Impeding changes to our Health Care system

[Trilby]

Oh, goody! I just heard on the news that insurance companies have found a loophole and can still deny coverage to children with pre-exisiting conditions! Thank God!

for a minute there, I was worried some poor fu**ing kid would get some health care. Whew!

Originally Posted by Urbane Guerrilla

For starters, you show me where in the Constitution you're going to find authority for Congress to tell the citizenry where they are going to spend their moneys. And if you reply "Commerce Clause," I'm going to say, "Oh really?"

Start with the taxing powers of Congress:

Article I, Section 8:
The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States.

For the common defense AND the general welfare.

Now you can argue that affordable and accessible health care for all (or most) Americans is not in the general welfare of the US and I would disagree.

And yes, the Commerce Clause which the Courts have interpreted to go beyond simply interstate commerce (or economic activity).

The precedents are numerous, including recent examples in which conservatives like Scalia broadly interpreted the commerce clause.

Historically, George Washington and Congress in 1790 enacted the first health care mandate.

In 1790, Congress (many of the same founding fathers who wrote the Constitution) enacted a law requiring ships to carry medical supplies and provide health care for crew.

In 1798, those same Founding Fathers enacted the Act for the Relief of Sick and Disabled Seamen which created the U.S. Public health Service as well as the Marine Hospital Services (MHS).

The law forced every merchant mariner to pay 20 cents a month into a fund to pay for their medical care. This was one of the first direct taxes on individual citizens.

Government mandates for health care are nothing new.

Originally Posted by Brianna

Oh, goody! I just heard on the news that insurance companies have found a loophole and can still deny coverage to children with pre-exisiting conditions! Thank God!

for a minute there, I was worried some poor fu**ing kid would get some health care. Whew!

The "loophole" only means that insurance companies claim they may not have to cover pre-existing conditions in kids immediately as the law intended, but it would have to wait until 2014.

Its easy enough for Congress to fix when they get back from recess.

[Urbane Guerrilla]

An unprincipled and inflationary attack upon the American economy is newish, and unwise, and it's not providing for the general welfare either. And it's something Republicans don't do, for which I'll salute them. Even Nixon's non-conservative wage and price freezes weren't what this is, and were abortive in any case. It was Reagan who managed the successful formula -- and Kennedy preceded him in the same. The laws of economics do not alter with the majority party. (Start reading with Hazlett. I did.)

Of course, we can take the power to levy this tax away from Congress, advising them that the next try had better be a reform that doesn't nationalize a sixth of the economy or anything near it. We have a few years to get that done, at least. Then we can Hope for something more in our pockets than Change.

Nothing in the power to levy taxes says, "magnify the public debt until it destroys the currency," and that is where Washington has been screwing up for a long time. I can't cheer along irresponsibility of that kind; I want good government -- you clearly don't -- and I'm not getting very much. If they wanted something to brag on, they should have kept that one-year Clinton surplus (the existence of which I still rather doubt -- it seemed to have the half-life of some isotopes of californium), achieved without mucking with tax rates, something they are openly contemplating again now. Well, everybody but the Dem Party knows you can't tax your way into prosperity. You prosper by lowering the cost of doing business, and that includes taxation along with everything else.

Originally Posted by Urbane Guerrilla

An unprincipled and inflationary attack upon the American economy is newish, and unwise, and it's not providing for the general welfare either. And it's something Republicans don't do, for which I'll salute them. Even Nixon's non-conservative wage and price freezes weren't what this is, and were abortive in any case. It was Reagan who managed the successful formula -- and Kennedy preceded him in the same. The laws of economics do not alter with the majority party. (Start reading with Hazlett. I did.)

Of course, we can take the power to levy this tax away from Congress, advising them that the next try had better be a reform that doesn't nationalize a sixth of the economy or anything near it. We have a few years to get that done, at least. Then we can Hope for something more in our pockets than Change.

Nothing in the power to levy taxes says, "magnify the public debt until it destroys the currency," and that is where Washington has been screwing up for a long time. I can't cheer along irresponsibility of that kind; I want good government -- you clearly don't -- and I'm not getting very much. If they wanted something to brag on, they should have kept that one-year Clinton surplus (the existence of which I still rather doubt -- it seemed to have the half-life of some isotopes of californium), achieved without mucking with tax rates, something they are openly contemplating again now. Well, everybody but the Dem Party knows you can't tax your way into prosperity. You prosper by lowering the cost of doing business, and that includes taxation along with everything else.

None of the above makes the case that the taxing powers of Congress, including to tax citizen for the general welfare of the US is unconstitutional.....just that you dont like it.

The other weak argument centers around those states, like Virginia, enacting their own legislation to prohibit the individual mandate to be enforced in the state.

That ignores the "supremacy clause" of the Constitution:

Article VI
This Constitution, and the laws of the United States which shall be made in pursuance thereof; and all treaties made, or which shall be made, under the authority of the United States, shall be the supreme law of the land; and the judges in every state shall be bound thereby, anything in the Constitution or laws of any State to the contrary notwithstanding

The "unconstitutional" arguments make for great political theater and the opportunity for a few state AGs to win political favor from the right...but the legal arguments are weak.

[Urbane Guerrilla]

You clearly do not wish to engage on the philosophical front -- on what a government should be doing -- when you can retreat into legalisms, which are weak philosophically. This is really a discussion on the philosophy of government -- and you are up against a small-government, liberty-minded sort of chap. Now then, dare you demonstrate how much the opposite you are?

Actually, you demonstrate that very thing, at length, in every political thread you post in. Makes me wonder why you would place such value upon subadulthood, that you would argue for it so fiercely, even while occasionally disclaiming either fierceness or argument. But no -- that you are motivated in the direction of aggrandizing the state is beyond merely evident; it is dominant.

And there is neither Constitutional mandate nor any especially sensible reason to magnify the public debt, or the public sector -- as I was at pains to point out.

Originally Posted by Urbane Guerrilla

You clearly do not wish to engage on the philosophical front -- on what a government should be doing -- when you can retreat into legalisms, which are weak philosophically. This is really a discussion on the philosophy of government -- and you are up against a small-government, liberty-minded sort of chap. Now then, dare you demonstrate how much the opposite you are?

Actually, you demonstrate that very thing, at length, in every political thread you post in. Makes me wonder why you would place such value upon subadulthood, that you would argue for it so fiercely, even while occasionally disclaiming either fierceness or argument. But no -- that you are motivated in the direction of aggrandizing the state is beyond merely evident; it is dominant.

And there is neither Constitutional mandate nor any especially sensible reason to magnify the public debt, or the public sector -- as I was at pains to point out.

When all else fails and you cant support your assertion that the health reform legislation is unconstitutional, fall back on your "sub-adult" characterization of those with whom you disagree...in and of itself, not very adult.

UG, you're a one trick pony.

As to maginfying the debt, the greatest perpetrators of that in the last 50 years were Reagan and Bush, both of whom more than doubled the national debt.

And as to aggrandizing the state, I would point you to again to the last 50 years and those accomplishments that libertarians scream are "big government, anti-freedom" and that most Americans proudly supported.

civil rights - including equal access to public accommodations and an end to workplace discrimination

cleaner and healthier environment resulting from comprehensive government regulations

medicare - providing affordable health care and extending the quality of life for millions of seniors

reducing childhood hunger

significantly reducing disease through tax payer funded medical research

enhanced consumer protections - food safety, auto safety, toys/household products, etc - through numerous regulatory controls of the "free market"

expanding opportunities for higher education to millions of kids of working families through govt subsidies

I could go on, but I dont want to overwhelm you with these anti-libertarian successes

Tell me, which of the above dont you like or believe would have been accomplished by the "free market" with little or no government intervention?

added:
Oh, and while I am all for support democratic movements in other countries, where in the Constitution does it suggest that the US should be "freedom fighters" or the police force of the world if the US is not facing a direct threat?

[Undertoad]

This is really a discussion on the philosophy of government

This is a standard libertarian trick: if you can't get a good result in the Real World, where people make and judge and implement laws, just change the argument to the libertarian utopian "philosophy" world that doesn't actually exist and never has existed.

And then the argument is about what kind of world that would be, and you can win any of those arguments, because you've constructed it.

[classicman]

Originally Posted by Brianna

Oh, goody! I just heard on the news that insurance companies have found a loophole and can still deny coverage to children with pre-exisiting conditions! Thank God!

for a minute there, I was worried some poor fu**ing kid would get some health care. Whew!

Yup - you would think in 2000+ pages they could have at least gotten that part right.

I'm sure we'll be promised fixes and they will attempt to address it, but I got a feelin' its gonna cost more, like all the rest of the changes they're probably going to include. Perhaps then we can get a better idea of what this really is and what it will cost.

What's wrong with the comprehensive health care reform legislation?

Not a 2000 page bill (it was about 225 pages in the final printing in the Record) or the even smaller (20 page?) reconciliation bill.

Its racist!

According to "Doc" Thompson, substituting for Glenn Beck (he of the phantom 12,000 new IRS agents) today:

"Racism has been dropped at my front door and the front door of all lighter-skinned Americans. The health care bill the president just singed into law includes a 10 percent tax on all indoor tanning sessions starting July 1st, and I say, who uses tanning? Is it dark-skinned people? I don’t think so. I would guess that most tanning sessions are from light-skinned Americans. Why would the President of the United Stats of America — a man who says he understands racism, a man who has been confronted with racism — why would he sign such a racist law? Why would he agree to do that? Well now I feel the pain of racism."

Not only racist, but anti-freedom!

Who cares if the tax might serve as a disincentive to the carcinogenic practice of indoor tanning...bah, its anti-freedom...."if I want to increase the chance of skin cancer, its my right!"

added:
UG...I hope you have better sense than to fry yourself for purely cosmetic purposes like Boenher.

[TheMercenary]

Health overhaul likely to strain doctor shortage

By LAURAN NEERGAARD
AP Medical Writer

Better beat the crowd and find a doctor.

Primary care physicians already are in short supply in parts of the country, and the landmark health overhaul that will bring them millions more newly insured patients in the next few years promises extra strain.

The new law goes beyond offering coverage to the uninsured, with steps to improve the quality of care for the average person and help keep us well instead of today's seek-care-after-you're-sick culture. To benefit, you'll need a regular health provider.

Yet recently published reports predict a shortfall of roughly 40,000 primary care doctors over the next decade, a field losing out to the better pay, better hours and higher profile of many other specialties. Provisions in the new law aim to start reversing that tide, from bonus payments for certain physicians to expanded community health centers that will pick up some of the slack.

Who is going to staff these "new" non-existing clinics?

http://hosted.ap.org/dynamic/stories...03-29-03-18-15

[Clodfobble]

Nurse practitioners.

There is a clinic in my grocery store that staffs only nurse practitioners, and they can give checkups, as well as diagnose and prescribe medications for every common ailment. We also go to two doctors' offices where the default appointment is with the nurse practitioner, and you only get to see the primary care doctor if there's something strange wrong with you.

With less required schooling, they can get practicing in the field quicker, have less educational debt to have to pay off, and can carry minimal (perhaps even no?) malpractice insurance, all of which means better access and lower prices for sick people. I like the trend.

[Spexxvet]

My experience is that nurses, nurse practioners, physician assistants, and technicians are already doing to much of a doctor's job.

[Shawnee123]

I really like both the nurse practitioner and the PA in my doctor's office. If I just need something for a cold or something I can get in to one of them about any time. But, I really like my doctors in general: I have one main one I see in the practice, but have seen them all at one time or another. My mom got us in on the ground floor when two of them started the practice, because I was insisting I was way too old to continue seeing the pediatrician.

[TheMercenary]

Originally Posted by Clodfobble

Nurse practitioners.

There is a clinic in my grocery store that staffs only nurse practitioners, and they can give checkups, as well as diagnose and prescribe medications for every common ailment. We also go to two doctors' offices where the default appointment is with the nurse practitioner, and you only get to see the primary care doctor if there's something strange wrong with you.

With less required schooling, they can get practicing in the field quicker, have less educational debt to have to pay off, and can carry minimal (perhaps even no?) malpractice insurance, all of which means better access and lower prices for sick people. I like the trend.

I like the trend as well and fully support it.

It is not an answer to the problem. Not now and not in the immediate future. There are not enough to go around.

Btw, yes they all carry malpractice insurance. But it does not cost as much, about 10 - 20% less than a doc.