Affordable Care Act Supreme Court Hearings this week

[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.

[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...

[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.

[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.

[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.

[scottw]

Originally Posted by zimmy

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

are they?

I think it was Justice Breyer that made this broad suggestion yesterday as well, but I'm not sure that it is true...

I know a few people that were either injured or became quite ill needing cance treatments etc while uninsured....and the "tax payer" did not pay for their medical costs, most were covered/treated by help from charitable trusts through the hospitals, payment arrangements worked out through the various providers and on...I don't think that hospitals that admit patients or treat them in the emergency room can simply bill the taxpayer for services not paid by the uninsured....to suggest that anyone that needs medical services and can't pay for them at that time either out of pocket or through some form of insurance instantly places a financial burden on "the taxpayers" is...... "a stretch"

[PaulS]

Originally Posted by zimmy

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

Originally Posted by scottw

are they?

I don't think that hospitals that admit patients or treat them in the emergency room can simply bill the taxpayer for services not paid by the uninsured....to suggest that anyone that needs medical services and can't pay for them at that time either out of pocket or through some form of insurance instantly places a financial burden on "the taxpayers" is...... "a stretch"

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

[Jim in CT]

Originally Posted by PaulS

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

"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...

[RIROCKHOUND]

Originally Posted by Jim in CT

"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?

[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.

[RIROCKHOUND]

Originally Posted by RIJIMMY

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).

[PaulS]

Originally Posted by Jim in CT

"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? They don't, the state govern. sends out the $ based on the total uncompensated care and the amount of surcharge collected You're saying that surcharge is passed on to all insurance carriers? Maybe. Anyone know for sure?IT is passed onto any carriers doing business in that state.

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

NY also has a surcharge to subsidize teaching hospitals.

[Jim in CT]

Originally Posted by RIROCKHOUND

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

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...

[zimmy]

Originally Posted by PaulS

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

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.

[spence]

Originally Posted by zimmy

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

[JohnnyD]

Originally Posted by RIROCKHOUND

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

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.

[RIJIMMY]

Originally Posted by spence

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

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

[zimmy]

Originally Posted by JohnnyD

cannot afford it, tough crap - pay up anyway.

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?

[detbuch]

Originally Posted by RIROCKHOUND

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).

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?

[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!!!!!!!!!!!!!

[RIROCKHOUND]

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

[zimmy]

Originally Posted by RIJIMMY

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

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

[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....

[detbuch]

Originally Posted by zimmy

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

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.?

[Raven]

[Jim in CT]

Originally Posted by detbuch

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.?

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.

[Jim in CT]

Originally Posted by spence

have you every known anyone who didn't use health care in their lifetime?

-spence

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.