Supreme Court upholds health care reform

Angry Citizen

Same applies to me. I found out I was a diabetic when I was twenty. No insurance company in the world would touch me without exorbitant fees, and none of them would've helped pay for my insulin for at least a year and only after I met my deductible.

Thankfully, the city has a program that helps people such as myself not die - it's much like how Medicaid will be in 2014.

ThinkToday

I've not had any issues with getting my wife and child with pre-existing conditions covered. Like yours, the pre-existing conditions were serious. It's been awhile, but as best I can remember, they weren't covered for 12months unless they were transitioning from one insurance to another without a significant break (e.g. typical job change situation). Even then, if they hadn't been treated for the condition within the past 12 months, that was ok too for getting coverage. My understanding was regardless of the outcome of the ACA, pre-existing conditions were being made a thing of the past. A very good thing for those whose illness is through no fault of their own.

mheslep

The cost of insurance has not come down but gone up significantly in the last two years. So you would agree what your daughter really needs from this law is the no pre-existing condition exclusion rule, and not necessarily 2700 pages of other things?

mheslep

One of the news worthy points of the story is that is not entirely the case here. The Chief Justice, Roberts, appointed by former President Bush, voted to uphold the health care law and for largely unanticipated legal reasoning. Also Justice Kennedy who votes both ways, voted with the minority to strike down the law.

mheslep

Eh, at the *federal* level America has no across the board VAT, though there are some on certain .. items and they hit the poor/middle incomes just as you point out. America has ample State and local VATs, implemented as simple sales taxes.

ThinkToday

Yes, it doesn't always follow what's expected.

Roberts appointed by GWB
Scalia appointed by Reagan
Kennedy appointed by Reagan
Thomas appointed by GWB
Ginsberg appointed by Clinton
Breyer appointed by Clinton
Alito appointed by GWB
Sotomayor appointed by BO
Kagan appointed by BO

In general, they do tend to vote the way you'd expect, but I think Kennedy becoming a swinger and Roberts swing on this and the AZ immigration case stand out. I think people tend to forget O'Connor (Reagan) was a frequent swinger, and Souter (GWB) and Stevens (Ford) were mid-tending left on many votes, even though conservative republicans appointed them.

CAC1001

From my (maybe incorrect) understanding, a sales tax is different from a VAT. A sales tax shows up on the receipt, whereas a VAT taxes each stage of the production and distribution of a good or service. It doesn't show up on the receipt and is thus hidden. You only know it's there by the higher prices for said particular goods and services it is applied to.

mheslep

Yes, that's my understanding of how its done in the EU, though I think of notification as an aspect of implementation, and not a fundamental characteristic of the thing itself.

nitsuj

The restrictions on insurance companies looks awesome. I would love to know the income health insurance companies make. Exchanging those profits for more healthcare seems fair (for the greater good), for a business model of "House always wins".

As far as the subsidy side / "tax increase" ect it maybe just growing pains.

Come budget cuts for 2015+ maybe, just maybe citizen health will be put before military/philanthropy/NASA/.....what budget expense could possibly force healthcare funding back onto the chopping block?

Oh right politicking.

Borg

This is one of the reasons that I am for health care reform in some form. The big problem is that this isn't fair to the insurance companies if only the sick had to get insurance.

If you don't buy car insurance and wreck your car, you're out a car. But, with the way health care is, you don't have to buy insurance and you can still be treated by going to a hospital that can't turn you away. Even if you gave people the ability to opt out (no pay, no coverage), the evening news would be full of sob stories of people who suddenly didn't think that it was fair once they became very ill. So, until someone comes up with a plan for something better and not just the desire to kill it, I think that this is a reasonable compromise to achieve the goal of universal health care.

I am curious though what happens to the money paid as 'tax'. Does that money go to the insurance companies or does the federal government keep it?

Astronuc

Some interesting commentary on the decision and Roberts's vote:

http://news.yahoo.com/blogs/power-pl...103301790.html

I think Roberts played his hand well. He established that tax for what it is, and basically left it to Congress to rescind it as they see fit. Now it's up to the people, as it should be, to elect officials that represent their collective will. If the majority want this healthcare program or not - let them elect their representatives accordingly. The next Congress will have a chance in 2013 to rescind the law. Whether or not, there will be another chance in 2015.

Meanwhile - neither presidential candidate, nor Congress, is addressing the chronic budget deficit or failing economic recovery.

CAC1001

From what I have researched of universal healthcare systems, single-payer is not the ideal form. Single-payer is the form the political left in the United States want, but that usually is more ideology-driven on their part. The best forms of universal healthcare, from what I've seen, are systems that are a combination of public and private elements.

Jimmy Snyder

I'll step in for Russ. This is wrong on two points. First, the federal govt does not require insurance for vehicle drivers, only states do. Second, the states do not require you to own a vehicle and hence, they do not require you to have insurance.

ThinkToday

Part of the problem is the people that wreck the car and want to buy the insurance after the wreck, expecting it to cover the wreck. IMO, there are important issues with ACA.

1) Clearly, the people that have medical issues by no fault of their own shouldn't be penalized with a higher rate. IMO, there should be a high risk subsidized pool for inherently high risk people that are victims of genetics, the environment, accident, war, crime, etc.

2) On the other hand, people that engage in risky activity should have to pay a premium for that behavior. If I have a stack of speeding tickets, should you (with a clean record) and I pay the same for car insurance? The ACA model says yes, no pre-existing conditions (tickets, accidents, drunk driving convictions), which is silly, IMO. If I engage in risky behavior, smoke, eat all high fat food, drink a lot, use drugs, sky dive, motocross, drag race, free climb, etc., should I pay the same for health care as someone that lives a relatively "normal" healthy lifestyle, gets plenty of safe exercise, and doesn't routinely engage in high risk activities? The ACA model says yes, no pre-existing conditions (drug convictions, gang leader in south LA, etc.), which is silly, IMO.

IMO, a serious problem with ACA is the lack of personal responsibility and accountability.

Ryan_m_b

Having single payer and private systems are not mutually exclusive. In the UK anyone can use a public NHS hospital/doctor/dentist but they also have the choice to go to private clinics paid for with private health insurance. There's little difference in the actual care but waiting times (a notorious problem for the NHS) are reduced.

ThinkToday

Years ago, I worked with a doctor that was trained in Great Britain. He commented the health care for someone with and emergency condition is very good (heart attack, stroke, MVA), but care for more chronic conditions wasn't very good, unless you had some private paying option to be treated outside the government system. How are things now? You commented about the waiting times. Do the people have a say about their care, as far as quality and timeliness with the government? Does the government adequately respond to the concerns of patients, or has it become something people just have to live with? Do you see change in the future of medicine in England or is the system pretty well locked down?

Is your health care like Canada? I had an acquaintance that worked for CP Railroad, and he had a brain tumor with an estimate of about 6-12 months to live, if untreated. They told him he had to wait 6 months to get an MRI to determine course of care! Apparently, there were very few MRI and they were booked. A friend of his is a US radiologist, and he flew him to the US and did a stat MRI on him to take back to his doctors in Canada. As a practical matter, what he had was going to kill him, treated or not, but not even scheduling critical tests ASAP is unheard of in the US health system. Perhaps he could have lived another 6-12 months, if treated early and aggressively.

Ryan_m_b

I don't think this thread is a great place to start a conversation about the National Health Service (don't want to detract from the actual conversation of the SCOTUS decision) but I'll quickly answer best I can.
Of course the people have a say, we are a democracy you know. The NHS has to conform to various targets which are always political issues and is constantly under review (we've just enacted a big reform to shake up the organisation again). I'm not too clued up on the runnings of the NHS myself though I have a friend who is somewhat of an expert, we've had many conversations about the endless peer-reviewed studies that come out about how to better allocate resources, what organisational methods should be employed etc and that's all before you actually get down to the medicine itself. "Locked down" would imply a static organisation which is very much not the case.
That wouldn't happen here and I'm very surprised that happened in Canada (I'm not doubting you but that sounds like one of those freak cases that gets reported on the media as though it was a widespread thing). Here you might have to wait weeks to months for a consultation/test/operation on a non-emergency illness which isn't ideal at all and is an issue constantly being tackled but for an emergency you would get it right away.