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Archive for Wednesday, July 4, 2012

Tyranny?

July 4, 2012

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To the editor:

So Congressman Tim Huelskamp (Kansas, 1st District) marks the Supreme Court decision declaring the Affordable Heath Care Act as constitutional as “a definite date in the advance of governmental tyranny.” Let me see. That would make the state of Massachusetts a tyranny for about five years now. It would also make Mitt Romney the tyrant in chief.

Interestingly, the people of Massachusetts enjoy their tyranny, probably because 98 percent of them are now covered by health insurance and don’t need to worry about bankruptcy if they get sick and lose their job. Sixty-two percent say they would choose to be tyrannized all over again. Incidentally, Kansas has been a tyranny for over 20 years now, since it mandated car insurance for all its drivers.

Perhaps Congressman Huelskamp has a warped notion of what tyranny consists of. It certainly is not about just a policy disagreement. Perhaps he should spend some time in Syria, for instance, and experience what real tyranny is all about. Just think, Huelskamp, but for the grace of the federal courts, could have been my congressman.

Comments

jayhawklawrence 1 year, 9 months ago

If the Republicans lose the health care argument they are correct to worry about other issues our country is facing because we cannot solve these issues by simply cutting taxes for the wealthy and gutting all of our social services. To believe this is a solution is to believe in conservative mythology.

At the same time, we cannot buy things we cannot afford and this has been a complaint that most Americans have against politicians who do not know how to manage money. Who are the better financial managers?

I believe both parties have demonstrated repeatedly that they cannot be trusted with money.

What we need in government is a better qualify control system of management much like Gingrich referred to when he briefly mentioned using ISO qualify principles to rein in government. It got zero traction because no one had a clue what he was talking about.

The problem with Gingrich is that he is brilliant and at the same time a human train wreck.

The people we need in government today are not in government. That is the problem.

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1 year, 9 months ago

A couple of comments.

Universal health care. As early as 2010, Pope Benedict called for universal health care, saying it is an inalienable right. "Pope Benedict XVI and other church leaders said it was the moral responsibility of nations to guarantee access to health care for all of their citizens, regardless of social and economic status or their ability to pay.

Access to adequate medical attention, the pope said in a written message Nov. 18, was one of the "inalienable rights" of man" ""Justice requires guaranteed universal access to health care," he said, adding that the provision of minimal levels of medical attention to all is "commonly accepted as a fundamental human right."

Governments are obligated, therefore, to adopt the proper legislative, administrative and financial measures to provide such care along with other basic conditions that promote good health, such as food security, water and housing, the cardinal said.

Private health insurance companies, he said, should conform to human rights legislation and see to it that "privatization not become a threat to the accessibility, availability and quality of health care goods and services."" (http://www.catholicnews.com/data/stories/cns/1004736.htm) Granted, I disagree with one part of what he said about contraception and abortion (the former should be freely available and the latter is a matter of choice), but then that's his belief.

Bottom line, the ACA is a major step in the right direction, yet the fear mongers and obstructionists will have nothing of it. At every turn they have pushed against legislation President Obama wanted. But, that's another matter entirely, when you have a minority acting like the anal sphincter and clamping shut so nothing goes through, grinding our county's body to a halt.


@christy kennedy. Excellent comment. I know doctors elsewhere who quit their specialties because the "Insurance Companies" wouldn't pay even what they said they would.

@ Dr. Bruner. Excellent letter. If you read these comments above, you'll find that many of them are personal attacks and do not relate to your letter. Drive on sir.

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verity 1 year, 9 months ago

Another little side effect that might happen if Obamacare is rescinded.

Because of spending too much money on overhead, medical insurance companies are having to refund about one billion dollars. I'm sure ALL of you want that money to go back to the insurance companies instead of being refunded to the people who were overcharged.

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christy kennedy 1 year, 9 months ago

Good letter. I am therefore afraid to read the comments. One of my inlaws who's a family practitioner and a dean at KU Med told me yesterday that every doctor he knows thinks "Obamacare" doesn't go far enough, and that EVERY PERSON should have health insurance and that even if you don't give a crap about the welfare of your fellow human beings you should understand that it COSTS MUCH MORE for all of us when un- and underinsured people delay medical treatment.

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JackMcKee 1 year, 9 months ago

Guadian, let me ask you a question. Do you work for free?

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Jim Phillips 1 year, 9 months ago

Dr. Bruner,

I was once a patient of yours. I guess that's why I find your concern about patient welfare laughable. I fired you because you seemed more concerned about your fees than my care. Obviously, nothing has changed in 20 years.

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SJGD 1 year, 9 months ago

Thanks, Dr. Bruner, for your thoughtful comments.

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camper 1 year, 9 months ago

For a long time the private insurance business did an a good job of providing health care to workers. But "fringe" benefits such as this are shrinking and becoming more expensive. Increasingly, more people are falling out of the pool. The result is more cost passed on to those who are covered, and less care to those who fall out. When are we going to realize that a change of approach is needed? We are no longer in the Pst WWII boom.

Public Option is the best way to go.

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WoodKarina 1 year, 9 months ago

as Jesse said I didn't even know that a stay at home mom able to get paid $5067 in a few weeks on the computer. have you seen this page(Click on menu Home more information) http://goo.gl/L0KQH

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jayhawklawrence 1 year, 9 months ago

This past week the focus was on the Republican mantra of "repeal and replace" regarding health care and it becomes very clear that their idea of "replace" is only lip service and the Eric Cantor idea of a health care plan is total BS. I think that is not on opinion. It is a fact.

Sometimes it feels like we are up against an entrenched philosophical wall that has been long in the making which is much like a conspiracy against the American people.

The roots of this are surely found in front groups such as ALEC and the KOCH Brothers to name a few.

We need to make sure that they don't succeed in taking over this country as they have succeeded in shutting down our government.

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Mike Ford 1 year, 9 months ago

gotland....I saw a town called Gotland in Sweden where my father just returned from. They have socialized medicine and railways and everything else. My father was able to ride sixty miles out from Stockholm to Sigtuna, Sweden on a train that went 110 miles an hour and covered that in less than half an hour. Remind me again like the Will McAvoy character on HBO's "Newsroom" what the Archie Bunker version of America is good at ? that's what I thought.....

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JayhawkFan1985 1 year, 9 months ago

The GOP doesnt care about reality. The GOP is the party of big brother from the book 1984. The believe in Doublespeak. You remember...hate is love, war is peace, etc.

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Bob Harvey 1 year, 9 months ago

Re: the question of being charged more if you do not have insurance. On the surface that is false, since practices normally only maintain one fee schedule (it would be far too cumbersome to manage more than that)

Are the bills to non-insured higher? Short answer yes, for the very reason given above. in another posters comments. Insurance companies have negotiated discounts with medical providers. Providers sign these agreements in the hope that participating with the various payers out there would bring in a larger volume of patients. For example, physicians will contract with Blue Cross of Kansas for the simple reason that a large percentage of their patients have Blue Cross insurance. So technically a non-insured patient receives the same bill as the insurance company does, but without the contractual discount is stuck with the total.

The concept of cost sharing (charging insurance companies more to cover the cost of low or no pay patients) has been gone for years. For example, Medicare pays a set fee for each procedure performed. So a mid-level office call for a family physician or a cardiologist is paid at the same rate. There is no negotiation with Medicare over payment rates. Insurance companies pay pretty much the same way. When a physician contracts with an insurance company he/she is basically agreeing to the insurance companies contract rates. Very few physicians (except the uber-large group practices that control a local marketplace) have any contract leverage with an insurance company. It's either you agree to our payment rates or you don't participate with us. There is no longer any method for a practice to inflate it's charges to help offset the lack of payment by others.

This is where my previous thoughts on Medicaid come in. Medicaid rates are traditionally the lowest of all payers. At times their payments represent .25 on the dollar or less. If a practice accepts Medicaid in its current form and has even 30% of its patients coming from Medicaid it will most assuredly face the eventual closing of its doors. Sadly, that is what I see coming about unless someone comes up with a method of fair payment to at least equal costs that are incurred.

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Carol Bowen 1 year, 9 months ago

"Liberals" versus "conservatives" or "Democrats" versus "Republicans" is meaningless name calling. None of the labels are bad, just different philosophy groups which overlap, by the way. The polls show that some Republicans support the ACA and some Democrats do not. There are moderate liberals who share philosophies with moderate Republicans. Even those labels don't work. How about those who support ACA, those who support parts of ACA, and those who do not support ACA?

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FlintlockRifle 1 year, 9 months ago

Has anyone seen this,?? True or not a interesting read----------

Chief Justice Roberts actually ruled the mandate, relative to the commerce clause, was unconstitutional. That’s how the Democrats got Obama-care going in the first place. This is critical. His ruling means Congress can’t compel American citizens to purchase anything. Ever. The notion is now officially and forever, unconstitutional. As it should be.

Next, he stated that, because Congress doesn’t have the ability to mandate, it must, to fund Obama-care, rely on its power to tax .

T herefore, the mechanism that funds Obama-care is a tax. This is also critical. Recall back during the initial Obama-care battles, the Democrats called it a penalty, Republicans called it a tax. Democrats consistently soft sold it as a penalty. It went to vote as a penalty. Obama declared endlessly, that it was not a tax, it was a penalty.

But when the Democrats argued in front of the Supreme Court, they said ‘hey, a penalty or a tax, either way’. So, Roberts gave them a tax.

It is now the official law of the land — beyond word-play and silly shenanigans. Obama-care is funded by tax dollars. Democrats now must defend a tax increase to justify the Obama-care law. Finally, he struck down as unconstitutional, the Obama-care idea that the federal government can bully states into complying by yanking their existing medicaid funding. Liberals, through Obama-care, basically said to the states — ‘comply with Obama-care or we will stop existing funding.’ Roberts ruled that is a no-no . If a state takes the money, fine, the Feds can tell the state how to run a program, but if the state refuses money, the federal government can’t penalize the state by yanking other funding. Therefore, a state can decline to participate in Obama-care without penalty. This is obviously a serious problem. Are we going to have 10, 12, 25 states not participating in “national” health-care? Suddenly, it’s not national, is it?

Ultimately, Roberts supported states rights by limiting the federal government’s coercive abilities. He ruled that the government can not force the people to purchase products or services under the commerce clause and he forced liberals to have to come clean and admit that Obama-care is funded by tax increases.

Although he didn’t guarantee Romney a win, he certainly did more than his part and should be applauded. And he did this without creating a civil war or having bricks thrown through his windshield. Oh, and he’ll be home in time for dinner.

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Ray Parker 1 year, 9 months ago

All patriots call it tyranny when a Marxist power grab arbitrarily concentrates excessive governmental powers in the hands of few federal bureaucrats.

Spirit

Spirit by parkay

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Gotland 1 year, 9 months ago

D.C. is the new Great Britian, Obama the new king George.

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yourworstnightmare 1 year, 9 months ago

There are two questions.

1) Should all Americans have access to health care when needed (i.e. is health care a right)?

2) How should all Americans be given access to health care when needed?

Obamacare and Romneycare answer the first in the affirmative.

In response to the second, they both used a market-based approach and the current insurance industry.

To those who disagree with Obamacare and Romneycare, I would like to hear your honest answers to these questions.

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verity 1 year, 9 months ago

I may be wrong, and hope that I am, but I was under the impression that people without medical insurance are often charged a lot more because they are in no position to bargain for better prices. My bills always have a write off from the provider usually of the amount between what they charge and what the insurance company will pay.

Anybody know more about this?

I fear that the AHCA is a hodge podge of good and bad ideas, probably in large part because of money spent by the insurance companies in lobbying. But, at this point, what are we going to have if it is repealed, now that it has been partially implemented? People certainly seem to like the provisions of being able to keep children on parent's policies until 26 and the one about pre-existing conditions.

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JackMcKee 1 year, 9 months ago

it's a little early to resort to hyperbole, don't you think Jafs?

And Medicare for all is basically the public option, which the GOP wouldn't allow. There is no doubt that the public option was the best solution. Once people realize they like the ACA reform will become easier. Thus one reason for the opposition from the insurance industry.

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Bob Harvey 1 year, 9 months ago

A previous commentor brought up the matter of physician offices in Lawrence and Douglas Country not accepting Medicaid patients into their practices because of the low reimbursement rates. That, I assure you, is a true statement. Medicare however has been a different matter and is, for the most part, universally accepted in this area.

I would ask the good doctor (LTE) how open his practice is at accepting Medicaid patients currently. Would he and his colleagues change their acceptance policies when many more thousands of their county residents are covered under the Medicaid program? Would you be able to keep your office doors open? Would you have to reduce your compensation?

Regardless of your answers today what will happen to your profession when the federal government requires you to do so?

There are very, very few physician practices in this community that welcome Medicaid patients. Those practices owned by LMH do since they fulfill a valuable mission; providing an access to care outside of the ER. Regrettably private practices simply cannot afford the reimbursement from Medicaid in great numbers because the cost of running their practices requires a certain amount of revenue. How can any business remain open when their revenue is less than their cost?

It will be interesting to see what the future holds.

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Cait McKnelly 1 year, 9 months ago

Let's keep the government out of our healthcare! Unless you're a woman capable of reproduction.
(Did I get that right?)

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voevoda 1 year, 9 months ago

"Taxation without representation is tyranny." But Congress passed the ACA, so I guess by definition it's not tyrannical. There may be provisions of the law that are misguided, but that's a different issue. It might have been better to set the whole thing up like Medicare--then the issues of Constitutionality and "tyranny" never would have arisen.

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Liberty_One 1 year, 9 months ago

The LTE author subverts his own arguments with the facts he provides. So 62% of Mass residents like their bill? What about the 38% who don't? A tyranny of the majority is a tyranny nonetheless. Tyranny is about the powerful imposing their will through force upon the weak to take away the weak's rights to life, liberty or property.

There are greater and lesser acts of tyranny, but history has shown that the smaller acts of tyranny are often preludes to the larger ones.

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JackMcKee 1 year, 9 months ago

I guess that's where we differ because I consider this to be the very type of problem that the government exists to fix.

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Mike Ford 1 year, 9 months ago

After hearing this enumerated states rights amendment nonsense for some time now (including from that loser Derek Schmidt AG of Kansas at the Constitution Days last September at the Dole Center) why don't any of you omit the facts conservatives mention the supremacy clause of the federal government??? gee....when was the Supremacy Clause used most? oh, Brown V. Board of Education, Little Rock, Ole Miss, George Wallace and Alabama, The Civil Rights Act of 1964 and Fair Housing Act......wow you didn't want segregation to end and you don't want health care now....trying to do the double speak like Rand Paul did concerning an owner/ operator's rights over the customers even if it sounded racist when he said it concerning the elimination of public segregation over liberatarian views. You are citizens of the US.....the states are dependant sovereigns of the US Government as mentioned by SCOTUS justice John Marshall in Worcester V. Georgia case... and the Articles of Confederation is no longer enacted except in the minds of denialists who lost the US Civil War and the furtherance of segregationist law. Nothing like proudly being on the wrong side of history....maybe John Roberts didn't want to be there with you. My wife has two co-workers with dual Canadian citizenship. Guess where they went for health care issues? back to Vancouver and Ottawa.... not here.....my dad rode a train from Kenora, Ontario to Quebec City, Quebec, last summer. He spent much of the trip explaining to the Canadian travelers he spoke to that this country was not full of raging uneducated LOUD people and that the tea partiers they heard didn't speak for everyone. Their health care system has been working for fifty years helping the Canadian GM, Ford, and Chrysler subsidiaries avoid the health care costs that brought down their Detroit bretheren. Some people want to willfully walk into the fan though.

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JackMcKee 1 year, 9 months ago

The problem, jafs, is that health care costs are spiraling out of control to the point it has become a national crisis. Single payer would have been the best solution but the obstructionist GOP wouldn't allow that to happen so we have a compromise. It's hopefully a first step to a real solution.

The US leads the world in health care expenditures yet fails to deliver the quality of care most other nations provide for a fraction of the cost.

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Phil Minkin 1 year, 9 months ago

Regardless of what one thinks of the Affordable Care Act, it was passed and deemed constitutional by the Supreme Court. Not acting to implement it in the hope first, that Romney gets elected and secondly, that he is able to get Congress to overturn it. Should people quit paying income tax or sell drugs in the hope that those laws get repealed? In Brownback's case he should hope for the best, but plan for the worst and not deny the low income citizens of Kansas heathcare. Sam fiddles while Kansans die.

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JohnBrown 1 year, 9 months ago

The only medical mandate Republicans favor are vaginal probes.

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Flap Doodle 1 year, 9 months ago

The disappointed Progressives are still relying on the "...but __ did it first..." trope?

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Brock Masters 1 year, 9 months ago

I don't understand how someone with the LTE writers education cannot grasp the simple difference between state power and federal power. The state and its people can do many things that the federal government cannot do - our country was designed to protect the individuality of the states and to limit the power of the federal government. Hence, it is not tyranny when a state exercises it power in a legal manner. It is tyranny when the federal government oversteps it power.

Now the SCOTUS has ruled it constitutional we have to live with it, but this new taxing power of the federal government should scare everyone, liberal conservative and none of the above.

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hotmess 1 year, 9 months ago

Tyranny? Our current commander in chief and his ideas are the hallmark of a path to totalitarianism.

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BornAgainAmerican 1 year, 9 months ago

Liberals love to play the Romney/Massachusettts card. That card and 50 cents might get you a cup of coffee if you go to McDonalds. Romney has vowed to repeal ObamaTax if he is elected. ObamaTax is only a pathway to government healthcare. How many Medicare and Medicaid recipients are among the patients you see Dr. Bruner? Do you limit the number or refuse to see them period? Other physicians say that they cannot keep their office open if they have too many of these government insured patients. Are they lying? What happens when all of your patients pay you with government insurance? Do you think the government will bail you out with subsidies? Hmmm...considering how the government gets ripped off in virtually every other entitlement program, that may not be a bad racket come to think of it. The Doctors can then be on the government gravy train, just like everyone else. Maybe not a bad strategy after all. .

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beatrice 1 year, 9 months ago

Before someone says it, we understand -- not everyone needs to purchase auto insurance, only those who drive.

So perhaps people should also be excused from the requirements of the Affordable Care Act once they prove that they will never get sick.

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tomatogrower 1 year, 9 months ago

Huelskamp is just trying to protect the insurance companies that might have to actually spend money on health care instead of CEO wages and advertising. Poor insurance companies. Poor rich CEO's. Everyone's always picking on them.

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