Health Care Law Ruling

[technomage]

I admit that the right obviously put a bias spin about unions on the whole thing,

More than "spin"--it was an outright lie, and one so preposterous as to be noted as such. Yet I commend you for noting a wrongful action on the part of the right, and publicly acknowledging it.

but "malicious lawsuit" is your subjective view.

Yes it is--which is why I mention it as a possibility (to be precise, a suspicion on my part), and do not make an actual accusation. In the defense of Crossroads GPS, they were forced to wait beyond the 20-day statutory limitation for action on their FoIA request. (It seems only fair--you noted where they had done wrong, it behoves me to note where theyhad acted within their rights, and that also reduces the possibility of my "malicious lawsuit" suspicion.)

We have a right for full transparency (you know, one of the many campaign promises) on the criteria used for acceptance and denial of these waivers and we shouldn't have to resort to the Freedom of Information Act to get it.

Sean, do you honestly think the HHS was stalling on the request? Or were they trying to get the information together, fulfilling requests in the order in which they had received them?

where political bribery and corruption has run amok,

That's a specific accusation of moral turpitude on the part of the current administration. I shall have to ask you to either producce evidence, or withdraw the argument. (I do not ask you to withdraw either the accusation or the opinion, as those are perfectly within your rights.)

I did not vote for Obama. I do not know if I will vote for Obama in 2012, though the odds are pretty good that I shall. (I oppose Romney on multiple points of his platform.) I am not particularly emotionally invested in Obama or his presidency. But I am vehemently opposed to the vilification of our public officials for false excuses. If you remember, I frequently battled Minnesota (among others) about just such issues. Just as I defended Bush against flse accusations, so I will defend Obama against false accusations. Do you have a problem with that?

[seanD]

Tech, in the future, if you're going to break up my posts, at least have the courtesy of linking to my original post.

[technomage]

Tech, in the future, if you're going to break up my posts, at least have the courtesy of linking to my original post.

I meant to, but I got your post loaded, then my connection died. I had to copy and paste things into notepad, and then forgot to use the regular "Reply" function to get the correct header.

ETA: I made the explanation, then forgot the actual apology. I do apologize for not linking to your post correctly,

[Ansgar Seraph]

The mandate/tax is the most disliked because it is the most publicized. And it's still a huge issue! Don't pretend that Robert's flip-flop magically made the problem go away.

Did I ever say that the problem magically went away? Nope. I wrote: " Long term, I'm guessing the ACA will start going up in popularity as the focus shifts to its policies apart from the mandate. We'll know by the DNC convention whether it'll be an election topic." To which you responded with talk of magical popularity, to which I responded with non-magical factors that could affect public opinion, to which you came right back to your starting point. It makes a man wonder what the point of it all is!

However, there are plenty more reasons besides to despise the healthcare act. For instance:

[The Independent Payment Advisory Board] will essentially mean rationed care for our nation’s seniors. The 15 officials who will make up the board will not only be empowered to make what is expected to be billions of dollars’ worth of cuts to Medicare every year, but will be required to do so when spending exceeds targeted rates. IPAB’s recommended cuts will become law unless a supermajority in Congress vetoes the board’s proposal and creates its own cost-cutting proposal of equal size — an unlikely scenario even in the most harmonious of political times.

Due to the ACA’s restrictions on IPAB’s cost-cutting methods, the board is expected to focus on minimizing payments provided to doctors who serve Medicare patients. However it is no longer financially viable for many physicians to serve Medicare patients as it is, and such cuts would exacerbate a Medicare-doctors shortage that is already affecting patients’ access to care throughout the country.

http://dailycaller.com/2012/03/19/repeal-ipab-now/

Here's a fun topic: Conservatives decrying a regulatory body that is potentially tasked with making Medicare cuts . . . at least one that isn't Paul Ryan's hypothetical government handing out Medicare vouchers of continuously decreasing value. But I digress.

The "Daily Caller" is wrong on at least two fronts. First, the IPAB can't propose rationing care. From WhiteHouse.gov:

The Facts About the Independent Payment Advisory Board. Nancy-Ann DeParle. 2011-04-20. Accessed 2012-07-03

IPAB is specifically prohibited by law from recommending any policies that ration care, raise taxes, increase premiums or cost-sharing, restrict benefits or modify who is eligible for Medicare.

Congress then has the power to accept or reject these recommendations. If Congress rejects the recommendations, and Medicare spending exceeds specific targets, Congress must either enact policies that achieve equivalent savings or let the Secretary of Health and Human Services follow IPAB’s recommendations.

© source where applicable

There is also no need for Congress to overturn the IPAB's recommendations by super-majority, unless it is overriding a presidential veto (perhaps Tucker Carlson simply assumes that any Senate action in the future will require a super majority?). Congress can therefore find an equivalent amount of savings from somewhere other than Medicare to cover the recommended budget savings. As far as I can tell, the predicted savings targets are speculations of the "Daily Caller" and not much else.

So here is yet another part of the ACA that has been completely altered in the fevered imaginations of Conservatives in order to create a monster to fight. "Death Panels!" Sarah Palin cried. "Death Panels!" her followers echoed. Whether it was true or not didn't matter at all.

Want another reason? How about the fact that many doctors are planning to retire early because of ethical questions surrounding Obama's plan and the fact that it will be almost impossible to run a profitable private practice? Says one doctor, "We will be moving further away from humanity-based health care and more towards the patient as a commodity. This was not the way my father practiced—nor will I. Winding down to retire early."

http://blog.heritage.org/2012/03/14/...ear-obamacare/
http://www.heritage.org/research/rep...act-on-doctors

But hey, at least you'll be able to keep your dead-beat 26-year old on your insurance plan. Thanks, Obama! Now if only he could find a doctor.

That's not a fact; it's speculation, based on anecdotal evidence, at best. There's no way to know how many doctors will actually leave their profession and no good way to tell what factors led to that decision. It's probable that many of the doctors who leave the profession are independent-practice physicians, a group that has experienced difficulties and dwindling ranks for the last few decades. As more doctors integrate into group practices and hospital environments, the comparative cost of independent practices will undoubtedly rise due to traditional market forces. Some of the doctors who do end up closing their practice will blame the ACA, some won't. But there's no way to tell, at the moment, what factors are truly behind those future decisions.

As for the ACA being unpopular among doctors? I've read the Physician's Foundation survey and many of the doctors opposing the ACA bring up good points (and not all the doctors opposed the ACA for "conservative" reasons). It remains, however, that the survey largely rested on independent practitioners, the class of physicians who were already experiencing decades-long professional exodus to hospital-based care and group practices. It remains to be seen how much extra stress will be placed on physicians. But the answer to that problem surely isn't to limit the number of patients! The answer to that problem is medical education and practice reform — $250,000 for a medical degree is unnecessary and physician's assistants and nurse practitioners are widely under-utilized. The problem of more patients may well be a temporary stress on the medical system but the solution is to train more medical professionals, not restrict care to those who need it!

Finally, you have to ask yourself, if ObamaCare is so great then why did Obama and his cronies specifically and explicitly exempt themselves from it?

http://www.washingtontimes.com/news/...one-but-obama/

He even handed waivers to his union buddies.

http://www.theblaze.com/stories/how-...waivers-is-in/

These were already covered by technomage (thanks, techno!) as clear misrepresentations of the truth. I'll only add the anecdotal story of seeing the "Congressional Exception" canard posted to a friend's Facebook account. Someone had gone through the trouble of painting his van with that very same question, sourcing a page and line from the PPACA. Naturally curious, I looked up the line . . . it sat in the middle of a paragraph dealing with exceptions to catastrophic care coverage, completely unrelated to the purported Congressional exception. So now people aren't just making stuff up, they are slapping their stupidity on vans and creating make-believe references.

Great for winning a battle of ideas, I guess. Morally reprehensible, maybe, but it works!

Like I said, the more you dig into ObamaCare, the more it stinks. But don't worry, the media will keep buttering up the public with misleadingly worded polls that present a false picture of what Obama's plan really entails.

"Oh, don't worry about the kick in the nuts, you're getting $100! Isn't that swell?"

So, in the above, you listed four objections to the ACA. One was highly speculative, while three were simply misrepresentations of reality. I don't think you have a very good handle of "what Obama's plan really entails."

—Sam

[joel]

Long term, I'm guessing the ACA will start going up in popularity as the focus shifts to its policies apart from the mandate.

Except that, as I understand, the policies have already started causing people to lose insurance and causing health care and insurance costs to rise. I expect this trend to continue, since most of the policies I have heard of in the misnamed "affordable care act" have the effect of increasing costs.

But the answer to that problem surely isn't to limit the number of patients! The answer to that problem is medical education and practice reform — $250,000 for a medical degree is unnecessary and physician's assistants and nurse practitioners are widely under-utilized.

Indeed. This problem is caused by government enforcement of the existing health-care cartel, which artificially restricts competition by limiting the number and sizes of schools and admission, and limiting the number of hospitals. And restricting the possibilities to be nurses, midwives, etc, like you point out.

If we returned to unhampered markets/competition (instead of economic fascism), then this wouldn't be a problem.

[Pilgrim]

Obama: Mandate is Not a Tax

OBAMA: My critics say everything is a tax increase. My critics say that I’m taking over every sector of the economy. You know that. Look, we can have a legitimate debate about whether or not we’re going to have an individual mandate or not, but…

STEPHANOPOULOS: But you reject that it’s a tax increase?

OBAMA: I absolutely reject that notion.

Source

© source where applicable

So much for that...

Obama isn't calling it a tax is he? It's his critics. This is why Roberts is a genius for his Party. Now people can say, "hey it IS a tax" and blame Obama for the new tax right into the elections. The cynic in me thinks Roberts did this just so that now the GOP can say it's a tax and hold Obama's feet to the fire on it and not because he actually things the law is good.

[Conductor42]

I may not be the biggest fan of the individual mandate, but it's not the first product the government has forced you to purchase.
Many others we're forced to purchase, such as:
Police Services, Fire Protection Services, the War in Iraq, Roads that we drive on, automotive insurance if you wish to drive on the roads that you've already purchased, etc.

[joel]

I may not be the biggest fan of the individual mandate, but it's not the first product the government has forced you to purchase.
Many others we're forced to purchase, such as:
Police Services, Fire Protection Services, the War in Iraq, Roads that we drive on, automotive insurance if you wish to drive on the roads that you've already purchased, etc.

Yes, and arguably most of those are even worse, because not only are you forced to purchase the product, but you are forced to purchase it from a government-enforced monopoly.

This mandate is just a new addition to a long train of abuses and usurpations.

The thing that makes this one stand out is that the supreme court upheld it with reasoning that gives the government absolute power. Almost nothing is unconstitutional now (as long as the government calls the penalty a "tax"). The de facto despotism is now de jure.

[technomage]

government-enforced monopoly.

Emphasis added. You have a definition of "monopoly" so contrary to facts, is it any wonder I accuse you (and some other libertarians) of being willing to stand on your head while arguing that white is black?

[RBerman]

I may not be the biggest fan of the individual mandate, but it's not the first product the government has forced you to purchase. Many others we're forced to purchase, such as:Police Services, Fire Protection Services, the War in Iraq, Roads that we drive on, automotive insurance if you wish to drive on the roads that you've already purchased, etc.

That is true. And when the government forces you to spend money to have something it has decided you need, we call that a "tax." Would that the law and the lawmakers had been forthright about that. (Car insurance doesn't fit with the other things you mentioned, because you're not forced to buy it unless you have decided to buy a car as well. ACA is more like forcing non-drivers to buy car insurance, in order to lower the premiums for those who actually do drive.)

[KingsGambit]

That is true. And when the government forces you to spend money to have something it has decided you need, we call that a "tax." Would that the law and the lawmakers had been forthright about that. (Car insurance doesn't fit with the other things you mentioned, because you're not forced to buy it unless you have decided to buy a car as well. ACA is more like forcing non-drivers to buy car insurance, in order to lower the premiums for those who actually do drive.)

I can agree with this. Though I'm no Obama supporter, I do support the basic idea of his healthcare plan, but cringe every time he tries to insist it's not a "tax". It's a fairly extreme example of doublespeak.

[joel]

Emphasis added. You have a definition of "monopoly" so contrary to facts, is it any wonder I accuse you (and some other libertarians) of being willing to stand on your head while arguing that white is black?

"Monopoly" as commonly used today (and as in the dictionary) means the exclusive supplier of a thing. Or an exclusive control over something.
Both of these senses apply in this instance.

I don't know what you are objecting to. Are you perhaps thinking that only "private" firms can be/have monopoly? That is nowhere in the definition. In fact, historically (common law tradition), the word "monopoly" referred specifically to exclusive control established/enforced by the government. E.g., according to the great jurist Edward Coke around 1600,

"A monopoly is an institution or allowance by the king, by his grant, commission, or otherwise to any person or persons, bodies politic or corporate, for the sole buying, selling, making, working, or using of anything"

But the meaning of what I said should be clear, even if you have your own favored definition of the word. The distinction I made is that, forced to buy health insurance, you are still left a choice among which of the competing insurance sellers you will purchase from; whereas when you are forced to "purchase" (as Conductor42 put it) fire protection services, you do not have any such choice--your forced purchase is from one particular supplier.

[technomage]

I don't know what you are objecting to.

No, I don't suppose you do. I wonder if you ever will.

[joel]

No, I don't suppose you do. I wonder if you ever will.

Not if you don't say. I'm not a mind reader.

[technomage]

For those Conservatives who oppose the ACA ... I rather think this political cartoon says it all: http://www.startribune.com/opinion/161024445.html