Federal Judge Strikes Down Part of Obamacare Law


by talk2glenn
Tags: federal, judge, obamacare, strikes
Mech_Engineer
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Dec13-10, 07:56 PM
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Quote Quote by wasteofo2 View Post
It was always a dumb idea to force people to buy private health insurance.
You're right, we should just hold them responsible for their actions. If you don't have health insurance, and you get in a car wreck and need $100,000 in medical care to save your life, it's your job to pay for it.

Quote Quote by wasteofo2 View Post
Simply make it illegal for healthcare companies to turn down people or charge them for prexisting conditions.
Wait a minute- it should be illegal to force people to buy health insurance, but we should force health insurance companies to let high-risk candidates in, regardless of how much it raises the cost for everyone else? What if someone refuses to buy health insurance until they get cancer or HIV, and then want in? We should have to pay for that?

Quote Quote by wasteofo2 View Post
That would be a great way to make US healthcare seriously streamline its costs.
If by "streamline" you mean "completely screw up," you're right!

Quote Quote by wasteofo2 View Post
There certainly is some money to be squeezed out of the most expensive healthcare in the world, after all.
Where? Last I checked, hospitals are going out of business left and right due to the emergency room being overrun by people with no money and no insurance using the ER as their primary care physicians, and it costs someone with proper health insurance $500 to get a band-aid in the ER because there were 25 people like him who skipped on their bills.
CRGreathouse
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Dec13-10, 08:05 PM
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Quote Quote by Mech_Engineer View Post
Wait a minute- it should be illegal to force people to buy health insurance, but we should force health insurance companies to let high-risk candidates in, regardless of how much it raises the cost for everyone else? What if someone refuses to buy health insurance until they get cancer or HIV, and then want in? We should have to pay for that?
Sigh...

You said this so much better than I did.
jbunniii
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Dec13-10, 08:15 PM
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While the personal mandate makes sense economically, it did seem like the federal government may be overstepping its bounds. (Not that it doesn't routinely do so on countless other matters! We all have to pay for Medicare, whether or not we ever enroll in the system.)

I say it makes economic sense because the insurers have a valid argument that if they are required to insure anyone regardless of health, then many people will buy insurance only if they become ill.

But there are ways around that which do not require everyone to buy insurance. How about:

1) insurers must offer coverage to anyone who applies, and are not permitted to drop coverage except for serious fraud or nonpayment of premiums;

2) no one is required to have health insurance

however

3) insurers are entitled to charge more (for some period of time) for those who have not maintained continuous coverage starting at some date after the legislation takes effect

This is more or less how auto insurance works, and it would still have been a massive improvement over what we had before, where insurers could and did cherry-pick only the healthiest applicants, and drop them the moment they started costing money.

There will still be some people who buy insurance only when they become ill, and this will drive up costs for everyone, but at least those people who game the system in this way will be forced to pay more from their own pockets.
mheslep
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Dec13-10, 08:16 PM
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Quote Quote by mugaliens View Post
Exactly. By the way, I have my eye on a VLJ (very light jet) but I think $3.2 Million is too much, so I'll just take it for $32,000, instead.
Damn greedy jet makers. Single payer for jets is what we need.
Gokul43201
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Dec13-10, 08:21 PM
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This is probably an extremely silly question (and it comes without reading the ruling of the Fed Court, so it's also a lazy question): how is forcing someone to buy health insurance any more unconstitutional than forcing them to (for instance) purchase social security through a tax?
Al68
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Dec13-10, 08:23 PM
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Quote Quote by Ivan Seeking View Post
At this point, two out of three Federal courts have upheld the mandate.
I think the important point is that this will be decided by the Supreme Court. Considering recent rulings, it seems unimaginable that SCOTUS would rule that the power to regulate commerce among the states equals a power to force citizens to buy a product.

Of course, it's just as obvious that, despite their pretenses to the contrary, not a single U.S. judge in the country honestly interprets the commerce clause that way.
Al68
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Dec13-10, 08:27 PM
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Quote Quote by lisab View Post
Wow, you must have not seen a hospital bill lately! In my experience, (hospital bills) >> (insurance premiums)
If your experience was representative, there would be no insurance industry. Insurance companies are in business to make money, not lose it. Their margins may only be 2-4%, but that's profit, not loss, which means (insurance premiums) > (hospital bills) + (everything else covered by insurance).
mheslep
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Dec13-10, 08:30 PM
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Quote Quote by jbunniii View Post
.)
I say it makes economic sense because the insurers have a valid argument that if they are required to insure anyone regardless of health, then many people will buy insurance only if they become ill.
Yes that's a point that should be watched. Several Republic politicians have made noises that, after getting the rid of the purchase mandate either through the courts or through legislative repeal, they kind of like all the requirements on insurers. Well that's economic nonsense as well.

But there are ways around that which do not require everyone to buy insurance. How about:

1) insurers must offer coverage to anyone who applies, and are not permitted to drop coverage except for serious fraud or nonpayment of premiums;

2) no one is required to have health insurance

however

3) insurers are entitled to charge more (for some period of time) for those who have not maintained continuous coverage starting at some date after the legislation takes effect

This is more or less how auto insurance works,
Eh, no, auto insurers are not required to cover anyone that applies nor keep them. They routinely drop people for one too many fender benders or tickets. Most states have a high risk liability insurance pool that they run, in conjunction with, if I recall, one or more designated carriers, so that everyone can get the minimal liability insurance required to be on the road. That, is a good model in my opinion health care - high risk pools for the chronically ill wherein the term 'insurance' doesn't make any economic sense.
Al68
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Dec13-10, 08:36 PM
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Quote Quote by wasteofo2 View Post
Simply make it illegal for healthcare companies to turn down people or charge them for prexisting conditions.
Some of us want and need medical insurance, not a comprehensive health care plan that covers things we have no desire to pay for. Covering pre-existing conditions is by definition not insurance.

Making private "insurance only" policies illegal is just as bad as trying to force people to buy comprehensive health care plans.

I have a novel idea: stay out of peoples' private business. If politicians really thought they could offer a better deal for health insurance, they would have no need or reason to pass any law to do it.
talk2glenn
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Dec13-10, 08:44 PM
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Quote Quote by Gokul43201 View Post
This is probably an extremely silly question (and it comes without reading the ruling of the Fed Court, so it's also a lazy question): how is forcing someone to buy health insurance any more unconstitutional than forcing them to (for instance) purchase social security through a tax?
Social Security is treated as a tax and separate expenditure (benefit) under the law, and was upheld by the Supreme Court under the general welfare and tax clauses of the Constitution. It does not consider Congressional power under the commerce clause.

The insurance mandate is, under the statute, a penalty for not not complying with statutory requirements to obtain private health insurance, and it is justified under commerce.

Roosevelt also had Congress change the language of the Social Security statute to make it more like a "tax" and "benefit" than an "insurance". Congress could have written the "penalty" up as a "tax", but that would have brought its own challenges (SS was unsuccesfully challenged on the basis that it was a tax on some people to provide benefits for the other, and therefore didn't satisfy "general welfare" or "equal protection" - same could have happened here). They could also have simply nationalized health care outright (the public "option", as a tax-and-benefit program), which would be apparently legal, but that was a political non-starter.
russ_watters
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Dec13-10, 08:50 PM
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Quote Quote by Gokul43201 View Post
This is probably an extremely silly question (and it comes without reading the ruling of the Fed Court, so it's also a lazy question): how is forcing someone to buy health insurance any more unconstitutional than forcing them to (for instance) purchase social security through a tax?
SS is a government program, paid for by a tax. Health insurance is private and paid for by private fees.
jbunniii
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Dec13-10, 08:55 PM
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Quote Quote by Al68 View Post
Some of us want and need medical insurance, not a comprehensive health care plan that covers things we have no desire to pay for. Covering pre-existing conditions is by definition not insurance.
What should be done about people with conditions that preclude them from being insured? If they can't afford care that will manage their condition (e.g. diabetes, high blood pressure, whatever), then it is likely they will end up in a very expensive emergency room situation at some point, effectively on the taxpayers' dime.

There are two ways to reduce this cost: either all laws forbidding emergency rooms from turning away patients should be repealed, and let these people die on the street, or provide them with some sort of coverage that they (1) are entitled to buy and (2) isn't priced so high that they are unable to buy it.

You can do this one of two ways: either by requiring the private sector to cover these people (with government subsidies if necessary); or offer a public option. The latter was dead in the water before it even got started. As a result, we got the rather mediocre Obama plan which no one seems to like very much and which may even be unconstitutional.

Or we kick the can down the road for another 20 years (and say "too bad" to those who need coverage and can't get it), just like we did when Hillarycare failed.
WhoWee
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Dec13-10, 08:56 PM
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Quote Quote by CRGreathouse View Post
Sigh...

You said this so much better than I did.
If you want to buy a homeowners policy would you expect the company to take a look at the house - maybe see if you have a gas leak and a few sparking wires - or a roof? Would it be unreasonable for them to charge higher rates if your house was a fire hazard?

I have a specific example of what is going on in the health insurance market presently. Medicare has something called a Guarantee Issue period for Medigap (supplements).

A situation developed recently where a 65 year old woman was losing her Medicare Advantage plan - it was being discontinued. She had several very expensive Part B drugs -cost approx $130,000 per year and used a nebulizer.

Under the 2011 Medicare Advantage plans available, she would be responsible for 20% of the cost of the Part B prescriptions - roughly $26,000. Because her plan did not renew, she had a Guarantee Issue and took a Medigap plan at a cost of about $85 per month that covered 100% of (her share of) the Part B prescription cost.

By contract, the insurance company will collect roughly $1,000 per year in premiums and pay out $26,000 in Part B prescription costs - plus the (20% balance) of all of her Dr. visits, MRI's, CT scans, ambulance rides, plus the Part A co-insurance (hospital) amounts. She will pay nothing else for any of these items as long as she pays her premium.

The insurance company can not drop her, but will have the right to increase the premiums for everyone in her risk pool - but can't single her out.

In this scenario, who is the bad guy? Is it her, the insurance carrier, Medicare, the drug manufacturer, the FDA, the doctor, the insurance carrier that left the area, or is everyone or nobody to blame?

Health care reform was too complicated an issue to be handled in the manner Congress and the President handled it - I hope the Court restores sanity to the lawmaking process.
jbunniii
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Dec13-10, 09:01 PM
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Quote Quote by WhoWee View Post
If you want to buy a homeowners policy would you expect the company to take a look at the house - maybe see if you have a gas leak and a few sparking wires - or a roof? Would it be unreasonable for them to charge higher rates if your house was a fire hazard?
This is not a very good analogy, as you can move to another house if yours is uninsurable (and you probably knew it was uninsurable when you CHOSE to move there), but you cannot move to another body, and the one you are stuck with may have maladies that you could not have prevented even if you lived a model lifestyle, e.g. inherited conditions.

One could argue that such conditions should be tested for prior to birth, and if found, offer an abortion, but I think many opponents of Obamacare wouldn't like that very much, either!
WhoWee
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Dec13-10, 09:12 PM
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Quote Quote by jbunniii View Post
This is not a very good analogy, as you can move to another house if yours is uninsurable (and you probably knew it was uninsurable when you CHOSE to move there), but you cannot move to another body, and the one you are stuck with may have maladies that you could not have prevented even if you lived a model lifestyle, e.g. inherited conditions.

One could argue that such conditions should be tested for prior to birth, and if found, offer an abortion, but I think many opponents of Obamacare wouldn't like that very much, either!
Insurance is a business that protects you against all or part of your risk - nothing else.

If you owned a restaurant and the Government dictated how much you could charge customers along with the type and size of portions (regardless of your cost) would it be fair?
Gokul43201
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Dec13-10, 09:18 PM
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Quote Quote by russ_watters View Post
SS is a government program, paid for by a tax. Health insurance is private and paid for by private fees.
Thanks for the response. So, any problem with constitutionality might be resolved if healthcare were nationalized? If the USSC does rule this unconstitutional, I wonder if Dems will push for such a "fix".
Mech_Engineer
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Dec13-10, 09:50 PM
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In my opinion, Social Security IS unconstitutional. Problem is, there are so many people invested and dependent on it it's hard to think of a way out. It's the elephant in the room no one wants to talk about; it's day will come though, probably when it goes into chatastrophic bankruptcy (as it is it's just started paying out more than its bringing in...)

My plan for getting us (as a country) off Social Security:
  1. New workers enetering the marketplace do not have to pay for SS. Instead, they get tax breaks for 401k or other individual retirement savings plans.
  2. Current workers (like me) that have paid some into SS but are more than 10 years away from retirement can pull out their SS investments as tax-credits on their returns, up to some maximum per year until they're out. This money can be invested in an IRA or 401 for a significant tax benefit. It will cost the gov't money yes, but that's the price we pay for getting into such a mess.
  3. Retirees currently on SS (or people close to retiring) can keep their SS benefits as promised by the government. They were told they could depend on it, and that commitment will be honored.

15-20 years from now, problem fixed. Move on.
CRGreathouse
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Dec13-10, 09:56 PM
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Quote Quote by Mech_Engineer View Post
15-20 years from now, problem fixed. Move on.
Those would be a painful few years...


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