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Archive for Thursday, November 19, 2009

Forced insurance raises constitutional issue

November 19, 2009

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— In 2006, long before there was an Obama administration determined to impose a command-and-control federal health care system, a young orthopedic surgeon walked into the Goldwater Institute here with an idea. The institute, America’s most potent advocate of limited government, embraced Eric Novack’s idea for protecting Arizonans from health care coercion. In 2008, Arizonans voted on Novack’s proposed amendment to the state’s Constitution:

“No law shall be passed that restricts a person’s freedom of choice of private health care systems or private plans of any type. No law shall interfere with a person’s or entity’s right to pay directly for lawful medical services, nor shall any law impose a penalty or fine, of any type, for choosing to obtain or decline health care coverage or for participation in any particular health care system or plan.”

Proponents were outspent 5-1 by opponents who argued, meretriciously, that it would destroy Arizona’s Medicaid program, with which many insurance companies have lucrative contracts. Nevertheless, the proposition lost by only 8,687 votes out of 2.1 million cast, and Arizonans will vote on essentially the same language next November.

But does not federal law trump state laws? Not necessarily. Clint Bolick, a Goldwater Institute attorney, says, “It is a bedrock principle of constitutional law that the federal Constitution established a floor for the protection of individual liberties; state constitutions may provide additional protections.”

In 1997, the U.S. Supreme Court held that under the Constitution’s system of “dual sovereignty,” states’ “retained sovereignty” empowers them to “remain independent and autonomous within their proper sphere of authority.” The court has been critical of the “federalism costs” of intrusive federal policies, and recently has twice vindicated state sovereignty in ways pertinent to Novack’s plan.

In 2006, the court overturned an interpretation of federal law that would have nullified Oregon’s “right to die” statute. The court said states have considerable latitude in regulating medical standards, which historically have been primarily state responsibilities.

In 2000, Arizona voters endorsed an English immersion policy for students for whom English is a second language. Federal courts had issued an injunction against such policies because they conflicted with federal requirements of bilingual education. This year, however, the Supreme Court mandated reconsideration of the injunctions because they affect “areas of core state responsibility.”

The court says the constitutional privacy right protects personal “autonomy” regarding “the most intimate and personal choices.” The right was enunciated largely at the behest of liberals eager to establish abortion rights. Liberals may think, but the court has never held, that the privacy right protects only doctor-patient transactions pertaining to abortion. David Rivkin and Lee Casey, Justice Department officials under the Reagan and first Bush administrations, ask: If government cannot proscribe or even “unduly burden” — the court’s formulation — access to abortion, how can government limit other important medical choices?

Democrats’ health bills depend on forcing individuals to buy insurance or face severe fines or imprisonment. In 1994, the Congressional Budget Office said forcing individuals to buy insurance would be “an unprecedented form of federal action,” adding: “The government has never required people to buy any good or service as a condition of lawful residence in the United States.”

This year, the Congressional Research Service delicately said “it is a novel issue whether Congress may use the (Commerce) Clause to require an individual to purchase a good or service.” Congress has the constitutional power to “regulate commerce ... among the several states.” But a Federalist Society study by Peter Urbanowicz and Dennis Smith judges it perverse to exercise coercion under the Commerce Clause “on an individual who chooses not to undertake a commercial transaction.” As Sen. Orrin Hatch, R-Utah, says, there is “a fundamental difference between regulating activities in which individuals choose to engage” — e.g, drivers can be required to buy auto insurance — “and requiring such activities” just because an individual exists.

House Majority Leader Steny Hoyer, D-Md., says Congress can tax — i.e., punish — people who do not buy insurance because the Constitution empowers Congress to tax for “the general welfare.” So, could Congress tax persons who do not exercise or eat their spinach?

When asked whether any compulsory insurance purchases are constitutional, Speaker Nancy Pelosi was genuinely astonished: “Are you serious? Are you serious?” In 1803, in Marbury v. Madison, Chief Justice John Marshall wrote, “The powers of the legislature are defined and limited; and that those limits may not be mistaken, or forgotten, the Constitution is written.” He was serious.

Comments

kugrad 4 years, 4 months ago

notajayhawk, there is no such thing as a person who does not use the health care system. EVERYONE gets sick, everyone gets prescriptions at some time or another, everyone goes to the doctor. The ONLY exceptions are people who are so poor they CAN'T AFFORD HEALTH CARE. These people also, without exception, use the health care system eventually, they just don't pay for it. Now, as you've pointed out, the government can require you to pay taxes, which then go to private companies to provide a whole host of services whether you want them or not. Clearly, they can compel you to purchase insurance, although most people would be covered by their employer. However, if you are SO upset that a private company is involved, you should put your full support behind a PUBLIC option. This is essentially the kind of thing conservatives should like, taxation where the taxpayer gets choices about where to invest. Some of us already pay the tax, the problem is we pay for those who don't too. Now the government wants everyone to share the burden. It is not only right, it is fair.

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ComradeRedRooster 4 years, 4 months ago

Notajayhawk, I believe you have a stalker!

Obey Obama Oink Oink

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porch_person 4 years, 4 months ago

notajayhawk,

"There is also a fundamental difference between collecting taxes for the administration of government and forcing people to pay for a product from a private company that they may or may not want and may or may not use." --- notajayhawk,

What "private company" are you talking about? You wouldn't be misrepresenting the health care reform bill, would you? That just wouldn't be like you.

(laughter)

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notajayhawk 4 years, 4 months ago

kugrad (Anonymous) says…

"Income taxes are compulsary and I don't recall ever seeing that right explicity granted to the Federal govt. in the constitution, although I could be wrong (I'm no constitutional scholar)."

Try reading the 16th amendment.

There is also a fundamental difference between collecting taxes for the administration of government and forcing people to pay for a product from a private company that they may or may not want and may or may not use.


arizonajh (Anonymous) says…

"What can I say? I am tied to my insurance through my employer."

No, you're not. You are free to shop for an individual policy. I can get a family policy on my own - from the same company, incidentally - for about half the cost as going through my employer because we don't need all the coverage options my employer carries (and chances are neither do you) and I can set my deductibles/co-pays to levels I am comfortable with.

Incidentally, I said 'my last ER visit,' I no longer have that particular plan. That plan was from a private, shareholder owned insurance company. BC/BS companies are typically mutual insurance companies owned by the policyholders, and even without the profit incentive they somehow cost more, don't they? (My current employer just switched from a shareholder-owned to BC/BS and our premiums increased almost 50%.)

"So the doctor is the first person you see when you go to the emergency room? No receptionist/check-in person, no nurse, no one comes in to clean the examining room when you leave, just a “doctor to look at them and say it's not life-threatening, go somewhere else.”"

One of the things you're forgetting is that most of those people are on salary and it really doesn't cost squat for the extra people that come through the ER. I.e., to an extent, the actual dollar costs involved are pretty much the same if an ER sees 100 people during a shift or 115. And most of the expense involved with an ER visit is in expensive diagnostic tests, as much as 40% of which are unnecessary - the non-emergent cases don't get those (at least if they're uninsured).

Now, it would be cheaper per person if the total shift costs were split 115 ways instead of 100 ways - but if one of the goals here is to divert some of these people to primary care providers instead of the ER, then we won't save much, if anything.

And in any event, the situation you describe in stores DOES happen in ER's. People come in all the time that are 'frequent flyers' - drug seekers, hypochondriacs, and yes, people that use the ER as their primary care clinic on a regular basis. And yes, I have seen physicians give a cursory glance to such 'regulars' and sign their discharge papers.

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porch_person 4 years, 4 months ago

Free education seems to be working for a lot of countries. Ireland, France,.....

Creates a more capable workforce.

I like your post, gccs14r. Worth considering.

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gccs14r 4 years, 4 months ago

There should not be health "insurance", there should simply be healthcare. There would be providers and there would be recipients, and the taxpayers would pay for most of it in the form of taxes. Medical/dental/pharmacological school education would be free for qualified students who agree to work in the national system for a period of years (more than ten) to be determined by the health service, then they would be free to become privateers if they so choose. People would be free to purchase service from privateers if they so choose, but they would still have to pay taxes for the national system, much as they do for education. All public providers, procedures, prescriptions, and patients would have a code, and everything would be logged into a central system for payment and to prevent fraud and abuse. It's a simple system and doesn't require 4,000 pages of verbiage to implement.

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workinghard 4 years, 4 months ago

Lots of comments, too many to read through. What I want to know is, how is the issue of illegal immigrants dealt with. Do they have to buy the insurance also, will they have to show proof of legal residency? How is that all going to work?

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porch_person 4 years, 4 months ago

When the situation looks desperate, whip out the "anti-tax" rhetoric and claim that the entire system of government is inauthentic.

"Let's not pay taxes at all. To hell with America. I want to be an American, I just don't want to pay for it. Not with my dollars. I'll be like Ron Paul and make my own money."

And the ironic part is that these arguments are coming from flag-waving, symbol using conservative morons.

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Richard Heckler 4 years, 4 months ago

Here is my program for real reform:

Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it’s a better program, because it ensures that everyone has access to a uniform package of benefits.

Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.

Recommendation #3: Medicare should monitor doctors’ practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.

Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.

Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.

Is the House bill better than nothing? It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. People will conclude that we’ve tried health reform and it didn’t work. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.

Read more at: http://www.huffingtonpost.com/marcia-angell-md/is-the-house-health-care_b_350190.html&cp

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kugrad 4 years, 4 months ago

Income taxes are compulsary and I don't recall ever seeing that right explicity granted to the Federal govt. in the constitution, although I could be wrong (I'm no constitutional scholar). I think the argument that the Federal govt. does not have the power to require health insurance is a weak one, which Will knows full well. If nothing else, the Clear and Present Danger doctine would be in effect because we do face a crisis if people continue to remain uninsured. There is really no debate in Washington over the NEED to reform health care, nor on the fact that the economic impact of failing to do so on the deficit is staggering. States rights people have long fallen back on that argument to supposedly limit the power of govt., but all they really do is weaken the rights of citizens by letting basic rights be addressed 50 different ways, ways that are often inadequate. If you think the states did a great job with civil rights before the feds got involved, you are insane. A strong federal government is the best way to address issues that affect us all across all 50 states.

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ComradeRedRooster 4 years, 4 months ago

Many of the provisions for collection through the IRS is unconstitutional. Obama's regime wants us to believe that our taxes won't raise yet the IRS collects the fines and fees, that makes it a tax under the 16th amendment.

The Supreme Court better shut this down after its passage.

Pray for your beloved Barak: Psalms 109:8 says, 'Let his days be few; and let another take his office'

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jumpin_catfish 4 years, 4 months ago

Everyone in nobody out. Someone said this is exactly like car insurance but they are wrong because you can choose not to drive but you can't choose not to alive. It is not a requirement of citizenship to have healthcare insurance. These fools in DC must be replaced and 2010 just around the corner.

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bennyoates 4 years, 4 months ago

All sorts of rightwing maggots post links and pictures galore on this site. merrill does the same thing, but from a progressive point of view, and some people complain. What's more, merrill's links are credible and constructive, unlike those of his reactionary counterparts.

Keep up the great work, merrill!

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just_another_bozo_on_this_bus 4 years, 4 months ago

I wrote--

--Funny how none of the complaints about being forced to buy insurance includes an acknowledgment that those provisions are there at the insistence of the health insurance lobby--

Jaywalker displayed his typical reactionary tendency--

"Oh. So it's the evil health insurance lobby who strove for this? The Democrats' don't deserve any pub for the plan to get everyone covered? Interesting."

OK, I know this will be hard for you to understand, but my complaint was about the money that controls and corrupts our political system. That would include both Democrats and Republicans, and given that the Democrats are now in control, my complaint was primarily directed that the corrupt Democrats who are legislating on behalf of the insurance lobby. (the Republicans are mostly just holding their breath and turning purple because the Democrats are getting lobbyist money they see as rightly belonging to them.)

You can now demonstrate once again how much you hate arguing against what I actually said, and treat us all to whatever your straw man argument of the day is.

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Pilgrim2 4 years, 4 months ago

merrill (Anonymous) says…

A family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs.


You never have answered the question about where those figures come from, Richard. Isn't it about time you revealed your source for that particular part of your BS propaganda?

HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.


What part of D-E-A-D do you not understand, Richard? None of that crap is in either of the bills that are actually under consideration in Congress. (They're bad enough already.) Yet you keep spamming the forum with the same crap time after time after time. I believe that's probably the 753rd time you've cut-n-pasted that particular waste of LJW server space.

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arizonajh 4 years, 5 months ago

notajayhawk (Anonymous) says…

Your insurance sucks, btw. My deductible for my last ER visit was $50, $20 more than an office visit. I make more than $20/day, so it's worth it to me to go to work.

What can I say? I am tied to my insurance through my employer. It is Blue Cross/Blue Shield and we are a 45,000 person company in over 100 countries so it must be that our we are with a fly by night insurer and too small of company to get the great terms you get.

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arizonajh 4 years, 5 months ago

“So “evaluating” everyone isn't expensive? ”

And I said that where? It's not, however, AS expensive. All that's required is for a doctor to look at them and say it's not life-threatening, go somewhere else. I believe cg22165 was talking about conditions that can otherwise be treated in a doctor's office (the example he gave was pneumonia), not open wounds, broken limbs, or unconscious patients from a MVA. Those would have gone to an emergency room regardless.

So the doctor is the first person you see when you go to the emergency room? No receptionist/check-in person, no nurse, no one comes in to clean the examining room when you leave, just a "doctor to look at them and say it's not life-threatening, go somewhere else." Even if it is less expensive to "evaluate" than "treat" the fact that I'm not paying for as much as they could spend should make me feel better about this transfer of wealth as R's like to say?

Ok lets play it your way. What kinds of things could have been treated by an office visit but are left to emergency rooms? How about pneumonia that was a chest cold but now is shallow breathing and high fever. How about that rusty nail that gets stepped on that could have been taken care of by a shot but turns into blood poisoning and foot the size of a football. etc. etc. The ER has to treat these people.

“I've seen the “no shirt-no shoes” signs in restaurants and convenience stores.”

And all thieves are shoeless or something?

I think you know what I was saying. Your "The store, however, does not have the option of refusing admission to the store solely because the person is a known thief." is complete B.S. My point was a private business can refuse service to ANYONE as long as it does not fall under discrimination under the Civil Rights Act of 1964. If you have stolen from me or even if I think you have stolen from me I am not required by any law to allow you back into my place of business. A hospital can see a person 10 times for different problems knowing they can not pay but if they are hurt the hospital must treat them. Or to use your example if a restaurant has someone dine and dash they are not required to serve the person the time they come in just because they are hungry. If you can't see the difference then there is no point in continuing this discussion.

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bankboy119 4 years, 5 months ago

Merrill,

From your first post,

  1. Uniform Benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care for everyone, regardless of the size of your wallet.

If this were true and the coverage was so great then why wouldn't our representatives have the same coverage? The answer is they still would have their "Cadillac plans".

National coverage is not the answer.

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Richard Heckler 4 years, 5 months ago

What cha think about the 25% tax increase the most expensive medical insurance industry is laying on consumers for 2010? That means $14,000 2009 costs go to $18,000 2010 cost = must be exciting for a fiscal conservative NOT.

Won't be long until the opposition will be supporting $25,000 medical insurance policies and coming on here exclaiming what a thrilling experience it is. I've seen one employer memo coming in at $18,310 for 2010. Whoaaaaa what a bargain

Whereas National Health Insurance which is not Obamacare could be had for so much less yet providing excellent care and the same level of care for everyone for around $3000 per family annually. Shouldn't taxpayers have the choice of National Insurance For All? Absolutely!

HR 676 would cover every person for all necessary medical care including: long term care such that cancer demands prescription drugs hospital surgical outpatient services primary and preventive care emergency services dental mental health home health physical therapy rehabilitation (including for substance abuse) vision care hearing services including hearing aids chiropractic durable medical equipment * palliative care

A family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs.

HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.

National Health Insurance http://www.healthcare-now.org/

Doctors for Single Payer http://www.pnhp.org/

Unions for HR 676 http://unionsforsinglepayerhr676.org/union_endorsers

Organizations and Government Bodies Endorsing HR 676 http://www.pnhp.org/action/organizations_and_government_bodies_endorsing_hr_676.php

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2Bfrank 4 years, 5 months ago

What constitution?

soon to be replaced by Corporate Board Charter Rules.

Our big corporations have learned from CHINA.

nothing to stop capitalism in an AUTOCRACY.

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notajayhawk 4 years, 5 months ago

arizonajh (Anonymous) says…

"So “evaluating” everyone isn't expensive? "

And I said that where? It's not, however, AS expensive. All that's required is for a doctor to look at them and say it's not life-threatening, go somewhere else. I believe cg22165 was talking about conditions that can otherwise be treated in a doctor's office (the example he gave was pneumonia), not open wounds, broken limbs, or unconscious patients from a MVA. Those would have gone to an emergency room regardless.

"I've seen the “no shirt-no shoes” signs in restaurants and convenience stores."

And all thieves are shoeless or something?

The fact remains that a restaurant has no way of knowing whether you can pay for your food until after you've eaten it and been presented with the bill. And the rest of the patrons pay for those walkouts. Which was Satirical's original point about emergency rooms.

"Let's see my deductable for the doctor is $15, my deductable at the emergency room is $500. I don't make $485 a day so I think the incentive to miss a day of work is the approx. $250 (the day's wages minus the extra $485 in deductable) it will cost me to wait till after work. ..."

And of course everyone else has those same figures.

Your insurance sucks, btw. My deductible for my last ER visit was $50, $20 more than an office visit. I make more than $20/day, so it's worth it to me to go to work.

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arizonajh 4 years, 5 months ago

notajayhawk (Anonymous) says… "What makes you think people with insurance won't do the same? Why miss a day of work to go to the doctor when you can go to the ER after work - when you have insurance, who cares if it costs 50 times as much?"

Let's see my deductable for the doctor is $15, my deductable at the emergency room is $500. I don't make $485 a day so I think the incentive to miss a day of work is the approx. $250 (the day's wages minus the extra $485 in deductable) it will cost me to wait till after work. I guess the single person making $125,000+ a year may struggle with that trade off but seeing as the median income in Kansas is $40,624 I don't think it's a dilema most will find compelling. Also at the doctors office I get an appointment which means I may miss a couple hours from work (not a whole day) going there but the emergency room is most critical first, then first come... I could be there till morning waiting my turn.

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arizonajh 4 years, 5 months ago

notajayhawk (Anonymous) says…

"You're wrong.

Well, not entirely - they don't have to treat everyone. But they do have to evaluate everyone, and if the condition is life-threatening they have to at least be stabilized before transfer.

(The above applies only to hospitals that participate in Medicare, BTW.)"

Ok let's split hairs a little shall we? So "evaluating" everyone isn't expensive? Do they still require a staffer to check them in, a nurse to take vitals, a doctor to "evaluate" them and staff to clean up after the evaluation? Can they refuse to "treat" someone who has a broken leg, a cut requiring stitches or someone that's been in a car wreck and is bleeding or unconscious? You seem to be saying they don't have admit them but they still have to provide services for free - which is my point. Transfering them is also cost free I'm sure. Does insurance pay for ambulances? I believe they do. And who pays when an uninsured person is transfered to the county hospital? Most people insured or not only go to the emergency room when things get really bad. As far Medicare can you give me a run down of KC area hospitals that don't except Medicare? In Phoenix the only ones are the surgical centers (called hospitals) and the Mayo Clinic neither of which have emergency rooms anyway.

You also said, "The store, however, does not have the option of refusing admission to the store solely because the person is a known thief. They still have to provide the same service they allow other customers to have - to peruse the merchandise, use the fitting rooms, etc."

Now, I believe you're wrong- I see the "We reserve the right to refuse service to anyone" signs all over the place. I also have seen obviously homeless people run out of stores, malls, gas stations because the owners know they don't have any money or are looking to steal or simply looking for somewhere to sit or stand away from police that force them to keep moving or be arrested. I've seen the "no shirt-no shoes" signs in restaurants and convenience stores. I've seen the "no more than two students at a time in store" signs. The only reason that a business can't refuse service is in violations related to the civil rights act. As far as I know if you've been robbed by someone or that person has stolen from you in the past you are not required to let them back in your store. By contrast a hospital (that takes Medicare) must provide service to someone even if they know from past dealings with the person the individual has no ability to pay for the services.

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jafs 4 years, 5 months ago

jaywalker,

There are other ways to cover everyone.

The particular plan that requires individuals to buy health insurance clearly helps the private insurance companies.

I wonder what kind of plans we'd see if our legislators received no money from any lobbyists.

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notajayhawk 4 years, 5 months ago

merrill (Anonymous) says…

"25% increases are on the table for 2010 most likely due to the industry blowing health care dollars on misinformation and bribery to the tune of $1.4 million dollars a day."

Uh, yeah, mertle.

Even if they spent $1.4 million per day for the entire year, that's a whopping 0.0004 of our annual healthcare spending. Yeah, that really accounts for that 25% increase, all right.

Don't you ever get tired of looking like such a fool?

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Richard Heckler 4 years, 5 months ago

Forced mandates = higher insurance rates

25% increases are on the table for 2010 most likely due to the industry blowing health care dollars on misinformation and bribery to the tune of $1.4 million dollars a day.

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Richard Heckler 4 years, 5 months ago

The National Organization for Women Update: Senate Joins House in Attacking Women's Access to Abortion Care

The Senate version of the health care bill, released last night, purports to be less harsh, but make no mistake: the anti-abortion provisions of this bill are harmful to women. What's worse, we know there will be an attempt to amend the Senate bill to go all the way with a provision mirroring the House's Stupak-Pitts Amendment.

We are pulling out all the stops to prevent Stupak-like language from being added to the Senate bill.

NOW chapters around the country are rallying and demonstrating, phoning, writing and emailing their Senators. Our message is simple: keep abortion safe, legal, and accessible to every woman. Anti-abortion measures have no place in health care reform!

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mutualrespect37 4 years, 5 months ago

I'm intrigued by the way George invokes the implicit privacy rights of our constitution and extends the logic here that is often used to underwrite abortion rights to speak to the choice or( non-choice) involved in forcing people to buy health insurance or face sanctions. Very provocative.

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jaywalker 4 years, 5 months ago

"Funny how none of the complaints about being forced to buy insurance includes an acknowledgment that those provisions are there at the insistence of the health insurance lobby"

Oh. So it's the evil health insurance lobby who strove for this? The Democrats' don't deserve any pub for the plan to get everyone covered? Interesting.

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Pilgrim2 4 years, 5 months ago

just_another_bozo_on_this_bus (Anonymous) says…

Funny how none of the complaints about being forced to buy insurance includes an acknowledgment that those provisions are there at the insistence of the health insurance lobby.


As unresponsive as ever, boohoozo. Address the question. Can Congress mandate that private individuals purchase health insurance without violating the Constitution?

Here's a hint: The answer is HELL no!

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notajayhawk 4 years, 5 months ago

arizonajh (Anonymous) says…

"Correct me if I'm wrong but don't we currently require hospitals to treat everyone who shows up at their emergency room door (the insured without proof ((no card)), uninsured, illegals, foreign visitors etc.)?"

Okay.

You're wrong.

Well, not entirely - they don't have to treat everyone. But they do have to evaluate everyone, and if the condition is life-threatening they have to at least be stabilized before transfer.

(The above applies only to hospitals that participate in Medicare, BTW.)


cg22165 (Anonymous) says…

"You know, there is no law that says if you open a store, you have to let people walk in and take whatever they like without paying. A store has the option to try to prevent this; a hospital does not."

The store, however, does not have the option of refusing admission to the store solely because the person is a known thief. They still have to provide the same service they allow other customers to have - to peruse the merchandise, use the fitting rooms, etc. The analogy is sound, if strained - if you'd like a better one, how about a restaurant?

"Another way this is possible is if the same treatment costs less to produce. For example, the treatment for pneumonia at the doctor's office costs less than it does at the emergency room. People without insurance seek treatment at emergency rooms."

What makes you think people with insurance won't do the same? Why miss a day of work to go to the doctor when you can go to the ER after work - when you have insurance, who cares if it costs 50 times as much?

Also, I thought all these people that don't currently have access to insurance are those with pre-existing conditions that would be expensive to treat?

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Richard Heckler 4 years, 5 months ago

This sort of sums up precisely why we must continue:

10 Reasons to Support U.S. National Health Insurance Act

Written by Andrea Miller

Tuesday, 03 March 2009

Here are 10 great reasons to support HR 676, the U.S. National Health Insurance Act: http://guaranteedhealthcare4all.org/sites/default/files/10-Reasons.pdf

  1. Everybody In, Nobody Out. Universal means access to health care for everyone, period.

  2. Portability. If you are unemployed, or lose or change jobs, your health coverage stays with you.

  3. Uniform Benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care for everyone, regardless of the size of your wallet.

  4. Prevention. By removing financial roadblocks, a universal health system encourages preventive care that lowers an individual’s ultimate cost and pain and suffering when problems are neglected and societal cost in the over-utilization of emergency rooms or the spread of communicable diseases.

  5. Choice. Most private insurance restricts your choice of providers and hospitals. Under the U.S. National Health Insurance Act, patients have a choice, and the provider is assured a fair payment.

  6. No Interference with Care. Caregivers and patients regain their autonomy to decide what’s best for a patient’s health, not what’s dictated by the billing department. No denial of coverage for pre-existing conditions or cancellation of policies for “unreported” minor health problems.

  7. Reducing Waste. One third of every private health insurance dollar goes for paperwork and profits, compared to about 3% under Medicare, the federal government’s universal system for senior citizen healthcare.

  8. Cost Savings. A guaranteed health care system can produce the cost savings needed to cover everyone, largely by using existing resources without the waste. Taiwan, shifting from a U.S. private health care model, adopted a similar system in 1995, boosting health coverage from 57% to 97% with little increase in overall health care spending.

  9. Common Sense Budgeting. The public system sets fair reimbursements applied equally to all providers, private and public, while assuring that appropriate health care is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.

  10. Public Oversight. The public sets the policies and administers the system, not high priced CEOs meeting in private and making decisions based on their company’s stock performance needs.

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Richard Heckler 4 years, 5 months ago

National Health Insurance does not remove competition from the actual health care industry. It will be alive and well. Profits will be based on customer service and clinic performance based on the clients experience. This is my perception of competition.

The National Health Insurance movement does not intend to go away. We know elected officials would have it that way however it is likely an issue for 2010.

There is nothing in the bill to curb the cost which will increase with the mandate that insurance corporations cannot deny based on pre-existing conditions. One way to deny is cost.

The nations consumers could have excellent National Health insurance for all.if one would remove: elected officials as shareholders special interest campaign funding the insurance industry recklessly spending health care dollars to bribe votes the news media offering misinformation ( their large advertising revenue is at stake)

Remember it is the most expensive medical insurance in the world that denies care and/or cancels coverage after taking ones money for years and years. National Health Insurance for All would not allow such arrogance.

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Chris Golledge 4 years, 5 months ago

L1, I'm just going off of what my friends who've worked in emergency rooms have told me.

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Liberty_One 4 years, 5 months ago

cg22165 (Anonymous) says…

"People without insurance seek treatment at emergency rooms."

Myth alert!

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Chris Golledge 4 years, 5 months ago

Also, you said, "The only way this is mathematically possible is if the new consumers use less medical care than the current consumers. Why do they use less medical care?"

Another way this is possible is if the same treatment costs less to produce. For example, the treatment for pneumonia at the doctor's office costs less than it does at the emergency room. People without insurance seek treatment at emergency rooms.

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OdensRaven 4 years, 5 months ago

And elections are just mild annoyance to those in power. Apparently they can make draconian amendments for any desire.

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Chris Golledge 4 years, 5 months ago

Satirical, You know, there is no law that says if you open a store, you have to let people walk in and take whatever they like without paying. A store has the option to try to prevent this; a hospital does not. Your theft analogy breaks down on this point.

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Satirical 4 years, 5 months ago

OdensRaven.... "Affirmative action is unconstitutional, so is the income tax."

Actually, the income tax is in the Constitution. It is the 16th Amendment:

"Amendment XVI The Congress shall have power to lay and collect taxes on incomes, from whatever source derived, without apportionment among the several states, and without regard to any census or enumeration." http://www.law.cornell.edu/constitution/constitution.amendmentxvi.html

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OdensRaven 4 years, 5 months ago

The constitution? That quaint old document? Affirmative action is unconstitutional, so is the income tax. The people in government do what ever they want, they don’t care about a piece of paper.

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Satirical 4 years, 5 months ago

Arizonajh… “Why would you want to continue a system where YOU pay for those who don't want or can't afford health care. If the constitution does not allow us to force these people into insurance then why does the constitution allow companies to shift that cost to those of us that are responsible and do carry it?”

I can understand why you are upset that you have to pay for emergency room visits, but remember, you also have to pay higher prices for most goods because sellers increase prices to compensate for theft. So basically you are paying for theft. Why would you want to continue a system where YOU pay for those who don’t want to pay for stuff? Why does the Constitution allow this? Because the Constitution is almost entirely about what the government can or cannot do, not private companies.

Also, by requiring all individuals to buy health care, because some people are free riders, would be like requiring everyone to buy theft insurance, because thieves exist.

How do you think costs go down when more people are on insurance? The only way this is mathematically possible is if the new consumers use less medical care than the current consumers. Why do they use less medical care? Likely because they are young and healthy. So basically this new health care bill would tax the young and healthy and transfer their wealth to the older generation (the Baby Boomers are so poor, they definitely need our money) and those with unhealthy lifestyles. How is that more fair? I don’t like paying extra because thieves exists and I don’t like having higher insurance charges because there are freeloaders, but if I want the good/service that is the price I pay.

There is a difference between forcing hospitals to treat individuals regardless of ability to pay, and requiring all citizens (oh wait, you mean 12 million illegal aliens will still get free emergency care treatment?) to buy a product or services.

One is requiring people to pay for something, IF they chose to do X. Ex: If you want to own a car, you must have auto insurance. If you want to open a hospital, you have to treat everyone. The government doesn’t force the person to do X. The other is requiring people to pay for something, simply because they breathe. This is different than requiring registration for the draft, which is a right of the sovereign. Once you are out of the womb, you are basically in debt to the government (or an insurance company).

This op-ed is far from a law review article, and there are better legal arguments to be made than the ones to which George Will alludes. However, he does raise some legitimate points.

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2Bfrank 4 years, 5 months ago

as we all march toward the end of the democracy, you are beginning to get a good glimpse now of the 'corporate state'.

China has proven that an autocracy gets along quite well with capitalism. Guess who is next?

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arizonajh 4 years, 5 months ago

Correct me if I'm wrong but don't we currently require hospitals to treat everyone who shows up at their emergency room door (the insured without proof ((no card)), uninsured, illegals, foreign visitors etc.)? If so, by doing that we make the hospitals pay for people who have no insurance. The hospitals would go under if they actually did pay outright for them so they transfer the cost to the insured (or more accurately their insurers) by raising the cost of treatment. The insurance companies are not going to take that loss sitting down so they raise the rates on the insured. Now everyone here seems to have insurance (or they would not be complaining about the government providing it) so are you not now personally paying for the uninsured to receive medical care at it's most expensive delivery point, the emergency room? Why would you want to continue a system where YOU pay for those who don't want or can't afford health care. If the constitution does not allow us to force these people into insurance then why does the constitution allow companies to shift that cost to those of us that are responsible and do carry it? It seems to me that if you can't force people to buy insurance then you shouldn't be able to make me pay (via cost shifting through my insurer) when they get into a car wreck, come down with swine flu or break their leg during a pick-up basketball game. I'd be willing to lose the mandate for insurance if we also get rid of the requirement that our hospitals treat all. But know this if we do lose this requirement and you are in an accident and you don't have your insurance card on your person don't be surprised if the hospital staff asks you and your broken legs and dripping head wound to wait outside until your wife leaves work, locates your insurance card and brings your proof of insurance to the check in desk. I mean, you getting that blood everywhere is going to have to get cleaned up by someone and who is going to pay for that if this alleged wife and alleged insurance card never shows up?

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pace 4 years, 5 months ago

The health corporations are funding the idea that it is not the right of people to have health care reform. Lets get it right. They tellin us It is a sacred right of the people to pay out the ying yang for steadily decreasing and expensive coverage with no control of the changing rules. I am sure it is holy that millions are losing coverage or getting cheated but I do believe it is my right to run the money changers out of the temple. I think it is my right to ask the government to regulate and deliver such public services.

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just_another_bozo_on_this_bus 4 years, 5 months ago

Funny how none of the complaints about being forced to buy insurance includes an acknowledgment that those provisions are there at the insistence of the health insurance lobby.

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Pilgrim2 4 years, 5 months ago

just_another_bozo_on_this_bus (Anonymous) says…

“In 2006, long before there was an Obama administration determined to impose a command-and-control federal health care system,”

With an opener like that, you know George took a double dose of hyperbole pills on the day of its writing.


Address the issue, boohoozo. Does the Congress have the constitutional authority to force everybody to buy health insurance from whatever source?

If you have read it, you would know the answer is NO! And not just no, but HELL no!

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TrooGrit 4 years, 5 months ago

Pelosi said "Are you serious?" Does this not frighten you to death, that we have a speaker of the House that is so freakin' out of touch with the Constitution and what it means??? Impeach this woman...NOW!

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AgeQuodAgis 4 years, 5 months ago

SRS you aren’t going anywhere. We are all on this sinking ship together. I

f our superiors in the one party government want their 12.4%, just be grateful they don’t take it all.

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bearded_gnome 4 years, 5 months ago

sorry george, beat you to this weeks ago. unconstitutional for the federal government to require individuals to buy something. also, I blogged that that, and enforcement via the IRS (including jailing you for not getting health insurance) violated something like four different amendments to the constitution including protection from self incrimination (5th amendment).

these people actually want to make the IRS the health care enforcer.

the latest Pelosi bill calls for a new bureaucrat: the "health choices commissioner" who will in fact dramatically limit yor choices and prevent you from choosing the health insurance you already have, or what you want.

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Healthcare_Moocher 4 years, 5 months ago

Merrill is living proof that eating to much tofu clouds your judgement.

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SettingTheRecordStraight 4 years, 5 months ago

AgeQuodAgis,

And if I could opt out of Social Security today I would. Just let my have my 12.4%!

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Flap Doodle 4 years, 5 months ago

The linkbot has woken. Fear his mad copy/paste skillz!

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AgeQuodAgis 4 years, 5 months ago

We already have force insurance it is called social security.

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SettingTheRecordStraight 4 years, 5 months ago

It's clear that a government takeover of health care must include further health care rationing, higher taxes, a deemphasis of personal responsibility, insurance mandates, wealth redistribution, cuts to Medicare, fewer choices, wait lists for elective procedures, a spread-the-wealth-around mentality, an increase in unhealthy lifestyle choices, fewer students entering the medical profession, an erosion of freedom, and substandard care for millions.

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just_another_bozo_on_this_bus 4 years, 5 months ago

"In 2006, long before there was an Obama administration determined to impose a command-and-control federal health care system,"

With an opener like that, you know George took a double dose of hyperbole pills on the day of its writing.

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Brent Garner 4 years, 5 months ago

Ah, but George, you do err not understanding the present situation. If a liberal says it is so, the it is so! It is only potentially unconstitutional if a conservative says it! Please, George, update your language files!!

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Richard Heckler 4 years, 5 months ago

Let's all pay our own way for the same level of care = no discrimination!

Let ME pay for National Health Insurance with MY tax dollars for MY National Health insurance.

Here's the deal. National Health Insurance is not a free ride and never will be perhaps with few exceptions.

You see my tax dollars will pay for my portion therefore no one else would be paying for MY National Health Insurance coverage. A 3.3% payroll tax is doable.

However if you listen to the republican party NOT and Max Baucus you would be led to believe that my tax dollars are not my tax dollars. How can that be?

The fact that National Health Insurance would come from the rather substantial tax dollar cookie jars simply means that no monthly or weekly deductions would come out of my pay check per se..

Since federal, state, and local governments collect trillions in taxes of all kinds—income, sales, property, corporate etc etc this is how medical bills would be paid as it is now.

You see as we speak the government tax dollars support medical insurance payments to the tune of at least $1.2 trillion which is quite a gravy train I'd say. Next year this will increase by changing nothing and not passing the National Health Insurance Act.

In essence MY tax dollar amount to pay MY portion of National Health Insurance would be about $2700 annually for the entire family.

What coverage would this buy the family:

long term care such that cancer demands prescription drugs hospital surgical outpatient services primary and preventive care emergency services dental mental health home health physical therapy rehabilitation (including for substance abuse) vision care hearing services including hearing aids chiropractic durable medical equipment * palliative care

A good deal that would free up more expendable cash to be spent elsewhere thus creating new jobs. Things like birthdays,christmas,home improvements,taking better care of my lover and investments would benefit.

Social Security and Medicare are two very smart insurance plans.

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Richard Heckler 4 years, 5 months ago

I'm with George on this one. Face it National Health Insurance is STILL the only way go. Why?

10 Reasons to Support U.S. National Health Insurance Act

Written by Andrea Miller

Tuesday, 03 March 2009

Here are 10 great reasons to support HR 676, the U.S. National Health Insurance Act: http://guaranteedhealthcare4all.org/sites/default/files/10-Reasons.pdf

  1. Everybody In, Nobody Out. Universal means access to health care for everyone, period.

  2. Portability. If you are unemployed, or lose or change jobs, your health coverage stays with you.

  3. Uniform Benefits. No Cadillac plans for the wealthy and Pinto plans for everyone else, with high deductibles, limited services, caps on payments for care, and no protection in the event of a catastrophe. One level of comprehensive care for everyone, regardless of the size of your wallet.

  4. Prevention. By removing financial roadblocks, a universal health system encourages preventive care that lowers an individual's ultimate cost and pain and suffering when problems are neglected and societal cost in the over-utilization of emergency rooms or the spread of communicable diseases.

  5. Choice. Most private insurance restricts your choice of providers and hospitals. Under the U.S. National Health Insurance Act, patients have a choice, and the provider is assured a fair payment.

  6. No Interference with Care. Caregivers and patients regain their autonomy to decide what's best for a patient's health, not what's dictated by the billing department. No denial of coverage for pre-existing conditions or cancellation of policies for "unreported" minor health problems.

  7. Reducing Waste. One third of every private health insurance dollar goes for paperwork and profits, compared to about 3% under Medicare, the federal government’s universal system for senior citizen healthcare.

  8. Cost Savings. A guaranteed health care system can produce the cost savings needed to cover everyone, largely by using existing resources without the waste. Taiwan, shifting from a U.S. private health care model, adopted a similar system in 1995, boosting health coverage from 57% to 97% with little increase in overall health care spending.

  9. Common Sense Budgeting. The public system sets fair reimbursements applied equally to all providers, private and public, while assuring that appropriate health care is delivered, and uses its clout to negotiate volume discounts for prescription drugs and medical equipment.

  10. Public Oversight. The public sets the policies and administers the system, not high priced CEOs meeting in private and making decisions based on their company’s stock performance needs.

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