Obamacare and the Supreme Court

[Pelado]

Who knows. Poor drafting, sloppy legislating, fear alternative path not politically viable, belief current structure is constitutional...

In 2009, President Obama was asked whether the individual mandate in his healthcare plan was really just a tax in disguise. "I absolutely reject that notion," he responded.

But if the president had been brave enough back then to call a tax a tax, his healthcare law might not be in such a mess today...

If the administration loses, its biggest domestic achievement could be in ruins. It would have been simpler to fess up and call the mandate a tax from the start.

http://www.latimes.com/news/opinion/...1427494.column

[All-American]

Let me throw this out here to help me understand if people really view the mandate as impermissible because of liberty concerns or if there is another issue (like the form of how it was actually enacted):

http://www.cougarboard.com/board/mes...tml?id=8425086

I've made that argument before, and I think Pelado does a good job showing why this administration's approach is different. One of the things the Court discussed yesterday, however, was the idea that even this approach might be an impermissible direct tax, since it is not apportioned among the states as required in Article One (and which is not affected by the sixteenth amendment to the extent that it does not levy an income-based tax). Courts in the past have also apparently been smart enough to know that there's really no difference between charging a tax on a select group and charging a general tax on everybody, but discounting the tax for those not in that select group. That's different from offering a tax credit on income tax to homeowners, for example, because the two acts in tandem have the same effect as the impermissible act, with no other permissible effects.

I don't completely understand this argument, but it's one in the mix.

[All-American]

Who knows. Poor drafting, sloppy legislating, fear alternative path not politically viable, belief current structure is constitutional...

Or because what they really want is to be able to command that everybody buy insurance. It's a mandate, not a tax incentive.

[All-American]

Day three transcript:

http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-393.pdf

http://www.supremecourt.gov/oral_arguments/argument_transcripts/11-400.pdf?hpt=hp_t1

Also, believe it or not, the University of Chicago has liberals, too:

http://www.huffingtonpost.com/geoffrey-r-stone/supreme-court-health-care_b_1385270.html

[SoonerCoug]

I think law is sort of like interpreting the bible and religion. Judges do what they want and then find verses/cases to support their actions.

[Pelado]

I think Pelado does a good job showing why this administration's approach is different.

Completely agree.

[creekster]

Completely agree.

That Pelado character has really stepped up his game here, dont you think?

[RobinFinderson]

It is very interesting to watch conservative CUFfers slowly reason out the fact that private insurance is NOT a good way to meet the nation's health care needs. I'm not saying that I'm smarter than anyone on this issue, but this fact has seemed obvious to me for a long time, and it is why I don't really care if Obamacare gets shot down by the SCOTUS.

What I think, and what I hope others will eventually agree with, is that the provision of medical care, at a basic level, needs to be handled like public education. Whatever its current flaws, and there are MANY, public education has been a HUGE success in terms of offering a realistic chance for poor people to improve their circumstances in life. Just as public education is really very modest in what it offers, compared to private education, we need a modest baseline healthcare service that is FREE to all citizens. It should cover routine stuff, catastrophic stuff, and offer modest end-of-life care (rationed based on the age of the person, and the likelihood of a successful outcome in treatment). Just as private education offers a superior product for those who can afford it, we will let the private healthcare market develop a separate set of services for people who can afford to pay for that.

[All-American]

It is very interesting to watch conservative CUFfers slowly reason out the fact that private insurance is NOT a good way to meet the nation's health care needs. I'm not saying that I'm smarter than anyone on this issue, but this fact has seemed obvious to me for a long time, and it is why I don't really care if Obamacare gets shot down by the SCOTUS.

What I think, and what I hope others will eventually agree with, is that the provision of medical care, at a basic level, needs to be handled like public education. Whatever its current flaws, and there are MANY, public education has been a HUGE success in terms of offering a realistic chance for poor people to improve their circumstances in life. Just as public education is really very modest in what it offers, compared to private education, we need a modest baseline healthcare service that is FREE to all citizens. It should cover routine stuff, catastrophic stuff, and offer modest end-of-life care (rationed based on the age of the person, and the likelihood of a successful outcome in treatment). Just as private education offers a superior product for those who can afford it, we will let the private healthcare market develop a separate set of services for people who can afford to pay for that.

Were I a legislator, you'd have a much better chance talking me into supporting publicly-provided emergency care. It seems to me that when a man's life is on the line and immediate support is necessary to keep him alive, it's not really the time to look for his insurance card. The tricky part, though, is defining the point of stability at which private insurance should cover the costs.

[Moliere]

It is very interesting to watch conservative CUFfers slowly reason out the fact that private insurance is NOT a good way to meet the nation's health care needs. I'm not saying that I'm smarter than anyone on this issue, but this fact has seemed obvious to me for a long time, and it is why I don't really care if Obamacare gets shot down by the SCOTUS.

What I think, and what I hope others will eventually agree with, is that the provision of medical care, at a basic level, needs to be handled like public education. Whatever its current flaws, and there are MANY, public education has been a HUGE success in terms of offering a realistic chance for poor people to improve their circumstances in life. Just as public education is really very modest in what it offers, compared to private education, we need a modest baseline healthcare service that is FREE to all citizens. It should cover routine stuff, catastrophic stuff, and offer modest end-of-life care (rationed based on the age of the person, and the likelihood of a successful outcome in treatment). Just as private education offers a superior product for those who can afford it, we will let the private healthcare market develop a separate set of services for people who can afford to pay for that.

I like this post, except I hate it when people call things free. It's not free for everyone. It would only be free for 47% of Americans.

I'd support a baseline single-payer system that has modest copays and covers 100% of costs, but I think it would be better to institute another payroll tax to cover the costs of this system. The payroll tax could be progressive, but having everyone pay into the system might be a good incentive for people to try and stay healthy or to at least not game the system.

[Color Me Badd Fan]

I've come around more to a single payer system because Obamacare projects to be so awful.

My #1 concern about health care isn't the access for poor people or even the quality. Primarily I'm concerned about costs and secondarily I'm concerned about access for people with preexisting conditions. Obamacare not only doesn't address the costs, it will actually make the price of health insurance more expensive for a majority of people.

If one's primary concern are the ridiculous costs, then the single payer system holds a lot of virtue. No longer can the anesthesiologist (sorry for continuing to harp on this example) get away with charging me, a cash customer, $1,000 for 15 minutes of his time while I imagine the insurance companies have negotiated a significantly lower amount. Bargaining power, or lack thereof, was a bitch for me, and under a single payer system it can be a bitch for the anesthesiologist. Additionally, my $1,000 wouldn't, to the same extent, subsidize the people that don't pay.

Like Moliere said, this thing would have to be a payroll tax, like Social Security and Medicare. Hell, I'd even support a Federal sales tax, especially a $1.00 surcharge on every package of Oreos and every order at McDonalds. I'm tired of 47% of this country not paying anything and this would be a way to make them "pay their fair share."

[LA Ute]

Or because what they really want is to be able to command that everybody buy insurance. It's a mandate, not a tax incentive.

It would be a mistake to assume a whole lot of thought went into what should be in the bill before it was passed. The Senate staffers who wrote it saw it as an advanced first draft and were expecting many details would be worked out in conference, which never happened because of Scott Brown's election in Mass. The whole thing is an amazing mess.

[UtahDan]

It is very interesting to watch conservative CUFfers slowly reason out the fact that private insurance is NOT a good way to meet the nation's health care needs. I'm not saying that I'm smarter than anyone on this issue, but this fact has seemed obvious to me for a long time, and it is why I don't really care if Obamacare gets shot down by the SCOTUS.

What I think, and what I hope others will eventually agree with, is that the provision of medical care, at a basic level, needs to be handled like public education. Whatever its current flaws, and there are MANY, public education has been a HUGE success in terms of offering a realistic chance for poor people to improve their circumstances in life. Just as public education is really very modest in what it offers, compared to private education, we need a modest baseline healthcare service that is FREE to all citizens. It should cover routine stuff, catastrophic stuff, and offer modest end-of-life care (rationed based on the age of the person, and the likelihood of a successful outcome in treatment). Just as private education offers a superior product for those who can afford it, we will let the private healthcare market develop a separate set of services for people who can afford to pay for that.

I think I paid about $12K in health insurance for my family last year, not including deductibles, co-pays and parts insurance didn't cover (another couple thousand in an admittedly very unusual year for us). If the care is just as good and my tax is anything less than that then I am for it.

[Moliere]

It would be a mistake to assume a whole lot of thought went into what should be in the bill before it was passed. The Senate staffers who wrote it saw it as an advanced first draft and were expecting many details would be worked out in conference, which never happened because of Scott Brown's election in Mass. The whole thing is an amazing mess.

I said it first....

http://www.cougaruteforum.com/showpost.php?p=768364&postcount=2

EDIT: The initial bill was absolutely a mess and unworkable. That's why they passed the reconciliation bill, which modified the first bill for some much needed enahncements and changes. But it was still a mess even after that. They were stuck with reconciling the first bill because they would have been filibustered had they tried to pass different bill.

I still think the whole process of how Obamacare came to be is fascinating and is worthy of a book (Kennedy passing away, special election of Scott Brown in a heavily Democratic state to a somewhat iconic senate seat, Democrat politicians in Mass. trying to overturn the special election provision for a governor appointment provision which was switched the last time they tried to game the system, fudging the economics to get the reconciliation bill to pass the 5-year funding test, etc.).

[calicoug]

I've made that argument before, and I think Pelado does a good job showing why this administration's approach is different. One of the things the Court discussed yesterday, however, was the idea that even this approach might be an impermissible direct tax, since it is not apportioned among the states as required in Article One (and which is not affected by the sixteenth amendment to the extent that it does not levy an income-based tax). Courts in the past have also apparently been smart enough to know that there's really no difference between charging a tax on a select group and charging a general tax on everybody, but discounting the tax for those not in that select group. That's different from offering a tax credit on income tax to homeowners, for example, because the two acts in tandem have the same effect as the impermissible act, with no other permissible effects.

I don't completely understand this argument, but it's one in the mix.

That's different... how?