Will ObamaCare Stand?

[BLADEMDA]

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Watch this video:

http://video.foxnews.com/v/1529334428001/reagan-solicitor-general-defends-obamacare

It looks like the Law will stand up next week. I'm hoping the Judges strike it down 5-4 but I wouldn't bet on it.

 

[GoodmanBrown]

Watch this video:

http://video.foxnews.com/v/1529334428001/reagan-solicitor-general-defends-obamacare

It looks like the Law will stand up next week. I'm hoping the Judges strike it down 5-4 but I wouldn't bet on it.

I was watching Fox News this morning, and 3 of the 4 analysts believed the law would be upheld. Roberts, Scalia, and Kennedy have all held on previous cases that the Commerce clause of the Constitution gives the federal government very broad powers. See Gonzales v. Raich for an example.

Most legal scholars (conservative and liberal) believe the law is eminently in the domain of the federal government and rejection would largely be a political move. It's telling that most of these challenges have been from conservative, Tea Party-backed state attorneys general.

Slate has an interesting article positing that the Supreme Court members were unexpectedly stung by the strong backlash that Citizens United prompted and, despite nominally being above the fray, will uphold the law to keep from making the Supreme Court look even more politically motivated. Roberts himself may vote in favor of the law to get priority to pen the opinion, and thus keep the scope of the decision relative narrow.

 

[BLADEMDA]

I was watching Fox News this morning, and 3 of the 4 analysts believed the law would be upheld. Roberts, Scalia, and Kennedy have all held on previous cases that the Commerce clause of the Constitution gives the federal government very broad powers. See Gonzales v. Raich for an example.

Most legal scholars (conservative and liberal) believe the law is eminently in the domain of the federal government and rejection would largely be a political move. It's telling that most of these challenges have been from conservative, Tea Party-backed state attorneys general.

Slate has an interesting article positing that the Supreme Court members were unexpectedly stung by the strong backlash that Citizens United prompted and, despite nominally being above the fray, will uphold the law to keep from making the Supreme Court look even more politically motivated. Roberts himself may vote in favor of the law to get priority to pen the opinion, and thus keep the scope of the decision relative narrow.

I know we are on opposite ends of the political spectrum but your analysis is dead on.

I think it will be 6-3 in favor of upholding the law as written.

 

[BLADEMDA]

Can we really afford this law? I realize the U.S. Supreme Court won't be evaluating cost in its decision. But, can we as a society afford ObamaCare?


"President Obama's 2013 budget estimated that the cost of providing health insurance to millions of middle-class Americans over ten years will jump by 30 percent. A Congressional Budget Office (CBO) report earlier this year showed a marked increase in overall federal health-care spending from what was originally reported when ObamaCare was being debated"

 

[countingdays]

Justice Scalia, "the worst thing about the living constitution is that it will destroy the constitution."

We are no longer a nation of laws. The law is supposed to protect us from the government, not be contorted into the instrument of our oppression. Next they'll claim your thoughts are intellectual property and thus subject to regulation under the interstate commerce clause.

Also, Kagan should recuse herself. Her presence is almost as offensive as the lack of respect for the constitution shown by the democrats who passed this law and any justices who vote to uphold it.

This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.

 

[GoodmanBrown]

Can we really afford this law? I realize the U.S. Supreme Court won't be evaluating cost in its decision. But, can we as a society afford ObamaCare?

"President Obama’s 2013 budget estimated that the cost of providing health insurance to millions of middle-class Americans over ten years will jump by 30 percent. A Congressional Budget Office (CBO) report earlier this year showed a marked increase in overall federal health-care spending from what was originally reported when ObamaCare was being debated"

I honestly don't know. I support many of the individual objectives in the law, but taken as a whole, there will be many unexpected consequences and issues.

The MA bill that Romney passed has consistently been over budget, while still not insuring all Massachusettians. Dems used shady accounting to make this one seem less costly than it will be. I don't know where the money will come from. I honestly wouldn't disagree with you that this bill may be a stepping stone for a Canada style system.

Not having been around for the 80s heyday of medicine, I don't know quite how to feel. As long as I've been shadowing doctors, they've been upset with the regulation and the paperwork. Do Canadian, British, Australian, or French doctors do less paperwork than American doctors? I think they probably do with their simpler payment schemes. Do they make less? Maybe so, though it seems like Canadian and Australian doctors make pretty decent pay. I'm not sure how I feel about the ACA and healthcare reform in general.

 

[yappy]

Does anyone else feel that on a logical level, if the individual mandate portion of the bill is struck down, they should also repeal EMTALA?

I think these two issues could be handled together. Either health care is something that the individual must pay for and take responsibility for the consequences of not being covered;or, it is something that can be considered some sort of inevitability due to an imposed public contract between hospitals and patients. In which case, they must begin paying for it prior to an illness strikes.

 

[BLADEMDA]

http://firstread.msnbc.msn.com/_new...ypocrisy-on-all-sides-with-individual-mandate

MSNBC (not FOX) on Obama arguing with himself over the individual mandate

 

[countingdays]

I'm against the law, but that's beside the point.

There is a process to amend the constitution and it doesn't involve passing unconstitutional laws and having them upheld by activist judges. If you want to create a new power for government, write an amendment and vote on it.

It is no accident that the process to amend the constitution is difficult.

 

[GoodmanBrown]

Does anyone else feel that on a logical level, if the individual mandate portion of the bill is struck down, they should also repeal EMTALA?

I think these two issues could be handled together. Either health care is something that the individual must pay for and take responsibility for the consequences of not being covered;or, it is something that can be considered some sort of inevitability due to an imposed public contract between hospitals and patients. In which case, they must begin paying for it prior to an illness strikes.

I kind of like this idea. It seems very internally consistent. Either you acknowledge you're going to need health care at some point and plan for it, or you don't and have to face the consequences if things go wrong. I feel like an EMTALA for those under 18 would have to be in effect though because no one could stomach a kid dying because their parents were total ****-ups who didn't have health insurance for their children.

I'm against the law, but that's beside the point.

There is a process to amend the constitution and it doesn't involve passing unconstitutional laws and having them upheld by activist judges. If you want to create a new power for government, write an amendment and vote on it.

It is no accident that the process to amend the constitution is difficult.

GS, if the Supreme Court decides what's constitutional or not, and they uphold the law, ipso facto, the law is constitutional. And calling the current Supreme Court "activist judges" is a bit contrived as this is the most conservative court we've seen in quite a few years.

Anyone know when the decision comes out? Are they ruling within a few weeks of oral arguments?

 

[countingdays]

I kind of like this idea. It seems very internally consistent. Either you acknowledge you're going to need health care at some point and plan for it, or you don't and have to face the consequences if things go wrong. I feel like an EMTALA for those under 18 would have to be in effect though because no one could stomach a kid dying because their parents were total ****-ups who didn't have health insurance for their children.



GS, if the Supreme Court decides what's constitutional or not, and they uphold the law, ipso facto, the law is constitutional. And calling the current Supreme Court "activist judges" is a bit contrived as this is the most conservative court we've seen in quite a few years.

Anyone know when the decision comes out? Are they ruling within a few weeks of oral arguments?

The supreme court has failed in it's duty to perform its duties 'under the constitution' in the past and may do so again.
I'm calling any judge who creates law an activist judge. Hopefully you are right and we don't have an activist court, because this government power absolutely does not exist under the constitution. If it is found anywhere, it is in wrong decisions of past courts that should be overturned, not expanded.

 

[countingdays]

Does anyone else feel that on a logical level, if the individual mandate portion of the bill is struck down, they should also repeal EMTALA?

I think these two issues could be handled together. Either health care is something that the individual must pay for and take responsibility for the consequences of not being covered;or, it is something that can be considered some sort of inevitability due to an imposed public contract between hospitals and patients. In which case, they must begin paying for it prior to an illness strikes.

The law is not about healthcare, it is about health insurance being forced on healthy young people who don't want or need it, to fund government provision of insurance to the welfare dependent democrat voters- aka buying votes. Welfare recipients vote democrat, so a good way to stay in power is to increase the number of welfare recipients.

 

[aneftp]

The issue with the mandate is when does it stop?

If we require people to all get some time of private insurance wether its subsidized by the US government or employers. Where does it stop?

Than why doesn't government require all new parents to have mandatory life insurance policies because in the event of death it's to the economic benefit of the state for the child to have a $500k-1 million death policy so the state isnt overburden with raising the child.

 

[yappy]

I fail to see how my post pertains to any points you raised in this... I agree with it.

I would even extend it - both D and R politicians buy votes one way or another.

The law is not about healthcare, it is about health insurance being forced on healthy young people who don't want or need it, to fund government provision of insurance to the welfare dependent democrat voters- aka buying votes. Welfare recipients vote democrat, so a good way to stay in power is to increase the number of welfare recipients.

 

[pgg]

The supreme court has failed in it's duty to perform its duties 'under the constitution' in the past and may do so again.
I'm calling any judge who creates law an activist judge. Hopefully you are right and we don't have an activist court, because this government power absolutely does not exist under the constitution. If it is found anywhere, it is in wrong decisions of past courts that should be overturned, not expanded.

Arguably, it'd take more of an "activist" court to overturn ~70 years of "interstate commerce clause" precedent shenanigans, than it would to uphold this law as a reasonable exercise of the federal government's powers under that same over- and mis-used interstate commerce clause.

They won't do it, of course. We're stuck with bad case law and precedent ...it never goes away. At best, subsequent decisions might narrow the focus of a previous bad ruling. My favorite (bad) example is the Slaughter-House series of decisions. We're STILL stuck with that **** 140 years later, and the Court STILL does acrobatic nonsense and mental gymnastics to figure out ways to apply the 14th Amendment without running afoul of decisions that just about everyone on the right and left agree were an egregious error.

 

[BLADEMDA]

Arguably, it'd take more of an "activist" court to overturn ~70 years of "interstate commerce clause" precedent shenanigans, than it would to uphold this law as a reasonable exercise of the federal government's powers under that same over- and mis-used interstate commerce clause.

They won't do it, of course. We're stuck with bad case law and precedent ...it never goes away. At best, subsequent decisions might narrow the focus of a previous bad ruling. My favorite (bad) example is the Slaughter-House series of decisions. We're STILL stuck with that **** 140 years later, and the Court STILL does acrobatic nonsense and mental gymnastics to figure out ways to apply the 14th Amendment without running afoul of decisions that just about everyone on the right and left agree were an egregious error.

Correct. I say 6-3 the law gets upheld as is.

 

[countingdays]

Correct. I say 6-3 the law gets upheld as is.

It's about time to shake the case law-etch a sketch, get back to the constitution as a baseline, and stop ****ing up my country with flawed judicial law-writing.
We are supposed to be a nation ruled by the people, not by a a few judges who think their opinions matter more than the law as it is written.

 

[aneftp]

Doesn't matter how this law is played out.

I think we are heading towards a single payer system.

If that happens we better get our 35-40 hour work week along with 8 weeks paid vacation and 2 weeks paid cme. That's what the majority of socialized medicine docs get.

I would mind getting paid $150k for those types of hours.

Heck I met UK neurosurgery resident and he doesn't even work 50 hours as a resident.

 

[BLADEMDA]

Doesn't matter how this law is played out.

I think we are heading towards a single payer system.

If that happens we better get our 35-40 hour work week along with 8 weeks paid vacation and 2 weeks paid cme. That's what the majority of socialized medicine docs get.

I would mind getting paid $150k for those types of hours.

Heck I met UK neurosurgery resident and he doesn't even work 50 hours as a resident.

I still expect my Canadian level pay for that work week

 

[pgg]

It's about time to shake the case law-etch a sketch, get back to the constitution as a baseline, and stop ****ing up my country with flawed judicial law-writing.
We are supposed to be a nation ruled by the people, not by a a few judges who think their opinions matter more than the law as it is written.

Well, blame the elected presidents who appointed them instead of strict constructionists. They didn't get there by winning a lottery.

Elections have consequences ...


Aside from that, there's a vital and democracy-preserving function served by having a veto-power-wielding branch of government in which members serve for life and are not directly accountable to voters.

Historically, the judicial branch has ****ed up a lot less than the other two, so I'm inclined to cut 'em some slack. 🙂

 

[pgg]

Heck I met UK neurosurgery resident and he doesn't even work 50 hours as a resident.

How long's his residency?

 

[aneftp]

How long's his residency?

I don't think it's any longer than our system.

It's some type of UK law that "junior doctors" can work more than 50 hours a week. Kinda of like the 80 hour work week in the USA with residents (which I am still kinda of pissed since I just did 2 months of 110-120 hours a week (call q2-q3 post call home at 4pm) in my ICU rotation) before the 80 hour week went into effect back in 2003-2004

 

[jwk]

Justice Scalia, "the worst thing about the living constitution is that it will destroy the constitution."

Great quote. The "living and breathing" concept of the Constitution is a liberal creation. That is exactly the OPPOSITE of what it is supposed to be. The only living and breathing part is supposed to be the amendment process, which was deliberately set very high. If only we had a President, Attorney General, and HHS Secretary who understood it.

 

[GoodmanBrown]

Great quote. The "living and breathing" concept of the Constitution is a liberal creation. That is exactly the OPPOSITE of what it is supposed to be. The only living and breathing part is supposed to be the amendment process, which was deliberately set very high. If only we had a President, Attorney General, and HHS Secretary who understood it.

A lot of the posters here feel the mandate is unconstitutional because it is forcing citizens to purchase a private product.

So, would a single-payer system financed with taxes be constitutional? How would you feel about a Canadian system?

 

[aneftp]

A lot of the posters here feel the mandate is unconstitutional because it is forcing citizens to purchase a private product.

So, would a single-payer system financed with taxes be constitutional? How would you feel about a Canadian system?

Of course congress can impose a tax to finance a single payer system.

But good luck with that. None of them would get reelected. Americans are deeply opposed to paying more in taxes.

Just look at the Health Law. They are taxing those making more than 200/250k single/married and that barely passed.

Imagine a single payer system where 80-90% of people get taxed to pay for the system. Aint going to fly over very well with the voters. It's political suicide to impose more taxes year days until government starts accounting for their current problems.

 

[jwk]

A lot of the posters here feel the mandate is unconstitutional because it is forcing citizens to purchase a private product.

So, would a single-payer system financed with taxes be constitutional? How would you feel about a Canadian system?

Of course it's unconstitutional.

Canadian system? Only if you want to wait months if not years for care that we take for granted, and don't mind essentially getting cut out of a lot of major procedures and joint replacements just as you finally reach retirement age.

 

[GoodmanBrown]

Of course it's unconstitutional.

Canadian system? Only if you want to wait months if not years for care that we take for granted, and don't mind essentially getting cut out of a lot of major procedures and joint replacements just as you finally reach retirement age.

I tend to agree with aneftp that a single payer system with new taxes would be largely unfavorable (seeing as the administration has had a hard time convincing people that the ACA is a good thing), but how do you posit a single payer would be unconstitutional? Does the federal government not already levy taxes (with explicit constitutional permission) for services rendered to every person in the country? What's your logic that this would be unconstitutional? As for wait times, a lot of other countries have single payer systems without huge waits or denial of coverage we deem pretty standard. Japan, for instance, has excellent coverage at a fraction of the US's cost.

Finally, anyone catch reactions to today's oral arguments? I'm suddenly not so sure it'll be a landslide win for the ACA... Any reactions to today?

 

[BLADEMDA]

I tend to agree with aneftp that a single payer system with new taxes would be largely unfavorable (seeing as the administration has had a hard time convincing people that the ACA is a good thing), but how do you posit a single payer would be unconstitutional? Does the federal government not already levy taxes (with explicit constitutional permission) for services rendered to every person in the country? What's your logic that this would be unconstitutional? As for wait times, a lot of other countries have single payer systems without huge waits or denial of coverage we deem pretty standard. Japan, for instance, has excellent coverage at a fraction of the US's cost.

Finally, anyone catch reactions to today's oral arguments? I'm suddenly not so sure it'll be a landslide win for the ACA... Any reactions to today?

FOX News is predicting a 5-4 decision against ObamaCare. We shall see in about 90 days.

Also, the govt. simply needs to increase the Medicare Tax and/or impose a National sales tax in order to cover every single Citizen for health care. The individual then still has the right to purchase his/her own private policy but everyone has coverage for basic
care

 

[jwk]

FOX News is predicting a 5-4 decision against ObamaCare. We shall see in about 90 days.

Also, the govt. simply needs to increase the Medicare Tax and/or impose a National sales tax in order to cover every single Citizen for health care. The individual then still has the right to purchase his/her own private policy but everyone has coverage for basic
care

Define basic care - and then what about the rest? You don't pay, you die?

 

[sineapse]

I don't think it's any longer than our system.

It's some type of UK law that "junior doctors" can work more than 50 hours a week. Kinda of like the 80 hour work week in the USA with residents (which I am still kinda of pissed since I just did 2 months of 110-120 hours a week (call q2-q3 post call home at 4pm) in my ICU rotation) before the 80 hour week went into effect back in 2003-2004

Not just the UK, across all of Europe. 'European Working Time Directive' states you cannot work more than 48 hours a week. This is normally waived to 55 hours. It has caused a lot of upheaval and consternation within our medical system, especially for those within the surgical specialities.

Neurosurgery 'residency' is 10 ten years in total. There are only 49 spots in the country and you have to reapply halfway through your training.

Another thing to bear in mind with socialised medicine is that post residency, all attendings aka consultants get paid the same basic rate ($120-160k a year), some manage to do private work dependant on the speciality. Flipside to this is that we have no undergraduate college debt, considerably less med school debt and no malpractice fees for NHS work.

 

[jwk]

"Can you create commerce in order to regulate it?" asked Kennedy, most often the swing vote on the panel.

"Can the government require you to buy a cellphone because that would facilitate responding when you need emergency services?" asked Roberts.

"Do you think there is a market for burial services?" asked Justice Samuel Alito, comparing the inevitability of death with the inevitability of medical care.


These are pretty simple questions and perfectly on point as to why this law is unconstitutional. Maybe, just maybe, one or more of the lib side of the court will actually come to their senses and vote to uphold the Constitution. I know, I know, it's a stretch, but once in a while, common sense, along with the rule of law, finally bursts through.

 

[aneftp]

For opponents against the health law (myself included), it's a catch 22 situation like I posted earlier.

I think the mandate to force citizens to enter into a contract with a private entity (insurance companies) is unconstitutional. And like I made the example of requiring all birth parents to take out life insurance policies for themselves in case they die and this will save the state money to raise the child.

The Supreme court justice also made a similar argument saying if the mandate is required, what will stop the government from requiring someone to buy burial insurance because if no one has money to bury a love one, than the state eventually spends it's money for burial or requiring cell phones for faster EMS response.

Of course liberal judges like Ginsburg will rule in favor of the mandate. She's so set in her ways. She made the argument social security wasn't well liked when it was introduced in the 1930s as a kinda of retirement/helping seniors out system. But Ginsburg's argument is silly since Congress authorized taxes to pay for the social security system and most people pay into it.

This health care law (with the exception of some taxes on say industries like the tanning industry or taxing the top 5% of earners). This health care law mandate requires citizens to deal directly with the private insurance instead of the government.

Saying that. If this law gets over turn, the public will say, "what now" "we are back to square one" with millions of uninsurable people. How do we get those people health plans?

That's the million dollar question after this case gets decided (if the law gets struck down). Government will need to off them an alternative. That means government will need to expand medicare to that group. Not sure how we will pay for it since we are basically spending 20% of our entire national budget on medicare alone these days.

 

[jwk]

For opponents against the health law (myself included), it's a catch 22 situation like I posted earlier.

I think the mandate to force citizens to enter into a contract with a private entity (insurance companies) is unconstitutional. And like I made the example of requiring all birth parents to take out life insurance policies for themselves in case they die and this will save the state money to raise the child.

The Supreme court justice also made a similar argument saying if the mandate is required, what will stop the government from requiring someone to buy burial insurance because if no one has money to bury a love one, than the state eventually spends it's money for burial or requiring cell phones for faster EMS response.

Of course liberal judges like Ginsburg will rule in favor of the mandate. She's so set in her ways. She made the argument social security wasn't well liked when it was introduced in the 1930s as a kinda of retirement/helping seniors out system. But Ginsburg's argument is silly since Congress authorized taxes to pay for the social security system and most people pay into it.

This health care law (with the exception of some taxes on say industries like the tanning industry or taxing the top 5% of earners). This health care law mandate requires citizens to deal directly with the private insurance instead of the government.

Saying that. If this law gets over turn, the public will say, "what now" "we are back to square one" with millions of uninsurable people. How do we get those people health plans?

That's the million dollar question after this case gets decided (if the law gets struck down). Government will need to off them an alternative. That means government will need to expand medicare to that group. Not sure how we will pay for it since we are basically spending 20% of our entire national budget on medicare alone these days.

The question is - should the government be all things to all people, and despite the Constitution, should it mandate federally paid (and tax supported) healthcare for all? The answer is NO.

 

[Apollyon]

Government will need to off them an alternative.

This typo made me laugh - you can insert two letters in two different positions, and get quite a different meaning.

Government will need to offer them an alternative.

Government will need to off them as an alternative.

 

[aneftp]

This typo made me laugh - you can insert two letters in two different positions, and get quite a different meaning.

Government will need to offer them an alternative.

Government will need to off them as an alternative.

Sorry, def. a typo on my part. Meant to say "government will need to offer them an alternative".

But anyways getting back to the mandate. If law gets upheld, Congress will be given the green light to require any activity for the better of the country (cell phones, burial insurance, eating better etc). I don't think requiring health care is the lone exception that makes it so special.

But the Supreme Court is known to interpret different laws in different ways. One of the more recent had to do with affirmative action in 2003 and the deciding vote was Sandra Day O'Connor who basically said it was unconstitutional for race base "points". But than decided to say it's constitutional (for now) to continue to use race based admissions but hopefully in the future we can do away with race based admissions. I am saying, WTF? did they just decide.. That was a very perplexing decision.

 

[scudrunner]

Not just the UK, across all of Europe. 'European Working Time Directive' states you cannot work more than 48 hours a week. This is normally waived to 55 hours. It has caused a lot of upheaval and consternation within our medical system, especially for those within the surgical specialities.

Neurosurgery 'residency' is 10 ten years in total. There are only 49 spots in the country and you have to reapply halfway through your training.

Another thing to bear in mind with socialised medicine is that post residency, all attendings aka consultants get paid the same basic rate ($120-160k a year), some manage to do private work dependant on the speciality. Flipside to this is that we have no undergraduate college debt, considerably less med school debt and no malpractice fees for NHS work.

How many hrs/wk do attendings work? How about vacation?

 

[mersault]

these hearings are absolutely fascinating. here's a quote from todays transcript:

MR. KNEEDLER: Well, in the first place, I don't — the point isn't that there has to be a — an affirmative cause of action to decide this. You could — for example, to use the Medicare reimbursement issue is, one of the things that this Act does is change Medicare reimbursement rates. Well, the place where someone adjudicates the validity of Medicare reimbursement rates is through the special statutory review procedure for that.

has anyone read anything about how the rates are changing for anesthesia?

 

[BLADEMDA]

The question is - should the government be all things to all people, and despite the Constitution, should it mandate federally paid (and tax supported) healthcare for all? The answer is NO.

Why not? we pay for the care one way or the other. Right now they just show up in my ER and it costs all of us a lot more money. Why not provide BASIC care for all U.S. citizens? Isn't that already a defacto reality?

All we need to do is bump us the medicare tax a bit for everyone. Plus, states can institute a Medicaid tax for no pay/poor. This tax can simply be sent to the hospital/provider if you prefer as reimbursement.

I agree with Paul Ryan about saving Medicare with a voucher but a total knee replacement is one thing vs a ruptured appendix. See the difference?

Block grant Medicaid funding to the states and give Medicare patients a voucher to buy insurance in the open martket.

 

[GoodmanBrown]

Why not? we pay for the care one way or the other. Right now they just show up in my ER and it costs all of us a lot more money. Why not provide BASIC care for all U.S. citizens? Isn't that already a defacto reality?

All we need to do is bump us the medicare tax a bit for everyone. Plus, states can institute a Medicaid tax for no pay/poor. This tax can simply be sent to the hospital/provider if you prefer as reimbursement.

I agree with Paul Ryan about saving Medicare with a voucher but a total knee replacement is one thing vs a ruptured appendix. See the difference?

Block grant Medicaid funding to the states and give Medicare patients a voucher to buy insurance in the open martket.

I did not expect this from you, Blade. As you said above, we definitely fall along different political stripes. But this is a system I would happily get behind.

 

[BLADEMDA]

I did not expect this from you, Blade. As you said above, we definitely fall along different political stripes. But this is a system I would happily get behind.

Well, my GOP friends would prefer a Medicaid volucher so patients could purchase their own insurance. This voucher would allow a basic health care plan even more basic than the Medicare voucher.

One way or the other everyone in the U.S. gets health care; the only question is how we pay for it and how much basic care we allow them to get.

 

[yappy]

Blade, what do you think of this theory. I've been thinking about it for a while.

What if Physicians, hospitals, and dentists were allowed to write off tax commitments on their income or profits for treating patients who were deemed "eligible" based on their low incomes or inability to get insurance. This way there is no government overhead that needs to be supported by tax dollars orther than the already existing IRS and every dollar spent (not collected) would be going towards patient care.

I imagine practices and hospitals would optimize their income by finding the best mix of paying patients and tax-write-off-patients. Patients would be treated and it would be efficiant. It's win-win.

Wouldn't that be awesome?

Well, my GOP friends would prefer a Medicaid volucher so patients could purchase their own insurance. This voucher would allow a basic health care plan even more basic than the Medicare voucher.

One way or the other everyone in the U.S. gets health care; the only question is how we pay for it and how much basic care we allow them to get.

 

[BLADEMDA]

Blade, what do you think of this theory. I've been thinking about it for a while.

What if Physicians, hospitals, and dentists were allowed to write off tax commitments on their income or profits for treating patients who were deemed "eligible" based on their low incomes or inability to get insurance. This way there is no government overhead that needs to be supported by tax dollars orther than the already existing IRS and every dollar spent (not collected) would be going towards patient care.

I imagine practices and hospitals would optimize their income by finding the best mix of paying patients and tax-write-off-patients. Patients would be treated and it would be efficiant. It's win-win.

Wouldn't that be awesome?

It would help Physicians but not most hospitals as they are non profit organizations.

 

[periopdoc]

Blade, what do you think of this theory. I've been thinking about it for a while.

What if Physicians, hospitals, and dentists were allowed to write off tax commitments on their income or profits for treating patients who were deemed "eligible" based on their low incomes or inability to get insurance. This way there is no government overhead that needs to be supported by tax dollars orther than the already existing IRS and every dollar spent (not collected) would be going towards patient care.

I imagine practices and hospitals would optimize their income by finding the best mix of paying patients and tax-write-off-patients. Patients would be treated and it would be efficiant. It's win-win.

Wouldn't that be awesome?

I am not even good at taxes, but I can think of at least a half-a-dozen easy ways to scam that system. The oversight necessary for a program like that would be enormous. If we could count on nobody scamming the system then it would be a great idea.

-pod

 

[dozitgetchahi]

Interestingly, NPR was having a rather panicky discussion earlier today on the subject of "what happens if Obamacare is thrown out altogether?" Apparently they feel there's a decent chance of it happening.

 

[GoodmanBrown]

Interestingly, NPR was having a rather panicky discussion earlier today on the subject of "what happens if Obamacare is thrown out altogether?" Apparently they feel there's a decent chance of it happening.

Whichever way it went, it's already decided now. We just have to wait until June to find out what they've decided.

I think a lot of people thought it would be a cake-walk for the government's side. Even conservative legal scholars thought it would be heavily decided in the government's favor. It probably hinges on Kennedy's decision right now. He was actually less negative than other more vocal judges like Scalia and Alito. And if Kennedy votes to uphold the law, then Roberts likely will also. So, that's why I think we're seeing a 5-4 striking down of the law or a 6-3 upholding. Only time will tell.

I think it is commonly agreed that Solicitor General Donald Verrelli didn't do a very good job defending the law in oral arguments.

 

[countingdays]

Whichever way it went, it's already decided now. We just have to wait until June to find out what they've decided.

I think a lot of people thought it would be a cake-walk for the government's side. Even conservative legal scholars thought it would be heavily decided in the government's favor. It probably hinges on Kennedy's decision right now. He was actually less negative than other more vocal judges like Scalia and Alito. And if Kennedy votes to uphold the law, then Roberts likely will also. So, that's why I think we're seeing a 5-4 striking down of the law or a 6-3 upholding. Only time will tell.

I think it is commonly agreed that Solicitor General Donald Verrelli didn't do a very good job defending the law in oral arguments.

I think Roberts votes first.

Hard to defend all law that is diametrically opposed to the intent of the u s constitution.

 

[periopdoc]

The sequence of the final vote is pretty much irrelevant. They will have the prelim vote, so Roberts will be able to figure out how he wants to cast his final vote based on the results of the prelim.

- pod

 

[countingdays]

The sequence of the final vote is pretty much irrelevant. They will have the prelim vote, so Roberts will be able to figure out how he wants to cast his final vote based on the results of the prelim.

- pod

Oh ok.

If the worst happens, then it'd be nice to have Roberts limit the impact on loss of individual liberty and avoid some of the increase in federal tyranny by writing a focused opinion.

 

[BLADEMDA]

Whichever way it went, it's already decided now. We just have to wait until June to find out what they've decided.

I think a lot of people thought it would be a cake-walk for the government's side. Even conservative legal scholars thought it would be heavily decided in the government's favor. It probably hinges on Kennedy's decision right now. He was actually less negative than other more vocal judges like Scalia and Alito. And if Kennedy votes to uphold the law, then Roberts likely will also. So, that's why I think we're seeing a 5-4 striking down of the law or a 6-3 upholding. Only time will tell.

I think it is commonly agreed that Solicitor General Donald Verrelli didn't do a very good job defending the law in oral arguments.

No it's not decided. Kennedy has changed his mind before on critical decisions after the preliminary vote.

In one celebrated case decided in 1992, Rehnquist initially assigned Kennedy to write a majority opinion for five justices allowing prayers at public school graduations. In the end, Kennedy ended up writing the opinion for a different five-justice majority striking down the graduation prayers. According to several accounts, Kennedy simply changed his mind during the writing process.

Read more: http://www.foxnews.com/politics/2012/03/29/justices-meet-friday-to-vote-on-health-care-case/#ixzz1qjRMJEJC

 

[jwk]

No it's not decided. Kennedy has changed his mind before on critical decisions after the preliminary vote.

In one celebrated case decided in 1992, Rehnquist initially assigned Kennedy to write a majority opinion for five justices allowing prayers at public school graduations. In the end, Kennedy ended up writing the opinion for a different five-justice majority striking down the graduation prayers. According to several accounts, Kennedy simply changed his mind during the writing process.

Read more: http://www.foxnews.com/politics/2012/03/29/justices-meet-friday-to-vote-on-health-care-case/#ixzz1qjRMJEJC

It would be nice if it ended up with better than a 5-4 vote to overturn. There were some pretty basic common-sense arguments and questions offered by the conservative side - broccoli, burial plots, etc. - that should make even the most liberal justice take pause and think twice on the questions "Congress wouldn't do that, would it?" and "Congress never had that intent, did it?" Sadly though, several believe in that "living and breathing document" crap. They, as do many liberal judges, think it's their job to interpret the Constitution, rather than interpret whether or not a law is allowed under the Constitution. Those are two totally different mindsets.