From a doctor's perspective, is it better to repeal or keep healthcare reform

[Dave89]

You know the GOP and Fox & friends are doing a great job when the knee-jerk reaction to any problem among a significant portion of the population is "Nope, government's too big, slash spending (except defense) and cut taxes!"

Lets see some data. Really, anything other than "Obummercare too big gov'mt herp derp spending my money ruining 'Murrica! Freedom!!111"

And BTW, Fox watchers are not necessarily idiots.

Something Solicitor General Verilli and the progressives in the Supreme Court learned painfully this week.

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[dyeguy21]

You know the GOP and Fox & friends are doing a great job when the knee-jerk reaction to any problem among a significant portion of the population is "Nope, government's too big, slash spending (except defense) and cut taxes!"

Lets see some data. Really, anything other than "Obummercare too big gov'mt herp derp spending my money ruining 'Murrica! Freedom!!111"

Also, come Sunday, we will have the highest corporate tax rate in the world. Something that will inherently hurt US-based businesses when dealing on a global scale.

http://blogs.wsj.com/washwire/2012/03/30/corporate-tax-rates-crown-spurs-u-s-action/

 

[crmellon]

And BTW, Fox watchers are not necessarily idiots.

Something Solicitor General Verilli and the progressives in the Supreme Court learned painfully this week.

Verilli's arguments were shockingly inept. Which is quite profound considering his distinguished career.

 

[GoodmanBrown]

Also, come Sunday, we will have the highest corporate tax rate in the world. Something that will inherently hurt US-based businesses when dealing on a global scale.

http://blogs.wsj.com/washwire/2012/03/30/corporate-tax-rates-crown-spurs-u-s-action/

The trick here is that US tax law has so many loopholes and deductions that companies can get away with paying much lower real tax rates. So, the US really doesn't have that high a tax rate all things considered. I'm all for lowering the rate, but also removing most deductions. Thus, every corporation pays a lower %, but it's more even. That way you don't need a team of lawyers and accountants to get you out of paying a fair amount.

 

[notbobtrustme]

The trick here is that US tax law has so many loopholes and deductions that companies can get away with paying much lower real tax rates. So, the US really doesn't have that high a tax rate all things considered. I'm all for lowering the rate, but also removing most deductions. Thus, every corporation pays a lower %, but it's more even. That way you don't need a team of lawyers and accountants to get you out of paying a fair amount.

Not to mention perfectly profitable companies, such as GE, get billions of dollars from the federal government while not paying a single dime.

 

[Dave89]

Verilli's arguments were shockingly inept. Which is quite profound considering his distinguished career.

It's the product, not the salesman.

 

[ResIpsaLoquitur]

Doctors are slaves? Like police officers? Judges? We all have a right to a trial - that doesn't make judges "slaves". Can we please be adults here? You can disagree with healthcare reform without "omg the world will end".

Anyway I don't like parts of it but short of universal health care, I support the individual mandate. I think it's probably 50/50 that it will be struck down. The conservative section of the court has a majority but the justices (including originalists like Scalia) have traditionally given congress wide powers under the commerce clause (reasoning is stare decises for Scalia). Again it's very possible it will be struck down, but I don't see it as a foregone conclusion one way or another.

One sure result will be that physician, especially subspecialty, salaries will decline regardless of what happens. You could completely ignore healthcare reform and physician salaries will still drop due to Medicare (and then private insurance which follows Medicare).

Long term I don't see any realistic option besides universal health care in 20 years. Regardless of what doctors want or libertarians or whoever else, the momentum just won't allow anyone to do anything but that.

I wholeheartedly agree with your assessment but I am a lot more sceptical of Scalia's vote despite your stare decisis justification because conservative thinking on what Obama desires has become so rabid as to be self-deleterious if there's even a slight chance of destroying Obama in the aftermath.
A serious overhaul is needed but the voices of opposition are getting louder as the inevitable approaches. I am more interested in hearing solutions dissenters can propose to the sticking points rather than the blind amplification of the 'Policy of No' that is relegating once reasonable conservative positions into callous histrionics. The Michele Bachmann-esque approach that prescribes throwing out PPACA, and doing nothing is even more irresponsible than exaggerating the lies about 'loss of freedom', 'socialism', and 'government takeover' that talking heads have adopted.

 

[Dave89]

I wholeheartedly agree with your assessment but I am a lot more sceptical of Scalia's vote despite your stare decisis justification because conservative thinking on what Obama desires has become so rabid as to be self-deleterious if there's even a slight chance of destroying Obama in the aftermath.
A serious overhaul is needed but the voices of opposition are getting louder as the inevitable approaches. I am more interested in hearing solutions dissenters can propose to the sticking points rather than the blind amplification of the 'Policy of No' that is relegating once reasonable conservative positions into callous histrionics. The Michele Bachmann-esque approach that prescribes throwing out PPACA, and doing nothing is even more irresponsible than exaggerating the lies about 'loss of freedom', 'socialism', and 'government takeover' that talking heads have adopted.

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

I think that this week the real spectacle was provided by Breyer and Ginsburg. Breyer advocated federal control of essentially all markets, and Ginsburg shamelessly whored herself out for the majority of the healthcare bill, begging for "salvage."

I think something many fail to realize is that "Obamacare" or PPACA or whatever name you ascribe to this disaster is not Obama's compassionate brilliance on paper. It is a 2700-page jumble of special interest input.

 

[ResIpsaLoquitur]

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

I think that this week the real spectacle was provided by Breyer and Ginsburg. Breyer advocated federal control of essentially all markets, and Ginsburg shamelessly whored herself out for the majority of the healthcare bill, begging for "salvage."

I think something many fail to realize is that "Obamacare" or PPACA or whatever name you ascribe to this disaster is not Obama's compassionate brilliance on paper. It is a 2700-page jumble of special interest input.

I will simply ask that you omit these simplistic arguments that have been regurgitated by others with persuasions similar to yours, and instead offer solutions for what you see the problem to be.
Accusing the leopard of having spots is hardly ground-breaking. Neither one of us is a constitutional expert so I'd refrain from questioning the consitutionality of something that is currently up for a decision, that by and large will not change the gist of the matter - that health care reform is NOT optional. The sooner you jump onto the constructive phase of this process, the sooner you will be able to incorporate your hitherto undeclared solutions to the problem. Conservatives are not unreasonable - the fact that they have been consumed by blind hate for all things Obama is what is unreasonable, and is defeating any discourse on important problems we face as a society. Give us your solutions on how to fix the problem.....saying 'No', 'Overreach', and 'Unconstitutional' is not a solution. Criticism is cheap...cheaper than intelligent discourse, or even a faltering attempt at it!

 

[SurfingDoctor]

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

Violations of the Constitution is not a very valid argument for the rights of human beings. The rights of human beings preclude anything in the Constitution. It used to be against the Constitution to allow African Americans to be considered citizens, or women the right to vote, or to drink alcohol. Common sense eventually overturned all these "violations" of the Constitution. Some people think it's their Constitutional right to prevent same-sex marriage... the whole argument is totally dull. The right to receive care for health fits into the same arguments as those from history. But it really wasn't a matter of Constitutional versus non-Constitutional that made the change, it was that people realized that the Constitution doesn't actually dictate what is in the best interest of everyone in society.

 

[Lysinee]

1) Do you think the SC will just remove the individual mandate or the entire bill?

2) How close do you think the voting will be?

 

[SteinUmStein]

1) Do you think the SC will just remove the individual mandate or the entire bill?

2) How close do you think the voting will be?

1) No one can claim to predict this. If it's just the mandate, 2012 and 2013 will be extremely interesting years in politics, economics, and health care.

2) It will almost certainly be 5-4 either way. I don't see any likely scenario where it is anything other than 5-4 against on partisan lines or 5-4 for with 1 conservative defector.

 

[Lysinee]

Best scenario would be if it's 4-4 after 8 votes, and the last voter is the swing voter. Basically, voter 9 would decide eveything.

1) No one can claim to predict this. If it's just the mandate, 2012 and 2013 will be extremely interesting years in politics, economics, and health care.

2) It will almost certainly be 5-4 either way. I don't see any likely scenario where it is anything other than 5-4 against on partisan lines or 5-4 for with 1 conservative defector.

 

[dagnytaggart]

1

 

[Gut Shot]

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

Considering this "unprecedented federal overreach" was the product of conservative thought, you're damned if you do and damned if you don't.

 

[SteinUmStein]

Considering this "unprecedented federal overreach" was the product of conservative thought, you're damned if you do and damned if you don't.

Exactly. Apparently anything liberals eventually endorse is "federal overreach". It's been posted about before but maybe it got buried. It's important so I'll repost a recent article on where the individual mandate came from.

http://www.huffingtonpost.com/chris-weigant/the-individual-mandates-c_b_1386716.html

It's very much a conservative idea at its core. Make everyone have a stake in their own health care, and make them at least somewhat responsible for the costs that they will inevitably incur someday (rather than showing up at the ER and making us all eat their bill they can't pay through higher premiums and hospital bills).

 

[Dave89]

I will simply ask that you omit these simplistic arguments that have been regurgitated by others with persuasions similar to yours, and instead offer solutions for what you see the problem to be.
Accusing the leopard of having spots is hardly ground-breaking. Neither one of us is a constitutional expert so I'd refrain from questioning the consitutionality of something that is currently up for a decision, that by and large will not change the gist of the matter - that health care reform is NOT optional. The sooner you jump onto the constructive phase of this process, the sooner you will be able to incorporate your hitherto undeclared solutions to the problem. Conservatives are not unreasonable - the fact that they have been consumed by blind hate for all things Obama is what is unreasonable, and is defeating any discourse on important problems we face as a society. Give us your solutions on how to fix the problem.....saying 'No', 'Overreach', and 'Unconstitutional' is not a solution. Criticism is cheap...cheaper than intelligent discourse, or even a faltering attempt at it!

Keep dismissing arguments from the other side as "simplistic", "regurgitated", and "based on blind hate for all things Obama." Honestly, it makes you look like the smaller person.

 

[Dave89]

Violations of the Constitution is not a very valid argument for the rights of human beings. The rights of human beings preclude anything in the Constitution. It used to be against the Constitution to allow African Americans to be considered citizens, or women the right to vote, or to drink alcohol. Common sense eventually overturned all these "violations" of the Constitution. Some people think it's their Constitutional right to prevent same-sex marriage... the whole argument is totally dull. The right to receive care for health fits into the same arguments as those from history. But it really wasn't a matter of Constitutional versus non-Constitutional that made the change, it was that people realized that the Constitution doesn't actually dictate what is in the best interest of everyone in society.

Can you explain how the current situation has anything to do with the rights of human beings? I think this was your thrust, though I may be wrong...

 

[Dave89]

Considering this "unprecedented federal overreach" was the product of conservative thought, you're damned if you do and damned if you don't.

There's a misconception that anything Republicans do can be fairly called "conservative." It matters not a whit that Gingrich, Santorum, and GWB assign to themselves that label. Or the Republicans in general. For the most part, once politicians get in office they follow their urges to buy future elections from their constituencies.

Again, political conservatism is the idea that less government involvement in those areas that can be managed effectively by the market and a free society, the better. And that less government control over citizens is always to be desired.

 

[ResIpsaLoquitur]

Keep dismissing arguments from the other side as "simplistic", "regurgitated", and "based on blind hate for all things Obama." Honestly, it makes you look like the smaller person.

Do you have solutions or are you still snared up in ideological grandstanding? I take the 'smaller person' comment as a compliment, and once again implore your powers of solution to the constructive phase of this discussion. In case you haven't figured out my drift....I'll be explicit...There is NO 'other side' in this argument...There is a 'problem' and there are 'solutions'. If you are stuck on 'sides' then you have already claimed the dunce cap, and are no longer a viable participant...That is my point...read all my postings and then come back with something more substantive than you are currently offering because I do not care that you have a 'side'....only that you have the urgency required to weigh in on the problem purely on its merits! Clear enough??

 

[redsquareblack]

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

I think that this week the real spectacle was provided by Breyer and Ginsburg. Breyer advocated federal control of essentially all markets, and Ginsburg shamelessly whored herself out for the majority of the healthcare bill, begging for "salvage."

I think something many fail to realize is that "Obamacare" or PPACA or whatever name you ascribe to this disaster is not Obama's compassionate brilliance on paper. It is a 2700-page jumble of special interest input.

But it's not unprecedented. The precedent was set in the 30s with Social Security.

 

[phltz]

Aha. So, skepticism of an unprecedented federal overreach based on possible violations of the Constitution is "conservative."

I think that this week the real spectacle was provided by Breyer and Ginsburg. Breyer advocated federal control of essentially all markets, and Ginsburg shamelessly whored herself out for the majority of the healthcare bill, begging for "salvage."

I think something many fail to realize is that "Obamacare" or PPACA or whatever name you ascribe to this disaster is not Obama's compassionate brilliance on paper. It is a 2700-page jumble of special interest input.

It really isn't unprecedented at all. The "mandate" in the ACA consists of a financial incentive in your income taxes. If you don't have health insurance, you pay more money to the IRS. This is exactly the same mechanism that the government has used for decades to encourage all sorts of other behavior - donations to charities, home ownership, education, etc. If you don't have a home mortgage, you're effectively being penalized by the IRS because you're paying more taxes than you otherwise would. If you don't donate money to a charity, you're being penalized by the IRS. And, once the ACA becomes fully operational, if you don't have health insurance, you'll be penalized by the IRS.

This is the exact opposite of unprecedented. It is completely precedented. It's the exact same thing that the government has been doing for ages.

I've yet to hear anyone give a coherent explanation for why the ACA is any different under the law than the home mortgage deduction. I mean, the ACA is clearly better policy, but on strict constitutional grounds, what's the substantive difference between them?

 

[phltz]

The problem that the Supreme Court is addressing is the "pay more money" that you're referring to in the Affordable Care Act. Under ACA, if you choose be exempt from the health care tax you are to pay a "penalty" amounting to over $600. The state of Florida argues that this "penalty" violates the Anti-Injunction Act's clause, "no suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any court by any person, whether or not such person is the person against whom such tax was assessed."

The question we should ask is does the ACA practically force the states to waive their independence to not be subject to the government in terms of controlling the provisions of health care to its constituents by having the Department of Health and Human services give the states a fiscal offer that they cannot refuse? DHHS's ACA would offer to cover over 90% of the state's cost of implementing ACA (excluding administrative costs) which for most states would be stupid to refuse. I don't think this is a matter of financial incentives for the individual but it is a significant financial matter for the states.

This is so off base, it isn't even wrong. It's like you put an article about the ACA and the supreme court case into a blender, pureed the whole mess, and then tried to decipher the result. Or maybe you watched a segment on the evening news about the lawsuit while tripping on acid. It's hard to tell which. Where are you getting your information from?

The ACA doesn't allow you to pay a penalty to exempt yourself from the health care tax. The penalty is the tax.

The Anti-Injunction act, if it applies to the ACA, would mean that no one can bring a court case regarding the mandate until after they have already payed the penalty. If it applied, the courts couldn't consider the mandate's constitutionality until at least 2014. Taxes can neither violate or conform to the Anti-Injunction Act, the Anti-Injunction act describes how, when, and under what circumstances people can bring cases to court that involve taxes.

The State of Florida isn't arguing that the Anti-Injunction Act applies to the ACA, they are arguing that it doesn't apply. They want to litigate this now, not wait another two years.

Part of the ACA provides extra money to states that expand their medicaid programs. States that do not expand their programs will be eligible for less money. This is a completely different part of the bill from the mandate. There has also been a challenge to the constitutionality of this, on "states' rights" grounds, but it is completely unrelated to the constitutionality of the mandate.

 

[pupster]

Verilli's arguments were shockingly inept. Which is quite profound considering his distinguished career.

It's hard to sell water when the masses aren't buying....

 

[Gut Shot]

There's a misconception that anything Republicans do can be fairly called "conservative." It matters not a whit that Gingrich, Santorum, and GWB assign to themselves that label. Or the Republicans in general. For the most part, once politicians get in office they follow their urges to buy future elections from their constituencies.

Again, political conservatism is the idea that less government involvement in those areas that can be managed effectively by the market and a free society, the better. And that less government control over citizens is always to be desired.

I would like you to read this excerpt from the 1989 health care plan put forth by that hippie think tank, The Heritage Foundation:

"This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses. Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between household and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services - even if that means more prudent citizens end up paying the tab.

A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself."

I find the notion of shepherding individuals to take personal responsibility and enter the private health insurance market to be aligned with your definition of "political conservatism." Sorry, the RINO trick doesn't fly here.

 

[SteinUmStein]

I would like you to read this excerpt from the 1989 health care plan put forth by that hippie think tank, The Heritage Foundation:

"This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses. Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between household and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services - even if that means more prudent citizens end up paying the tab.

A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself."

I find the notion of shepherding individuals to take personal responsibility and enter the private health insurance market to be aligned with your definition of "political conservatism." Sorry, the RINO trick doesn't fly here.

Wow, I have never agreed so much with the Heritage Foundation. It's kind of creepy.

For those of you who don't know what the Heritage Foundation is: it's the premier conservative think tank, which took a leading role during and in the years since Ronald Reagan's presidency. http://en.wikipedia.org/wiki/The_Heritage_Foundation

 

[JackShephard MD]

This is so off base, it isn't even wrong. It's like you put an article about the ACA and the supreme court case into a blender, pureed the whole mess, and then tried to decipher the result. Or maybe you watched a segment on the evening news about the lawsuit while tripping on acid. It's hard to tell which. Where are you getting your information from?

The ACA doesn't allow you to pay a penalty to exempt yourself from the health care tax. The penalty is the tax.

The Anti-Injunction act, if it applies to the ACA, would mean that no one can bring a court case regarding the mandate until after they have already payed the penalty. If it applied, the courts couldn't consider the mandate's constitutionality until at least 2014. Taxes can neither violate or conform to the Anti-Injunction Act, the Anti-Injunction act describes how, when, and under what circumstances people can bring cases to court that involve taxes.

The State of Florida isn't arguing that the Anti-Injunction Act applies to the ACA, they are arguing that it doesn't apply. They want to litigate this now, not wait another two years.

Part of the ACA provides extra money to states that expand their medicaid programs. States that do not expand their programs will be eligible for less money. This is a completely different part of the bill from the mandate. There has also been a challenge to the constitutionality of this, on "states' rights" grounds, but it is completely unrelated to the constitutionality of the mandate.

Right, and it's old news that the justices balked at the Anti-Injunction Act and will decide the validity of the ACA and mandate. Kennedy will be the swing, and he's been leaning slightly towards striking down the mandate. If the mandate does fall, it's unclear if the entire law follows suit.

They raised some good questions and Verilli's follow up arguments were weak.

 

[ResIpsaLoquitur]

Wow, I have never agreed so much with the Heritage Foundation. It's kind of creepy.

For those of you who don't know what the Heritage Foundation is: it's the premier conservative think tank, which took a leading role during and in the years since Ronald Reagan's presidency. http://en.wikipedia.org/wiki/The_Heritage_Foundation

The Heritage Foundation in it's statements above, has stayed true to form with the often touted Republican/conservative principle of 'personal responsibility'. I cannot find issue with their logic as spelled out so it is interesting and maybe even disingenuous that the most inflammed consternation on the individual mandate is coming from the conservative movement.
Whereas it is evident that the Heritage Foundation/conservatives have abandoned this type of thinking enmasse, I am eager to hear what they have articulated to replace the sound logic they rightly advanced (no pun intended) before PPACA co-opted their idea.

 

[phltz]

Whereas it is evident that the Heritage Foundation/conservatives have abandoned this type of thinking enmasse, I am eager to hear what they have articulated to replace the sound logic they rightly advanced (no pun intended) before PPACA co-opted their idea.

I don't think it's accurate to say that the PPACA co-opted their ideas. That makes it sound like the people behind the PPACA nefariously swiped those ideas in an order to somehow take them from the right. This is inaccurate.

The fact of the matter is that the PPACA is a solidly centrist act that was deliberately crafted to be a compromise position that would appeal to people across the political spectrum. The idea was that our health care system desperately needs reforming, and so if it was necessary to for everyone to meet halfway on an arrangement that wasn't anyone's dream situation, that would be the way to go. The democrats bent over backwards to accommodate republican and conservative ideas, meeting them more than halfway in hopes of having a bill that would receive widespread support. Despite the fact that the democrats crafted a bill that is heavier on conservative than liberal ideas and methods, the republicans flew into fit of outrage. Not a single republican voted for the PPACA, and they've done nothing but try to stonewall, obstruct, and undermine it since it passed.

It's hard to look at this an see anything other than that the republicans are acting in bad faith, that they have no particular objection to the content of the bill, that they just want to make sure they win and the democrats lose. The fact that there's real governing that needs to happen, and that the American people desperately need for _someone_ to step up and be an adult and craft good policy is apparently of no interest to them.

If someone has a clear explanation of why I'm wrong, I'd love to hear it. It's pretty disheartening to feel like our political system is being unilaterally driven into the ground by one party which has lost any interest in having an effective government if they're not the ones in charge of it.

 

[Dave89]

But it's not unprecedented. The precedent was set in the 30s with Social Security.

To the great misfortune of those who would make your case, the mandate in the bill never mentions a "tax"; rather, the fee for not buying health insurance is explicitly referred to as a "penalty." That makes it incomparable to, say, Social Security, which is a tax.

You see, the not-so-widely known fact is that liberals could, in theory, construct a far more socialized healthcare system constitutionally (although I'm not sure the American people would buy their argument). The truth of the matter is that the current liberal Democrats have so little regard for constitutionality of their agenda that they didn't really bother to sort out the kinks. Had they put a bit more effort into this bill, it might not have even been credibly challenged.

 

[scarshapedstar]

To the great misfortune of those who would make your case, the mandate in the bill never mentions a "tax"; rather, the fee for not buying health insurance is explicitly referred to as a "penalty." That makes it incomparable to, say, Social Security, which is a tax.

So your objection could be satisfied... semantically?

 

[redsquareblack]

To the great misfortune of those who would make your case, the mandate in the bill never mentions a "tax"; rather, the fee for not buying health insurance is explicitly referred to as a "penalty." That makes it incomparable to, say, Social Security, which is a tax.

You've dodged the whole point entirely. Whether or not it's a tax or a penalty has no bearing on whether or not the ACA is "unprecedented".

Tax or no, Social Security mandated that people pay into a retirement plan; citizens are compelled into economic activity.

The truth of the matter is that the current liberal Democrats have so little regard for constitutionality of their agenda that they didn't really bother to sort out the kinks.

Are you really so foolish as to believe that people on the liberal end of the spectrum really have no regard for Constitutionality?

 

[Dave89]

So your objection could be satisfied... semantically?

This is not semantics. Verilli tried to argue that it's a tax for purposes of taxing powers but not a tax under the Anti-Injunction Act. It is absurd just how many contortions must be undergone to try to twist the PPACA into a constitutional jumble.

 

[phltz]

This is not semantics. Verilli tried to argue that it's a tax for purposes of taxing powers but not a tax under the Anti-Injunction Act. It is absurd just how many contortions must be undergone to try to twist the PPACA into a constitutional jumble.

As I understand it, your stance is that the government could do exactly the same thing as is described under the PPACA, which is that the IRS would collect extra money from people without appropriate health insurance, and that it'd be hunky-dory if the word "tax" had been used in the bill. But the exact same actions, structures, and bureaucracy are a big problem, because the word "penalty" was used? How is this not semantics?

 

[Dave89]

You've dodged the whole point entirely. Whether or not it's a tax or a penalty has no bearing on whether or not the ACA is "unprecedented".

Tax or no, Social Security mandated that people pay into a retirement plan; citizens are compelled into economic activity.

Have you read the transcript or listened to the audio of the oral arguments? Whether or not the penalty is a tax makes a great deal of difference. To argue that paying taxes is considered being "compelled into economic activity" with regard to the Interstate Commerce Clause really is a torturous argument.

Are you really so foolish as to believe that people on the liberal end of the spectrum really have no regard for Constitutionality?

When Nancy Pelosi was asked how PPACA was constitutional, she responded: "Are you serious? Are you serious?...That is not a serious question."

I could give you multiple quotes from the blatantly liberal justices deriding the Constitution. Ginsburg comes to mind especially vividly.

Also, I didn't say they have "no" regard for constitutionality. I said they cared so little they did not put very much effort into ensuring the law passed constitutional muster.

 

[Dave89]

As I understand it, your stance is that the government could do exactly the same thing as is described under the PPACA, which is that the IRS would collect extra money from people without appropriate health insurance, and that it'd be hunky-dory if the word "tax" had been used in the bill. But the exact same actions, structures, and bureaucracy are a big problem, because the word "penalty" was used? How is this not semantics?

I didn't say the government could do this in either case. I did say that whether it's a tax or not is not "semantics."

 

[Kevin Baker]

I would like you to read this excerpt from the 1989 health care plan put forth by that hippie think tank, The Heritage Foundation.........

He's right. The republican party has, for decades, been taken over by big government shills. Reagan is responsible for EMTALA and codifying this idea that healthcare is a right.

The sooner the true fiscal conservatives realize this, and move en masse to a different party, the better.

 

[redsquareblack]

Have you read the transcript or listened to the audio of the oral arguments? Whether or not the penalty is a tax makes a great deal of difference.

I don't recall saying the distinction wasn't important. It just wasn't important to the point I was making, which was that to call this "unprecedented" is false.

To argue that paying taxes is considered being "compelled into economic activity" with regard to the Interstate Commerce Clause really is a torturous argument.

In '35, it was legislated that everyone has to pay into a retirement fund and an unemployment fund. In the 60's same idea with Medicare. The mechanism of the pay-in may be taxation, but it doesn't change the fact that the relationship established by the PPACA has a rich precedent.

When Nancy Pelosi was asked how PPACA was constitutional, she responded: "Are you serious? Are you serious?...That is not a serious question."

Incredulity at a question somehow implies a lack of regard for the Constitution?

I could give you multiple quotes from the blatantly liberal justices deriding the Constitution. Ginsburg comes to mind especially vividly.

Would love to read some.

Also, I didn't say they have "no" regard for constitutionality. I said they cared so little they did not put very much effort into ensuring the law passed constitutional muster.

Little premature to draw that conclusion, isn't it?

 

[Dave89]

I don't recall saying the distinction wasn't important. It just wasn't important to the point I was making, which was that to call this "unprecedented" is false.

In '35, it was legislated that everyone has to pay into a retirement fund and an unemployment fund. In the 60's same idea with Medicare. The mechanism of the pay-in may be taxation, but it doesn't change the fact that the relationship established by the PPACA has a rich precedent.

Ok, gotcha. But the fact of the matter is that this is unprecedented; do you know of another time the government has mandated that individuals purchase a product, in the process essentially creating a market?

Incredulity at a question somehow implies a lack of regard for the Constitution?

I think the tone in which she asked the question revealed that the constitutionality of the PPACA jumble was not, shall we say, a weighty concern to her. The video (or, at least the audio) is widely available.

Would love to read some.

Ginsburg on Egyptian TV: "You should certainly be aided by all the constitution-writing that has gone one since the end of World War II. I would not look to the US constitution, if I were drafting a constitution in the year 2012." - Really? And we're supposed to believe you are doing your best to make sure laws are not in violation of the document?

Kagan: "it should come as no surprise by now that many of the votes a Supreme Court justice casts have little to do with technical legal ability and much to do with conceptions of value." - i.e. our values are prioritized to some degree when in conflict with constitutionality.

Little premature to draw that conclusion, isn't it?

Hey, I'm just using the argument from that non-partisan lol Slate. Dahlia Lithwick: "That the law is constitutional is best illustrated by the fact that—until recently—the Obama administration expended almost no energy defending it."

 

[Gut Shot]

Ok, gotcha. But the fact of the matter is that this is unprecedented; do you know of another time the government has mandated that individuals purchase a product, in the process essentially creating a market?

What market are these individuals creating, Dave? The private health insurance market? Sorry, that's been around awhile.

Ginsburg on Egyptian TV: "You should certainly be aided by all the constitution-writing that has gone one since the end of World War II. I would not look to the US constitution, if I were drafting a constitution in the year 2012." - Really? And we're supposed to believe you are doing your best to make sure laws are not in violation of the document?

So essentially your argument comes down to disgust that Ginsburg's response wasn't "**** yeah, U.S. Constitution #1, baby! Best document in the history of the world... you copy that bitch, Egypt! You copy it word for word!"

There is a much simpler explanation than Ginsburg having some sort of sinister, clandestine liberal contempt for America. Maybe she's just right. Perhaps, after examining the founding documents of other free countries, she simply reached the conclusion that our 225 year old, 27 time-amended Constitution isn't the best place to start.

Here, this bloke says it better than I can:

"To be sure, our Constitution has the merit of having endured with only one really huge constitutional crisis — the Civil War — for a long time, and of having produced a very rich and free country; that’s good. But much of that, I suspect, comes not from the constitutional text, but from the constitutional traditions that have emerged since then, both in the courts and elsewhere; adopting the U.S. Constitution would not adopt those traditions.

And it might well be that Egypt might be well-served by a very different approach than the U.S. Constitutions — for instance, with regard to relations between the federal government and more local governments, with regard to whether to have a Presidential system or a parliamentary system, with regard to how hard the constitution would be to amend, with regard to how judges are selected and how long they serve, with regard to how the President is selected, with regard to the relationship between the two chambers of the legislature, with regard to whether all executive officials work for the President or whether some are independently elected or selected, with regard to just how to craft the criminal justice system, and so on. (And here I just speak of the big picture questions, and not more specific details.) Remember that even our own states’ constitutions differ in many respects, especially with regard to separation of powers and the selection and tenure of judges, from the U.S. Constitution. Again, that the constitutional text, coupled with a wide range of extratextual political and legal practices, has worked well for us over 200+ years doesn’t tell us that it would work well for Egypt for the coming years."

 

[SteinUmStein]

What's the deal with the recent push to consider the US Constitution some sort of holy, perfect document? We've had to heavily modify and add to it to keep it up to date and it still shows its age. It wasn't sent down to us from on high, a bunch of white dudes in wigs did the best job they could writing it (and it was a pretty fantastic job for the time period in which it was written), but we could spend hours here pointing out the numerous flaws and holes that have been stitched together over 200+ years. It's a work in progress, not a pristine, timeless document that should never be altered.

 

[Dave89]

What market are these individuals creating, Dave? The private health insurance market? Sorry, that's been around awhile.

Yes, but it's a market people choose to participate in (or not). Whereas Verilli tried to push the idea of a mandatory insurance market. This has not existed.

So essentially your argument comes down to disgust that Ginsburg's response wasn't "**** yeah, U.S. Constitution #1, baby! Best document in the history of the world... you copy that bitch, Egypt! You copy it word for word!"

There is a much simpler explanation than Ginsburg having some sort of sinister, clandestine liberal contempt for America. Maybe she's just right. Perhaps, after examining the founding documents of other free countries, she simply reached the conclusion that our 225 year old, 27 time-amended Constitution isn't the best place to start.

Hey, there are certainly problems with the Constitution. Especially the part which counts slaves differently than freemen, which is obviously completely obsolete. But you'd think that if her job is to interpret this document full-time, she'd at least have enough pride in the Constitution to suggest that the ideals espoused in it should serve as a model, or at least be considered. If you have a product for function A, and someone inquires of you how he might perform that function, you should probably suggest your product. If you do not, either you're a crappy salesman or the product is junk. And if the product is junk, why be its salesman?

Here, this bloke says it better than I can:

"To be sure, our Constitution has the merit of having endured with only one really huge constitutional crisis — the Civil War — for a long time, and of having produced a very rich and free country; that’s good. But much of that, I suspect, comes not from the constitutional text, but from the constitutional traditions that have emerged since then, both in the courts and elsewhere; adopting the U.S. Constitution would not adopt those traditions.

And it might well be that Egypt might be well-served by a very different approach than the U.S. Constitutions — for instance, with regard to relations between the federal government and more local governments, with regard to whether to have a Presidential system or a parliamentary system, with regard to how hard the constitution would be to amend, with regard to how judges are selected and how long they serve, with regard to how the President is selected, with regard to the relationship between the two chambers of the legislature, with regard to whether all executive officials work for the President or whether some are independently elected or selected, with regard to just how to craft the criminal justice system, and so on. (And here I just speak of the big picture questions, and not more specific details.) Remember that even our own states’ constitutions differ in many respects, especially with regard to separation of powers and the selection and tenure of judges, from the U.S. Constitution. Again, that the constitutional text, coupled with a wide range of extratextual political and legal practices, has worked well for us over 200+ years doesn’t tell us that it would work well for Egypt for the coming years."

Yes, this does put her statement in better context. But to me this does not sound like somebody very enthused with our democratic republican system, and I'm not sure why she chooses to be a Justice.

 

[Dave89]

What's the deal with the recent push to consider the US Constitution some sort of holy, perfect document? We've had to heavily modify and add to it to keep it up to date and it still shows its age. It wasn't sent down to us from on high, a bunch of white dudes in wigs did the best job they could writing it (and it was a pretty fantastic job for the time period in which it was written), but we could spend hours here pointing out the numerous flaws and holes that have been stitched together over 200+ years. It's a work in progress, not a pristine, timeless document that should never be altered.

Really? C'mon, I expected better from you.

Look, nobody thinks the Constitution is a perfect document. But the key is the fundamental idea of limiting government power and control. The ideals expressed are considered crucial to many people, and at least a vote of confidence for those would be nice. Especially from people who are essentially paid to study and defend them.

 

[SteinUmStein]

Really? C'mon, I expected better from you.

Look, nobody thinks the Constitution is a perfect document. But the key is the fundamental idea of limiting government power and control. The ideals expressed are considered crucial to many people, and at least a vote of confidence for those would be nice. Especially from people who are essentially paid to study and defend them.

Sorry, I'll FTFY - replace "bunch of white dudes in wigs" with "Our Esteemed and Beloved Forefathers, Founders of the Greatest Nation ever to grace God's Green Earth."

Is that better?

 

[Dave89]

Sorry, I'll FTFY - replace "bunch of white dudes in wigs" with "Our Esteemed and Beloved Forefathers, Founders of the Greatest Nation ever to grace God's Green Earth."

Is that better?

I think you know that's not what I was getting at.

 

[SteinUmStein]

I think you know that's not what I was getting at.

I do respect the fundamental idea of limited government and keeping as much power as possible out of the hands of the federal government, so I'm sorry if I seem flippant about that. It really is important to allow individuals and then states (in that order) to have as much autonomy as possible. If that instantly labels me as a "conservative" then I accept that label. Classical conservatism appeals to me a great deal more than what currently passes as conservatism in the US today.

 

[phltz]

Yes, but it's a market people choose to participate in (or not). Whereas Verilli tried to push the idea of a mandatory insurance market. This has not existed.

It's not accurate to say that the PPACA pushes a mandatory insurance market. It provides a (not particularly large) financial incentive to participate in the insurance market. If insurance participation was enforced by jail time, I'd agree that it was mandatory. Instead it's enforced by preferential income tax treatment, which is exactly the same way that the government encourages you to have a home mortgage. And even the most brain damaged fool can understand that a home mortgage isn't mandatory.

Hey, there are certainly problems with the Constitution. Especially the part which counts slaves differently than freemen, which is obviously completely obsolete. But you'd think that if her job is to interpret this document full-time, she'd at least have enough pride in the Constitution to suggest that the ideals espoused in it should serve as a model, or at least be considered. If you have a product for function A, and someone inquires of you how he might perform that function, you should probably suggest your product. If you do not, either you're a crappy salesman or the product is junk. And if the product is junk, why be its salesman?

You're thinking of the wrong analogy. The Supreme Court Justices are not salesmen for the Constitution. They are caretakers. They have inherited the upkeep of a centuries old, rambling house, with a lot of additions, and a few wings that have been broken down and hauled out. The house was built for a small family in the late 18th century, but is currently inhabited by a large a diverse family little like the original intended inhabitants. Through appropriate refurbishments and changes, and a lot of tender loving care and hard work, the house has continued to do a very good job of housing and protecting those who live in it.

A family in town is looking for a new house, because their old (and pretty terrible) house finally collapsed. These Supreme Court Justices have a lot of experience with houses, so this family asked them for advice. Do you expect them to say, "Sure, build a new house that's carefully designed to look like our old, rambling, somewhat broken down and cobbled together house?" Or do you expect them to say, "Well, we've discovered that when you build the roof this way, it takes a tremendous amount of effort to keep it from leaking catastrophically every time it rains, and the way the bathrooms are set up just invites bickering about who's spending too much time in there. We love the old place, but if you're starting from scratch, learn from our experience and do a bit better."? And if they give the second piece of advice, does it mean that they're somehow poor caretakers of their house? That they don't have the skill, commitment, love, and dedication to look after it? Or does their honest appraisal of the house suggest that they are, in fact, exactly the right people to be taking care of it, because they look at it with honest, though loving, eyes?

 

[Gut Shot]

Yes, but it's a market people choose to participate in (or not). Whereas Verilli tried to push the idea of a mandatory insurance market. This has not existed.

Now there are some fine mental contortions. The private health insurance market is the private health insurance market, regardless of the existence of incentives to purchase a policy.

Furthermore, as should be abundantly clear by now, there is already no choice whether or not to participate in the market. Everyone already does. The only question is whether people buy in up-front or push the costs they incur onto others.

Until you get that in your head this discussion isn't going anywhere.

But you'd think that if her job is to interpret this document full-time, she'd at least have enough pride in the Constitution to suggest that the ideals espoused in it should serve as a model, or at least be considered.

No, I wouldn't think that at all. I would hope that hope that a sitting Supreme Court justice would be learned and impartial enough to offer a candid and useful suggestion when asked a question about which she knows a great deal. She did that.

If you have a product for function A, and someone inquires of you how he might perform that function, you should probably suggest your product. If you do not, either you're a crappy salesman or the product is junk. And if the product is junk, why be its salesman?

There is no salesman, Dave, because nobody was selling anything. There wasn't a U.S. Constitution Promotional Tour going on when Ginsburg made her remarks. She was objective, a quality I like in a Justice.

 

[JackShephard MD]

More evidence that the government is wasteful:

http://www.federaltimes.com/article/20120402/AGENCY04/204020302/1001

The General Services Administration's top official abruptly resigned and her top deputies were fired or put on administrative leave Monday amid a breaking scandal that the White House chief of staff called "a gross misuse of taxpayer dollars."

GSA's Public Buildings Service spent $822,000 on the biennial Western Regions Conference in Las Vegas for only 300 employees, according to an inspector general's report.

The expenses included $147,000 for airfare and hotel lodging for six planning trips by conference organizers. That figure included $100,000 on two "scouting trips" and five off-site meetings and an additional $30,000 on catering costs for those trips, according to the report.

Among the other expenses were $3,200 for a mind reader; $6,300 on a commemorative coin set displayed in velvet boxes; and $75,000 on a training exercise to build a bicycle, according to the IG report, which was obtained by Federal Times.

These are just the few that get caught.

 

[GoodmanBrown]

More evidence that the government is wasteful:

http://www.federaltimes.com/article/20120402/AGENCY04/204020302/1001

These are just the few that get caught.

I'm not saying this wasn't a waste of taxpayer money, but couldn't one argue the banks handing out huge (i.e. billions in) bonuses while they were technically bankrupt also constitute a form of taxpayer fraud?