"The insurance company pays."

I don't think that's true. If the patient is uninsured, how does the hospital know which insurance company to bill? You're saying that surcharge is passed on to all insurance carriers? Maybe. Anyone know for sure?

I'm guessing that hospitals write off a ton of uncollected (and never to be collected) medical bills from folks who can't pay.

This problem isn't getting solved no matter what happens. My objection ha snothing to do with paying for others, my objection is based on the unconstitutionality of it, IMHO of course...

So..
It's the right thing to do, but the wrong way to do it?

auto insurance is state mandated, not federally.

Thats my fault for a bad example. I know it is state mandated and macintosh apples to green apples.
I think it is mandated in 49 of 50 states.

The point is, it is still a mandated purchase, intended to protect you AND others from your actions (or an accident).

NY also has a surcharge to subsidize teaching hospitals.

In my opinion, yes. I don't think that people who get sick (through no fault of their own) should have to pay one cent more for medical costs than healthy people. None of us control who gets sick and who doesn't (for many diseases), so it seems fair that we share the costs. I just don't think you should ignore the constitution to do it.

Also, I would't apply this to people who choose to eat like pigs or smoke, they should pay the costs of their medical care.

It's a brutal problem, I don't pretend to have any brilliant insights...

In all cases, the bill is somehow paid. If the hospital covers it, it is passed on to everyone in their hospital bills. If the hospital uses the losses as a write-off- the tax revenues are made up somewhere else (or put on the credit card of our kids), if the insurance companies pay a surcharge- it affects our insurance rates.

In any case, I do think the constitutionality of the health care law treads a thin line, but so does passing off the cost of the uninsured to everyone else and that is established by prior practice for decades.

A good point made today on Morning Joe, have you every known anyone who didn't use health care in their lifetime?

David Brooks had a good opinion piece yesterday...

http://www.nytimes.com/2012/03/27/op...ef=davidbrooks

-spence

Any my point was that it's a conditionally mandated purchase. If someone doesn't agree with paying for auto insurance or cannot afford it, they can ride a bike.

On the other hand, the ACA is an mandated purchase for being a living, breathing human being. If you disagree with ACA or cannot afford it, tough crap - pay up anyway.

no, I dont.
Nor do I know anyone who didnt use food stores, some form of transportation, eat at restaurants or buy toilet paper.

Actually, that isn't true. There is assistance to pay for it if you can't afford it. The alternative is the current system, where if you can't pay for it, you go in uninsured and everyone pays for it anyway. If you don't want to pay for it, you get hurt and everyone else pays for it. How is that a better system?

Should that 50th state be required to mandate it because the other 49 have? And if the Federal Gvt. can mandate health care for all of us why shouldn't it mandate auto insurance, or anything else for that that matter, for all of us? If the Federal Gvt need not be limited to its Constitutionally limited powers to mandate, but can mandate anything, are the states even necessary? Would it not be better to eliminate the mish-mash of 50 different governments, and all of us then be gathered under the mandate of one central government? Are the states necessary? Are they merely obstacles to good, uniform government?

From Brooks article -


Second, Obamacare centralizes Medicare decisions — and the power of life and death — within an unelected Independent Payment Advisory Board. Fifteen experts are charged with controlling costs from the top down.

Hmm, so he is basically agreeing its a death panel? So, Sarah Palin WAS RIGHT???

OMG!!!!!!!!!!!!!

Do they pay the bill when they do those other things?

I'm gonna get you one of these shirts as a going away present....:hihi:

Should all the state and local regulations, taxations, mandates, and ordinances that govern the sale and purchase of those other things be replaced by Federal mandates? Wouldn't that make it more uniform and fair, more equal, and even more affordable for all of us? Shouldn't state and local governments be eliminated and replaced by the Federal Gvt.?

:happy:

The constitution is a list of enumerated powers. It specifically lists powers granted to the federal government, and it specifically says that everything else is left to the states.

Having these types of things mandated by the feds might be more consistent and fair. However, the constitution doesn't say that it can be ignored to promote fairness or consistency.

Johnny D is exactly correct, the analogy of auto insurance is a terrible analogy, because no one is forced to drive a car, and many peopl are not impacted by auto insurance requirements because they don't drive (lots of folks in big cities don't drive, and thus can avoid buying auto insurance without penalty). Obamacare requires every single human being to enter into a contract with a private company. Nothing like that has ever been proposed, I don't think. That it hasn't been proposed doesn't mean it's unconstututional, that's why we have the Supreme Court.

Once again you miss the point entirely. It doesn't matter, as far as the constitutionality of the law is concerned, that everyone will use healthcare at some point.

Everyone will die at some point. That doesn't mean the feds can mandate how we handle our funeral arrangements.

Everyone eats food. That doesn't mean the feds can mandate a healthy diet for all of us.

Spence, you need to seperate your love of Obama from the question of constitutionality. Just because this was Obama's idea, doesn't necessarily mean it's constitutional. Obama's agenda is not a litmus test for constitutionality. The number of people impacted by healthcare is absolutely, conmpletely meaningless to the Supreme Court.

So, if the SCOTUS upholds it as constitional, and you agree with it in principal, would you then support 'Obamacare'?

I feel bad for the Solicitor General...must be rough being laughed at in the Supreme Court when you are trying to defend landmark legislation...

someone mentioned Justice Thomas, I don't know about questions he asked or didn't ask but I'm sure he was wondering how it is possible that this legislation was signed by a President who some claim was a Constitutional scholar of some sort and sworn to uphold and defend the Constitution....passed by a Congress(needing every trick in the book employed) made up of many people with legal backgrounds and sworn, I think, to uphold and defend the Constitution,.... and now argued by a guy who, I guess, is supposed to have some knowledge of what he is arguing with regard to the Constution....

Actually, several people have been exempted from the mandate. But, when you argue with a progressive, you do so with someone who views "fairness," "equality," and equitable distribution of pain and gain through a centralized authority above any Constitutional consideration. When you point out that legislation may be unconstitutional, you will either get no response, or be led into a discussion of fairness, equity, or some contrived model of economic advantage. And usually, if not always, the instrument or means to achieve the goal is the Federal Government, which begs the question--are States necessary or are they (as well as the Constitution) an obstacle to good, efficient government?

I support the notion that no one who gets sick, through no fault of their own, should have to suffer financially. I'd support a plan that solves that issue in an efficient way. I don't know if Obamacare does that. And there's a lot more to Obamacare than the individual mandate. If Obama was serious about reducing medical costs, and he is not, then he would have included tort reform as part of Obamacare. He won't do that, because his party is in the pocket of the Trial lawyers lobby.

Obama has attacked the health insurance industry, as if their whopping 6% profit margins are the problem. That's just ideological BS for the Spences of the world, just like his current war on the wealthy.

Very well articulated, sir!

Detbuch:
I believe all judge's decisions regardless of the time period are informed by their own political beliefs and inclinations and if you look at the Supreme Court there have been periods where different ideologies have held sway with different degrees of impact.
General comment:
If in fact the idea that mandating health insurance by requiring those who do not have it to pay a penalty fee then I think that the issue becomes one of restructuring the law so that those who do not have health insurance pay a higher rate of tax or there is a deduction of the cost of that insurance for those who have paid for the insurance. One of the big problems with health care that is behind the heath insurance law is that the uninsured do not have the means to gain access to preventive medicine and over time they in turn result in larger payments for all users of the health care system in the US. While adding another deduction/credit to the tax goes against my idea that deductions should be eliminated and all rates reduced the "tax" objection to the bill seems to me one that could be worked around.

Big difference, with all of those items there are already set costs. The argument made by the Administration is that the price of health care is heavily influenced by how one pays for it.

-spence

It matters because if people are going to use health care they are going to participate in interstate commerce regardless if they're paying for it or not. If everybody is participating then there's no real argument that someone can really opt out.

Jim, I actually read the entire transcript from yesterday...have you?

-spence

The price of health care is also very heavily influenced by government regulation and mandate. In the case of the Federal Government, much of the mandates are unfunded. It was the Federal Government, in the first place, that forced hospitals to accept emergency patients that have no insurance. It is Federal regulation and collusion that artificially raises the price of drugs to be much higher than necessary. And if the government thinks that a mandate can require uninsureds to pay for insurance, that means it believes that those people could have purchased insurance before the mandate, so it shouldn't have forced hospitals to accept them unless they payed for the uninsured health care they received just as any customer must pay for the product it buys in any other transaction. And the force of local laws would be sufficient for such transactions. As for those that cannot afford to buy insurance, won't their costs still be shifted to those who are insured, even if the government picks up the tab for them in which case the cost is shifted to the tax payer. And isn't the so-called shift in costs that occurs now overestimated--the article that I posted in the other thread relates a study that estimates the cost shift not to be $1,000 for an average policy, but an annual cost of about $80. So the government creates problems, then expands its power in order to "solve" the problems--in this case with a "solution" that is even more expensive for most, and in the same stroke changes the fundamental relation of the individual to the government. Government power expands, individual freedom contracts. But it is all for the better and is more efficient, and the power of government pervades into all aspects of our economic lives, which is virtually all aspects.

If all commerce can be "regulated" by the Federal Gvt., which this mandate would give it the power to do, I ask again, in this thread, for the fourth time, are States and the Constitution necessary? Are they not obstacles to efficient centralized government? Would it not be better to just abolish them?

Not as much as one would conclude by how the Court has adjudicated for the past 75 years. The period between the FDR Court to now is the time when adherence to the text of the Constitution was deliberately discarded in favor of desired political outcomes. There are various reasons for that, the main being the prevalence of progressive philosophy in our universities and educational institutions and the efforts of progressive politicians which culminated in the FDR administration all-out attack on the Constitution. This is all well documented and easily researched. That only "radical" Tea Party types and conservative talk radio, and "radical right wing" politicians discuss it, is due, again, to how our elites in the media, and the rest of us for that matter, have been educated, and the gradual acceptance of generations of the status-quo. Current generations have known only this, and accept it as correct.

Though there were some differences in Constitutional interpretation before FDR, they were not major deviations from the Constitution and the greatest problem was the slavery issue. Not that there were not attempts to expand Federal power beyond Constitutional enumerations, some of which may have succeeded to some degree, but there was no great (except for slavery) disagreement on Constitutional authority between those of opposing parties. Even Grover Cleveland, a Democrat, vetoed hundreds of bills (I think it was hundreds--it was a lot) because he considered them to be unconstitutional. Judges were not forced to consider a barrage of assaults on the Constitution because there weren't that many. And when they adjudicated, there was far more faithfulness to Constitutional text and intention.

Spence, in your previous post, you didn't make a reference to the Commerce clause. you implied that the individual mandate was justified because of how many people participate in healthcare. I was reacting to what you posted.

No, most health CARE is not interstate. Some products that are used may have crossed state borders and such products can be "regulated"--whatever that means. But the actual care, unless the hospital is straddling a border, is usually intrastate, not interstate. A great deal of health care is only consultative with no products being used or exchanged. In any event, the B R O A D, expansive, "interpretation" of "commerce," "regulate,." and "interstate," is not justified in the text of the Constitution, neither was it intended according to the extant documents of ratification and explanations given in letters and statements later by the founders. But that is, apparently, not important to you. Valid arguments about what such broad interpretation and the power it grants to the Central Government, and the fundamental change in the relation between the citizen and the government also seem to be of no importance to you. What seems to matter only is a solution to a problem regardless of what precedence that solution gives to government to "regulate" every aspect of our lives. No matter even that much of the problem is created by government in the first place--the same government that presumes to fix it. Nor does it seem to matter to you that the solution, along with the train of solutions over the past 70 years, destroys the foundation, the structure of limited, representative government built specifically to ensure individual lilberty, and replaces the structure with an amorphous, unlimited administrative apparatus. An apparatus that will replace individual sovereignty and more "efficiently" solve all our "collective" problems. I ask again, of what use are 50 different State governments and an unadhered to Constitution to such an apparatus?

it was statements like these and other tortured definitions of convenience that found the Solicitor General being laughed at on the floor of the Supreme Court the last few days. :)

from : MOTHER JONES

Obamacare's Supreme Court Disaster
—By Adam Serwer

The White HouseSolicitor General Donald B. Verrilli Jr. should be grateful to the Supreme Court for refusing to allow cameras in the courtroom, because his defense of Obamacare on Tuesday may go down as one of the most spectacular flameouts in the history of the court.

Sounding less like a world-class lawyer and more like a teenager giving an oral presentation for the first time, Verrilli delivered a rambling, apprehensive legal defense of liberalism's biggest domestic accomplishment since the 1960s—and one that may well have doubled as its eulogy.


that's from BIG Obamacare supporters:uhuh::)

clearly, based upon statements by people here, the answer is either.."no", the States and the Constution are not necessary in their minds/views ....or....."maybe", but they are so woefully uninformed on States Rights and the Constitution that these considerations never enter into any of their arguments :)

it's depressing........fortunately, it's been shown the last few days that you can try to argue around and around the Constitution and logic and common sense, but it's tough to argue through it...


Madison- Federalist #45
"The powers delegated by the proposed Constitution to the federal government, are few and defined. Those which are to remain in the State governments are numerous and indefinite. The former will be exercised principally on external objects, as war, peace, negotiation, and foreign commerce; with which last the power of taxation will, for the most part, be connected. The powers reserved to the several States will extend to all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State."


JUSTICE KENNEDY: "And here the government is saying that the Federal Government has a duty to tell the individual citizen that it must act, and that is different from what we have in previous cases and that changes the relationship of the Federal Government to the individual in the very fundamental way."


interesting, this would appear to represent, and I think what is really the essence of the "Fundamental Change" that we were promised by this President, which may/should be a change that he has no authority to promise

Gotta luv your statement.
Common sense is not so common.
It comes from an open mind, experience and practical knowledge.

“Fathom the hypocrisy of a Government
that requires every citizen to prove
they are insured....


but not everyone must prove they are a citizen.”