, on the same day as the ACA ruling, there was a ruling that went 7-2 allowing states to keep federal funds meant for certain programs if the states choose not to implement such programs. Kagan and Breyer voted with the 5 conserva-justices. I don't like the decision at all and I think it sets up more shenanigans by Governors who are often little tinpot dictators, themselves. Breyer's often gone his own way, and Kagan definitely is being watched by liberals on some of her decisions. Like the country as a whole, the supreme court has lurched to the right over the last couple of decades, so the term "liberal justice" has lost it's meaning because someone like Kagan - or even Souter before he retired - is truly centrist. They only seem liberal because they often counterbalance far right decisions.

[flabbybody]

u wonder why we hate them? did you see Louisiana Gov Jindal on Meet the Press? 1) He's not going to set up state run insurance exchanges for Loisiana citizens. (Fed government will do it anyway as Dr Dean pointed out... oops) 2) He will not seek additional Medicaid money being made available to states via AHC expanded coverage thresholds. (says it expands federal deficit)

This coming from the leader of a state who's citizens are among the most destitute in America. There are adults in his state who have never been to a dentist. This pathetic pig will pander to his party idealogues instead of helping the people he was elected to serve. Just so he can come on national TV to debate Howard Dean and make like he's a pure conservative. Maybe he thinks it's a way to beat out Rubia for the VP spot which Jindal has a 24 hour- a- day boner for.
Human lives in exchange for political theatre. This is why we hate you cocksuckers.

[Prospero]

British press reported today that Mississippi was about to become first US state with no abortion clinics. The Govenor (Republican) determined to block abortion there by any means has introduced a medical requirement that the last of the clinics will operating cannot fulfill. So they were due to close. More of the Republican war on women! But a judge has blocked the closure at the 11th hour.

Come on our redoubtable Republicans here. Justify this policy?
GOP State Rep - We have literally stopped abortion in Mississippi - YouTube (http://www.youtube.com/watch?v=IsM4n8DeSi0)
http://www.nydailynews.com/news/national/judge-stops-closure-mississippi-abortion-clinic-article-1.1106196

[Odelay]

I think Roe v Wade gets overturned very soon. Back in the day, Kennedy would side with O'Connor and Souter to prescribe constraints around how a state can limit abortions. These days, GOP legislatures have gone wild. One of these personhood bills is going to get appealed and Kennedy will get a chance for a do over. He's indicated lately that he's most comfortable siding with Alito, Scalia and Thomas. Roberts will join them because he's a staunch anti-abortion Catholic. Roberts won't have the pang of conscience he had with ACA which was law passed by US Congress & signed by the President. Roe v Wade was law formulated by the Supreme Ct in 1973. Roberts will shoot it down with no problem.

[flabbybody]

can't see the court overturning Roe v Wade if Prez wins reelection. Roberts is now an Obama guy

[buttslinger]

Roberts doesn't want to hang with Scalia and Clarence Thomas. Ruth Bader Ginsburg has George and Alec at her parties.

[robertlouis]

I think Roe v Wade gets overturned very soon. Back in the day, Kennedy would side with O'Connor and Souter to prescribe constraints around how a state can limit abortions. These days, GOP legislatures have gone wild. One of these personhood bills is going to get appealed and Kennedy will get a chance for a do over. He's indicated lately that he's most comfortable siding with Alito, Scalia and Thomas. Roberts will join them because he's a staunch anti-abortion Catholic. Roberts won't have the pang of conscience he had with ACA which was law passed by US Congress & signed by the President. Roe v Wade was law formulated by the Supreme Ct in 1973. Roberts will shoot it down with no problem.

Depending on one's politics, if this DID happen, it would return America to the Dark Ages or at least an era where women have no say over what happens to their bodies. Margaret Attwood's brilliant but bleak dystopia The Handmaid's Tale may not be that far away - a truly chilling prospect.

[BluegrassCat]

I think Roe v Wade gets overturned very soon. Back in the day, Kennedy would side with O'Connor and Souter to prescribe constraints around how a state can limit abortions. These days, GOP legislatures have gone wild. One of these personhood bills is going to get appealed and Kennedy will get a chance for a do over. He's indicated lately that he's most comfortable siding with Alito, Scalia and Thomas. Roberts will join them because he's a staunch anti-abortion Catholic. Roberts won't have the pang of conscience he had with ACA which was law passed by US Congress & signed by the President. Roe v Wade was law formulated by the Supreme Ct in 1973. Roberts will shoot it down with no problem.

I don't think Roe v Wade is overturned anytime soon. Sure Roberts will vote against it, but Kennedy, who voted to reaffirm the essential holding of Rove v Wade in 1992 will probably uphold it.

[Prospero]

I don't think you can say that Robert's is Obama's guy on the strength of the affordable health care ruling. Bit premature that!

[broncofan]

[QUOTE=broncofan;1163288]"We must remember it is a constitution we are expounding". It is not supposed to have the "prolixity of a legal code." These words were spoken by Chief Justice Marshall in McCullough v. Maryland. The Constitution gives the federal government enumerated powers. It does not specifically list activities the federal government is allowed to partake in.

When it comes to the issue of the constitutionality of federal law, ever since Marbury v. Madison, it only matters what the Supreme Court says. You can find five people, ten people, a billion people. But can you find five people on the Supreme Court? No. So you must pay the tax, or go where everyone else who makes frivolous tax evasion arguments go.QUOTE]
If you believe in a living Constitution, that can simply be changed by any judge or polition on a whim; then there is not a list of activities that the Federal government is prohibited from. In fact, there is absolutely no limit to the Federal government's authority. (Which begs the question, why even have State governments?) .
There is no list of activities the federal government is prohibited from because their powers are enumerated. But the enumerated powers are not listed as specific activities, but broad powers to act. The federal government is a government whose powers are limited in scope, but plenary within each power.

This is not a matter of a "living constitution" v. "dead constitution issue. It is just that the clauses granting power to the federal government must have meaning. For instance, the narrowest interpretation of interstate commerce would give the government the right to regulate commercial activity as goods were crossing a border and not before or after. If the states could pass laws that restrict commerce on either side of that border and those laws were inconsistent with one another, then the commerce clause grants a void and meaningless power.

Those powers that are not granted to the federal government reside in the states. The states still retain all the powers not expressly granted to the federal government. It's just that states do not have supremacy over the federal government where the federal government is authorized to act and most importantly cannot violate the bill of rights either (which by the way is usually what state's rights advocates mean when they want greater sovereignty for their individual state).

[broncofan]

(such as more clearly defining when a tax becomes a regulatory effort rather than a revenue raising measure).
Smart point, but as far as I remember in many cases the Court looks at the effect of a measure rather than the intent behind it. This could just be in Commerce Clause cases, but many laws the federal government passed were pretty transparently to regulate behavior that was not strictly commercial and where the intent was to also influence social behavior.

In a sense, taxes always regulate purchasing patterns and thus exert such regulatory effects. The fact that municipal bonds are tax exempt means they have lower interest rates and are a better bargain for those in the highest marginal tax bracket. The fact that certain types of education are deductible encourages people to participate in that education program. The capital gains tax is based on encouraging people to own certain types of assets for certain periods of time; otherwise they would be taxed at a higher rate. The tax here does raise revenue for the specific service provided, constrained only if it is a taking or violation of due process.

[Token Williams-Black]

"Obamacare" explained in layman's terms...->http://www.reddit.com/tb/vbkfm

[buttslinger]

I don't think you can say that Robert's is Obama's guy on the strength of the affordable health care ruling. Bit premature that!

ha ha, very true, but he's not Scalia's guy either. And that is a GOOD thing,


http://www.reddit.com/tb/vbkfm
Simpler explanation than that: All the practical shit that every other industrialized country but ours has had for decades.

[flabbybody]

that website did not address a major issue.
I'm concerned that Republican governors like Jindal are saying they won't set up the insurance exchanges. It seems like thats an important part of making this work. If the Federal government is forced to set them up in non-complying states, will low income residents still qualify for the subsidies? Those same governors will certainly not opt for expanded Medicaid so where does that leave those folks? No one would believe that a politician would go so far to undermine Obamacare but after listening to the likes of Jindal and Perry of Texas, it's clear they don't give a rat's ass for their citizens' well being. Even fatso Governor Christy (who I respect) is hinting he may not put the exchanges together by 2014.
Anyone have an idea how this will be resolved ?

[buttslinger]

The Republicans have a problem, you can only bluff so long before you have to show your hand and lose your money. Obama will be re-elected, Fat Rush Limbo will get tired jumping up and down, and Republicans will have lots of soul searching to do. The Republicans have no real plan for ANYTHING!!!! The economy, China, Iran, Syria, Health costs, Immigration, Women's Rights, Gay Rights, Jobs, Taxes, well no, they have tax plans and Inheritance tax plans and Stock Dividends plans. But everything else is dire threats, warnings, and whining. After the election, the never say die party will become the sour grapes party.

[Odelay]

Depending on one's politics, if this DID happen, it would return America to the Dark Ages or at least an era where women have no say over what happens to their bodies. Margaret Attwood's brilliant but bleak dystopia The Handmaid's Tale may not be that far away - a truly chilling prospect.
Nahh, it won't plunge all of America into the dark ages, just states like Mississippi and Utah. And even in those places, impregnated girls will travel to "Blue" liberal states to get an abortion, if needed. Some of the more liberal states, like Washington on the west coast, have already passed strongly supportive reproduction rights laws which would be the rule of the day if Roe v Wade were overturned.

I found Atom Egoyan's film Felicia's Journey to be a very good movie telling the simple story of a Northern Ireland lass who travels from her home country where abortion is severely restricted to London to have the option to end her pregnancy. As much as I like The Handmaid's Tale, I don't think that dystopia will be realized in the near future.

[BluegrassCat]

that website did not address a major issue.
I'm concerned that Republican governors like Jindal are saying they won't set up the insurance exchanges. It seems like thats an important part of making this work. If the Federal government is forced to set them up in non-complying states, will low income residents still qualify for the subsidies? Those same governors will certainly not opt for expanded Medicaid so where does that leave those folks? No one would believe that a politician would go so far to undermine Obamacare but after listening to the likes of Jindal and Perry of Texas, it's clear they don't give a rat's ass for their citizens' well being. Even fatso Governor Christy (who I respect) is hinting he may not put the exchanges together by 2014.
Anyone have an idea how this will be resolved ?

I was reading a piece about how Arizona originally refused to implement Medicaid, and didn't finally cave until the early 80's. So these red state governors will probably refuse the free money at first. But as time goes on and the state still has to bear the cost of these people anyway, pressure from within the state will build and eventually they'll quietly slink back to D.C. with their hands out. Sad thing is all that political posturing will hurt some people in the meantime unnecessarily.

[broncofan]

I wonder why there is such a deep loathing of this on the right when, leaving aside the issue of how it is paid for, almost all of its provisions for extending health care are positive ones eg. preventing insurance companies from denying cover to those with pre-existing medical conditions. Why is something designed to enhance the health coverage for the nation so loathed by those whose primary concern seems to be to avoid paying tax?
As your post indicates they are all excuses. The support of states' rights is to prevent the Federal government from helping people who are suffering, to support unconscionable state laws that ratify the most parochial, superstitious and often transparently hateful of views. They don't want to pay any sort of tax that might potentially go to someone undeserving and so they want a referendum on every policy measure that takes a penny out of their pockets.

I heard a story the other day about a Republican woman complaining that she couldn't get fully compensated for a major injury she sustained in a car accident because the Republicans have passed tort reform in her state. Tort reforms limit recovery for injuries and are passed by Republican legislatures to protect the insurance industry against large judgments. To pass the laws, Republicans try to conjure up mental images of career con artists faking paraplegia or something and making everyone's insurance premiums go up. Nearly the same images they've used to stimulate outrage in the heartland by making folks afraid of the "black welfare mom" to achieve welfare reforms. The woman, who supported tort reform kept saying, "but I'm one of the people who really deserves the settlement." For some reason I feel like this pretty much sums up the Republican mentality. Pure toxic hatred until they find they're not immune to it and then self-pity.

[Stavros]

Broncofan, when you write They don't want to pay any sort of tax that might potentially go to someone undeserving and so they want a referendum on every policy measure that takes a penny out of their pockets... you highlight the kind of 'moral dilemma' that upon investigation cannot be resolved by politics.

For example, enough people these days are aware that smoking cigarettes on a regular basis runs the risk of causing cancer -why should non-smokers pay any kind of general health tax to treat someone for an illness that was caused by their own behaviour? Young people who become habitual drinkers run the risk of another cancer, cirrhosis of the liver. But if you take the argument further, the US govt does not raise a special tax to fight specific wars, so you are not in a position to say: Yes, I will pay taxes for the military involvement in Grenada, but not in Iraq. A list-based system would not work, most people would not taxes if it was simply a matter of choice, politics can only offer at the national level an enabling principle, leaving it to bureaucrats and local officials to work out the day to day details.

But as I said before, the research that has gone into cancer has had multiple spin-offs in science which have benefited people who don't smoke. Just as we have email from previously secure/secret messaging systems in the military; just as tampons were developed from the use of absorbent materials used to make bandages in the First World War, and so on. There are many people who need medical treatment for 'life-style' behaviour, but just as many falling ill because of environmental pollution, inherited conditions, car accidents and so on. We are all in this together, to try and separate out those who merit care and those who don't doesn't work as your example shows, and in practical terms it is a waste of time.

The ability to pay already has mainained an order of preference, including in the UK, but the British Medical Association fought for the right for doctors to maintain their private patients and the Attlee Government in 1945-47 had to accept the compromise to get the NHS off the ground.

[broncofan]

Well put Stavros. We cannot earmark every dollar we give to the government. Since we all do things that put ourselves at risk, despite that some do them more, we cannot avoid our obligations just to spite a few people we think are frauds. And as you say, cancer research for those who have developed cancers related to consumption is no less beneficial to those who do not smoke or drink.

This mentality occurs in poker as well, where there's always one person who can't stand someone getting away with stealing a hand, so he will call just to see the other guy's aces. And he will lose all of his money because he's sure he's being suckered. Sometimes you have to accept that there's a one in a thousand chance you're being had.

I assure everyone that the person who is "living off of the government" and foregoing all worthwhile employment is not getting an especially good deal as it is. And our insurance rates are not going to skyrocket if we do not prevent all of the legitimate claims from being fully compensated to spite the one scum who cheats.

The Republicans still have the playground mentality that they would rather everyone starve than risk the chance that someone gets a free lunch.

[Odelay]

^^^^^
spot on

I try to be a good liberal and watch out for people who are less fortunate than I am. But even I sometimes have some bad thoughts when I see all these obese people in the Midwest where I live, driving in motorized carts, presumably paid for by Medicaid. But as you say Broncofan, their lives aren't all that great, and then I think of all the people that Medicaid helps who are truly deserving of that assistance. I just can't stay angry at the scammers or irresponsible for long when I see all the good that the programs do as a whole.

[prontosenioro]

i really hope Obamacare won't be applied

[buttslinger]

My area got hit with violent thunderstorms last friday, my brother had no electricity for two days, and I have to tell ya, Daniel Boone I am not.

[NYBURBS]

As your post indicates they are all excuses. The support of states' rights is to prevent the Federal government from helping people who are suffering, to support unconscionable state laws that ratify the most parochial, superstitious and often transparently hateful of views. They don't want to pay any sort of tax that might potentially go to someone undeserving and so they want a referendum on every policy measure that takes a penny out of their pockets.

I heard a story the other day about a Republican woman complaining that she couldn't get fully compensated for a major injury she sustained in a car accident because the Republicans have passed tort reform in her state. Tort reforms limit recovery for injuries and are passed by Republican legislatures to protect the insurance industry against large judgments. To pass the laws, Republicans try to conjure up mental images of career con artists faking paraplegia or something and making everyone's insurance premiums go up. Nearly the same images they've used to stimulate outrage in the heartland by making folks afraid of the "black welfare mom" to achieve welfare reforms. The woman, who supported tort reform kept saying, "but I'm one of the people who really deserves the settlement." For some reason I feel like this pretty much sums up the Republican mentality. Pure toxic hatred until they find they're not immune to it and then self-pity.

That's pretty way off the mark imo. Decentralized government isn't necessarily about pushing off the downtrodden or passing repressive laws. For many, it's about avoiding oligarchy, which is what we seem to have more and more these days. A citizen in NY is taxed and then a small cabal of legislators and bureaucrats make back room deals to decide how to spend that money in Idaho or Nebraska (and vice versa). Also, by design you have very little voice in a national government, which is why it was originally thought best that it handle only a very small number of issues, but that was more of less done away with during the New Deal. Big centralized government is actually the least responsive and hardest to change. It doesn't mean that local rule is some guaranteed utopia, but somewhere along the line we lost the balance between local and national.

On a side note, I think the ruling in this case is going to spur a fight to amend the constitution to restrict the taxing power of the federal government. I was a bit shocked when they ruled that this isn't a direct tax, and now I'm starting to see editorials and opinion pieces that are talking about it. And tbh, a measure that would restrict the ability to tax and spend would be quite popular with many people. I think Roberts popped open the Genie bottle with this opinion.

[broncofan]

NYBURBS, good post, well stated and a good defense of state's rights (in theory imo).

Yes, a Constitutional amendment. I hope three-fourths of the states aren't drinking that kool-aid. Again, I have no powers of prediction at all so I'm not saying an amendment restricting the taxing power won't pass, but that's a lot of support that's required.

I understand why some people want local rule and I've heard the traditional reasons. I've also been treated to the Southern Hospitality in certain parts of this country and am pretty sure I know why they don't want the national government interfering in their local politics. It's not because they have a social conscience or don't think the national government is responsive enough to the needs of their citizenry. There are valid reasons to have decentralized government (as you say), and the Constitution does provide for limits to the power of the national government.

But I personally think the reasons most people (not you) give are pretext. The only reason I say this is because I've seen a number of the cases where people bring up the state's rights argument and it's usually for the reasons you eloquently stated, to avoid civic responsibilities or to abuse the fk out of some segment of people in a way that only some places will tolerate.

[NYBURBS]

NYBURBS, good post, well stated and a good defense of state's rights (in theory imo).

Yes, a Constitutional amendment. I hope three-fourths of the states aren't drinking that kool-aid. Again, I have no powers of prediction at all so I'm not saying an amendment restricting the taxing power won't pass, but that's a lot of support that's required.

I understand why some people want local rule and I've heard the traditional reasons. I've also been treated to the Southern Hospitality in certain parts of this country and am pretty sure I know why they don't want the national government interfering in their local politics. It's not because they have a social conscience or don't think the national government is responsive enough to the needs of their citizenry. There are valid reasons to have decentralized government (as you say), and the Constitution does provide for limits to the power of the national government.

But I personally think the reasons most people (not you) give are pretext. The only reason I say this is because I've seen a number of the cases where people bring up the state's rights argument and it's usually for the reasons you eloquently stated, to avoid civic responsibilities or to abuse the fk out of some segment of people in a way that only some places will tolerate.

I understand where you're coming from, and there is plenty of hate out there from all sides (from radical leftists to hard core right wingers), I just think that we need some better balance. As to the amendment process, you're correct that it's quite difficult to pull off, but you can also force a convention if you get 2/3 of the states to call for one. Tbh, I don't think I'd want to see a convention at this point in history (an amendment proposed by Congress would be a bit safer than a general convention), but I really do think there is going to be a big push-back as soon as enough people realize what just happened with that ruling.

[flabbybody]

forget repeal. aint gonna happen guys.
look at Prohibition. at the time everyone agreed that was a universally stupid idea (a vastly larger consensus of the population than currently opposes Obamacare). Yet it took 14 years to get the politicians of that era to get it off the books. And even then, it was only because we were in a world wide depression and the 18th Amendment made 90% of Americans functional criminals.. including the mayor and police commissioner of New York City.

so let Romney say he'll repeal Obamacare on day one of his presidency. He needs to check the history books.

[hippifried]

I was kind of hoping the Supremes would have shot down the Republican mandate. It wouldn't have affected the rest of the act. Just the funding. I can't think of a single good reason for the insurance industry to have ever been part of this. The hedge betters are dictating too much of our governance as it is. It's out of hand.

[flabbybody]

i really hope Obamacare won't be applied
u may get your wish. White House just announced employer mandate delayed for one year. Looks like implementing Obamacare will be a disaster
http://hotair.com/archives/2013/07/02/breaking-obamacares-employer-mandate-to-be-delayed-until-2015/

[robertlouis]

u may get your wish. White House just announced employer mandate delayed for one year. Looks like implementing Obamacare will be a disaster
http://hotair.com/archives/2013/07/02/breaking-obamacares-employer-mandate-to-be-delayed-until-2015/



You guys do know that the rest of the developed and civilised world thinks that you're utterly crazy about Obamacare, right?

[Prospero]

And do they care?

[flabbybody]

You guys do know that the rest of the developed and civilised world thinks that you're utterly crazy about Obamacare, right?
people here fall into 2 camps.
those who get employer based coverage and don't want Obamacare to muck things up for them. These are the Americans who essentially believe "hey I got a good plan through work and my wife and kids are covered so fuck everyone else"
The rest of us who have to buy our own insurance or live life without coverage (the unemployed and underemployed) stand to benefit from its implementation. Problem is no one really understands how the damn thing will work (including Obama), so we're in a state of confusion. Probably a year from now we'll know more.... just don't dare get sick til then, or wait it out til you're eligible for Medicare (65 years old)

[paulclifford]

>You guys do know that the rest of the developed and civilised world thinks that you're utterly crazy about Obamacare, right?

Civilized?

Most patients in the UK, Canada, and Brazil (to pick 3 arbitrary examples of the "civilized world") loathe their nationalized healthcare systems, and with good reason: Poor quality of medical outcomes, and long waiting times.

The first is often caused by the second, especially in the case of cancer, a disease that doesn't respect government directives to wait.

Average wait time to see a specialist in the UK (including, of course, a surgeon): about 18 weeks, with a "maximum legal waiting period" of 26 weeks. Apparently, you have the right to "file a complaint" against the NHS if you wait longer than 26 weeks . . . if you're still alive, of course.

These sorts of waiting times are similar in Canada and Brazil, and with similar kinds of medical outcomes. In Canada, for example, which in some ways has an even more oppressively centralized healthcare system than the UK, mortality rates for breast, prostate, and colon cancers are about 16% higher than in the US. This is due to: long waiting times to see specialists; shortage of diagnostic screening equipment; and decisions by "cost-efficiency" panels not to make available the latest, cutting-edge drugs, therapies, and medical devices — most of which come from the US where there's still a big incentive to innovate in these areas — because they are always initially very expensive. So in the interests of "keeping Canada's healthcare costs down," you ladies with breast cancer, and you guys with prostate cancer, will simply have to die . . . . OR, as many have done in the past, seek treatment elsewhere — like south of the border in the US, for example. This latter strategy is getting to be increasingly popular in all countries with increasingly centralized healthcare systems: it's called "medical tourism."

There are countless news stories and documentaries that reveal a standard of care that is nothing short of scandalous. Routine neglect of elderly patients, cancer patients writhing in agony because their pain medications were not administered, clinicians eating patient food while patients starve, nurses ignoring patients desperate to use the toilet—all are commonplace. Most disgusting of all is the recent scandal that involuntary euthanasia is being performed on the elderly — sometimes from the general incompetence of a highly bureaucratized system, but also for the hard-nosed reason of having to free up more beds for younger, tax-paying patients.

http://www.telegraph.co.uk/health/heal-our-hospitals/10178296/13000-died-needlessly-at-14-worst-NHS-trusts.html

13,000 died needlessly at 14 worst NHS trusts
The needless deaths of thousands of NHS patients will be exposed in a report this week.

The NHS’s medical director will spell out the failings of 14 trusts in England, which between them have been responsible for up to 13,000 “excess deaths” since 2005.

Prof Sir Bruce Keogh will describe how each hospital let its patients down badly through poor care, medical errors and failures of management, and will show that the scandal of Stafford Hospital, where up to 1,200 patients died needlessly, was not a one-off.

* * * * * * * * * * * * * * *

http://www.dailymail.co.uk/news/article-2161869/Top-doctors-chilling-claim-The-NHS-kills-130-000-elderly-patients-year.html

Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year

— Professor says doctors use 'death pathway' to euthenasia of the elderly
— Around 29 per cent of patients that die in hospital are on controversial 'care pathway'
— Pensioner admitted to hospital given treatment by doctor on weekend shift

NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly.

He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country.

Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

He said this showed that claims they had hours or days left are ‘palpably false’.

In the example he revealed a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy was put on the LCP by a covering doctor on a weekend shift.

Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway.

‘Very likely many elderly patients who could live substantially longer are being killed by the LCP.

‘Patients are frequently put on the pathway without a proper analysis of their condition.

‘Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically.'"

* * * * * * * * * * * * * * *

Here's a better example of "civilized":

http://www.dailymail.co.uk/news/article-2283150/Hinchingbrooke-Hospital-The-failing-NHS-trust-taken-private-firm-Circle.html

Transformed: The failing NHS trust taken over by private firm has one of the highest levels of patient satisfaction

— Hinchingbrooke Hospital is ranked one of the highest for patient happiness and waiting times
— It was on the verge of going bust when it was taken over by Circle last year
— It is the first NHS trust to be run entirely by a private firm

The first NHS trust to be run entirely by a private firm has one of the highest levels of patient satisfaction in the country.

Hinchingbrooke, a hospital in Cambridgeshire with 160,000 patients, was on the verge of going bust when it was taken over by Circle last year.

But NHS figures show it is now ranked as one of the highest for patient happiness and waiting times.

The company running the trust has slashed losses at the hospital by 60 per cent and will soon begin to pay off burgeoning debts built up over years of mismanagement. The takeover deal, which saved the hospital from closing down, is seen as a blueprint for the future of many NHS trusts.

The George Eliot Hospital in Warwickshire is already considering adopting the model."

* * * * * * * * * * * * * * *

[The George Eliot Hospital apparently did not adopt this model. It was one of the 14 NHS Trusts exposed in the Telegraph article above.]

[Anyway, this is someone's idea of "the rest of the civilized world"? Looks uncivilized to me.]

[flabbybody]

thanks for an informative post paulclifford.

my wealthy Canadian friends and family fly here to see New York specialists when they have anything more serious than a cold. They run from their free health care and gladly pay cash for high quality US doctors. Then they'll tell me with a straight face how America needs get on board with national healthcare and join the rest of the "civilized" countries.

"so why is your triple bypass surgery being done in Manhattan when it would be free back home in Vancouver?" duh, cuz I can afford it

[trish]

Of course if you're wealthy enough and your condition is serious, you'll fly anywhere to receive the best care the world can offer. National healthcare is for those who can't afford care.

[paulclifford]

>>"so why is your triple bypass surgery being done in Manhattan when it would be free back home in Vancouver?" duh, cuz I can afford it

If you Google a phrase like "Middle Class and Medical Tourism" you'll see many links to articles on who it is, exactly, who takes advantage of relatively inexpensive air travel to countries providing lower cost, higher quality medical care for whatever ails them.

It isn't the very wealthy. It's mainly the middle class.

Additionally — and this is the important point — "waiting time" is a COST, as relevant as the money price, incurred by anyone demanding a product or service. If you asked a driver, for example, "Would you rather pay a market price of $5.00/gallon of gasoline, and be able to obtain it quickly, and at any time? Or would you rather pay a government mandated price-ceiling of $1.50/gallon, but be required to queue up for several hours, and obtain a mandated maximum amount of it only on Mondays, Wednesday, Fridays, or Tuesdays, Thursdays, Saturdays, depending on whether the first number on your license plate is odd or even?"

I believe most drivers would opt for the first. Because TIME is a cost to them, not just money. And most people would rather make economizing decisions on a personal, individual level, rather than have some third party make them for them.

So if someone's heart disease actually allows her to wait up to 26 weeks for "free" bypass surgery, that's great. But how many really believe the waiting time makes the procedure "free"?

[paulclifford]

>>>Of course if you're wealthy enough and your condition is serious, you'll fly anywhere to receive the best care the world can offer.

True enough. The very wealthy always have options that the less wealthy and the poor do not have. This is true by definition.

>>National healthcare is for those who can't afford care.

That's the sales pitch. But if you asked the poor, "Would you rather have crappy medical care that was free, or high quality medical care that was more expensive"? what would their answer probably be?

There are two main issues in healthcare that shouldn't be conflated: the quality of the healthcare outcome from the patient's point of view; and the cost in both time and money from the patient's point of view.

Despite some poorly constructed and interpreted statistical models to the contrary, the US is quite far ahead in the first issue even when compared with the advanced industrial economies of western Europe, Japan, Korea, Australia, and New Zealand. For example, if you subtract certain unfortunate events in US statistics that I believe have little or nothing to do with Americans' overall access to healthcare — i.e., suicides and high-speed automobile accidents (where the driver and passengers are dead immediately after the accident) — the US is at the top of the list in terms of 1) longevity, 2) positive outcomes from treatments for major illnesses like heart disease and cancer, 3) access to specialized elective surgeries that are non-cosmetic (hip replacements, knee replacements, prosthetic limbs, corrective vision surgery, etc., and 4) the US is even at the top of the list — surprisingly for many people — in infant survival (i.e., it has the lowest rate of infant mortality). This last deserves a little explanation.

It seems that many countries, including Europe and Asia, have a peculiar definition of what it means to be "born alive". In some countries, for example, if a baby if born severely underweight, undersized, or early, it is defined as "stillborn", because the chances are very great that it won't thrive even for the next 24-72 hours. Since these babies are defined as stillborn, they go into the "stillborn" statistics, and not the "infant mortality" statistics, which only includes babies that have thrived past a certain time period. Obviously, this practice — some would call it "manipulation", while others less generously might declare it to be "fudging the data" — has the effect of making it appear as if infant mortality is very low — lower than it really is, IF one counted every baby that showed any sign of life whatsoever (heartbeat, respiration, body movements that aren't merely reflex, etc.). This latter is actually the US standard, which, ironically, conforms to the standard suggested by the World Health Organization.

In sum: the reason infant mortality appears to be higher in the US than in many other countries is that US medical practice counts every baby.

Where the US doesn't compete so well with other countries is in the issue of cost. I think we all know that. There are several reasons for this that are pretty well understood: 1) When there's a great demand for something, the cost usually goes up. That makes intuitive sense, right? US medical care is expensive precisely because so many people like it and want to use lots of it. No mystery there.

The mystery is that with most other products — computers and smart phones, for example — providers usually respond to the great demand by expanding supply (in order to reap larger profits). Additionally — and very importantly — the possibility of getting fat profits usually acts as a reliable lure to new providers. The new providers compete amongst themselves, and with the established providers, and competition almost always results in lower prices for the buyer.

Which brings us to point 2)

The main problem with US healthcare — including health insurance — is the lack of competition. If you modeled the healthcare market along the same lines as the computer and smartphone markets, you'd have similar results in the first as you do in the second: lots of competition; lots of innovation; lots of improvements in access; lots of price-cutting. And the major benefits, of course, go to the buyer: she gets exactly what she wants, at (more or less) the price she wants, without having to compromise to someone else; and that someone else gets what he wants without having to compromise to her.

That's the main difference between economic transactions in the private market, and political transactions in the public one: if I vote Gary Johnson and you vote Barack Obama, we both cannot have our choice at the end of the election: the political process allows only one "product" to dominate; so now every Johnson voter must "consume" the political product known as Obama. Conversely, if I vote for an Android device by purchasing it, and you vote for an iPhone by purchasing it, neither one of us has to compromise or give up anything.

In beginning economics classes, it's common to talk of the market as a kind of "democratic voting process," in which each consumer "votes for a product or service with his or her dollars." But actually, it's the other way around: the political voting booth is really an imperfect model of the much more democratic private market. In the latter, everyone can (in principle) get what he or she wants without imposing that choice on everyone else. That's obviously not the case with decisions made via the voting booth.

Consider this:

I can get on my cellphone right now in New York City and call up L.L. Bean in Portland, Maine, and say, "Hello, L.L. Bean? I've been surfing your Website and I really like that plaid shirt. I'd like to order two of them. Here's my credit card number." It's that simple. I get what I want; L.L. Bean gets what they want. Transaction done!

Yet, I cannot get on my cellphone in New York City and call up BlueCross-BlueShield in Maine, and say, "Hello, BlueCross-Blueshield Maine? I've been surfing your Website and I really like one your policies. It covers me for exactly what I want, no more and no less; I like the premium and I like the deductible. I'd like to subscribe. Here's my credit card number." You know what they'll say? They'll say, "We cannot sell you a policy. The laws say that you have to live in Maine for that."

Imagine what such a policy would do to prices at L.L. Bean if the retail clothing industry had the same kind of laws as the insurance industry that restricted interstate commerce! If I were forced by law only to purchase clothing from New York retailers, they would be in the cozy position of charging much higher prices — because they would have a "captive" customer base. That I can freely seek lower prices and better merchandise literally anywhere imposes a powerful constraint on how high New York retailers would be willing to charge for clothing.

And that is precisely why almost everyone in the US can find shoes and pants and jackets that are pretty high quality (often very high quality) at whatever prices they think they can afford, yet they often cannot find health insurance that is high quality and affordable! For the simple reason of lack of competition.

I've already been too wonkish in this post. I'll just say that if the "wise ones" in congress were actually interested in getting more health insurance to more people at higher quality and lower prices, they would move to start abolishing the many laws — federal and state — that restrict and hamper competition between the states. A nice start would be to abolish the McCarren-Ferguson Act, which idiotically handed health insurance providers the power to form cartels within their home states, and thus create little pools of "captive consumers" who would literally have to move to another state to get a difference insurance policy from the ones being offered.

There are several other issues, too, that should be radically altered, but I'll leave the matter here for now.

[flabbybody]

I don't know what you do for a living paulclifford but I wish you were Obama's chief health care advisor

[paulclifford]

>>>I don't know what you do for a living paulclifford but I wish you were Obama's chief health care advisor

I appreciate hearing that, amigo!

For what it's worth, I just wanted to post the following:

http://www.cbsnews.com/8301-505267_162-57595225/cbs-news-poll-finds-more-americans-than-ever-want-obamacare-repealed/

July 24, 2013 10:10 AM
CBS News poll finds more Americans than ever want Obamacare repealed

* * * * * * * * *

The main problem today, in general, is that people instinctively grasp the fact that as consumers, they prosper in a free market; but as producers, they all want special protection from the free market by government.

The US no longer really has a "democracy", at least as I understand that term. I believe that ended around 1913, when some basic structural changes to the political system were made, specifically: the 16th amendment (federal personal income tax); the 17th amendment (direct voting of senators); and, of course, the implementing of a central bank (the Federal Reserve).

[paulclifford]

Reposted in "Zero Hedge":

http://www.zerohedge.com/news/2013-08-01/guest-post-10-reasons-why-obamacare-going-ruin-your-medical-care-and-your-life

10 Reasons Why Obamacare Is Going To Ruin Your Medical Care... And Your Life

by Elizabeth Lee Vliet, MD

Obamacare is a hodgepodge of new regulations, requirements, and penalties. I'd like to start by defining three terms, which, while obscure today, should begin to enter our everyday vocabulary as Obamacare continues to take effect:

Health insurance exchanges are the basket of qualified insurance policies that meet the new healthcare law requirements for expanded coverage. These may be set up by the states (many are refusing to do so, due to high cost and fear of bankrupting the state) or the federal government. The Exchanges are supposed to be fully operational by October 1, 2013, but it is questionable whether they will actually be in place by that deadline.

The individual mandate requires that individuals purchase health insurance that meets the new, expanded federal requirements. Individuals who do not comply face a financial penalty. Individuals who fall below minimum income levels will be eligible for taxpayer-funded subsidies to buy health insurance.

The employer mandate requires that businesses with more than 50 full-time employees must provide health insurance for all employees, and that insurance must meet the new standards set forth in the new law. Businesses that do not comply must pay a financial penalty for each employee, which for large companies can run into the millions of dollars annually. This is the piece of Obamacare that has been delayed by one year.

Selective Enforcement

Why delay one component of Obamacare and not the others? More specifically, why delay the employer mandate but not the individual mandate?

To answer that question, we must first understand this fact: Obama wants a single-payer healthcare system in the US.

This is not a secret:

Barack Obama, 2003: "I happen to be a proponent of a single-payer healthcare system for America, but as all of you know, we may not get there immediately."

Barack Obama, 2007: "But I don't think we will be able to eliminate employer-based coverage immediately. There is potentially going to be some transition time."

These quotes are not taken out of context. Anyone who has been paying attention knows that transitioning to a single-payer system has been Obama's and his cohorts' ultimate goal all along:

Rep. Jan Schakowsky (D-IL), 2009: "Next to me was a guy from the insurance company who then argued against the public option. He said it would not let private insurance companies compete. A public option would put the private insurance companies out of business and lead to single-payer. My single-payer friends, he was right. The man was right!"

Here, Rep. Schakowsky is suggesting that the "public option" will lead to their desired goal of a single-payer healthcare system. Single-payer proponents no longer use this term, since the public has clearly and consistently opposed it.

The "public option" has been renamed "Medicaid expansion," which serves the public-relations purpose of confusing the public and avoiding calling taxpayer-funded healthcare "single payer."

Jacob S. Hacker (Yale Professor), 2008: "Someone once said to me this is a Trojan Horse for single payer. It's not a Trojan Horse, right? It's right there! I am telling you. We are going to get there. Over time. Slowly. But we are going to move away from reliance on employer-based health insurance, as we should, but we will do it in a way that we are not going to frighten people into thinking they are going to lose their private insurance. We will give them a choice of public or private insurance when they are in the pool. We are going to let them keep their private insurance as long as their employer continues to provide it."

Hacker nicely sums up the underlying goals of Obamacare: not to increase competition or patient choice, but to drive people out of private insurance as a stepping stone to a government-run, single-payer system.

Stepping Stone to Single-Payer

Knowing Obama and his cohorts' goals, the purpose behind the delay of the employer mandate seems clearer: to hurry the "transition time" away from employer-based health insurance and to a single-payer system.

By forcing individuals to purchase compliant healthcare plans but not forcing employers to provide those plans, Obama is creating a swell of 10-13 million workers that must enroll in health insurance, but cannot obtain it from their employers. These workers thus have no choice but to use the government-controlled health insurance exchanges, or else pay a financial penalty.

This represents a doubling of the number of workers forced to get health insurance on the exchanges.

Remember, by enacting the dual mandates, Obamacare ostensibly was designed to ensure that its costs were borne by businesses, not taxpayers. But when the president decided to enforce only certain portions of the healthcare law and delay others, he shifted the cost of health insurance onto the backs of taxpayers.

This is all on top of the burdensome costs Obamacare has already created. Various studies have projected that private insurance premiums will rise between 20 to 60% in 2014, and some as much as 100%.

How long will the private-insurance market survive with such exploding costs? People will not be able to afford such massive premium increases. That seems to be the point: drive up costs and drive everyone into the arms of government-controlled medical care.

How Obamacare Affects You and Your Medical Care

The delay in the employer mandate is but one of dozens of negative impacts Obamacare will have on your medical services. As an independent physician, I've been discussing these issues with my patients for the past few years, helping them to prepare for what's ahead.

Here are the ten most important points that I tell my patients:

1. Your private insurance premiums will cost more and more each year.

2. You will lose the choices and flexibility in health insurance policies that we have had available up until now.

3. As reimbursements continue to drop, fewer and fewer doctors will take Medicare (for those 65 and older) or Medicaid (people younger than 65).

4. Fewer doctors accepting Medicare and Medicaid causes an increase in wait times for appointments and a decrease in the numbers and types of specialists available on these plans. Consumers would be wise to line up their doctors now. [NB: highly recommended]

5. Studies from various organizations and states have consistently shown that Medicaid recipients have longer waits for medical care, fewer options for specialists, poorer medical outcomes, and die sooner after surgeries than people with no health insurance at all. Yet an increasing number of Americans will be forced into this second-class medical care.

6. As more people enter the taxpayer-funded plans (Medicare and Medicaid) instead of paying for private insurance, the costs to provide this increased medical care and medications will escalate, leading to higher taxes.

7. With no eligibility verifications in place, millions of people who are in the US illegally will be able to access taxpayer-funded medical services, making longer lines, longer wait times, and less money available for medical care for American citizens… unless taxes are increased even more.

8. Higher expenditures to provide medical services lead to rationing of medical care and treatment options to reduce costs. This is the mandated function of the Independent Payment Advisory Board: to cut costs by deciding which types of medical services to allow… or disallow. If you are denied treatment, you have no appeal of IPAB decisions; you are simply out of luck, and possibly out of life. This is a radical departure from the appeals process required for all private health insurance plans. Further, the IPAB is accountable only to President Obama, and cannot be overridden by Congress or the courts. IPAB is designed to have the final word on your health. [NB: The Independent Payment Advisory Board is more popularly known as the "Death Panel."]

9. Under current regulations, if medical care is denied by Medicare, then a patient is not allowed to pay cash to a Medicare-contracted physician or hospital or other health professional. Patients who need medical care that is denied under Medicare or Medicaid will find themselves having to either: 1) look for an independent physician or hospital (quite rare these days); or 2) go outside the USA for treatment. [NB: This last is known as "Medical Tourism", and is gaining popularity. Panama and Belize have English-speaking clinics where Americans can pay cash and get their procedures and drugs that might be unobtainable except after long waiting periods in the US under the the new Affordable Care Act rules.]

10.Expect a loss of medical privacy. Beginning in 2014, if you participate in government health insurance, your health records will be sent to a centralized federal database, with or without your consent. [NB: The IRS will be tasked with implementing and enforcing key parts of Obamacare. They will have access to your healthcare information. Interestingly, the union that represents IRS employees recently declared that it does not want its members to be on Obamacare; they prefer their current health insurance plan. Seems to me, however, that we ought to be a "nation of laws, not of men"; so if an IRS employee can exempt himself from Obamacare, then I ought to be able to do so, too; conversely, if the government claims that Obamacare is good enough for me, then it ought to be good enough for those employees tasked with enforcing it.]

[broncofan]

I am not going to get involved in this debate yet since I want to see exactly how things pan out with the exchanges and ultimately the employer mandate. There is plenty wrong with that article since it supposes that a 2003 quote by Obama indicates a plan to undermine his own program to lead to a more comprehensive single payer system down the road. Typically people only tank something if they want it abolished (think Republicans working for regulatory agencies), not if they want to implement something even more sweeping.

One thing I don't understand is why critics of PPACA cannot seem to get the name right. How much literacy is required to remember those five letters or even the five words: Patient Protection Affordable Care Act.

When someone says Obamacare they sound about as intelligent as someone who calls the media the lamestream media.

[broncofan]

Sorry. That insult at the bottom of my last post seems to touch many people whose posts I like. So I don't mean it quite that way. I just prefer calling it PPACA, because saying Obamacare usually indicates a bias against it.

[Stavros]

I am not going to get involved in this debate yet since I want to see exactly how things pan out with the exchanges and ultimately the employer mandate. There is plenty wrong with that article since it supposes that a 2003 quote by Obama indicates a plan to undermine his own program to lead to a more comprehensive single payer system down the road. Typically people only tank something if they want it abolished (think Republicans working for regulatory agencies), not if they want to implement something even more sweeping.

One thing I don't understand is why critics of PPACA cannot seem to get the name right. How much literacy is required to remember those five letters or even the five words: Patient Protection Affordable Care Act.

When someone says Obamacare they sound about as intelligent as someone who calls the media the lamestream media.

You won't get much of a debate with Paul Clifford, he is only interested in making his points -based mostly on his imagination rather than the simplest of facts- and then moves on, or only replies to people he realises have not rumbled the fantasy world he lives in. PPACA is simple enough to reproduce, but we have heard it all before from people without any depth to their arguments -oblala, Tony Bliar, the EUSSR, Mrs Snatcher, Ronald Raygun, George Crash/Tush/Bash/ (and obscure to most but once brayed at me by an hysterical Tory: 'Stifford Craps'), not to mention 'the sheeple'....

[paulclifford]

>>>I am not going to get involved in this debate yet since I want to see exactly how things pan out with the exchanges and ultimately the employer mandate.

It's already clear how things are panning out with the employer mandate. There are articles every day on businesses, large and small, commercial and educational, that are laying people off, reducing employees' status from full-time (>30+ hours/week) to part-time (<30+ hours/week) to avoid having to pay a costly penalty per employee (if 50 employees or more). Additionally, the employer will no longer have to provide a mandated government-approved health insurance policy to these part-timers: they can buy their own insurance (if they can afford it); they can opt out of buying any insurance at all (by paying an individual penalty); or they can buy a subsidized policy online at one of the so-called Exchanges. Since the individual penalty is quite low, many individuals without employer health coverage will probably choose to opt-out entirely, and then jump back onto the system when they get sick, because the law now forbids any health insurance provider from denying coverage to anyone with a "pre-existing condition." So if you're young and healthy, there's very little incentive to get coverage. Better and cheaper to pay the opt-out penalty and get coverage when you get sick.

That, of course, is the exact opposite of what insurance is supposed to be. Insurance is the voluntary pooling of risk before something happens to you, not after. The time to buy fire insurance for your home is before it burns down, not after you have the pre-existing condition of a "burned home." If your home already has burned down, and you did not purchase fire insurance to cover this contingency, what you need now is not insurance but a helping hand — preferably by asking rather than by taking. But in any case, whether you ask or take, the help you receive for rebuilding your home should not be mislabeled "insurance for a pre-existing condition." It's charity, or welfare, or a "social safety net".

>>>There is plenty wrong with that article since it supposes that a 2003 quote by Obama indicates a plan to undermine his own program to lead to a more comprehensive single payer system down the road.

It's the exact opposite. Supporters of Obama, such as Barney Frank, admitted on videotape just after the law was passed by congress that what "we really want is a single-payer system"; "we" refers to the Obama administration, and frankly, Democrats in general.

>>>Typically people only tank something if they want it abolished

You're assuming a thoughtfulness and competency on the part of Obama that he has never shown. The man is an economics boob, and is simply driven by leftist ideology. His two chief economic advisors from his first term, Larry Summers and Christina Romer, both quit the Council of Economic Advisors before the end of his first term, claiming that he ignored all of their economic advice, and that he seemed to be driven purely by ideology rather than a pragmatic desire to get people employed in the private sector again.

And in any case, POTUS doesn't write bills; he only signs them into law. The bill originated in the House as a program to subsidize low-cost housing for returning veterans; when it got to the Senate, they gutted the whole thing and started over, morphing it into a comprehensive healthcare bill. Even then, it wasn't technically written by congressmen and senators, but by lobbyists and aides. No one single person had actually read the entire bill until after it had been passed. (That's why that great intellect of the House, Nancy Pelosi, quipped, "We have to pass the bill first to find out what's in it." Now that people ARE reading it and finding out what's in it, most of them hate it.)


>>One thing I don't understand is why critics of PPACA cannot seem to get the name right. How much literacy is required to remember those five letters or even the five words: Patient Protection Affordable Care Act. When someone says Obamacare they sound about as intelligent as someone who calls the media the lamestream media.

I usually use the term "Dinosaur Media" to describe the entrenched leftwing fossils comprising ABC, CBS, NBC, PBS, NPR, MSNBC, CNN, The New York Times, and The Washington Post. I don't call them the "Lamestream Media."

And critics certainly do have the name right: since the program is clearly one huge cluster-fuck for patients, the poor, employees, small businesses, medical-device entrepreneurs, private insurance providers, doctors, and the economy in general, an inside-the-beltway, alphabet-soup name like the "PPACA" is too polite and safely bureaucratic to identify its salient features: that no one asked for it; that no group of people demonstrated in the streets with signs declaring "We demand government healthcare! We demand an end to private insurance! We demand fewer full-time employees!"; that what people clearly needed first, above everything else, were JOBS; and that Obama — glued as usual to his mysterious BlackBerry and his teleprompter — bulldozed past all of that and pushed a multi-trillion dollar deadweight program on a fragile economy that is now impeding recovery — and it's not even fully implemented yet! Since all pundits on the left and the right have called this "Obama's 'signature' legislation", the one for which he really wants to be remembered, I think we should honor that by connecting his name to the program and repeating it, so that people never forget who stuck them with it.

"Obamacare" is the accurate and proper name for it; not the neutral and bureaucratic "PPACA," which is just a euphemism for what it can never be: it'll can never be affordable and it can never provide patient protection.

A more relevant question is this:

Why do supporters of the program constantly claim that Obamacare is a form of health insurance. It's nothing of the kind, and bears no relation to any traditional understanding of "insurance". It's actually an attempt — a failed attempt — to offer a kind of "guaranteed minimum health care". It's a social safety-net program; it's a kind of medical welfare program.

It's actually irrelevant if we call such a program "Obamacare" or the "PPACA". The main thing is not to call it "insurance." It ain't!

Right, now most of the private-sector labor unions hate it (they recently sent a letter to congress complaining about the whole program, even though they had supported it while it was being drafted); the union that represents IRS employees hates it (even though the IRS is tasked with forcing everyone else to comply with the program); congressional staffers hate it; doctors hate it; small businesses hate it; medical device manufacturers hate it; and so on. Personally, I don't think the program can actually be fully implemented; Obama will have to grant "special waivers", "special extensions", "special delays," to friends, bundlers, big donors, special interests, etc., by playing King, in order to get even some of the program in place. As he grants more and more arbitrary special favors to special interests, the monstrous unfairness of the whole thing will begin to dawn on people — if they're not already in denial, that is.

The main reason the proverbial man-in-the-street might have originally supported the program was the same reason that the famous "Obamaphone Lady" on a viral YouTube video claimed she was voting for Obama: "Mitt Romney? He suck! I votes Obama because he gonna give me a free phone!"

See:

Original Obamaphone Lady: Obama Voter Says Vote for Obama because he gives a free Phone - YouTube (http://www.youtube.com/watch?v=tpAOwJvTOio)

So she voted Obama because Obama gonna give her a free phone; others voted Obama because they believed (incorrectly) that they would get free forgiveness from paying off their school loans; and others voted Obama because they believed (also incorrectly) that Obama would give them something called "free health care."

In economics, this is known as the free-rider problem: "I need, I want, I desire, therefore, make someone else pay for it so I can get it for free, or for a greatly reduced price." A more accurate (if less politically correct) name for these special interest groups is "moochers" and "looters."

While it might, at present, be politically impossible to abolish the legislation, I believe that it can be completely defunded — like Frankenstein's monster without his electricity. We can let it stand dormant in a dark closet somewhere and worry about torching it at a later date, in a future, saner, administration.

(For more on how Obamacare will likely affect you, your health, your job, and the rest of the economy, buy the inexpensive Kindle version of a recent New York Times beststeller, "Obamacare Survival Guide." See:

ObamaCare Survival Guide: Nick Tate: 9780893348625: Amazon.com: Books@@AMEPARAM@@http://ecx.images-amazon.com/images/I/51NyVp3NJKL.@@AMEPARAM@@51NyVp3NJKL (http://www.amazon.com/ObamaCare-Survival-Guide-Nick-Tate/dp/0893348627/ref=sr_1_1?s=books&ie=UTF8&qid=1375517495&sr=1-1&keywords=the+obamacare+survival+guide)

[hippifried]

Why would anybody be stupid enough to pay money for some lame book telling them how much better off they'll be going bankrupt for getting sick without insurance?

BTW: The President hasn't had a blackberry since he took office.

Keep up.

[paulclifford]

>>>Why would anybody be stupid enough to pay money for some lame book telling them how much better off they'll be going bankrupt for getting sick without insurance?

I guess because they proved they were already stupid enough to vote for Hussein Obama because "He gonna give me free medical care!" At least the book explains why that won't happen, and how one can protect oneself from some of the consequences of a bad piece of legislation.

>>>BTW: The President hasn't had a blackberry since he took office.

BTW, you're wrong.

http://www.nbcnews.com/id/28780205/ns/technology_and_science-tech_and_gadgets/t/obama-gets-keep-his-blackberry/#.Uf4MUxZM6og

Obama gets to keep his BlackBerry
President's favorite tech tool will be allowed for personal use

By Suzanne Choney

msnbc.com

updated 1/22/2009 3:18:23 PM ET


Barack Obama gets to keep his beloved BlackBerry with him in the White House for personal use, a victory for the man considered the country's first high-tech president.

White House spokesman Robert Gibbs said today that "a pretty small group of people" — some senior staffers and personal friends — will be permitted to have the e-mail address that reaches Obama's smartphone.

The president has been adamant about continuing to use a BlackBerry, which has Internet and e-mail access, despite concerns that likely have made the National Security Agency as nervous as the Secret Service on Inauguration Day when Obama left his presidential limo twice to walk and wave to crowds along Pennsylvania Avenue.

[Ben in LA]

Another link sent to me...

http://www.eclectablog.com/2012/02/ronald-reagan-socialized-medicine-in.html

[Ben in LA]

...and a link about so-called "Obamaphones".

http://aattp.org/debunking-obamaphone-lies/

[trish]

I guess because they proved they were already stupid enough to vote for Hussein Obama because "He gonna give me free medical care!" What a stupid-assed characterization of the overwhelming majority of the American electorate that voted for Barrack Hussein Obama. Oh my God! Is his middle name really Hussein!! How horrible for you!

If there's any reason we won't get an efficient system of national health care it'll be because the republicans are obstructing it and delaying it at every turn. How many times has Congress tried to repeal it now?

[Ben in LA]

If there's any reason we won't get an efficient system of national health care it'll be because the republicans are obstructing it and delaying it at every turn. How many times has Congress tried to repeal it now?

40... :smh

[paulclifford]

>>>If there's any reason we won't get an efficient system of national health care . . .

I've already shown that there's no such thing as an efficient system of national health care. By definition, as long as government runs something — the postal service, the department of motor vehicles, Amtrak, Medicaid, etc. — that something will never, and can never, be "efficient." Health care is no exception.

You just want to claim that government is gifting you with something "free", even if it stinks. "I votes Obama 'cause he gonna give me a free phone!"

>>>it'll be because the republicans are obstructing it and delaying it at every turn.

The big bad Republicans in congress (specifically, the House, in which they're the majority) were voted in by their constituents . . . in other words, by people. It's not the big bad Republicans vs. the good, kind, giving Barack Hussein Obama. It's Barack Hussein Obama vs. a growing majority of people who simply hate what he's doing, especially with health care.

You're also in denial (why am I not surprised?): an increasing number of Democrats, in both the House and the Senate, are turning against Obamacare:

http://www.washingtonpost.com/blogs/the-fix/wp/2013/07/23/moderate-democrats-are-quitting-on-obamacare/

The Washington Post

Moderate Democrats are quitting on Obamacare

By Scott Clement, Published: July 23


The landmark health-reform law passed in 2010 has never been very popular and always highly partisan, but a new Washington Post-ABC News poll finds that a group of once loyal Democrats has been steadily turning against Obamacare: Democrats who are ideologically moderate or conservative.

Just after the law was passed in 2010, fully 74 percent of moderate and conservative Democrats supported the federal law making changes to the health-care system. But just 46 percent express support in the new poll, down 11 points in the past year. Liberal Democrats, by contrast, have continued to support the law at very high levels – 78 percent in the latest survey. Among the public at large, 42 percent support and 49 percent oppose the law, retreating from an even split at 47 percent apiece last July.

As King Obama grants "special waivers" and "special favors" and "special extensions" to groups of his choosing who don't want any part of the program, the moral unfairness of the program will be understood by every larger groups of people. And as the injurious effects of Obamacare begin to be felt by widening circles of people in the economy — especially King Obama's original supporters — more and more Democrats will turn against Obamacare, and possibly, against Obama himself, for either having lied to them ("If you're happy with your current health insurance, you can keep it!"), or for being grossly incompetent, or both.

Here's a copy of an email posted online, sent to Greg Mankiw, a very well known professor of economics at Harvard University:

http://gregmankiw.blogspot.com/2013/08/obamacare-versus-faculty.html

GREG MANKIW'S BLOG
Random Observations for Students of Economics

ABOUT ME
GREG MANKIW
UNITED STATES
I am a professor and chairman of the economics department at Harvard University, where I teach introductory economics (ec 10). I use this blog to keep in touch with my current and former students. Teachers and students at other schools, as well as others interested in economic issues, are welcome to use this resource.

SATURDAY, AUGUST 03, 2013

Obamacare versus the Faculty

I don't know how widespread this phenomenon is, but I thought I would share an email I received this morning:


I have been teaching multiple sections of economics for four years now at several Colleges and Universities in the State of Indiana. I have also been a frequent user of your texts in the classes that I teach.

With the implementation of the ACA (Affordable Care Act) these institutions are giving notification to their part-time faulty that their individual teaching schedules will now be limited to three sections. At the college this will likely result in the cancellation of 20-25% of the class sections in economics, and I would assume other areas will have a similar result. The students are not fully aware of the situation and many will be surprised that their desire to get a college education is now being impacted by the need to avoid the full implementation of the ACA.

Regardless if you are a Republican or a Democrat I would hope full-time faculty would voice their concern regarding the impact the implementation of the ACA could have on the attainment of higher education for the current student population and upon the lives of the dedicated part-time faculty that have been devoted to serving this student population.

My hope is that if faculty across the nation brought this to the public attention that we as a nation could have a more open and complete dialogue regarding the course we wish to set as a nation.

[End Mankiw excerpt]

* * * * * * * * * * * * * * *

A number of educational institutions have already fired staff, or reduced them to part-time status to avoid either having to provide them with very pricey government-mandated insurance, or to avoid having to opt-out of providing them with anything by means of paying a penalty per employee ("penalty" is the intellectually honest word for it. Obama originally insisted on calling it a "mandate" and the Supreme Court hedged by calling it a "tax".)

Max Baucaus, a very powerful Democratic senator from Montana, was one of the chief architects of Obamacare. He recently called it a "train wreck":

http://thehill.com/blogs/healthwatch/health-reform-implementation/294501-baucus-warns-of-huge-train-wreck-in-obamacare-implementation


Baucus warns of 'huge train wreck' enacting ObamaCare provisions
By Sam Baker
04/17/13 12:33 PM ET

Baucus, the chairman of the chamber's powerful Finance Committee and a key architect of the healthcare reform law, said he fears people do not understand how the law will work.

"I just see a huge train wreck coming down," he told Health and Human Services Secretary Kathleen Sebelius at a Wednesday hearing. "You and I have discussed this many times, and I don't see any results yet."

Baucus pressed Sebelius for details about how the Health Department will explain the law and raise awareness of its provisions, which are supposed to take effect in just a matter of months.

"I'm very concerned that not enough is being done so far — very concerned," Baucus said.

He pressed Sebelius to explain how her department will overcome entrenched misunderstandings about what the healthcare law does.
"Small businesses have no idea what to do, what to expect," Baucus said.
Citing anecdotal evidence from small businesses in his home state, Baucus asked Sebelius for specifics about how it is measuring public understanding of the law.

"You need data. Do you have any data? You've never given me data. You only give me concepts, frankly," he said.

Sebelius said in response that the administration is not independently monitoring public awareness of specific provisions but will be embarking on an education campaign beginning this summer.

"Educational campaign" is a government euphemism for "propaganda campaign."

King Obama, influenced by former henchmen like Cass Sunstein, is now using your tax money to pay for a centralized propaganda unit within the government called "The Nudge Squad."

http://www.breitbart.com/Big-Government/2013/07/30/Obama-nudge-squad


OBAMA ADMIN TO CREATE 'NUDGE' SQUAD TO SHAPE AMERICANS' BEHAVIOR

On Tuesday, Fox News obtained documents showing that the federal government is initiating a program designed to “nudge” Americans toward particular behaviors. The “Behavioral Insights Team” to be formed would work with the White House, as well as the Department of Health and Human Services and the Department of Agriculture, among others. The document, emailed by White House senior adviser on social and behavioral sciences Maya Shenker to a university professor, states, “Behavioral sciences can be used to help design public policies that work better, cost less, and help people achieve their goals.”

The document names several behavioral changes brought about by British “nudging,” including “sending letters to late taxpayers that indicated a social norm,” resulting in higher tax receipts. Another British policy promoted “adoption of attic-insulation.”

Dan Cruz, spokesman for the US General Services Administration, told FoxNews.com, “As part of the Administration's ongoing efforts to promote efficiency and savings, GSA is considering adding some expertise from academia in the area of program efficiency and evaluation under its Performance Improvement Council.”

Richard Thaler, who along with former Obama regulatory czar Cass Sunstein wrote the book titled Nudge, said, “The goal is to improve the efficiency and effectiveness of government by using scientifically collected evidence to inform policy designs. What is the alternative? The only alternatives I know are hunches, tradition, and ideology (either left or right.)”

The Obama administration has not been shy about attempting to use its influence – or taxpayer money – to push enthusiasm for its agenda, including Obamacare, nutrition, and gay rights.

Government has no business engaging in "behavior modification" for the sake of "nudging" people to their policies . . . thus keeping themselves in power, of course. In a democracy, it's the other way around: the people "nudge" the government by voting them in or voting them out. The people modify the government's behavior, not vice-versa.

For more on "nudge theory," see:

http://the-future-economist.blogspot.com/2013/03/nudge-theory-and-nanny-state-figure-1.html


Nudge Theory and the Nanny State

Justification of Nudge Theory

The main justification of Nudge Theory is that people have "reasoning failure". This is when people make judgements which damage lifetime happiness and so the state intervenes to prevent this.


Wow! So "people" have "reasoning failure" but politicians and government bureaucrats do not?

Amazing! We're back to the pre-democracy times when propagandists worshipped the monarch and the aristocracy — our "betters" — who simply "know best" what is in our self-interest. Except instead of worshipping a monarch and a class of aristocrats, they worship the State and class of technical "experts" who get to define what each individual's "lifetime happiness" is supposed to consist of!

One last post on your favorite "efficient" program of national health care:

http://benswann.com/premiums-skyrocket-198-congress-exempts-themselves-from-obamacare-provisions/


PREMIUMS SKYROCKET 198%: CONGRESS EXEMPTS THEMSELVES FROM OBAMACARE PROVISIONS
August 4 | Politics, US | Posted by Michael Lotfi

In a letter to the US Department of Health and Human Services (USDHHS), Ralph Hudgens, insurance commissioner for the state of Georgia, reports that Georgia insurance companies have filed new rate plans under Obamacare that will increase insurance rates up to 198%. Hudgens goes on to demand that the USDHHS delay implementation so that Georgia may get its house in order before the massive hikes take place. He also requests that the department justify the massive increases, as they are directly contradictory to what the President had promised. Finally, he demanded a prompt response to this “emergency situation”.

Georgia isn’t alone. A recent report from the Ohio Department of Insurance states that under Obamacare the average increase will be around 88%. Ohio and Georgia are certainly not unique. This story is repeated again and again all over the country.

Because Congress never read the bill, they had no idea how hard this would hit them. The law still remains unclear. Many threatened to quit their jobs on the Hill and move to the private sector because they could be forced to give up their subsidy. It seems odd that lawmakers threatened to abandon their constituents in a fit because they had to be included in a law that they forced upon us all.

All due to an amendment, which GOP lawmakers added to the Patient Care Act that required all lawmakers and their staff to be covered by plans “created” by the law or “offered through an exchange before 2014. The amendment reads:

“Section 1312(d)(3)(D): The only health plans that the Federal Government may make available to Members of Congress and their congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are created under this Act…or offered through an Exchange established under this Act.”

As of now, taxpayers pay almost 75 percent of premium payments for Congress as part of government employee benefits in Washington. Republican lawmakers believed that if America had to be a part of this then lawmakers and staff could not be allowed any exemptions. The law should apply to all Americans equally. Right?

Not so fast… Democrats had another plan. It was reported by Politico months ago that democrats in Congress were attempting to give themselves and staff an exemption. However, they quickly dismissed it as rumor. Harry Reid’s spokesman Adam Jentleson flatly denied a report that the democrat majority leader had sought an exemption for lawmakers and their staffers:

“There are not now, have never been, nor will there ever be any discussions about exempting members of Congress or Congressional staff from Affordable Care Act provisions that apply to any employees of any other public or private employer offering health care.”

There were even reports that some legislators would attempt to change the legislation by attaching an amendment to a must-pass funding bill.

“I don’t care what the answer is,” said Sen. Tom Coburn (R, Okla.). “Give us an answer so that if we want to do a legislative fix to take care of the people who actually work for us,” we can. “I mean, they’re going to be the only set of federal employees that actually get paid by the federal government that have to go into the exchange. (OPM knows) the answer—they just won’t share it. And I want time to legislate on it before we lose half our staff.”

As the 2014 deadline approaches, in plutarchy fashion, the President and Congress moved to exempt themselves and staff from provisions of the law, which would have possibly made them lose their subsidy. Obama told a group of democratic senators in a private meeting last Wednesday that he would find a solution for them. He came through. Lawmakers and their staff will now be exempt from a provision, which could force them to buy into the system the same way we do. They will continue to receive the subsidies they currently get regardless of the amendment, which could now make this against the law set forth in the Patient Care Act. Now lawmakers and staff will not feel the swift kick in the gut that the rest of us will. For now, Congress won’t have to leave their jobs on top of the Hill.


I predict that some private citizen will sue the federal government over one or more of its Obamacare provisions, and that the entire thing will have to be looked at again by the Supreme Court. People of good will should hope that, on the second time around, SCOTUS finds the program unconstitutional.

[trish]

By definition, as long as government runs something — the postal service, the department of motor vehicles, Amtrak, Medicaid, etc. — that something will never, and can never, be "efficient." Health care is no exception.You've shown Jack Shit. The Postal Service runs fine. It delivers letters in a just a few days time to every back woods place in the country...places you can't get a grayhound to...and for just a few lousy coins. It makes money, except when republicans...not unions...but republicans encumber it with an unreasonable ten year benefit prefunding plan. Amtrak works perfectly fine in the Eastern corridor. Rather than allow the Eastern corridors to financially carry the MidWestern one, the republicans want to privatize Amtrak, scrap service to the MidWest (fuck those hicks rights?) and let their buddies raid the Eastern corridor, steal the rights of way for themselves, the tracks, the trains and the profits. Social Security works perfectly fine. Just lift the cap.

What doesn't work so well is private corporations and banks. They're good at making short term profits for their shareholders, but they really suck at keeping the coastal states of the Gulf clear of oil. Not too good at keeping the ground water clean, or their factories from exploding. They're great at polluting the atmosphere, and also at rendering our antibiotics useless through overuse in hog factories. But hey, don't want no government regulations telling private citizens what they can and can't do, right?

Government is not the solution to every problem and neither is the Free Fucking Market. The founding fathers didn't establish a corporation. They didn't create bylaws for the shareholders to exploit everyone else. They established a Nation of laws of, by and for the people.

[Prospero]

What an amazing contributor to this forum Mr Clifford is with his carefully sculpted version of reality.. Heere is a full blown voice of ideology, shouting to us all through his loudspeaker.

The people elected the the party people who are dedicated to blocking everything and anything proposed by your President or the democrats. Indeed it is well on the record how the new right - the so called voice of ordinary people embodied by the tea party - bullied the old school republicans and unseated many - and now dominate with a creed of opposition to everything and anything that the president presents. There is a gridlock in US governance - and it is the making of the new Right. Of which you clearly are an articulate member.

[hippifried]

Lmg winded repetition of party line dogma doesn't necessarily equate to being "articulate". Evary political forum on the net has at least one poster using the same style, links, & even wording to push the same agenda. This isn't someone expressing themselves. It might as well be an algorithm. Perhaps with a human editor to hide the robotics.

[paulclifford]

>>>The Postal Service runs fine.

You definitely need to seek professional help.

>>>It delivers letters in a just a few days time

Assuming it doesn't lose them first, of course, as it often does.

>>>to every back woods place in the country...places you can't get a grayhound to...and for just a few lousy coins.

Wrong. The cost of mail delivery is in fact higher than a "few lousy coins," but the difference between what it really costs and what you actually pay is borne by the taxpayers, and not by the consumer of mail service who mails a specific letter. Additionally, it was, for a long time, simply illegal to dare to compete with the US Postal Service by delivering letters faster, cheaper, and/or more securely than they — with their fat, lazy, luddite unions — could do it. Eventually, packages and overnight delivery were permitted to the private, innovative sector of the economy, which is how FedEx and UPS became competitors to USPS. However, there are still federal laws preventing private mail carriers from delivering First Class mail on a competitive basis.

Even you could do a more or less decent job of delivering first-class mail if government coercively forbade anyone else from competing with you. In case you weren't aware, that sort of government-protected market for a good or service is known as a monopoly. It's no great achievement to "win a race" if a very strong umpire — government — prevents anyone else from competing against you.

And regarding the USPS's delivering letters to "every back woods place in the country," that's just one of the many reasons why it's going bankrupt and starting to close post offices around the country and reduce service: universal delivery forces high "fixed costs" on the organization — physical post offices, vehicles, fuel, electricity, heat, air-conditioning, mail boxes, staff, maintenance, etc. — even in places whose mail volume is so low, that it simply makes no sense to provide service there. Rural delivery makes no sense financially, but thankfully — because of electronic media such as email, digital bill-paying, etc. — it might simply become irrelevant.

Of course, these same electronic options for consumers are also reducing mail volume considerably in high-volume urban areas. Too bad for the USPS. It will simply have to suffer the same fate as the horse-and-buggy industry when automobiles appeared, and the tallow industry when incandescent lightbulbs were invented and mass produced: the fate is called obsolescence. Bye-bye, USPS! We're tired of waiting in long lines for stamps or envelopes, only to be met with a sign that says "Window Closed." That sort of service (or lack of it) is not what the 21st century is all about.

See this article from the Cato Institute, a free-market think-tank:

http://www.downsizinggovernment.org/usps

Privatizing the U.S. Postal Service

[Ben in LA]

If folks are complaining about the "high price" and quality of the USPS, just wait until it's privatized.

[trish]

Businesses routinely use bulk mailings to distribute flyers and coupons. They get a rate that's dirt cheap, but you don't ever see conservatives complaining about that effective subsidy.

The USPS is the only government agency mandated by the U.S. Constitution, the same sacred document that gave us freedom of speech, freedom from religion and the right for State militias to arm. The Post Office has served us well. It's the only government that collects a revenue directly for the services it provides...a few coins to post a letter. They deliver anywhere and everywhere in the U.S., something private delivery will never do. You probably didn't know that UPS and FED routinely hand off packages to out of the way boroughs and towns to the USPS for final delivery. You can't get bus service to every town in the country, you can't get wifi in every town to send email, but you can get a letter anywhere. If providing that service to every citizen cost a few extra coins, then count us in; by us I mean all the U.S. citizens whose have supported the postal service from this generation down to our forefathers.

Yet conservatives and libertarian subversives in Congress, who just hate it when people get together to improve the quality of their freedoms and their lives, are pushing to privatize the USPS. Of course they can't get the American people to go along with it, so instead they're attempting to dismantle it by restructuring its financial support and obligations.

https://www.commondreams.org/view/2012/05/26-1