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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

tomatogrower 2 years, 5 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.

beatrice 2 years, 5 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.

jafs 2 years, 5 months ago

Mandated auto insurance generally covers damage you may do to the other guy's car and driver, not your own or yourself.

Also, it's the state's responsibility to regulate auto insurance, not the federal government's responsibility.

Why is that distinction so often lost on liberals? Our constitution deliberately created a different scope for the two kinds of governments - the federal government was limited, with enumerated powers, while powers not enumerated to them went to the states, or the people.

So, the idea wasn't to create a huge and far-reaching federal government.

Liberty275 2 years, 5 months ago

Jafs, it's been hard of late to argue with you, you being right so much, but I can still nitpick. :-)

"Mandated auto insurance generally covers damage you may do to the other guy's car and driver, not your own or yourself."

No.

"Coverages Required in Kansas

Kansas law mandates that every automobile insurance policy sold in the state must have these minimum coverages:

Liability coverage
Blah blah some amount.

Personal injury protection (PIP or No Fault)
    Minimum amount required by law:
        $4,500/person for medical expenses
        $900/month for one year for disability/loss of income
        $25/day for in-home services
        $2,000 for funeral, burial or cremation expense
        $4,500 for rehabilitation expense
    Survivor Benefits: Disability/loss of income up to $900/month for one year
    In-home services up to $25/day for one year
Uninsured/Underinsured
    $25,000/person
    $50,000/accident

http://www.ksinsurance.org/consumers/autoinfo.htm

Neener neener neener. :-P

Liberty275 2 years, 5 months ago

No. PIP and uninsured motorist insurance covers you and your property.

Liability insurance covers the other guy. You can find the definition for liability at:

http://www.google.com/search?q=liability+definition

tomatogrower 2 years, 5 months ago

Ah yes. The old personal responsibility argument. But where do those without insurance run when they do get sick? The ER. And because most of us care about our fellow human beings we treat them. Then they get a huge bill, which they can't afford to pay. They are wiped out financially and owe the hospital money, still have a mortgage, credit cards got maxed while they were sick, etc. Then they file for bankruptcy. I realize you don't think that their plight will affect you, and just give a lawyer a job, but bankruptcies raise the prices for us all.
Of course, if you want to talk personal responsibility, then those who refuse to buy insurance, and have no money to pay up front should not be treated. Is that what you advocate? In my adult life, I have only gone without insurance for maybe 2months, and I"m not young. Lots of the jobs young people get nowadays don't offer insurance, like when I was young. Or you have to wait until you have been there 3 months.

Can someone please tell me why people wouldn't want insurance? Can someone tell me why it's ok for insurance companies to spend only 40% of the money they rake in on health care? I realize that jaf and liberty275 probably are those who live off of investment money, and are invested in insurance companies and will see their profits go down, but boo hoo.

jafs 2 years, 5 months ago

Well, that's a bit muddled, but I'll try to answer.

There are a lot of problems with our health care system, but I don't think this bill is the best answer to them.

If we want to provide health care to those that can't afford it, I'd much rather see us simply provide that, via taxes, by the government than do what this bill does.

I didn't have health insurance from my 20's to my 40's, didn't need it, and paid for my own health care costs out of pocket (which were quite low, because I take good care of myself).

Nobody said it's ok for insurance companies to only spend 40% on care, and I support regulating them, even to the point of requiring them to be non-profit companies, if we want to do that.

The problem is the individual mandate for me, and we don't need it to regulate insurance companies, or provide care to those that can't afford it.

For the record, I don't live off of investment money by any means, and have no financial stake in this decision one way or the other (except for a rather small IRA that may have some stock in insurance companies).

Liberty275 2 years, 5 months ago

"I realize that jaf and liberty275 probably are those who live off of investment money"

Sorry to bust your bubble, but I work 40 hour weeks and put money into an IRA. We are basically poor because we are trying to make something to retire with.

Why do you think I hold your philosophy in such contempt? I work hard for every thin dime I make and people like you want it taken away to support people that haven't bothered to develop a skillset or worked those 40 hour weeks to afford what little we have.

Your philosophy is theft. You should be ashamed.

Carol Bowen 2 years, 5 months ago

i can think of a few. Some prefer alternative medicine which is not covered by insurance or Medicare. Of course, they do have the option of forming an alternative medicine insurance company. They'd have to insure sick and well people to make it work.

Some just don't like to be forced to join.

Even with auto insurance, you have to have insureds in the group that do not have an accident to make the insurance work. Having young healthy people in the group spreads the risk more. It might lower premiums.

Personally, I do not think health care should be a profit-making industry. For example, some useful drugs are not produced because the profit margin is too low.

bad_dog 2 years, 5 months ago

jafs, keep in mind that one person's failure to obtain health insurance can harm those that do have coverage if they become ill or are injured and receive care without paying for it. As you know, the cost gets passed on to those of us with coverage through higher premiums.

As for the comparison to mandated auto insurance, many years ago I was involved in an accident with an uninsured driver from Wyandotte Co. I had $1,000 deductible and no rental car coverage. As the other driver (at fault) was not insured, I had to pay the deductible and absorb the expense of a rental car for three weeks while my insurer decided whether to total my almost new car.

When it was all said and done, I was out of pocket almost $1,800. While I got a judgment against that person, she left the state and it was never satisfied. My insurer was out $19,000 to replace my car and I lost the expenses noted above through no fault of my own. Those kinds of incidents only create higher premiums for those who abide by the law. My example was even more egregious as I directly absorbed almost 10% of that loss in addition to what got spread out amongst all policy holders. Needless to say, I now have the lowest deductible available, rental car coverage, deluxe PIP, etc.

One other note; I previously lived on the southern edge of WY Co. My auto premiums decrease by more than 1/3 when I moved south about 2.5 miles into JO. Co. When I asked my agent about the decrease, he explained it by stating the claims experience was so much worse in WY Co. e.g., so many more accidents involving uninsured drivers, auto burglaries, thefts, etc. than in JO Co.

Have a great 4th!

Topple 2 years, 5 months ago

Just throwing this out there, but I'm assuming your switch to the lowest deductible, rental car coverage, etc etc is costing you far more than the $1800 you spent due to that accident.

Fred Mertz 2 years, 5 months ago

No lost on me - I say get rid of them and the oil, wind and solar subsidies too.

jayhawklawrence 2 years, 5 months ago

Well, I often agree with you but not on this.

It is obvious that sick uninsured people are causing damage to everyone else and we are arguing over semantics and philosophy not reality.

Jayhawk1958 2 years, 5 months ago

It was the states that thought they had the power to decide segregation. This is what scares me about state run healthcare. The Governor has already turned away fed dollars.

Liberty275 2 years, 5 months ago

The presumptuous nature of the leftist is strong in Bea.

Tell me something Bea. Is there some law somewhere that says a person must seek health care if they are sick (other than easily communicable diseases)? Can the government force them to get heath care? Are you going to force them to get health care?

Your ilk doesn't get this from the talking points, but there comes a time when the bad news comes and some will say... "whatever". Has it ever crossed your mind that some people would rather die from an affliction than live with the after effects of cancer, a stroke, kidney failure, loss of fingers, bad nose job or massive third degree burns? Who are you, society or the government to tell an American citizen they have no choice but to live? It's none of your business unless it is your direct family.

Why should people have to prove they won't get sick if they don't want to recover from an illness? Are we going to force them to get better?

Side note - our family has so much health insurance that when I sneeze the doctor asks "how high?". (sorry for the disjointed metaphor, but it's pretty accurate). Needless to say, I can get the best cures we have. Any of them. But the day they tell me I'll be going in for dialysis weekly, or that the right side of my brain will never recover from the stroke will come just before the night I drink enough Glenlivet and have enough valium that whatever ailment I'm facing becomes irrelevant.

You don't just worship the nanny state, you can't fathom existence without it. Further, it's a sick sick mind that assumes everyone wants to or needs to cure their illnesses.

And people wonder why I loathe the left.

Carol Bowen 2 years, 5 months ago

Your comments are interesting, but using expressions like "Your ilk " is going for the knee caps. Weakens your argument.

Leslie Swearingen 2 years, 5 months ago

Don't say knee caps, please. I have just had to up the pain medications a notch. I very much would like to get better Does anyone think that I enjoy been in pain? I don't think there is any way to convince people of the benefits of eating right and exercising when they are young and strong. It is not about looks, it is about saving yourself a lot of pain later on in life. Seriously, we need some form of scared straight for those who are headed for health hell.

Topple 2 years, 5 months ago

I see expressions like "religious GOP freaks" thrown around a lot more against Conservatives on LJW than anything Liberals are suffering.

beatrice 2 years, 5 months ago

You have insurance, as you note, yet some day you may say "enough" and no longer seek treatment. I share that sentiment and saw my sister go through it with her cancer. After some rounds of treatment failed, she said enough. I get where you are coming from.

However, where in your having insurance -- by choice or by mandate -- does it say you must seek treatment? I don't recall my saying anything of the sort, nor have I read anything of the sort from anyone else. The insurance is mandatory, but what you choose to do with it is up to you. No need to loathe the left over an argument that doesn't exist.

If anything, loathe the right over forced care -- just ask the husband of Terri Schiavo. She had an agreement with her husband, yet her conservative parents backed by conservative legislators were the ones who tried to force her body be kept alive. That was some sick stuff right there.

verity 2 years, 5 months ago

I was wondering about that enforced health care also. I hadn't heard that one before, just the death panels. I didn't think about Terri Schiavo, but you are right on that one.

tomatogrower 2 years, 5 months ago

Liberty, you must take yoga lessons. Are conservatives against Obama care, because it wouldn't allow them to get the care they need, or are they against it, because it would force them to get the care? And as for making decisions about how you will die when you are sick or disabled, that's what the original bill included - requiring insurance companies to pay doctors for end of life discussion with patients, allowing patients to make these important decisions. You know, you and your doctor forming a "death panel". They had to take that out thanks to your buddy Palin.

Kate Rogge 2 years, 5 months ago

People who do not wish to receive medical treatment will not enter the arena of insured vs. non-insured heath care recipients. So some people will never want to receive medical treatment of any kind at any time in their lives and, therefore, they should not be required to buy health insurance? Jeeze, Louise. If that's your point (is it?) then I can see how it holds together. I'm not sure how we'd handle an eleventh hour conversion to wanting health care, and no one is willing to refuse treatment to a desperately ill person who doesn't have health insurance, but I agree forcing me to buy a service I'm determined never to use is wrong.

jafs 2 years, 5 months ago

Maybe if they just prove they won't get health care that others have to pay for?

brewmaster 2 years, 5 months ago

Beatrice,

Thank you for pointing it out. Your point is provocative and pertinent from many different perspectives.

RoeDapple 2 years, 5 months ago

I demand we all get life insurance. Except for those who will live forever.

Getaroom 2 years, 5 months ago

This is a ridiculous string of comments and I am sure more will follow from others. Dr. Bruner can defend himself for sure, but just for your information he does accept Medicare and It Is Not and entitlement program. This country is owned and operated by the less than 1%, and are sucking the life blood out of it as we sleep and breathe. Are you a part of that small slice of heaven? If not, that means your attitude about Free Market Capitalism has duped you. You are going down with just because of a worn out ideology that hasn't worked for years and is squeezing the "middle class" and wannabe's to death. Wrap yourself in the flag and see how much good it does you.

Liberty275 2 years, 5 months ago

You 99% fringe guys just scream the same line for everything, don't you? I'm surprised you didn't use the word "Koch".

"If not, that means your attitude about Free Market Capitalism has duped you."

The money placed into my bank account every other week by free market capitalism argues that it is not a worn out ideology that fights the middle class. OTOH, the amount withheld to pay for excessive government is annoying and not nearly enough to pay for all the garbage that nanny-state liberals want to foist on all of us. So soon you will want more.

Take enough of what I work for and I'll just stop giving it to you.

Liberty275 2 years, 5 months ago

"That card and 50 cents might get you a cup of coffee if you go to McDonalds"

$4.50 at Z's. Having taste costs extra.

I know my doctor does not accept any medicaid patients, and probably limits the medicare patients to those with a good supplemental policy.

bad_dog 2 years, 5 months ago

"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?"

I used to hear similar dire whining back in the early 90's when a fee schedule was being considered for health care practicioners treating workers' comp patients. "If you reduce the fee for an office visit by as much as $5, we'll be forced to close our doors." It happened, they didn't.

beatrice 2 years, 5 months ago

Romney has sworn to repeal Romneycare. Got it. And you know, that doesn't sound like a political flip-flop at all. Not at all. uh huh

Getaroom 2 years, 5 months ago

I think you have confused the President with the Entitled GOP Millionaires. Tyranny, you don't understand the meaning if it.

Fred Mertz 2 years, 5 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.

beatrice 2 years, 5 months ago

Fred, fair enough. I understand your point. However, what is the difference between someone needing access to healthcare in Massachusetts that won't bankrupt them and someone needing the same in any other state?

Sorry, but do you really think we should have allowed Social Security or Medicaid be issued state by state? Yes, we are a collection of states, but we are also a combined nation. Access to health care is a national issue, not just a state issue.

Fred Mertz 2 years, 5 months ago

beatrice - I posted a more detail post that answers your question above, but the simple answer is yes, it is a national issue, but unless we want to do it state by state then we should amend the constitution to provide for that federal power.

Let me add why I believe it is so important to follow the constitution and not bastardize it to make it fit the end we want.

Now that the SCOTUS has ruled that the federal government can tax an individual to affect their behavior what is to stop the federal government under right-wing control to tax abortion clinics or individuals that get an abortion?

Think something like that can't happen? No one thought the federal government could tax an individual for not purchasing health insurance until last week. Even the supporters of the ACA didn't think it as they argued against it being called a tax.

Following the Constitution is the only thing that protects you from me and me from you. So if you support the ACA you feel good that the Constitution was stretched to make it fit the ACA but how will you feel when that stretched constitution now covers something contrary to your beliefs like taxing people that have abortions?

beatrice 2 years, 5 months ago

Fred, I'm afraid Hell has not yet frozen over. Getting two-third's of our current legislature to agree to amend the Constitution just isn't going to happen, even if most people felt it would be in the best interest of the nation. Regarding not caring for how the Court has ruled, we don't really need to look to imagined future abortion rulings. We can just look at Citizens United to find a ruling I really think changes our nation on a very fundamental level, even more so than the ACA ruling. I don't like it, but they have ruled. And they have ruled in this case. I don't believe Justice Roberts has suddenly decided not to follow the Constitution.

Topple 2 years, 5 months ago

Yea, why worry about issues when they arise? Let's just address things AFTER the damage has been done.

usmctow 2 years, 5 months ago

Thank you Fred. I thought i was alone here. I'm glad someone else gets it.

Flap Doodle 2 years, 5 months ago

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

Fred Mertz 2 years, 5 months ago

Out with blame Bush, in with blame Romney? Mommy, mommy, why can't I have a national health care program? It isn't fair, lil' Mitt down the street has one!

beatrice 2 years, 5 months ago

Blame Romney? No, more like thank Romney. Too bad he is now scared to actually run on his accomplishments during his single term as Governor. If he did, he might get more people voting for him.

usmctow 2 years, 5 months ago

That's right. If Bea likes what they have in Mass. either fight for it here in KS. or move to Mass.

beatrice 2 years, 5 months ago

Sibling to "Do as I say, not as I do." Or did, rather, during his one term as a governor.

Funny thing is, this is now your guy. You are going to vote for the guy who started the insurance mandate form of legislation. Even though it is successful in Mass., he has to run, run, run from this accomplishment, while you twist, twist, twist your logic in order to support him. Funny indeed.

beatrice 2 years, 5 months ago

Snap, ... um ... have you been reading the headlines or read about the SC rulings? Progressives are far from disappointed.

Conservatives, on the other hand ...?

JohnBrown 2 years, 5 months ago

The only medical mandate Republicans favor are vaginal probes.

Phil Minkin 2 years, 5 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.

JackMcKee 2 years, 5 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.

jafs 2 years, 5 months ago

I agree that there are significant problems with our health care system, and you've described one of the worst ones - high costs and low quality relative to those costs.

But, I think this is not a good solution to those problems.

And, we have many problems, but using that as a reason to continually expand the scope and power of the federal government may not be the best thing to do.

paulveer 2 years, 5 months ago

JM, thank you for the uncharacteristically civil tone of this thoughtfully presented comment.

Mike Ford 2 years, 5 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.

JackMcKee 2 years, 5 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.

jafs 2 years, 5 months ago

And yet, the founders didn't intend for the federal government to fix all of our problems.

beatrice 2 years, 5 months ago

Since the can't fix all, they shouldn't attempt to fix any?

jafs 2 years, 5 months ago

It's a question of intent - if the founders had intended to form a large powerful federal government, they would have done so.

Instead, they created one with specifically enumerated powers, and left the rest to the states/people.

You may like this change, as many liberals seem to, in the direction of larger more intrusive federal power, but once we start changing things, others may want to change them in ways that you dislike.

beatrice 2 years, 5 months ago

We are not the nation we were more than 200 years ago. To that, I will agree.

jafs 2 years, 5 months ago

Obviously.

The question is whether or not we should continue to try to be faithful to the principles we were founded on, and if not, what should we switch to instead?

Those on the right would like to switch in the direction of more religious influence in government, which those on the left oppose, calling it unconstitutional.

But, then, those on the left want to expand the power and scope of the federal government without amending the constitution to do so, and the right call that unconstitutional.

Seems to me that both sides there have little real respect for constitutional principles.

So, if we abandon them, which side should get it's way and why?

beatrice 2 years, 5 months ago

Jafs, we have a system in place to determine what is and what is not constitutional. If the Right gains power and attempts to inject a greater influence of religion on our system, as you suggest might happen, I trust the Supreme Court will rule against their actions. In this instance, the Supreme Court ruled and found the ACA constitutional. It really doesn't matter what the Right calls it, our Supreme Court ruled and it was found to be within the guidelines of our Constitution.

We have not abandoned our system and the notion that we no longer respect constitutional principles seems like simple hyperbole to me.

jafs 2 years, 5 months ago

You trust the SC on this ruling, what about CU? 5-4 decisions mean there's a lot of disagreement among the justices - it's a very small margin of victory.

The Constitution requires interpretation and application to situations which didn't exist at the time it was written - there are substantial disagreements about how to do that correctly.

I see both the left and right, in many ways, as having little respect for our founding principles and guidelines, but in different directions.

Over the years, the ICC, which was originally intended to be used to regulate interstate commerce, has been expanded way beyond that scope by court decisions, without amending the constitution.

If there had been one more liberal justice on the current SC, it would probably have been declared that it's perfectly fine to mandate purchases of health insurance on the grounds of the ICC.

That's an example of a shift to the left - CU is an example of a shift to the right. If there had been another liberal on the court there, it would almost certainly not have gone the way it did.

When liberals throw around Romneycare as if states and the federal government have the same scope and power, even after having been educated on the subject, they demonstrate a lack of respect for constitutional principles, and the way we were founded.

When conservatives continue to try to inject religion into government and public schools, etc. they demonstrate the same lack of respect for those.

Both sides want to change/interpret the constitution in such a way as to let them pursue their agendas, without real concern about whether or not those agendas are in line with our basic principles.

jafs 2 years, 5 months ago

I'm curious about something - if the DOMA makes it to the SC, and the current court, with a slight conservative majority, rules it constitutional, what will you think then?

Will you agree that it's constitutional, or disagree, as I will? And, will you be as sanguine about trusting the court if that happens?

beatrice 2 years, 5 months ago

If I disagre with a decision, I don't continue to call that decision unconstitutiional, as many on here have continued to do with the ACA ruling. I agree with the ruling, so it shouldn't take you by surprise that I am optimistic as to the longterm results. Are you suggesting that I should disagree with the ruling even if I agree with it? That would be silly. As you know, I said the mandate was a tax long before the court made its ruling.

Even if a ruling goes against my personal beliefs, I will still acknowledge that the ruling was based on what the judges believe to be constitutional grounds. You and I can disagree with a ruling and still argue that it isn't the "right" ruling, but we are not in a position to say that a ruling isn't based on constitutional rights. This is why we have a Supreme Court and, as Chief Justice Roberts just demonstrated, rulings aren't just based on politics or on satisfying one side over another.

Is our system perfect? No. However, it is a system on which our nation has been built.

jafs 2 years, 5 months ago

Nicely missing the point.

Do you agree with the CU decision?

Also missing that virtually 1/2 of the Court disagrees with the decision - those who disagree are in very good company.

It's based on what 5 out of 9 justices believe to be correct.

With such significant dissent at the US SC level, I fail to understand why these decisions would be viewed as any sort of clear and correct rulings on constitutionality or lack thereof.

So, if the SC rules that the DOMA is constitutional, you'll agree that gay and lesbian folks have no constitutional right to marry?

jafs 2 years, 5 months ago

If we disagree with a decision, then that means that we think the court got it wrong, and interpreted/applied the constitution incorrectly, meaning that their conclusion as to constitutionality or lack thereof of legislation is wrong.

That would be an argument that there is no constitutional right for a corporation to unlimited speech, or that there is no constitutional right for the federal government to impose this sort of tax.

bad_dog 2 years, 5 months ago

Disliking something does not inherently connote tyranny.

voevoda 2 years, 5 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.

jafs 2 years, 5 months ago

It would have been much better.

The problem of a large minority not being represented in decisions is a significant one in our system don't you think?

yourworstnightmare 2 years, 5 months ago

In the past, minority opinions were taken into account through compromise.

Obama compromised with the GOP minority when he went the route of the individual mandate rather than the public option or single payer.

The minority GOP then retrenched against their own idea for political reasons.

This is the real problem. A minority who can gum up the works (e.g filibuster) for solely political purposes without regard to the welfare of the country. They will destropy the country before they let their opponent "win".

Cait McKnelly 2 years, 5 months ago

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

Bob Harvey 2 years, 5 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.

Cait McKnelly 2 years, 5 months ago

Given that Medicaid as we know it is going the way of the dodo bird and going to regular health insurance companies to administer and manage, this isn't going to be much of a problem in the future. Buried in the ACA is a provision that will help. Insurance companies will be capped at 20% of their gross income for management expenditures (including CEO salaries) and must, by law, spend 80% on direct healthcare. Since the current standard is 35%, this will help tremendously.

JackMcKee 2 years, 5 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.

jafs 2 years, 5 months ago

I think a public option would have been a little bit better, but by no means the "best" solution.

If we conceive of health care as a "right", then I think that directly delivering health care by the government to all is the best solution.

That means eliminating insurance entirely, and providing socialized care.

Medicare for all would be next best, and providing a public option that competes with private insurance is after that.

This bill is so long and complicated, and attempts to do so much, that I find it problematic. Some of the outcomes may be positive in some ways, others negative, and we won't really know for quite some time, since many of the provisions don't even take effect until 2014, and then change after that for a couple of years (the fine is set to increase each year).

verity 2 years, 5 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.

appleaday 2 years, 5 months ago

People without insurance are billed at a rate much higher than those who have insurance, because insurance companies negotiate prices with providers. Those without the means to pay default on their health care bills and this cost is absorbed throughout the system and passed on to consumers. Those without insurance tend to seek care only when they're sick, so they wind up in emergency departments and in hospitals, where treatment is far more expensive than at the preventive care level. I, for one, don't appreciate having my insurance premiums rise to cover the costs of the uninsured.

jafs 2 years, 5 months ago

Of course people like some of the current provisions, but the vast majority of the bill hasn't gone into effect yet, and won't until 2014, after which it will continue to change each year.

So, it will be quite a while before we will see what the outcome of all of the bill is, and whether or not we like it as a whole entity.

yourworstnightmare 2 years, 5 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.

verity 2 years, 5 months ago

1 I think health care is a basic human right---and universal care in the long run will save money.

2 I support single payer.

Fred Mertz 2 years, 5 months ago

Honest answers to your questions.

Health care is not a right. A right, from my perspective, is something you're born with and do not depend on anyone else to provide to you. i am born free, I have liberty and the right to express myself freely. No one can give these rights to me, although they can infringe upon them.

Health care is not a right as it depends on someone else providing it to me. Now, with that said, it is in our country's best interest to assist its citizens in having access to affordable health care. But there is a right and wrong way to do it. Taxing Americans to force them to buy health insurance is a wrong way.

Amend the Constitution to provide the power to the federal government to provide health care is an example of the right way to do it. Individuals contributing to health care clinics is another way.

The simplest way is to expand medicaide to provide health care acess to those needing health care coverage but only if we amend the Constitution to provide for it.

But, my best solution is for the states to do what MA do if their citizens want it. We need to maintain a federal government and not a national government.

yourworstnightmare 2 years, 5 months ago

I actually agree with much of what you say. I hope you will encourage your GOP elected officials to work on such measures.

Points of disagreement: "Taxing Americans to force them to buy health insurance is a wrong way." -Possibly, but Justice John Roberts decided that it was a constitutional way to do it.

"The simplest way is to expand medicaide to provide health care acess to those needing health care coverage but only if we amend the Constitution to provide for it." -Agreed, but why must the Constitution be amended for this. IOt was not amended at the creation of Medicaid, which relied on the taxation powers of the federal government. I don't see why an expansion wouldn't rely on the same constitutional backing.

Fred Mertz 2 years, 5 months ago

True, the SCOTUS has ruled the ACA constitutional, but rejected the commerce clause justification and by stating it was a tax, something Obama argued it wasn't. So, yes, it is constitutional, but in my opinion, it was the wrong way to do it.

You're right, the federal government probably could just go ahead and expand the current medicaid program, but I think it is important that we agree as a country on providing health care and to make it clear that it is the power of the federal government to provide it.

When we expand the powers of the federal government and dilute the Constitution by ignoring it, stretching it and otherwise bastardizing it we run the risk of being subjected to the whims of power. Thousands cheered the SCOTUS decision because they believe in national healthcare and didn't care how it came about. But those same people will wail and cry when power shifts and they are subjected to federal taxation that goes against their sensibility and morals.

jafs 2 years, 5 months ago

Romneycare doesn't answer that question that way - it's a state program, not a national one.

I don't know if it's a "right" or not - that depends on what we decide as a nation, I would think.

If we decide it is, then I'd prefer a socialized care system - it's much more direct and efficient than insurance.

FlintlockRifle 2 years, 5 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.

verity 2 years, 5 months ago

Seems to be a quote. What is the source?

beatrice 2 years, 5 months ago

It must be a conservative e-mail going around. The same thing is found in this comment on another site: http://abcnews.go.com/blogs/politics/2012/06/john-roberts-obamas-best-frenemy/

beatrice 2 years, 5 months ago

Now why am I not surprised to see you coming to his/her defense?

Carol Bowen 2 years, 5 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?

Bob Harvey 2 years, 5 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.

JayhawkFan1985 2 years, 5 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.

Mike Ford 2 years, 5 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.....

jayhawklawrence 2 years, 5 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.

camper 2 years, 5 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.

SJGD 2 years, 5 months ago

Thanks, Dr. Bruner, for your thoughtful comments.

Jim Phillips 2 years, 5 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.

JackMcKee 2 years, 5 months ago

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

Jim Phillips 2 years, 5 months ago

JackMcKee,

Let me answer this way. Well, never mind. If you didn't understand the point, you won't understand a response.

christy kennedy 2 years, 5 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.

verity 2 years, 5 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.

jafs 2 years, 5 months ago

So, the ACA is good legislation because it conforms largely to what the Catholic Church thinks we should do?

What ever happened to the separation between church and state?

The ACA is an overly long and complicated flawed response to some real problems with our health care system, and it will be a while before we see how it all shakes out in practice.

jafs 2 years, 5 months ago

Ok - I don't care what the Pope says - it shouldn't have anything to do with our public policy or laws - does that work better for you?

There are a couple of good things in the bill, of course, as is only to be expected with such a long and complicated one - it will be quite some time before all of the provisions come into play, and some time after that before we can judge the bill's outcome in it's entirety.

Your comparison is interesting - I believe that the Patriot Act is, in large part, unconstitutional.

jayhawklawrence 2 years, 5 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.

paulveer 2 years, 5 months ago

G is a brilliant as a 20w light bulb.

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