Affordable Care Act Supreme Court Hearings this week

[striperman36]

Should be interesting to see if they actually reach a decision.

My thought is they will punt it down the track until 2015 when individuals can file suit.

[Jim in CT]

My guess is they don't punt. I also predict that the vote will be 5-4. The deciding vote will be cast by Justice Kennedy, whose opinion is the only one no one can predict with any certainty. Thus I won't say which way the majority decides.

[TheSpecialist]

I seriously hope they demolish it.

Jim I have a question for you, if the government can regulate say utility costs and such why don't they come up with a blueprint for medical costs. I saw that when I had surgery what was billed out by the hospital and doctors, and what was paid by the insurance was a big discrepancy. It also shows just how much the medical industry over charges if they can settle for the rates they agreed to with the insurance companies. Why not have a blue book of rates for everything across the board. They could divide the country into regions and have different prices for different regions. I think that would be a prudent step in controlling healthcare costs. when their costs go up let them have a hearing and ask for a rate increase?

Could this work?

[Jim in CT]

Originally Posted by TheSpecialist

I seriously hope they demolish it.

Jim I have a question for you, if the government can regulate say utility costs and such why don't they come up with a blueprint for medical costs. I saw that when I had surgery what was billed out by the hospital and doctors, and what was paid by the insurance was a big discrepancy. It also shows just how much the medical industry over charges if they can settle for the rates they agreed to with the insurance companies. Why not have a blue book of rates for everything across the board. They could divide the country into regions and have different prices for different regions. I think that would be a prudent step in controlling healthcare costs. when their costs go up let them have a hearing and ask for a rate increase?

Could this work?

Specialist, I'm no expert on healthcare, it is a very complicated issue, and I know very little...

States currently DO regulate the costs of health insurance. Health insurance companies need to get their rates approves by state insurance departments.

That aside, I just don't know how we control these costs. The cost of providing quality care are so high, I just don't see how you contain it. People want the best care, and that cutting-edge technoogy is very expensive.

Today, most doctors will tell you that they lose money when they treat Medicare/Medicaid patients, because the pathetic reimibursements provided by the gov't simply doesn't cover the costs of the care provided. How do you solve that problem? Beats the heck out of me.

I also know that Medicare is in the red by tens and tens of trillions of dollars (that's trillions with a "t"). And the baby boomers will make that much, much, much worse. What's the answer to that problem? Beats me. Should we bankrupt our kids and grandkids so that all the baby boomers can live an extra 6 months? But what's the alternative? To pull the plug on all these people? How do you begin to solve these problems?

"Why not have a blue book of rates for everything across the board."

I think that's how medicare works. And the rates are not sufficient to cover the costs of the care. Here's part of the problem. If you have one politician who wants to set the rates at a level that covers the costs of the care, plus a reasonable profit for the doctor. You then have another politician who promises to cut those rates in half...he knows that's stupid, but he wants to get elected. That crap works, those promises get people elected, which is why cops get to retire at age 45 with insane pensions. You simply cannot leave these decisions to politicians who care more about getting re-elected than they care about doing the right thing.

Specialist, the Baby Boomers will VERY SOON force the rest of us to figure this out. Do we literally bankrupt ourselves to extend their lives by every day possible?

Beats me.

Starting January 1, 2011, TEN THOUSAND BOOMERS A DAY started turning 65. 10,000 a day. That will continue for 15 years.

I don't pretent to know the answer. But I do know for a certainty that we are in serious, serious trouble. This could literally bankrupt us. Medicare is tens of trillions in the red, and the boomers have barely begun to turn 65. I read that today, 50% of a person's healthcare costs are incurred in the last 6 months of one's life. Think of what that means when the baby boobers really start getting old and sick by the tens of millions. We can't possibly cover that expense, but I don't even like to consider the alternative.

All I know is this. I have 3 boys. I sure as hell don't want them to have to sell their houses to keep me alive for 6 more months when I'm 80 years old.

Where do we get, say, $50 trillion more to pay for the care that the baby boomers will need? Do the math. It's not possible, it just isn't. And that's exactly what we are facing.

[JohnnyD]

Originally Posted by TheSpecialist

I saw that when I had surgery what was billed out by the hospital and doctors, and what was paid by the insurance was a big discrepancy. It also shows just how much the medical industry over charges if they can settle for the rates they agreed to with the insurance companies.

Insurance companies and hospitals agree to pricing terms before an insurance company say "yeah, we'll allow our customers to use your doctors." The insurance companies leverage the wide availability of doctors to strong-arm hospitals into agreeing on cheaper terms. In turn, the hospitals utilize the volume increase to justify taking tighter margins.

Essentially, large insurance companies are provided wholesale pricing because of the leverage they hold in their larger customer base.

[Jim in CT]

Originally Posted by JohnnyD

Essentially, large insurance companies are provided wholesale pricing because of the leverage they hold in their larger customer base.

What he said...

[TheSpecialist]

Originally Posted by Jim in CT

What he said...

Exactly now if the Federal Government did the same thing healthcare would be significantly lower. If they can take what the insurance companies are giving and still be profitable, then they should start by using those rates.

[striperman36]

All the Op-Ed's are saying 5-4. the 4 arguments are very well defined for constitutional discussion.

Regardless, of the outcome I don't think this will be the last word for ObamaCare.

[PaulS]

As Jim said, it is very complicated and anyone who tells you they know how to fix it is crazy. There are some obvious areas (high RX costs, tort reform, unneeded tests, etc.) but how about lowering the cost of medical school? Anyone think of that? I never thought of that until someone mentioned it recently. We need more primary care Drs. But b/c PCPs earn so much less and they leave med. school w/so much debt, most medical school grads specialize b/c they can earn more $. Maybe a 2 tier system, subsidize the cost of a PCP educ. but if you want to spec., your last year or 2??? cost you much, much more. There is prob. a 1,000 things most of haven't heard of that that would need to change to really lower the cost.

[RIJIMMY]

Jeffrey Toobin says questioning by Supreme Court justices leads him to believe the health care reform law is in peril. He called today's session "a train wreck" for the White House

[PaulS]

It would be interesting to hear Thomas' questions.

[striperman36]

Originally Posted by PaulS

It would be interesting to hear Thomas' questions.

If he had any.

As I had started this, it's going to be very devisive in the decision.

I could almost see someone challenging SS contributions if they throw ACA out as being unconstitutional.

These decisions well either send us down the road of socialism or further breakdown what is perceived as American prosperity.

[RIROCKHOUND]

Originally Posted by striperman36

I could almost see someone challenging SS contributions if they throw ACA out as being unconstitutional.

Or things like Auto insurance... I'm a good driver, I think I'll go without....

[JohnnyD]

Originally Posted by RIROCKHOUND

Or things like Auto insurance... I'm a good driver, I think I'll go without....

You aren't obligated to own a car. Remember, driving is a privilege, not a right. If people don't like it, there's always a bicycle.

[zimmy]

Originally Posted by JohnnyD

You aren't obligated to own a car. Remember, driving is a privilege, not a right. If people don't like it, there's always a bicycle.

The tax payers are obligated to foot the bill of your medical costs if you are uninsured and get hurt.

[RIJIMMY]

Originally Posted by JohnnyD

You aren't obligated to own a car. Remember, driving is a privilege, not a right. If people don't like it, there's always a bicycle.

auto insurance is state mandated, not federally.

[scottw]

Originally Posted by RIROCKHOUND

Or things like Auto insurance... I'm a good driver, I think I'll go without....

maybe I missed something...when did the Federal Government start mandating auto insurance?

[Jim in CT]

Originally Posted by striperman36

If he had any.


I could almost see someone challenging SS contributions if they throw ACA out as being unconstitutional.

Not even close. Social security contributions are a "tax" levied by the federal government, and the constitution clearly says the federal government has the authority to collect taxes. If it's explicitly in the constitution, it cannot be considered unconstitutional.

The individual mandate is completely different. It's requiring individuals to eneter into a contract with a private company. If the feds can do that, why can't they make you buy a computer from Apple? Why can't they make you buy an electric car?

I hapen to like the individual mandate on the moral grounds that healthy people should help pay the cost of people who get sick through no fault of their own. However, I don't like Obama's willingnes to ignore the constitution when it suits him. If enough people want the federal government to have the authority to force us to buy things from a private company, we have mechanisms to amend the constitution to reflect that. Until then, the individual mandate seems unconstitutional to me.

[zimmy]

Originally Posted by striperman36

These decisions well either send us down the road of socialism or further breakdown what is perceived as American prosperity.

That is a stretch, but it certainly should raise the question, if you can't be required to have insurance, then shouldn't a hospital be able to reject the uninsured? Actually, I am not sure if the quote above is an either/or...

If it isn't unconstitutional to make taxpayers and insurance holders pay for others health care, how can it be unconstitutional to require people to be insured?

I bet most who are opposed to this already have health care. They may say they are opposed because of the government mandate for a person to have insurance is a government invasion. I don't believe that is why they oppose it. My gut feeling is the real issue for most them is they don't want to have to pay for the insurance of all the people who will be required to get insurance. Irony is, they already do pay for it. Beech is complicated.

[TheSpecialist]

Btw the 7 million dollars that the ortho doc generates is just from 2 days of surgery per week, the other 3 he is also generating revenue with 10 -15 office visits per day...

[RIJIMMY]

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!!!!!!!!!!!!!

[The Dad Fisherman]

Originally Posted by RIJIMMY

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

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

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

[RIROCKHOUND]

What does the health-care law mean to me? - The Washington Post

[Mr. Sandman]

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


but not everyone must prove they are a citizen.”