It's good news that the Supreme Court split 5-4 with Roberts (and not Kennedy?!?) as the deciding vote, to uphold the affordable care act. It's interesting that this was controversial, and certainly Roberts led the court to a very safe middle ground making the issue about taxation and saying the commerce clause could not apply. If anything, I wonder if this weakens the previous commerce powers of Congress as defined by Wickard v. Filburn, I'd love to hear what a lawyer thinks.
What does this mean?
Well in the short term not a whole lot, this healthcare bill requires a very slow roll-out of provisions. This was never a revolutionary law, which is why it was so surprising that people treated what was essentially a free-market giveaway as if it were some act of revolutionary socialism. But it will mean that states will have to go ahead and start implementing exchanges, it means that lots of other cost-control provisions are going ahead, coverage for pre-existing conditions will remain (victory!), and most importantly, we can start a great cultural shift from using emergency rooms or just plain avoidance to deal with necessary health maintenance and primary care needs.
Now, I know many that think single payer is the only way that healthcare can be provided might have been hoping this hodgepodge mix of free-market and social reforms would fail in favor of a truly government-administered system. I would say to them, don't worry! It's possible to have highly efficacious universal healthcare based on insurance for all and subsidization for those who can not afford it. Most systems not inherited from the Soviets came to universal healthcare from different angles, and only really the UK, Canada, and New Zealand represent totally government-administered healthcare systems in such countries. In between would be Sweden, Japan, France, or Australia with government-administered payment or mixtures of public and private hospitals with government sponsored insurance options. Even Russia now has a mixture of public and private healthcare spending. Then there are the systems which look a bit more like what the ACA will be. For instance Germany, which has had universal health care since Otto von Bismarck, has health coverage through employer-subsidized sickness funds, a mixture of public and private hospitals and clinics. Finally, the Netherlands system probably is most like the system proposed by the ACA. They describe it as "private insurance with social conscience", and the Netherlands enjoys metrics of patient satisfaction, short wait times, and access to procedures far superior to that of other systems including ours (which performs quite poorly on almost all metrics including access). On the extreme free-market side of universal health care is Singapore, which relies on universal governmental catastrophic insurance coverage, but an individual mandate on citizens to contribute to personal health savings funds which cover primary care and most expenditures until you go over a yearly limit. The only thing all of these systems have in common is that they spend half of what we spend yearly per capita on healthcare.
So, to those who oppose it because you either don't want healthcare or because you don't think it was enough, don't despair! For those who think it's the worst thing ever to pay for other's health insurance, don't worry! You already are! You have been since Reagan passed EMTALA. That won't change, the cost might actually get cheaper (or at least stop increasing at such a violent pace). For those who think that anything but single-payer is awful, don't complain! What's most important is that we have universal coverage that encourages primary care usage, getting patients out of the ER and subsidization for the poorest among us. The international experience shows that truly single-payer systems are the minority, and most systems are a mixture of public and private hospitals, insurance and personal expenditure. Further, one of the best systems in the world, the Netherlands system closely resembles what the ACA will accomplish and has resulted in excellent outcomes and patient satisfaction in that country. In fact, most single-payer systems perform worse in terms of access, wait times, and satisfaction than the mixed systems, with the possible exception of Sweden (probably because they put so much money into it).
This is a victory for healthcare and the country. Even if it's not "perfect", or even if you think people being treated for their medical problems is some kind of sin against capitalism, too bad. It will accomplish a great deal, there is international precedent that such systems work (and may work better than single-payer), and there is no escape from the fact that we have to pay for people's healthcare. We can do it expensively, wastefully, and emergently in the ER, or we can do it like thoughtful, decent citizens who care about each other's welfare and provide a baseline of access for all.
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I have been against this bill from the beginning and I was shocked this morning. HOWEVER, being a person who loves truth more than ideology, Thank you for this writing. You have opened my eyes to look at it from a different angle.
Of course, as has been pointed out on certain news programs, its interesting that they didn't just flat out state, "As written, any apparent 'tax' being applied is **voluntary** and unenforceable, to its irrelevant that there is one." Or is, being unable to actually tax, never mind jail, someone indirectly, if they are fined, and fail to pay it, somehow actually still "taxing" them. It sounds more like they are handing out mints, and asking, "Please put a quarter in the jar, before taking one."
It is not good that this unconstitutional monstrosity was upheld. senate and congress could do us all a favor and just lower the penalty/tax/ to one penney and that would make the mandate as useless as tits on a baor hog. That's one way to get rid of the mandate. Technically it would still be there, but the fine would only beone penny. I still say people who do not want insurance do not have to buy it and they should refuse to pay any penalty too. What will they do arrest millions of people? Wouldn't that just cost more? As I heard the decision today, I prayed for a asteroid to hit all the fucked up socialists. I can't wait for the day when angles descend upon this earth and destroy evil and marxist socialism for ever. They swords flaming as scared liberla run everywhere. I'll be right there in the middle asking for a sword and offering my assistance. may the first people they go after are freedom stealers.
I think much remains to be seen with this. If the costs result in certain income levels actually having less out-of-pocket to pay for basic medical, vision and dental care after fees and copays, it obviously isn't positive for their health at all. Until families can crunch some actual numbers, and see what types of services can be provided for, it's all just propaganda.
Please, continue to comment whenever possible. If I ever needed an example of the idiocy/insanity of the opposition I can just point at this comment and laugh.
It's not socialism. We are already paying for the uninsured, the cost is just being foisted on the responsible and the wealthy. It's cheaper to just insure people (see the Richmond study) than to leave them uninsured etc. There is no downside here other than the hyped up tea-party nonsense that I think should disqualify one permanently from being considered informed or intelligent.
It may be cheaper to insure people, but it is not right to force people against their will to purchase things they do not wish to purchase. How would you like it if all of a sudden a Republican congress and senate made up a law that says you have to purchase a book by Ken Ham and if you refuse you will be fined/taxed, or jailed? Not so funny when you are on the other side of it eh? mandates are made for dictatorships, not free countries. I hope the whole system crashes. At least I'll get to laugh at the morons in washington who need a lesson in humility and freedom.
Oh, do the 15 million plus illegal aliens also have to purchase insurance or do they just keep on getting free rides as always? They already can be arrested and charged with tax evasion since they do not pay into the system. I say either everyone pays taxes or no one pays taxes. Fair is fair.
Oh, and by the way did you know that Amish are exempt from this unconstitutional law? Looks like the Amish are about to get a few more converts come tax time.
I still say congress and senate should readjust the stupid punishment/penalty for not having insurance down to just one penny. Then make that penny tax deductible. I would do it just to piss off the liberals.
That's ok. Go ahead and laugh at me. I've been laughing at liberals for years. The more insane and the more marxist they get the more I laugh at how far down into hell they have reserved a place for themselves. There is no room in America for socialists. Congress should make socialism a felony worthy of banishment deportation. At this point there is nowhere else left to go.
America was the last best hope for humanity. Now we are as deep in the hellhole as all other nations. There are no more free nations left. looks like we may have to start one.
Like car insurance?
This is the "stupid government" argument, proposed most recently by Scalia to suggest that this empowers government to engage in almost any stupid act imaginable. Luckily as a democratic representative government we have recourse against such stupidity.
Virtually every industrialized country in the world has universal health insurance, either based on insurance mandate or taxes. Somehow, I don't think of Canadians, New Zealanders, Australians, Brits, French, Germans, Swedes, Dutch, Swiss, Spanish, Italians, Japanese, Singaporians, etc., as all living under dictatorships. Nice hyperbole. have you checked your pulse lately?
Very patriotic of you.
Because wishing an asteroid will strike the country is very humble.
They are specifically excluded from the bill, so yes, they will continue to be covered under EMTALA which was passed by that stinking socialist Ronald Reagan.
Fair is fair, so when the uninsured cost, on average, 700-1000 dollars a year to the taxpayers, not to mention higher premiums, higher medical costs, and overburdening our ERs, we should figure out a way to exact that cost back from them.
Forcing someone to buy car insurance never was very popular either. It is the same principle. Illegal as hell. blackmail. Only a government can get away with it.
We are not canada, sweden, UK, or anyone else. Our laws are based upn OUR constitution, not someone else's. We are a independent sovereign nation and europe can go to hell. We are not europe. We are America. if you like how they do things move there. Simple as that.
Oh and Germany was once a dictatoship and Canada may not entirely be a dictatorship but they are about as harsh on conservative christians as any sharia law state I have ever seen. They have very street anti-christian laws dealing with gayism and they are paranoid about guns. Sort of like mayor bloomberg and his sugar fetish. That fucker should be banished from America. Better yet everyone who purchases a soft drink in new York should drive him and plet him with ice and sugary soft drinks until he resigns. get rid of that dickheadtator. Nevr heard that temr before? You know what a dictator is and you know what a dickhead is. Now fuse the two into one and you have a dickheadtator even though there is little difference between the two.
Yes very patriotic of me to hope the sytem crashes. A system that is this crappy deserves a crash and it derserves to take down everyone who implemented it on the way down.
Tell ya what. The days of my service to government is over. I work on many eectrical systems and have worked on government systems before. Not anymore. I refuse to sell or service anything to a government organization unless they pay 3% health tax, a 10% safety tax, and a 95% government tax on top of the outrageously high labor rate I charge for government equipment. if hiospitals an make 6000 percent profict in under and hour, so can I. If they don;t like it, they can take their brojen down crap to the illegal alien down the street. maybe pedro can swap wires on it and finish burning it to a crisp.
The 15 million illegal aliens should have to pay back taxes. Social security, medica, mediciad, FICA, state and federal income taxes, property taxes, etc. If they are going to luive here the least they could do is stop sucking taxpayer titties and contribute to the fund.
Uninsured is not my business. If a sovereign citizen chooses not to have health insurance it is not my concern. If he goes to the doctor or ER and cannot pay, i am sure they have many chores around the place he could do for a while to pay off the debt. A little landscaping, a little janitorial work, some communiy service, etc. Maybe even mow the doctor's lawn for the summer. I bet we can think of some non paid labor to help out the hospitals with uninsured people. That should cut back on ER visits for people with the common cold at least.
Insuance premiums are high becuase hospitals charge too much money. If congress were smart they would have limited how much money hospitals can make for profit and them made insurance companies do the same.
Your problem is that you wan a single payer system so bad you are willing to kill to get it. I just wonder if Obama threatened Justice Roberts in any way? He has been known to put people on his personal hit list. Andrew Breibart being one of them. The navy seals who killed "Osama bin laden" were conveniently killed. hate to be the bearer of bad news but bin laden was dead in 2004. It was his brother who was killed last year. The body was nevr shown becuase it was not bin laden and to make sure the seals didn't talk they conveniently were attacked by the CIA, oops, I mean the taliban. Oh well same bunch of assholes. One is not particulalry worse than the other. Especially when we have feds running armed drones over America now.
I hope someone shoots of those damned things down and when the feds come to pick it up they get attacked by a herd of velociraptors. Probably won;t happen, but miracles can happen. That would be a great one. I hope everytime they launch a drone to spy on americans it explodes before it ever gets off thee ground the person giving the order has explosive violent diarreah for week.
Then again, a drone was shot down in texas. Hurray for the Texan who knew his rights as a soveriegn free individual. to hell with the new world order.
I still say bring back tarriffs and ban income tax.
As far as an asteroid hitting that would be bad for me too. Maybe aliens will land in my yard and ask me for my leader. I'll make an allaince with them. If they promist to wipe out all the leaders, only them will I tell them where they can be found. As a matter of fact, I would have the advantage of having my very own ex-politicians as my personal servants for life. Then I'll make some mandates of my own.
I love the reading comprehension. The entire article is about how single-payer is not necessary for effective health care delivery.
So you believe in freedom, but you want to cap profitability (or even just price capping) rather than leave it to the market?
Someone's off their meds. Or just drunk? We don't argue with cranks here by the way. I'm not interested in your paranoid conspiracy theories.
"conspiracy theory". Where have I heard that one before? Oh yeah. The Obama administration warned people not to believe in "conspiracy theories".
I took his advice. I do not believe in the conspiracy theory of global warming/global cool/climate change. I do not believe in the conspiracy theory of evolution either.
I like the health care system in the UK myself. Only 130,000 people got turned down for health care last year becuase their were too old or too expensive to treat. Looks like government is worse than the insurance companies.
Now that insurance companies know that people will be forced against their will purchase there is nothing stopping them from raising their rates tremendously and people will have to pay it. Thanks alot marxists.
What is people refuse to purchase the insurance then refuse to pay the penalty? What then? Is there another step? jail time?
No system is perfect. Free markets work the best if greed does not become too overwhelming. Socialist systems never work. They bog down the system. They make everyone equal - equally poor that is. Capitalism takes a poor man and with hard work he can become rich. Under socialism a man works had so that someone else gets his benefits and no one ever gets richer becuase they are taxed to death. no one gets to be ahead. Why even go to work if someone else is going to reap the reward?
Would you study hard and take a test if the teacher was going to give your grade to someeone else who failed? Only if you lost your mind.
Little jimmy made a D on his math test. Alice made a A. That's not fair. Let's make it equal. So under socialism and economic justice the eacher takes some of the people's grade at the top 1% and gives a large portion of their grade to the bottom grade makers. Now tell me if tht is justice or a crime? Looks like THOU SHALT NOT STEAL was broken again.
I feel sorry for those who have expressed so much hatred and ignorance on here! May God have mercy on your soul. Thank you Mark for posting this article, I hope it sheds some light for those who are just confused, or off their meds, or have had a little too much to drink ;)
"The more insane and the more marxist they get the more I laugh at how far down into hell they have reserved a place for themselves."
interesting fact: you don't know what Marxism means, and it shows.
"There is no room in America for socialists. Congress should make socialism a felony worthy of banishment deportation."
good idea, William: the government should round people up and punish them based on their political opinions. it's what the Founding Fathers would have wanted!
Hey conservatives, this is your legislation. It was invented by Heritage Foundation, proposed by the likes of Orrin Hatch, and enacted by your guy Romney. Now you're against it because the black democrat got it enacted? You guys would have a lot more credibility if you said something like "hey look this guy has no ideas, so instead he steals from us" rather than spewing the lies and unhinged propaganda for something you invented and supported before you where against it. Morons.
socialism is not a political opinion, it is a form of tyranny.
Romnye is not our guy. He is NOT a constitutional conservative. nevr has been and never will be. He just a somewhat better alternative to the crreature we have in office now. That being said, I now apologize to all creature everywhere for putting you down.
Romney and even some of the heritage foundation members are just as much Bilderberg New Word Order global government guys as any on the far left. Some more so, and that my friend is anti-conservative, even worse than liberalism.
"socialism is not a political opinion, it is a form of tyranny."
firstly, tyranny is a political opinion (or system, anyway). secondly, isn't punishing people for their political views a bit, you know....tyrannical?
"Some more so, and that my friend is anti-conservative, even worse than liberalism."
liberalism is anti-conservative now? like Locke, Smith, Burke, Paine or Jefferson?
Canada's "totally government-administered healthcare system" provides very limited coverage. There is a large private insurance market. Many Canadians with means take advantage of the pay as you go US system because of the vastly superior access.
Yes very patriotic of me to hope the sytem crashes. A system that is this crappy deserves a crash and it derserves to take down everyone who implemented it on the way down.
9/11 must have been the happiest day of your life.
America: Love it or leave it, pinko.
Oh, and did no one else notice that "William Henderson" outed himself as sockpuppeting the "Jeffrey Troys" comment, i.e. 'I still say that....' and 'Sure, keep laughing at me...'?
"Oh, and did no one else notice that “William Henderson” outed himself as sockpuppeting the “Jeffrey Troys” comment, i.e. ‘I still say that….’ and ‘Sure, keep laughing at me…’?"
you sure that's necessarily the case? he sounds like the sort of person who subjects a lot of people to his inane, spittle-flecked conspiracy theories, and who in turn is the subject of a lot of laughter.