Are you saying that both Houses of Congress have NOT treated the Commerce and General Welfare clauses as minor speed bumps and have NOT twisted them to suit political whims?
Are you saying that both Houses of Congress have NOT treated the Commerce and General Welfare clauses as minor speed bumps and have NOT twisted them to suit political whims?
Brevior saltare cum deformibus viris est vita
That would be hilarious, except that you actually believe it.Originally Posted by Aimless
When has is ever worked that way, on either side of the pond? Or put another way, do you actually expect the politicians who appoint these guys to appoint the best-suited candidates for the job, over the candidate(s) who are gonna give the properly politically-aligned answers?
A sad statement on humanity that you somehow expect this time to be different, when we have eons of history, and our present political landscape to tell us otherwise.
"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them."
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."
-- Thomas Jefferson: American Founding Father, clairvoyant and seditious traitor.
Which side of the pond has the greatest problems with healthcare costs?
Of course I do.Or put another way, do you actually expect the politicians who appoint these guys to appoint the best-suited candidates for the job
And which specific politically aligned answers are going to become the most relevant when it comes to the question of handling medicare costs?over the candidate(s) who are gonna give the properly politically-aligned answers?
"One day, we shall die. All the other days, we shall live."
K, then.
Next time I see you post in a huff about care for mental-illnesses, or medical research being politicized, or some "abortion drug" being hated on by the ignorant fundies, I'll be sure to say "I told ya so."
"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them."
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."
-- Thomas Jefferson: American Founding Father, clairvoyant and seditious traitor.
Okay but while you're holding out for Nostradamus's vindication we may as well acknowledge that about a third of the US healthcare spending is pure waste, that much of the remainder is unnecessarily high for fairly well-understood reasons, and that there's a small theoretical chance that your healthcare-spending trends can better approximate that of eg. some European nations.
I realise you're on a more-cynical-than-thou bender right now but really man it's no great secret what kinds of measures would need to be implemented to rein in your healthcare costs (if scrapping the whole system isn't an option). This board would be one of the necessary features for making those measures possible.
"One day, we shall die. All the other days, we shall live."
So how does this board reign in costs again?
Brevior saltare cum deformibus viris est vita
Same way Kansas saved money on bio textbooks, right? They'll declare that medical science is only a theory, which allows them to save money by denying payment for any treatments based on anything politically objectionable, like science.
"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them."
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."
-- Thomas Jefferson: American Founding Father, clairvoyant and seditious traitor.
On the plus side, based on yesterday's Supreme Court hearings, most of the the justices seem to agree that forcing people to buy health insurance is unconstitutional.
I really hope they see the deep constitutional issue behind this and throw out that requirement to buy health insurance. Despite the poor way the law was written, I'm not sure I'm comfortable with them throwing out the whole law. But it's hard to avoid the fact that the law was written in such a way that the justices could struggle to avoid invalidating the whole thing.
It was a passing curiosity if/how you'd change the commerce clause to make it less twistable by politicians. Sounds like the ACA might have been palatable as a national tax, instead of a mandate to buy insurance.
I wish they'd make the distinction between health insurance and health care in the first place.The bill benefits insurance companies more than anyone, but only if the individual mandate stays. If that goes, I'll bet the insurance industry will fight the pre-existing clause and lifetime limits, too.
Interesting anecdote: one of the claimants who's part of the law suit has filed for bankruptcy. She had health insurance, but it wasn't adequate to pay all her medical bills.
Well, if they don't invalidate the whole thing, we're going to be in a bad way with that mandatory insurance pool comprised entirely of uninsurable people, and I don't exactly trust the morons who crafted and passed this atrocity to be charged with fixing or repealing it. (And it's such a fundamentally flawed and broken piece of shit that the best outcome at this point is if it just all goes away, and maybe they take another shot at fixing things from a much less retarded starting point.)
"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them."
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."
-- Thomas Jefferson: American Founding Father, clairvoyant and seditious traitor.
Out of curiosity, how does one provide healthcare for the entire population without mandating health insurance? Bottom line is, poor people will rather not purchase health insurance, and end up in the emergency room and being helped anyway, costing more. Leaving the costs for the hospital/the government/the taxpayer. I don't see much wrong with mandating everyone to purchase basic health insurance, as long as you can choose your own insurance provider.
Over here, you're mandated to have basic coverage, and can purchase additional insurance for better and more coverage if you want to. You can get it from any insurer that you want. Also, they can't deny you for pre-existing conditions (thank god), and have to offer the basic coverage for a standard fee, the same for everyone. Seems to work out well.
Keep on keepin' the beat alive!
Me too. But the Obama Administration seems intent on obfuscating the two issues to make a "think of the children!" case instead of a legal argument.I wish they'd make the distinction between health insurance and health care in the first place.
Yes, but if they go back to the drawing board they will just push for full-blown socialized healthcare. Part of me wonders if the remaining act being left intact to wreck havoc on the system would serve an important lesson. Because, individual mandate or not, the thing was going to fuck everything up even more. Then again, I can't honestly wish for things to be more fucked-up which is why I don't support Obamacare.
As I've said before, in the US we have a broken health insurance system that needs to be fixed. There are a number of things that can be done to fix the system and create true pricing competition among the insurance companies. EG we don't allow people to deduct health insurance from their taxes if they are self-employed. And the insurance markets are all at the state-level, which limits your mobility and subjects insurance companies to 50 sets of laws (plus federal laws).
But if those issues were fixed, the government should absolutely subsidize people with low incomes who want insurance.
Still, I think it's fundamentally wrong to force people to buy anything. And, as I've argued before, a small and relatively homogeneous population in The Netherlands can get away with that kind of social-democratic policy. But it doesn't work in large 300+ million populations.
What will stop this from turning into another Medicaid except for the ill? Invalidating the mandate will make it pointless for healthy people to get insurance, but it will still make it profitable for the ill to do so. I presume the government would end up footing the bill, and we'd get government healthcare through the back door...
Hope is the denial of reality
Works for 80+ million in Germany. So please don't give us this "USA is oh-so-special", unless you mean the "special" kind of special.
When the stars threw down their spears
And watered heaven with their tears:
Did he smile his work to see?
Did he who made the lamb make thee?
Well, that's kinda bullshit, counter to the entire concept of insurance, and the reason that the taxpayers have to foot the bill for the system. "My house has just burned down, so I'd like to buy insurance to make everyone else pay to rebuild it."
You mean like the two centuries of other such lessons that we've apparently not learned a thing from?
Yeah... if anything, the only lesson learned from this will be that "it's fucked up because the crazy conservative judges broke it, so let's appoint more judges who'll let the government do anything it wants" ... and looking at who'll be appointing the next round of judges (and the choices he's already made), this is going to be an even worse problem than Obamacare.
On the bright side, my "kill them all and start over" theory does seem to be more appealing.
Germany... that's the country where more than 50% of people who live in the eastern half say they had it better under communism, right? So, yeah, great example of how well socialism "works."
"I predict future happiness for Americans if they can prevent the government from wasting the labors of the people under the pretense of taking care of them."
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."
-- Thomas Jefferson: American Founding Father, clairvoyant and seditious traitor.
This goes way back, long before Obama's administration, even before the employer-mandate/tax breaks. Sure, we have a borked insurance system. But people are so used to thinking that insurance=care that all the problem solving is seen through an insurance focused lens. Even controlling cost-of-care escalation had been left to the insurance industry, fiddling with preferred providers and pre-treatment approvals, lifetime limits, pre-existing exclusions, etc. Yes, we can do a number of things to fix the insurance industry and make health insurance affordable, accessible, portable, and 'fair'....but that won't fix the fundamental problems in getting universal care to so many millions of people.
It's not a (R) or (D) issue, but a national debacle that's become a crisis. I doubt each state can act independently to change either insurance or universal access and get the best results. It might be a states' right to decide their own policy, and SCOTUS may decide federal gov't can't compel individuals to buy insurance....but that won't make it less of an ongoing national crisis. What's Plan B? Where's the Republican plan?
It's highly doubtful the US would ever have a full-blown socialized healthcare system, because anything that hints at SSSocialism (tantamount to commine pinko lib'ruls taking away all of our freeedoms) is used as a political weapon of fear. Death panels, no choices, long lines, low quality, "European" care that'd be like the worst of 70's soviet bloc, no better than lines for gummint cheese allotment. Never mind that we already have a hybrid of "socialized medicine" with public/private partnerships. I don't suppose Dick Cheney considers his heart transplant was subsidized or sssocialized in any way.
Please call back when you've scaled this up to beyond 1% of the world's population and included substantial ethnic/cultural diversity.
Though arguably, your nation's grasp on its social welfare policies is all the more tenuous because you have to bail out all your neighbors...because they haven't been able to manage their social welfare policies.
The exceptions often prove the rules.
That sounds like something Romney would use to distance himself from the individual mandate he implemented, or how the Hoover Institute and Republicans are back-tracking from the individual mandate they wanted to go national! (with a dash of snarky
Germany would be Massachusetts and the EU would be the US. It's tough work to get 50 states, or a collection of small nations, to act as coordinated groups using the same social "welfare" policies. One thing can work great on small or regional levels, but fail at larger scales if it hasn't been tweaked accordingly. MA is a Commonwealth, like PA, and operates soooo differently than other states it's like visiting another nation (without Passports).We have our distinct languages and dialects, local economies, demographic groups, cultures, religions, and dominant ideologies. We have states wanting to secede from the Union, counties wanting to become their own state (Long Island!), no-man's land like DC, and territories with Presidential delegates that can't vote for POTUS!
The majority of people (I can't remember the exact number, but it's over 90%) in first world nations will interact with the health/illness related market sectors in their lifetime (chosen or not). Whether that means taking an Aspirin, getting vaccinations, having surgeries....raising pigs or growing wheat for public consumption...eating or working at a McDonald's. I'd say "healthcare" is such a broad category that impacts so many lives, that it is indeed a totally different type of "market place". <Reference to the SCOTUS justice who brought that up, and the Broccoli analogy.>
Pretty sure that more than 90% of people in first world countries will interact with food, and food is presumably more necessary for survival than healthcare. Does that mean we should have a government monopoly providing food to everyone? Ditto for clothing and housing.
Hope is the denial of reality
Hang on a minute there; just exactly how much money does the US government throw at producing corn and other edibles? And doesn't the US government (or the state level, I honestly forget which) ostensibly provide some money for basic survival needs such as comestibles in order to suppress unwanted social back-lash? Of course the systems are horrible for participant and provider alike, but they still exist!
In the future, the Berlin wall will be a mile high, and made of steel. You too will be made to crawl, to lick children's blood from jackboots. There will be no creativity, only productivity. Instead of love there will be fear and distrust, instead of surrender there will be submission. Contact will be replaced with isolation, and joy with shame. Hope will cease to exist as a concept. The Earth will be covered with steel and concrete. There will be an electronic policeman in every head. Your children will be born in chains, live only to serve, and die in anguish and ignorance.
The universe we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but blind, pitiless indifference.
No, that means the "healthcare" industry includes and incorporates "healthcare" principles into other crucial sectors: farming and agriculture, chemical interventions, animal husbandry and veterinarian science, meat slaughtering, waste treatment, food processing, food services, transportation and refrigeration, employee protections....all based on the end-consumer and Public Health.
The initial rationale for the FDA (mixing food and drugs into one agency) was based on human consumption and associated risks. Plenty of our foods have chemical additives, come from animals treated with antibiotics or vegetation treated with pesticides/herbicides, are processed en masse using anti-microbial techniques, etc.
"Healthcare" is such a broad category that it can't/shouldn't be constrained into one market sector, let alone monopolized by the health insurance industry. Regulation doesn't mean the same thing as "providing", so I'm not sure what you mean.
We can theoretically feed, clothe, and house ourselves, using rudimentary metrics. A return to nature and basic self-sustaining living is rather popular these days. But no one can perform their own appendectomy or culture their own antibiotics.....the shiny interweb machine isn't THAT great yet.
Nowhere near as much as it throws on healthcare. Not sure what your point is. The argument here isn't about money spent, but rather degree of government control.
Hope is the denial of reality
What in the world does "ethnic/cultural diversity" have to do with providing people with health care? Last time I look the medical needs of a hispanic are not that massively different from that of an african-american. And if you think that Germany consists of only one single culture, then you don't know anything about us.
Not to mention that you're already paying for those guys without insurance. Or do you think that emergency room care is free? Or that it is cheaper?
When the stars threw down their spears
And watered heaven with their tears:
Did he smile his work to see?
Did he who made the lamb make thee?
It has everything to do with public support for the provision of public goods.
Hope is the denial of reality
Hard to say. Its task will be to address future growth that exceeds a predetermined level. Even though it's scheduled to start up in a few years, there's a chance it won't have much to do for a few more years after that--and who knows what measures they'll have to take then?
That being said, my guess is that they'll end up implementing some of the many recommendations made by MedPAC that've been ignored by congress since that commission's inception. The impression I've gotten so far is that they'll eg. make changes to medicare's reimbursement guidelines that'll over the long term shift much of your healthcare to well-coordinated healthcare organisations with a stronger emphasis on primary care (as opposed to today's uncoordinated/fragmented system with its excessive focus on hospital-affiliated specialists). On the one hand, hospitals may end up losing money due to eg. not being able to charge 80% more for services that may just as easily be provided in primary care; on the other hand, they'll benefit from having fewer uninsured patients (directly as well as indirectly in the form of savings from not having to deal with the unnecessarily expensive emergency care uninsured patients may end up needing due to inadequate primary care). Of course, no hospital is all that thrilled by the prospect of being unable to charge $$$ for unnecessarily expensive diagnostic procedures, care and treatments
The IPAB looks more like a backup in the eventuality that the other measures fail to perform as well as expected. It's exciting, almost as exciting as some of the other proposed measures in this overhaul, but I have a feeling you guys will manage to once again skilfully shoot yourselves in the foot
I thought this was a nice summary of the dilemma you're facing:
Every Democratic and Republican policy expert knows that we must reduce congressional micromanagement of Medicare policy. Unfortunately, every Democratic and Republican legislator knows that mechanisms such as IPAB that might do so would thereby constrain their own individual prerogatives.
I gotta admit I find it a little funny that the two aspects of this overhaul that Republicans today oppose the most--the individual health insurance mandate and the IPAB--are essentially proposals that were spawned by Republicans (and warmly endorsed by eg. Romney) in the last couple of decades. These ideas remain as important today as they were then, but I guess supporting their realisation by the Obama administration would not be tactically sound.
Re. the wonders of insurance, well, one of the major sources of pure waste in your healthcare system is the overabundance of insurance plans.
"One day, we shall die. All the other days, we shall live."
Out of curiosity, how has the public support for Medicare and Medicaid looked for the past few decades?
"One day, we shall die. All the other days, we shall live."
Just pointing out that the gubmint does meddle in most societally important areas, in some fashion. Obviously the state that handed food out to its citizens eventually failed, but would anyone be as incredulous about "should the government provide everyone with protection from bodily harm?" (Of course it doesn't completely, again, but the extremes are probably not the most interesting cases)
And the corn money is a form of control, although that seems like more of a feed-back loop between the private sector interests and the government meddling.
In the future, the Berlin wall will be a mile high, and made of steel. You too will be made to crawl, to lick children's blood from jackboots. There will be no creativity, only productivity. Instead of love there will be fear and distrust, instead of surrender there will be submission. Contact will be replaced with isolation, and joy with shame. Hope will cease to exist as a concept. The Earth will be covered with steel and concrete. There will be an electronic policeman in every head. Your children will be born in chains, live only to serve, and die in anguish and ignorance.
The universe we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but blind, pitiless indifference.
It's much easier to maintain support for a wide-ranging social program than it is to get support for a new one. The old one already has a large constituency, which is going to support it for purely self-interested reasons.
And my argument wasn't against meddling, but rather government provision of a service.
Hope is the denial of reality
So is that an argument for private for profit prisons? I'm sorry, I'm honestly this dense today, I think it might be a better idea to watch moving pictures...
In the future, the Berlin wall will be a mile high, and made of steel. You too will be made to crawl, to lick children's blood from jackboots. There will be no creativity, only productivity. Instead of love there will be fear and distrust, instead of surrender there will be submission. Contact will be replaced with isolation, and joy with shame. Hope will cease to exist as a concept. The Earth will be covered with steel and concrete. There will be an electronic policeman in every head. Your children will be born in chains, live only to serve, and die in anguish and ignorance.
The universe we observe has precisely the properties we should expect if there is, at bottom, no design, no purpose, no evil, no good, nothing but blind, pitiless indifference.
As long as proper checks are in place, why not? Last I checked, American prisons, a vast majority government-operated, have rampant assaults and rapes. Not exactly a great model, is it?
Hope is the denial of reality
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