dxing
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Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 9:37 pm

A U.S. district Judge has struck down the "mandate" portion of the Health Care law. It will surely be appealed.

http://www.bloomberg.com/news/2010-1...quirement-thrown-out-by-judge.html

The Obama administration’s requirement that most citizens maintain minimum health coverage as part of a broad overhaul of the industry is unconstitutional, a federal judge ruled, striking down the linchpin of the plan.

U.S. District Judge Henry Hudson in Richmond, Virginia, today said that the requirement in President Barack Obama’s health-care legislation goes beyond Congress’s powers to regulate interstate commerce. While severing the coverage mandate, which is set to become effective in 2014, Hudson didn’t address other provisions such as expanding Medicaid.

“At its core, this dispute is not simply about regulating the business of insurance -- or crafting a scheme of universal health insurance coverage -- it’s about an individual’s right to choose to participate,” wrote Hudson, who was appointed by President George W. Bush in 2002.


This can't get to the Supreme Court fast enough IMO.
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windy95
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 9:44 pm

Quoting dxing (Thread starter):
This can't get to the Supreme Court fast enough IMO.

All of these suits need to be fast tracked.
 
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 9:48 pm

The fun thing about this is whichever side doesn't prevail will be crying judicial activism all over again.  
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Lufthansa411
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:00 pm

I wouldn't say the first round went to the states considering that of the three decisions that are in, 2 have been won by the government and now 1 has been lost. It will be interesting to see where this heads for sure.

Plus, the healthcare law will not be repealed, by the nature of how it was passed it would be nearly impossible to do. However, it is entirely possible to have certain sections shot down, as was the case in VA today. Only the mandate was found unconstitutional, not the healthcare law as a whole.

The dems were smart the way they passed this: in many parts, not as a giant whole and with a longer timeline. This means that only parts of the law can be challenged and by the time in gets to the Supreme Court in a couple of years most of the law will already be implemented and almost impossible to turn around.
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dxing
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:10 pm

Quoting Lufthansa411 (Reply 3):
2 have been won by the government and now 1 has been lost. It will be interesting to see where this heads for sure.

That's the thing. In order for this law to work the mandate almost has to survive. The States don't need to win every time, just once at the Supreme Court level and the financing for the law is thrown into complete chaos.

Quoting Lufthansa411 (Reply 3):
Only the mandate was found unconstitutional, not the healthcare law as a whole.

Never said the entire law was. Again, the States only needed to win once. Now the federal government is forced to appeal the decision.
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474218
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:10 pm

I suggest title of this topic should be changed to "Health Care Mandate, First Round Goes To The People".
 
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casinterest
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:12 pm

Quoting Lufthansa411 (Reply 3):
Only the mandate was found unconstitutional, not the healthcare law as a whole.

The law itself rested on a plan of bringing patient affordability by forcing everyone to have insurance. If everyone is not required to have insurance, the plan gets expensive for the Government and further increases the deficit, and individual insurance plans. If this mandate is upheld, obamacare will need to be repealed, or the democrats will be completely destroyed in 2012 and 2014.
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Tugger
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:56 pm

Quoting dxing (Reply 4):
That's the thing. In order for this law to work the mandate almost has to survive. The States don't need to win every time, just once at the Supreme Court level and the financing for the law is thrown into complete chaos.

Nah, it's simple really and I wish they would have done this in the first place, but all you have to do is change it from a "require to purchase" to a tax deduction. Basically establish a "medical support tax" something on the order of $7,000.00 (or $10k, $14K whatever the estimated cost is) per person and have a matching $7k deduction for providing your own. You could have exclusions and exemptions that leave the fiscal result as the same as it is now. It's simple and if the tax and deduction are crafted properly everyone will get their own insurance.

Simple.

As a fiscal conservative Republican I think that everyone MUST have health insurance/contribute toward universal access for all. And I also fully see the "wrong" in congress making it a "you must buy" requirement. That power is not granted to the congress. They overstepped their limits. Of course we will likely have to wait another two years at least with the structure of the incoming congress before this is able to be instituted. But it will happen, I do see universal access to health care coming to the USA.

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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 10:57 pm

Quoting 474218 (Reply 5):

I suggest title of this topic should be changed to "Health Care Mandate, First Round Goes To The People".

Utter nonsense. Given that the current system involves those of us who are insured double-paying for those who aren't through both premium increases and local taxes, this has nothing to do with "the people". The problems with the law relate to interstate commerce and the total lack of any action taken against frivolous malpractice suits.
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Alias1024
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 11:14 pm

Quoting casinterest (Reply 6):
The law itself rested on a plan of bringing patient affordability by forcing everyone to have insurance.

That's not why the requirement to have insurance was included in the law. The legislation requires insurance companies to no longer deny coverage to people with pre-existing conditions. Obviously, the insurance industry would be swimming in red ink if people could stay uninsured, then apply for and be guaranteed insurance only when they suffer an expensive injury or illness. The requirement to have insurance was to prevent people from doing just that.
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D L X
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RE: Health Care Mandate, First Round Goes To States.

Mon Dec 13, 2010 11:58 pm

Quoting dxing (Reply 4):
Again, the States only needed to win once.

No, the states* only have to win the Superbowl. This wasn't even a playoff game.

* Most states are not interested in breaking apart this law. This case was brought by our activist AG Cuccinelli, and does not enjoy wide support by the rest of the Commonwealth. Let's not get carried away.
 
LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:23 am

I've always felt that the mandate to purchase insurance was very wrong.

After all this would be first and only time in America that the government require every man, woman and child to go out and spend money by something, namely purchasing insurance from a private business. Nuts.

If you want to take part fine, but people(and States) should have the right to opt out.

At the end of the day hopefully enough holes are made in Obamacare that it becomes a meaningless law. Also with Republicans having the House, they hopefully will refuse to pass any funding bills the next two years that sends money towards program.
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DocLightning
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:41 am

Quoting Alias1024 (Reply 9):

That's not why the requirement to have insurance was included in the law. The legislation requires insurance companies to no longer deny coverage to people with pre-existing conditions. Obviously, the insurance industry would be swimming in red ink if people could stay uninsured, then apply for and be guaranteed insurance only when they suffer an expensive injury or illness. The requirement to have insurance was to prevent people from doing just that.

That and also the hospitals. Hospitals are required to stabilize patients regardless of ability to pay. The problem is that very often (and I mean very often) that stabilization is no small feat.

So now you have a patient who has received a good fraction of a million dollars worth of healthcare. Oh, the hospital can go after him with collections until they've collected his testicles, but that still doesn't get them their money.

The other thing is that forcing everyone to have insurance ensures that everyone has access to primary care and preventative care. That poor uninsured schmuck who had a stroke that took out half his brain now has no way to pay for long-term care, true, but if he'd had insurance he might not have had the stroke because his 190/120 blood pressure would have been properly controlled!
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photopilot
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:47 am

And the World continues to laugh at the world's biggest economy and country that somehow can't even manage to have Universal Health Care for all it's citizens. Astounding really......that healthcare isn't a universal right in the USA and that petty politics and bickering takes presidence.
 
IMissPiedmont
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:55 am

I find it a pity that my insurance company was allowed to double my premium, I now have crappy (read as useless) health insurance.

Obama, I'm sure, will again drop everything else and focus his one track mind on a problem that he is unwilling to really fix. Very sad.
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474218
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:58 am

[

Quoting photopilot (Reply 13):
And the World continues to laugh at the world's biggest economy and country that somehow can't even manage to have Universal Health Care for all it's citizens. Astounding really......that healthcare isn't a universal right in the USA and that petty politics and bickering takes presidence.


Why do you think we have the "world's biggest economy"?

Because we have resisted (up til now) the "cradle to grave coddling" that the rest of the worlds industrialized nations are now trying to get out from under.
 
Okie
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:58 am

"Despite the laudable intentions of Congress in enacting a comprehensive and transformative health care regime, the legislative process must still operate within constitutional bounds. Salutatory [sic] goals and creative drafting have never been sufficient to offset an absence of enumerated powers."

This is the heart of the decision, Congress has overstepped their contitutional bounds.

The government can not dictate that you to buy a pile of General Electric rubber dog poo, a bus, a GM car, or health insurance even with creative drafting.

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san747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 1:08 am

Quoting LAXintl (Reply 11):

After all this would be first and only time in America that the government require every man, woman and child to go out and spend money by something, namely purchasing insurance from a private business. Nuts.

Probably because the government understands that when an uninsured citizen uses health services without the ability to pay, the rest of us have to. Every argument I hear against illegal immigration centers on Americans having to pay for them using our hospital services (among others), but I never hear any mention of the fact that we pay just as much, if not more for uninsured Americans using hospitals. Mandating every citizen own health insurance rectifies that situation by making sure that citizen has the ability to pay for their OWN treatment and the hospital that provides them services doesn't get screwed out of (often) hundreds of thousands of dollars it costs to treat them, as Doc described.
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 1:25 am

Quoting photopilot (Reply 13):
And the World continues to laugh at the world's biggest economy and country that somehow can't even manage to have Universal Health Care for all it's citizens.

  

Quoting DocLightning (Reply 12):
The other thing is that forcing everyone to have insurance ensures that everyone has access to primary care and preventative care. That poor uninsured schmuck who had a stroke that took out half his brain now has no way to pay for long-term care, true, but if he'd had insurance he might not have had the stroke because his 190/120 blood pressure would have been properly controlled!

Yes yes yes. People against health care for all just don't seem to grasp the reality of double-paying for others. I don't like doing it - question is why do they??

Quoting IMissPiedmont (Reply 14):
Obama, I'm sure, will again drop everything else and focus his one track mind on a problem that he is unwilling to really fix.

Yes, since his party and the other are in bed with competing interests, there is no objective view to solve the problem of malpractice abuse and prescription fraud.

Quoting 474218 (Reply 15):
Why do you think we have the "world's biggest economy"?

I don't give a fig about that if I still have to pay for other people's care two or three times like we do with the current system. Please tell me why you enjoy having to do that.
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474218
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 2:34 am

Quoting Aaron747 (Reply 18):
Please tell me why you enjoy having to do that.


I don't enjoy it, I pay $811 a month for health insurance for my wife and myself. I do it because if, God forbid, we do need it we have it. My insurance would be a lot less if I didn't have to pay for "government mandated" things like, covering children up to 26 on their parents policy, mental health care, drug rehab, stop smoking classes, pre-natial care and delivery (my wife had a hysterectomy 30 years ago) and dozens of other feel good items politicians require insurance companies to cover because they were looking for votes from one bleeding heart group or another.

But I can't shop around and get just the coverage I want, a simple insurance policy that will pay if I am admitted to a hospital or have a catastrophic illness and let me cover my doctors visits. That would be real "health care reform".

But Obama care does nothing to lower costs only add more mandates.
 
D L X
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 2:46 am

Quoting 474218 (Reply 19):
But Obama care does nothing to lower costs only add more mandates.

False, unless you can cite a source to back you up.
 
474218
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 2:53 am

Quoting D L X (Reply 20):

False, unless you can cite a source to back you up.


All you have to do is do something the Democrats in Congress refused to, "read the bill'.
 
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WarRI1
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 2:53 am

Quoting D L X (Reply 20):
I didn't have to pay for "government mandated" things like, covering children up to 26 on their parents policy

Is that not part of the new bill? It was always 21for college students, before the Healthcare bill, unless I am mistaken. It was 18, unless you went to college in my company coverage.
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dxing
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 2:54 am

Quoting D L X (Reply 10):
Most states are not interested in breaking apart this law.

From the story in the OP:

The ruling is the government’s first loss in a series of challenges to the law mounted in federal courts in Virginia, Michigan and Florida, where 20 states have joined an effort to have the statute thrown out.

That's 22 States and with the recent election results there are several other States that are set to join the suit or start their own. Not a majority today, but a month from now that will most likely be a different story.

Quoting DocLightning (Reply 12):
So now you have a patient who has received a good fraction of a million dollars worth of healthcare.

We've discussed this before. Exactly how many times does that happen in a year at one hospital? Not many if I remember correctly. Again, the outlandish is portrayed as the norm. It seems to be the only way some can advance their argument.

Quoting Aaron747 (Reply 18):

Yes yes yes. People against health care for all just don't seem to grasp the reality of double-paying for others. I don't like doing it - question is why do they??

People double pay all the time. I have uninsured motorist coverage on my auto insurance policy. If my daughters attended private school as many children do, I'd be paying double as their parents do. My taxes go to support those on welfare and medicaid so in effect I pay for my own health insurance as well as indigents. Those (medicaid payments) are only set to grow with the advent of Obama Care in 2014 and is one of the main reasons that the mandate to buy has to remain. Without it those expanded medicaid roles will have their finances thrown into turmoil.
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D L X
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 3:07 am

Quoting WarRI1 (Reply 22):

Not my quote.

Quoting dxing (Reply 23):
That's 22 States

Which is not most.

Quoting dxing (Reply 23):
but a month from now that will most likely be a different story.

Yeah... your argument is reduced to a prediction into the future? That's not like you.
 
nonrevman
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 3:08 am

Quoting Lufthansa411 (Reply 3):
Plus, the healthcare law will not be repealed, by the nature of how it was passed it would be nearly impossible to do. However, it is entirely possible to have certain sections shot down, as was the case in VA today. Only the mandate was found unconstitutional, not the healthcare law as a whole.

I am not crazy about the healthcare bill, but the mandate is the one thing I am direly opposed to when it comes to the issue. Currently, my family of four does have health insurance. Yet, we are like most average Americans, where a job loss from either me or my wife would render health care unaffordable for all of us. I could see keeping the kids insured and having to drop my insurance just so we could put food on the table, a roof over our heads, and clothes on our backs. If the government mandated that I buy the insurance, I would either have to sacrifice one of the above or pay a fine. This is what gets me about the whole plan. If someone cannot afford to buy the insurance, how are they going to be able to afford the fine? Unfortunately, the bill does not cap the cost of health insurance. Already, rates are going up. My wife works at the hospital, so I know exactly what we are dealing with. Besides the mandate being an attack on the Constitution, it also puts the middle class in danger by forcing them to buy something that may not be affordable. Look closely at the Constitution, it says that the Federal Government can regulate commerce. Please not that "regulate commerce" does not equate to forcing it to happen. Not buying something is simply not the same thing as commerce.
 
D L X
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 3:37 am

Quoting 474218 (Reply 21):
All you have to do is do something the Democrats in Congress refused to, "read the bill'.

Please cite the portion of the bill that supports your claim.

Or admit to being wrong.

Quoting nonrevman (Reply 25):
Already, rates are going up.

Rates were going up before the health care bill for reasons entirely unrelated to the health care bill, but partially remedied by the health care bill.



Soooo much misinformation out there crowding out the truth.
 
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WarRI1
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 3:45 am

Quoting D L X (Reply 24):
Quoting WarRI1 (Reply 22):


Not my quote

It was 474218. These damn computers.
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474218
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 4:08 am

Quoting WarRI1 (Reply 27):
It was 474218. These damn computers.


Don't blame me, my hands were no where near your keyboard!
 
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WarRI1
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 4:17 am

Quoting 474218 (Reply 28):
Quoting WarRI1 (Reply 27):
It was 474218. These damn computers.


Don't blame me, my hands were no where near your keyboard!

No question, I could never make a living with a computer.  
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 4:20 am

Quoting 474218 (Reply 19):
My insurance would be a lot less if I didn't have to pay for "government mandated" things like, covering children up to 26 on their parents policy, mental health care, drug rehab, stop smoking classes, pre-natial care and delivery (my wife had a hysterectomy 30 years ago) and dozens of other feel good items politicians require insurance companies to cover because they were looking for votes from one bleeding heart group or another.

You just don't get it - everyone's insurance will be lower down the line if more people have preventative care. Insurance companies don't really care about the new law - it's more customers for them.

Quoting 474218 (Reply 19):
But Obama care does nothing to lower costs only add more mandates.

Patently false. You need a non-partisan fact check:

http://factcheck.org/2010/11/the-tru...h-about-health-insurance-premiums/

But don't get me wrong - I fault Obama for caving to liberal concerns and trial lawyers and not going after a real cost driver: malpractice premiums driven by absurd lawsuits that forget doctors are human like the rest of us.

Quoting dxing (Reply 23):
People double pay all the time. I have uninsured motorist coverage on my auto insurance policy

Not applicable. People have the option not to drive or own an automobile. Not so with one's health.
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474218
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 4:21 am

Quoting D L X (Reply 26):
Please cite the portion of the bill that supports your claim.

Or admit to being wrong.


Just wait, there are still two years before the bill goes in to effect. That is unless it is found "un-constitutional, which it should be!
 
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 4:30 am

Quoting 474218 (Reply 31):
Just wait, there are still two years before the bill goes in to effect. That is unless it is found "un-constitutional, which it should be!

Classic avoidance of the facts. That's the default go-to mode when all you have in your head are talking points. People tied to whatever rhetoric their favorite party is spewing operate in this mode all the time - it's no wonder the country has lost its grip on reality.
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WarRI1
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 5:32 am

Quoting 474218 (Reply 31):
Just wait, there are still two years before the bill goes in to effect. That is unless it is found "un-constitutional, which it should be!

It should be, your view, maybe it is not, what then? Should it still be killed, or modified over time to help your fellow citizens, and maybe your friends and family? Are not the legal citizens of the US deserving of healthcare, or should it be available only to certain folks who can afford it. That is a growing problem here now, less and less being able to afford it. Not quite fair to me. Maybe we need more jobs back here, not there.
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LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 6:03 am

Quoting nonrevman (Reply 25):
Unfortunately, the bill does not cap the cost of health insurance. Already, rates are going up.

   Yeah funny, I got some documents in the mail a few weeks back describing changes to our health coverage come 2011, and the rate chart guide and letter went to stress in a couple places that the 18% increase was very much due to;

"On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act that made certain changes to your existing health plan"

Then is goes on to list that for instance, they can no longer offer rates based on age bands(eg 40-46 grouped as one rate), they can no longer differentiate between genders in rate structure, plus "various other changes to your benefit plan design with increased cost associated with the administration and delivery of health care." Nice ha?

Thanks Mr. Obama for that "Affordable" work of yours.   
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 6:26 am

Quoting LAXintl (Reply 34):
Then is goes on to list that for instance, they can no longer offer rates based on age bands(eg 40-46 grouped as one rate), they can no longer differentiate between genders in rate structure, plus "various other changes to your benefit plan design with increased cost associated with the administration and delivery of health care."

Differentiating between genders is ridiculous - women are more susceptible to certain degenerative diseases than men and vice versa. Why should women pay more because they are susceptible to osteoporosis and breast cancer or men because they have 4x the risk for cardiovascular disease than women? It all balances out in the end.

Administrative costs due to change are temporary - once everyone is used to the system the benefits will be clear - why do you think these proposals enjoyed better than 70% approval from physicians?

Read the fact check documents previously posted.

Unbelievable btw that you would check mark a post calling for capping of premiums.

All of the opposition to this plan based on ideology is just that - opposition based on emotion, not facts. Likewise it's true that liberals calling for single payer were guilty of same. But the bottom line is - having everyone insured is best for all of us long term. There are still more kinks to work out for sure - I doubt if DC will ever get rid of the lobbying influence that prevents them from doing something about malpractice and prescription abuses, but we can only hope.

Quoting LAXintl (Reply 34):
Thanks Mr. Obama for that "Affordable" work of yours.

More people insured is more affordable for everyone long term. Short term all of the estimates, including the figures accepted by the CBO and AMA, projected increases for those with existing insurance.
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LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 6:55 am

I just finished reading the VA decision and its rather crafty. Judge Hudson's decision does not attack the purchase mandate up front, but takes the view that there is no law or precedence whereby a person inaction, lack of desire to participate in and or benefit from, and refusal to enter into the "stream of commerce" by not purchasing a commodity in the private market is punishable.

At the end of the day, by stripping way such individual or business penalty provisions, individuals are again able to take control and responsibility for their own futures.
Hopefully decisions like this can help unravel the Obamacare nightmare.

Quoting Aaron747 (Reply 35):
Why should women pay more because they are susceptible to osteoporosis and breast cancer or men because they have 4x the risk for cardiovascular disease than women?

Because that is insurance 101. Each party should have the commensurate risk assigned to it. Happens in auto instance, home instance, life insurance etc.. If women cost more in one area, or men in another let the risk and cost appropriately reflect such.
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 7:05 am

Quoting LAXintl (Reply 36):
Because that is insurance 101. Each party should have the commensurate risk assigned to it. Happens in auto instance, home instance, life insurance etc.. If women cost more in one area, or men in another let the risk and cost appropriately reflect such.

Health is a completely different thing - we're all going to die, that's a given. There is no opt out for dying - it's just a matter of how much pain and suffering leads up to it, particularly in the form of disease. Comparing to other types of insurance is garbage intellectual dishonesty - anybody can choose not to have a car, or a house, or to leave money to others should they die early. There is no way to opt out of health care because 99 out of 100 people with a serious injury or ailment will seek care for it. Life insurance is an optional thing and therefore the actuarial tables apply - for regular health care they should not.

Quoting LAXintl (Reply 36):
Hopefully decisions like this can help unravel the Obamacare nightmare.

Arguing totally on emotion by making this about the man or the people behind it. It's not perfect but it's a start - every attempt at Everest requires a base camp. Not going to bother further for those that wish to proceed on this issue with their heads buried in ideological quicksand. You guys who want to oppose this can go on about it, but I maintain it's idiotic to pay two or three times for everyone else as we do now. It's absurd and everyone sees it but you.
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DocLightning
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 7:08 am

Quoting dxing (Reply 23):

We've discussed this before. Exactly how many times does that happen in a year at one hospital? Not many if I remember correctly.

Often enough that in one month I saw five cases in medical school. No end-of-life planning or advance directives, unreasonable families threatening to sue, lawyers buzzing around, patient who wasn't quite brain dead.

A lot. You can deny it, but it happens A LOT.
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LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 7:42 am

Quoting Aaron747 (Reply 37):
Arguing totally on emotion by making this about the man or the people behind it.

Emotion yes absolutely as it effects me and my family.

As I stated in threads in the last year, I have lived under European government managed central social health care and never wish to do so again. Not only is the system a truly rationed one where your health care is decided by bureaucrats and all you are is a number on a waiting list, it also fails to properly take care of those in the system. One family member and acquaintance after another have had to get supplemental private policies to ensure they got the care they desired.

Personally as stated also prior, my opinion of existing health care in America is that its a global leader. I could not be happier with my insurance and providers. I don't need, nor want anyone to get in between that relationship and now to start dictating the terms of how such a relationship shall work going forward.

Now for my political leaning, that also tells me government should not be in the health care business either.
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 7:48 am

Quoting LAXintl (Reply 39):
I have lived under European government managed central social health care and never wish to do so again. Not only is the system a truly rationed one where your health care is decided by bureaucrats and all you are is a number on a waiting list, it also fails to properly take care of those in the system. One family member and acquaintance after another have had to get supplemental private policies to ensure they got the care they desired.

Nobody is making that happen here - expanding coverage is the name of the game.

Quoting LAXintl (Reply 39):
Personally as stated also prior, my opinion of existing health care in America is that its a global leader.

On the side of quality of technique and options for care, probably true. On the side of access, not at all true. That is what needs to be remedied.

Don't let facts get in the way of an emotional argument...

http://healthpolicyandreform.nejm.org/wp-content/uploads/2009/09/20090914_keyh_f1.jpg

http://healthpolicyandreform.nejm.org/wp-content/uploads/2009/09/20090914_keyh_t1.jpg
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LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 8:01 am

Quoting Aaron747 (Reply 40):
On the side of quality of technique and options for care, probably true. On the side of access, not at all true. That is what needs to be remedied.

Like everything, health care is a commodity and its OK if access is not equal. That is actually the beauty of our existing system imo. You can have the Rolls Royce down to Pinto or no plan. Its pure social reengineering trying to punish the Rolls in order to upgrade the pinto to a Chevy or have everyone on a single standard.

Also as a principle, the government should not be in the business of picking up after every Tom, Dick or Harry. Let them be free worry or decide about themselves.
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Aaron747
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 10:33 am

Quoting LAXintl (Reply 41):
Also as a principle, the government should not be in the business of picking up after every Tom, Dick or Harry. Let them be free worry or decide about themselves.

Mighty convenient for government if they choose not to do so, but those who go to the trouble to get an R.N. or M.D. behind their name have a professional oath to adhere to...and the vast majority take it rather seriously or they wouldn't have gone to all the trouble to enter that line of work. Your disregard for their motivations is telling. Make sure the next time you're in a hospital you stop by the trauma ward and tell the docs your opinion. Would love to see what kind of reaction you'd get.

Quoting LAXintl (Reply 41):
Like everything, health care is a commodity and its OK if access is not equal

You claim to be of faith...incredible. There is a baseline amount of access that should be considered acceptable and with ~40 million uninsured and climbing we ain't getting the job done. A basic understanding of commodities reveals that some are indeed very special - enough so that we go to great trouble to ensure people have basic access to them. Health care is one of them.

Quoting LAXintl (Reply 41):
Its pure social reengineering trying to punish the Rolls in order to upgrade the pinto to a Chevy or have everyone on a single standard.

Again nobody's doing that - reason #213 you could use a dose of fact checking.

[Edited 2010-12-14 02:34:25]
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simonriat
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 11:20 am

Quoting LAXintl (Reply 39):
As I stated in threads in the last year, I have lived under European government managed central social health care and never wish to do so again. Not only is the system a truly rationed one where your health care is decided by bureaucrats and all you are is a number on a waiting list, it also fails to properly take care of those in the system. One family member and acquaintance after another have had to get supplemental private policies to ensure they got the care they desired.




I feel I need to respond to this as I have worked for the National Health Service, here in the UK, for several years (Don't anymore due to politics) and my wife still does as a nurse.

Could you please indicate which country you were in.

The NHS is not perfect by any stretch of the imagination, but it does mean that every man, women and child has access to healthcare and is free at the point of delivery, regardless of your ability to pay.

It would appear that under the American system you can only access medical care if you have enough $$$$.

You state that the system is rationed and good job it is too, example actual case:-

A young man went into Ear, Nose and Throat (ENT) the other day, referred by his GP for a Septoplasty (basically a surgical procedure which straightens the septum), which was the incorrect procedure for a start as it was the shape of the nose which was a bit wonky not the septum, so the Dr informed the man that he possibly would need a rhinoplasty (a nose job), but when the Dr asked what the person did for a living (he was a soccer player), the Dr informed the patient that it was very inadvisable for him to have the procedure, due to various reasons, and to wait until after he had finished his career.

The above case would have been a complete waste of money, but I am guessing that it would have been done in the states if he had, had the correct medical insurance.

Waiting lists?
I would be interested to learn how it works in the states. (Also considering that My wife and I are seriously considering moving over there)

Again I can give an example. I am waiting for a general surgical procedure as a daycase, I have been waiting 2 years (due to some complications of my own), but before the current government came in we had a system of 18 weeks, whereby nobody would wait more than 18 weeks from referral to first definitive treatment. For certain specialities. Oncology been an exception whereby it was 2 weeks.

Again specific example of how it works. Its called a patient pathway over here. and the example given is a most basic

See your local GP
GP refers to specialist.
Specialist seen in Outpatients
Specialist says if patients needs procedure as inpatient or as a daycase or as above none at all.
Patient goes away and awaits a date for procedure.

NO insurance company involved to see if the patient has coverage, NO waiting to see if the patient has enough money. If the patient is deemed ill enough for the procedure then the patient will have the procedure.

I will defend the NHS to the hilt, yes it does have problems like any healthcare system but it is trying and will continue to improve. The Nhs is not interested in how much money a person has, it tries to look after its population the best it can, regardless of ability to pay.

I think it should be the specialist/ Dr who should say if I need a procedure is required, not my bank balance or my ability to pay.

I'm also guessing that ask any English person what they are most proud of here in the UK (and at the minute we don't have that many), the NHS would be up there.
 
dxing
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 11:35 am

Quoting D L X (Reply 24):
Which is not most.

Which is what I said.

Quoting D L X (Reply 24):
Yeah... your argument is reduced to a prediction into the future? That's not like you.

Given the election results at the State level its not that hard of a prediction to make.

Quoting Aaron747 (Reply 30):
Not applicable. People have the option not to drive or own an automobile. Not so with one's health.

Completely applicable as they have the option to drive a car without insurance even though it is breaking the law, which is why uninsured motorist insurance exists. People have the right to not purchase health insurance if they wish to gamble with their lives, both real and financial. Furthermore, given that a large segment of the population does not pay any taxes at all, and that their health care under this law will be purchased with tax credits, further reducing their already zero tax bill, as well as the raise in the economic level eligible for medicaid, many people will not be "buying" health insurance but rather getting the money for it from people who do have money. In other words the bill is just more wealth redistribution on top of forcing a purchase on someone who may not want it, or want all that the government mandates that they buy.

Quoting Aaron747 (Reply 37):
. Comparing to other types of insurance is garbage intellectual dishonesty -

Insurance is insurance, you are hedging against future loss.

Quoting Aaron747 (Reply 37):
It's not perfect but it's a start

A very bad and costly start.

Quoting Aaron747 (Reply 37):
Arguing totally on emotion

Sounds fine until you say:

Quoting Aaron747 (Reply 37):
You guys who want to oppose this can go on about it, but I maintain it's idiotic to pay two or three times for everyone else as we do now. It's absurd and everyone sees it but you.

Which is by and large a totally emotional response.

Quoting DocLightning (Reply 38):
A lot. You can deny it, but it happens A LOT.

During medical school. After those 5 cases in one month how many other cases did you see where the patient had insurance or was able to pay? 5 more? 10 more? How many total cases did the hospital see in that one month alone? 20? 50? 100? What was the ratio of loss in those 5 cases versus the income earned by all the rest seen at the hospital that month? I appreciate you making my point for me, that is that you are using the infrequent and trying to promote it as the norm.

Quoting Aaron747 (Reply 40):
Don't let facts get in the way of an emotional argument...

True.

http://blogs.abcnews.com/thenumbers/...upport-for-health-care-reform.html

The law’s never been popular, with support peaking at just 48 percent in November 2009. Today it’s slipped to 43 percent, numerically its lowest in ABC/Post polling. (It was about the same, 44 percent, a year ago.) Fifty-two percent are opposed, and that 9-point gap in favor of opposition is its largest on record since the latest debate over health care reform began in earnest in summer 2009.

More also continue to “strongly” oppose the law than to strongly support it, 37 percent to 22 percent.


Those are the people it most directly affects, the taxpayers.
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ltbewr
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:13 pm

I am in the view of what many here would call a 'liberal', but I do have issues with the health care insurance purchase mandate despite it's good intentions. I hope that this matter goes to the US Supreme Court and it is revoked as unconstitutional.

While I understand the principals of the mandate, I don't like the potential problems with it. I don't like that the IRS and other government agencies would enforce it including the use of large fines and maybe even jail if you don't cooperate. We all know the price would keep going up far above general inflation rates, taking away money from other spending and personal savings (like for buying a house, a car, retirement) with it's economic dislocations. Many employers would dump their health care insurance plans throwing more onto into the expensive private market. I don't like the idea of paying for insurance to a company with $10 Million an year CEO's, fancy buildings and pays peanuts to customer service staff.
 
dxing
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 12:32 pm

Quoting simonriat (Reply 43):
NO insurance company involved to see if the patient has coverage,

Since it is national healthcare the government bureaucrats are the involved in the same way as insurance companies are over here. Are you going to deny that they don't set standards that sometime say that a person's life has reached a point where the simple cost of keeping them alive or making them well is not worth the financial benefit of the system as a whole? (stories are lined up in anticipation).

Quoting simonriat (Reply 43):
NO waiting to see if the patient has enough money.

Because the money has already been taken, whether the patient wanted that money taken or not, and the patient has no real decision as to whether that money will actually be used to help them.

Quoting simonriat (Reply 43):
If the patient is deemed ill enough for the procedure then the patient will have the procedure.

And if not then they are sent packing and now they are on their own.

Quoting simonriat (Reply 43):
I think it should be the specialist/ Dr who should say if I need a procedure is required, not my bank balance or my ability to pay.

And if you are denied, and still feel that the procedure is necessary, what are your options? I'm guessing your bank balance and ability to pay will matter highly. And are you saying the government doesn't publish standards that the doctors must apply as to whether a person is sick enough, or too sick, to recieve the help they desire?
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LAXintl
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 1:35 pm

Quoting simonriat (Reply 43):
Could you please indicate which country you were in.

Experiences has been in Sweden, Belgium and Spain, from the early 70's till mid 90's.

Quoting simonriat (Reply 43):
I would be interested to learn how it works in the states.

My experience is wait list in the US are rather minimal as there is an economic incentive for parties to be accessible and get on with things. Its basically akin to typical service industries which want to see clients and offer a service.

While in Europe my experience was the total opposite, and even a doctors admitted to me there were limitation in access and even the existence particularly in the area of specialist once you got beyond your primary care providers. But even for primary care providers they were limited as workload and numbers of folks they were responsible for was large which resulted in often week long waits to get in to see them for basic things. I include dentist in this category also.

It is no coincidence that the concept of supplemental for profit health insurance has taken off in Europe in recent years also, which allows individuals broader access to doctors and services instead of being enslaved to the national system.

I'm sorry, but I much rather pay to play in a for profit system where the carrot is there as an incentive to providers, and the purchaser of the service can be in the deciding seat not Uncle Sam.
From the desert to the sea, to all of Southern California
 
windy95
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 1:58 pm

Quoting D L X (Reply 10):
This case was brought by our activist AG Cuccinelli, and does not enjoy wide support by the rest of the Commonwealth. Let's not get carried away.

SOrry but most of the country wants this repealed. And it does not matter whether you think he is an activist the mandate is unconstitutional.

Quoting photopilot (Reply 13):
And the World continues to laugh at the world's biggest economy and country that somehow can't even manage to have Universal Health Care for all it's citizens. Astounding really......that healthcare isn't a universal right in the USA and that petty politics and bickering takes presidence

Then why did the King of Saudi Arabia come to the States last month when he was sick and to Cuba, Great Britain, Sweden?

Quoting san747 (Reply 17):
Probably because the government understands that when an uninsured citizen uses health services without the ability to pay, the rest of us have to.

Still does not make it constitutional. If they do not like it then use the avenue the founders gave and try to change it.

Quoting Aaron747 (Reply 18):
I don't like doing it - question is why do they??

Why not allow plans to be sold over state line, à la carte and funded thru a pool to by the insurance for those who trully need it. That would be far cheaper than anything they have in store for us. And would avoid the middle man in DC.

Quoting 474218 (Reply 19):
My insurance would be a lot less if I didn't have to pay for "government mandated" things like, covering children up to 26 on their parents policy, mental health care, drug rehab, stop smoking classes, pre-natial care and delivery (my wife had a hysterectomy 30 years ago) and dozens of other feel good items politicians require insurance companies to cover because they were looking for votes from one bleeding heart group or another.

Amen...à la carte would be the way to go.

Quoting 474218 (Reply 19):
But I can't shop around and get just the coverage I want, a simple insurance policy that will pay if I am admitted to a hospital or have a catastrophic illness and let me cover my doctors visits. That would be real "health care reform".

But Obama care does nothing to lower costs only add more mandates

The governement mandates are what is killing us. Get them out of healtcare and we would all be better off.

Quoting Aaron747 (Reply 30):
- I fault Obama for caving to liberal concerns and trial lawyers and not going after a real cost driver: malpractice premiums driven by absurd lawsuits that forget doctors are human like the rest of us.

Malpractice and selling across state lines would of been a two page bill that would of sent shock waves through the system at no cost to the taxpayer.
 
FlyPNS1
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RE: Health Care Mandate, First Round Goes To States.

Tue Dec 14, 2010 1:59 pm

Quoting LAXintl (Reply 47):
I'm sorry, but I much rather pay to play in a for profit system where the carrot is there as an incentive to providers, and the purchaser of the service can be in the deciding seat not Uncle Sam.

That's fine, as long as you are comfortable with millions of American's with no healthcare spreading their disease and problems to the rest of society and slowly, but surely, dragging this country down to a 3rd world nation.

Quoting dxing (Reply 46):
Are you going to deny that they don't set standards that sometime say that a person's life has reached a point where the simple cost of keeping them alive or making them well is not worth the financial benefit of the system as a whole?

Private insurance companies do this all the time, so what's your point?

Quoting dxing (Reply 46):
And if not then they are sent packing and now they are on their own.

No different than private insurance. Again, what's your point?

Quoting dxing (Reply 46):
And are you saying the government doesn't publish standards that the doctors must apply as to whether a person is sick enough, or too sick, to recieve the help they desire?

Again, this is done by private insurance companies as well.

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