Judge in VA strikes down federal health care law

[lets-retire]

It may well be, but that's a really scary thought -- that something could actually be worse than the "system" currently in place. Hard to imagine anything less efficient, more costly and more of a headache to deal with in terms of bureaucracy.

Apparently you underestimate the power of the government. They can make the most simple task complex and confusing. They rival a computer's ability to really screw things up.

 

[dex]

It may well be, but that's a really scary thought -- that something could actually be worse than the "system" currently in place. Hard to imagine anything less efficient, more costly and more of a headache to deal with in terms of bureaucracy.

All you have to do is imagine the same people who brought you the IRS & TSA in charge of health care.

 

[explanade]

According to some politicians, we have the best health care in the world.

The judge probably isn't hostile to that line of thinking, as he's a Bush appointee.

 

[ziggy29]

The judge probably isn't hostile to that line of thinking, as he's a Bush appointee.

I didn't know Bush appointees got a better health insurance plan than other federal judges. You learn something new every day.

 

[explanade]

You get the sense that this law will ultimately be ruled along partisan lines if and when it reaches the SCOTUS.

They probably have great health care coverage there.

 

[ziggy29]

...ruled along partisan lines...

Making this, unfortunately, just like almost everything else in terms of public policy debate today.

The Founders weren't perfect, but some of them did presciently warn us against forming political parties. Unfortunately they developed a system which led to the formation of a natural party duopoly.

 

[M Paquette]

I didn't know Bush appointees got a better health insurance plan than other federal judges. You learn something new every day.

Judge Hudson gets pretty good care through his minority position in Campaign Solutions, Inc. They've been pretty good at taking care of their own. (I find it interesting that he hasn't had to sever his relationship with that firm. But that's just me.)

 

[lets-retire]

SURPRISE Thread Hijack warning.

I was thinking about this today and a couple things dawned on me. This health insurance law does three things: Provides guaranteed coverage, provides a limit on premiums based on the lowest premiums offered, and provides subsidies for low/no income people. It seems this bill tries to take into consideration the three issues that prompted the creation of Medicare/caid. Since this bill addresses those issues, why wasn't Medicare/caid scrapped? It seems to me that there would be huge savings by scrapping programs that offer the same or essentially the same benefits.

 

[ziggy29]

I was thinking about this today and a couple things dawned on me. This health insurance law does three things: Provides guaranteed coverage, provides a limit on premiums based on the lowest premiums offered, and provides subsidies for low/no income people. It seems this bill tries to take into consideration the three issues that prompted the creation of Medicare/caid. Since this bill addresses those issues, why wasn't Medicare/caid scrapped? It seems to me that there would be huge savings by scrapping programs that offer the same or essentially the same benefits.

Medicare is a government insurance program. I think the main legal contention to the new health care law is that it mandates buying a private product. There's plenty of precedent which says government can force you to pay taxes; there's none to suggest government can force you to purchase a private company's products.

In any event, if these legal challenges hold up if could be a boost to those who want to see a "Medicare for All" solution for the problem. Presumably if Medicare has already been declared constitutional, all they'd have to do (if the political will was there) is expand it to everyone and raise the taxes required to do it. Not saying this is what I want to see, but this seems to be an obvious approach around the legal hurdles.

 

[lets-retire]

Medicare is a government insurance program. I think the main legal contention to the new health care law is that it mandates buying a private product. There's plenty of precedent which says government can force you to pay taxes; there's none to suggest government can force you to purchase a private company's products.

In any event, if these legal challenges hold up if could be a boost to those who want to see a "Medicare for All" solution for the problem. Presumably if Medicare has already been declared constitutional, all they'd have to do (if the political will was there) is expand it to everyone and raise the taxes required to do it. Not saying this is what I want to see, but this seems to be an obvious approach around the legal hurdles.

Right, but wouldn't it be cheaper for the government if everyone was placed in the private market? If for no other reason than it would get rid of all of the overhead people in the Medicare/caid programs. Those who could afford insurance pay the insurance. Those who don't make enough money get a subsidy that really would not be much different than the Medicaid they currently have. To take it a step further those who are currently on Medicare/caid could receive a credit on their taxes or whatever that approximates the benefit they currently receive from the program they are on. My concern was that if the health insurance law is ruled constitutional, there will be several programs out there that provide essentially the same benefit. In this time of constrained budgets that seems very foolish.

Edited to Add: Obviously kicking everyone off Medicare/caid now might not be the best option, but it could be means tested so those with the means are free to face the open market. It could also be phased out so the young ones would eventually just be on the open market and not eligible for Medicare/caid.

 

[explanade]

You haven't been paying attention if you think the private market would be cheaper than the overhead for Medicare.

Insurance alone isn't responsible for the high costs we have. It's more the pushing of technology and certain drugs which are superfluous or the entrepreneurial aspects of medicine. There was a famous New Yorker article about a little border town in Texas which had the highest per capita reimbursements for Medicare or something like that.

Turns out the doctors had their own clinics set up and they were herding their patients there for a lot of the procedures. The lesson learned was the whole fee-for-procedure system instead of being compensated for results. The current system gives incentives to do more tests and procedures rather than on achieving results.

 

[ziggy29]

The current system gives incentives to do more tests and procedures rather than on achieving results.

Largely true, though "defensive medicine" and lawsuit abuse also plays into this to some degree.

 

[explanade]

Lawsuits amount to tens of billions at most, out of the trillions spent on health care.

Defensive medicine is harder to quantify but I haven't heard it being a double-digit percentage of health care spending either.

Of course a lot of defensive medicine could be mixed in with this entrepreneurial impulse too.

Was reading a story the other day about how pharma and other medical suppliers equip sales reps. with iPads when they push their products to doctors and hospital administrators. Of course these are all part of the health care prices inflation.

 

[ziggy29]

Lawsuits amount to tens of billions at most, out of the trillions spent on health care.

True. Lawsuits and legal judgments by themselves are a small portion of the overall cost of health care.

The practice of defensive medicine to avoid litigation is not as easy to quantify, but most industry analysts believe the cost of "defensive medicine" is several times as much as the direct cost of legal judgments. Add into that the cost of malpractice insurance, and the lawsuits themselves are chump change compared to the costs of defensive medicine and malpractice insurance.

 

[Texas Proud]

Medicare is a government insurance program. I think the main legal contention to the new health care law is that it mandates buying a private product. There's plenty of precedent which says government can force you to pay taxes; there's none to suggest government can force you to purchase a private company's products.

In any event, if these legal challenges hold up if could be a boost to those who want to see a "Medicare for All" solution for the problem. Presumably if Medicare has already been declared constitutional, all they'd have to do (if the political will was there) is expand it to everyone and raise the taxes required to do it. Not saying this is what I want to see, but this seems to be an obvious approach around the legal hurdles.

There is a problem... nobody is telling you you have to sign up for medicare... if you want to go without it... you can...


Also, it will never get passed....

 

[ziggy29]

There is a problem... nobody is telling you you have to sign up for medicare... if you want to go without it... you can...

True, but like Social Security, you paid into it without benefit for all those decades, it would seem foolish to not take advantage of it (unless you have the increasingly rare employer-provided retiree health insurance past age 65).

 

[chinaco]

I see a lot to cheer about. This judge said that government can not force a person to buy something simply because they are alive. That is huge. ....

My statement was more of concern about our collective well being in terms of access to affordable health care. That was what I meant about nothing to cheer about.

Perhaps we see different issues.

I do not believe the govt is out to get me... maybe my tax dollars... but not me!

 

[Texas Proud]

True, but like Social Security, you paid into it without benefit for all those decades, it would seem foolish to not take advantage of it (unless you have the increasingly rare employer-provided retiree health insurance past age 65).

I agree... but it seems that the difference is the new law mandates that you sign up or get a penalty.... medicare/caid does not...

In fact, if you throw in the 'caid' part, there are a lot of people who qualify but do not sign up... this was a good percent of the uninsured...

 

[samclem]

Since this bill addresses those issues, why wasn't Medicare/caid scrapped? It seems to me that there would be huge savings by scrapping programs that offer the same or essentially the same benefits.

Surprise! The new law will put MORE people into Medicaid (it raises the income threshold, making more people eligible).

The next major court challenge to the law (in FL) is backed by 20 states. It challenges the law's individual mandate and it also claims the federal government does not have the constitutional authority to force states to fund and manage the programs called for. The plaintiffs are specifically requesting that the entire law be entire law be struck down.

We'll see.

 

[samclem]

Just revisiting the bidding based on the latest news:


Today another judge, this time in FL, has ruled the health care law unconstitutional. This case was the "big one" with many states signed on as plaintiffs.

From Judge Vinson's ruling:

“I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that, ‘If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house’” .

(see footnote 30 at below link)

 

[dex]

Just revisiting the bidding based on the latest news:

Quote:
“I note that in 2008, then-Senator Obama supported a health care reform proposal that did not include an individual mandate because he was at that time strongly opposed to the idea, stating that, ‘If a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house’” .

If the Senator Obama quote is true; I am almost speechless. Not as a result that Obama said it; but that the news media did not find the quote and raise it when the bill was being discussed.

The point isn't if you agree or disagree, it is that the quote is in direct opposition to the current law and should have been raised.

I know, from working around network news people that they are no mental giants and research is relegated to entry level positions. But, there are services - Lexus/Nexus and others that you can use for basic research.

News journalism would be blind if not for hindsight. It is the only 'profession' that has no standards at all. To become a beautician is more difficult.

 

[ERD50]

I know, from working around network news people that they are no mental giants and research is relegated to entry level positions. But, there are services - Lexus/Nexus and others that you can use for basic research. .

Or google:

solve homelessness by mandating everybody to buy a house - Google Search

(I shortened the link since it is long, including the terms for a date range to exclude today)

Two results, one from Keith Olbermann.

-ERD50

 

[explanade]

What does what a politician say have to do with the legal deliberations in making this ruling?

Surprise, the judge is a conservative.

 

[samclem]

dex wrote

If the Senator Obama quote is true; I am almost speechless. Not as a result that Obama said it; but that the news media did not find the quote and raise it when the bill was being discussed.

The really funny part is that Paul Krugman pointed out, in 2008 when Senator Obama said it, that he'd regret his words. It's rare that I agree with him, but this time he was right.

I think it is fair to say that this President gets less rigorous treatment from the press than the last President. In the long run, I don't think this favorable treatment is good for him--he'd be better off with a lot more scrutiny, his policies would be better thought out and better "marketed" if being subjected to critical press treatment. How long would Robert Gibbs have lasted under any other president in our memory?

 

[Westernskies]

What does what a politician say have to do with the legal deliberations in making this ruling?

Surprise, the judge is a conservative.

As usual, there are those whose only agenda is to shut down this topic instead of participating in what has been rational discussion around the single most important issue facing retirees today ( IMO). I'd like to hear more, as perceptions and perspectives (on both sides) seem to have changed as we learn more about the content of the bill, and it wends it's way through the legal maze to SCOTUS.

I'll observe from the sidelines, don't want to be the one doing the hog-callin' on this thread.