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Q&A On Today's Obamacare Supreme Court Decision

Tyler Durden's picture





 

In about an hour, the US Supreme Court, three years after Chrysler, is about to have a profound impact on Wall Street one more time. As Goldman explains, the court is expected to release some of the final opinions of the current session, which ends this week. Rulings on the Affordable Care Act (ACA) as well as the Arizona immigration law are likely to capture the greatest amount of attention. With a number of opinions to get out, it is possible the court could wait until later this week (possibly Thursday, June 28) to release some of the remaining rulings for this term, though the court has not yet announced any additional dates for the release of opinions. Trading in the online prediction market intrade.com implies a 74% probability that the court will find the mandate unconstitutional; prior to the oral arguments in March, it implied only around a 35% probability the court would rule against the mandate. Goldman believes that the outcome is fairly unpredictable and that many market participants probably are relying too heavily on the oral arguments in trying to predict the outcome of the case.

For those curious what the long-term implications of today's ruling are, here is a complete Q&A from Goldman:

Q&A on the Upcoming Supreme Court Health Reform Decision

  • The US Supreme Court appears poised to rule on the health reform legislation enacted in 2010, the Affordable Care Act (ACA). The court has three basic options: (1) uphold the entire law; (2) strike only the aspects of the law that were under review--the individual coverage mandate or the Medicaid expansion, or (3) strike the entire law.
  • If the court strikes the key components of the law that are under review, it is unlikely that Congress will act quickly to "repair" the court's action. Such a ruling would reduce net federal spending by more than $300bn over the next ten years, and in the current fiscal environment lawmakers are less likely to want to allocate those funds to coverage expansion than they were when the law was originally enacted.
  • The court's decision, whatever it may be, should have a fairly modest effect on fiscal policy for 2013. Of the $600bn or so in policy changes that comprise the fiscal cliff, less than $50bn (0.3% of GDP) were enacted under the ACA and this fiscal restraint would only be removed if the entire law were struck down, which in our view seems less likely than the other outcomes.

Q: What does the health reform law do?

A: It provides new insurance subsidies, financed by Medicare spending cuts and tax increases. The Affordable Care Act (ACA) expands insurance coverage mainly through (1) an expansion of the existing Medicaid program for the low-income population and (2) new subsidies available through insurance "exchanges" that the law would establish in each state to facilitate enrollment in plans offered by insurance companies. To cover the cost of this expansion, the law established new taxes on individuals and several sectors of the health care industry, limited health-related tax preferences, and reduced Medicare payments to health care providers and insurers. The law also included several regulatory reforms meant to increase coverage and/or health system efficiency. The chart below shows the main components of the law, organized by the average fiscal effect from 2014 to 2019, as a share of GDP.

Q: What is the Supreme Court ruling on?

A: The court heard arguments on four questions:

  1. The individual mandate. The court is considering whether Congress exceeded its powers in mandating that virtually every individual obtain health insurance. The ACA requires most individuals to obtain insurance that meets minimum standards. Beginning in 2014, individuals who fail to obtain insurance must pay a monetary penalty (set at the greater of roughly $700 or 2.5% of income, once fully phased in). The mandate was enacted to expand the insurance risk pool to include individuals who receive uncompensated health care and, in particular, healthy individuals who might otherwise intentionally decline coverage. Several other aspects of the law either directly or indirectly relate to the coverage mandate, including a "guaranteed issue" requirement, which compels insurers to provide coverage to any eligible applicant regardless of health status and "community rating," which limits insurers' ability to price premiums based on the health risk of the applicant.
  2. Medicaid expansion. A group of states has asked the Supreme Court to invalidate the expansion of the Medicaid program on grounds that Congress has unconstitutionally coerced States into accepting conditions of the new law by threatening to withhold all federal funding for Medicaid (the largest source of federal funding for states) if they do not.
  3. Severability. If the court finds parts of the law unconstitutional, it must then also decide whether those aspects can be severed from the rest of the law, which would remain intact, or whether the entire law should be struck down. The most obvious provisions that are linked to the areas under review are the guaranteed issue and community rating requirements described above, which many view as inextricably linked to the individual coverage mandate.
  4. Whether the challenge to the mandate is barred by the Anti-Injunction Act. This is a technical question dealing with whether the court may hear a case related to a tax before the tax has actually been levied, but it could serve as a basis to delay a ruling until 2014, when the coverage mandate takes effect.

Q: When will it make its decision?

A: Most observers expect a decision the week of June 25. The ruling could come at any point, but there are two constraints on the timing. First, the court normally issues opinions on Mondays and Thursdays. Second, the court's session is scheduled to end the week of June 25. Some opinions are expected to be released this Thursday, June 21, but most observers expect the court to wait until the very end of its session, with June 25 or June 28 the most likely dates for the court to rule on the ACA.

Q: How will the court rule?

A: Anything is possible, but it looks like a close call between upholding the entire law and striking parts of it. Market participants appear to have more conviction in the likely outcome than one would expect in light of the fact that (1) most of the commentary over the last two months has been based on a few hours of oral arguments, (2) the consensus view shifted dramatically following the arguments, implying that the market has a limited ability to handicap judicial outcomes, and (3) the court is known for an absence of leaks prior to rulings so no new information has come to light since the arguments were held in late March. Despite this seemingly uncertain situation, trading in the online prediction market intrade.com implies roughly a 75% probability that the individual mandate will be struck down, up from 35% or so prior to the oral arguments and 55% about a month ago.

The ruling is likely to take one of three directions:

  1. Uphold the law in its entirety. The court could opt to leave the law unchanged. Questioning from the justices during oral arguments suggests that four of the nine justices--Breyer, Ginsburg, Kagan, and Sotomayor--might lean in this direction. Chief Justice Roberts and Justice Kennedy are seen as swing votes, while the remaining justices--Alito, Scalia, and Thomas--are generally expected to support striking down at least some parts of the law.
  2. Strike parts of the law while leaving the rest intact. It is possible that the court could decide to strike the mandate on individuals to obtain insurance and the expansion of the Medicaid program while leaving the broader law in place. A ruling against the Medicaid expansion could strike that provision from law entirely, but during oral arguments the possibility was raised of making participation in the Medicaid expansion voluntary for states as a constitutional remedy, which would stop short of completely striking the expansion. While some justices appeared to question the constitutionality of the Medicaid expansion, it seems more likely that the expansion will be upheld. The outcome regarding the individual coverage mandate is much less certain. As noted above, Justices Kennedy and Roberts appear likely to be the swing votes, but how they will rule on this issue is difficult to predict. In our view, the likelihood that the mandate will be struck down is lower than the 75% probability implied by prediction markets and is essentially a 50/50 proposition. If the mandate is struck down, the court must also decide whether to strike down the related insurance underwriting rules as well. This seems fairly likely, since several justices acknowledged the important linkage among them, and opponents of the law as well as the Obama Administration have asked that the court strike those related rules if they strike down the mandate.
  3. Strike the entire law. While certainly possible, this appears to be a less likely outcome than upholding the mandate or striking only part of the law. Some justices who appear likely to find parts of the law unconstitutional still appear to have doubts about striking the entire statute. For instance, Justice Scalia noted that "it can't be right" that the various provisions unrelated to the mandate had to fall with it, though at one point he nevertheless noted the possibility that they might have to be. Although Congress could in theory revisit the law following a court decision, justices across the ideological spectrum appeared to hold little hope that they would be able to do so.

While most commentary on the court's upcoming ruling presents these decisions as binary questions, it is also important to note that the court could split its ruling in several different ways, and while it seems unlikely following the oral arguments, it is even possible that the court could delay a decision until 2014, citing the Anti-Injunction Act noted above.

Q: If the mandate alone is struck down, how would this affect the financing of health benefits?

A: Public costs would decrease in the medium term but would also become more uncertain. If the mandate is struck down but the related insurance underwriting rules are left standing, fewer healthier individuals would purchase coverage than if the mandate were implemented. Private-sector insurance plans would be unable to turn applicants away despite pre-existing health conditions and could not price premiums according to health risk. This would be very likely to lead to an increase in health insurance premiums, which would make it even less likely that healthy individuals would enroll, thereby increasing premiums again and further reducing demand for insurance among the healthy. While there is general agreement that insurance premiums would rise under such a scenario, there is much more uncertainty regarding where this process would find equilibrium. The Congressional Budget Office estimates that non-group policies (i.e., policies purchased through newly created insurance "exchanges" or in the traditional non-group market) would increase by 15% to 20% compared with a scenario in which the mandate were fully implemented. Per-capita costs in Medicaid might also rise, though net spending in that program would also fall due to lower enrollment.

The upshot, according to CBO, is that lower enrollment at a higher per-enrollee cost would reduce net federal spending by roughly 0.16pp of GDP from 2014 (when the mandate and related provisions are scheduled to take effect), or over $300bn over the 2014 to 2022 period. If the mandate and the related underwriting rules were struck down, the reduction in net federal spending might be slightly greater, since without guaranteed access to insurance, even fewer individuals would take up the new federal subsidies.

Q: If the law is partly or entirely struck down, will a new law be enacted to replace it?

A: Not quickly and quite possibly not at all. Congress seems unlikely to quickly intervene to "repair" whatever changes the Supreme Court might order. The most important obstacle is political--the original law was passed when Democrats held the White House and both chambers of Congress, including a 60-seat majority in the Senate for most of the time the legislation was considered. This allowed them to make policy changes beyond the scope of what appears likely in the foreseeable future, when neither party appears likely to have much more than a slim majority in either chamber of Congress and a divided government is very possible. A second obstacle is fiscal--if the court strikes the mandate or even the entire law, it seems likely that lawmakers will be more interested in deficit reduction and less focused on coverage expansion than they were when the legislation was first drafted in 2009.

Q: If the court's decision reduces estimated spending, can Congress "spend" those funds on something else?

A: Not officially. Lawmakers have struggled since last year to find budgetary savings to offset the cost of new legislation and to match deficit reduction with increases in the debt limit, as was done in last year's Budget Control Act (BCA) and which House Speaker Boehner has recently proposed for the next debt limit increase. The pressure to find savings will become more intense later this year, as the debt limit approaches and Congress works to avoid, or at least reduce, the "fiscal cliff" at year end. Although the court's decision could reduce the deficit by more than $300bn over the next ten years (if it strikes the mandate or the Medicaid expansion but leaves in place the spending cuts and taxes used to finance them) Congress is unlikely to be able to use those savings to offset new spending or tax relief. Unofficially, however, it would not be surprising to see some lawmakers attempt to use a budgetary windfall created by the Supreme Court to justify delay of the scheduled spending cuts at year end (i.e., the "sequester").

Q: Is there a scenario in which a ruling would increase the projected deficit?

A: Yes, if the entire law were struck. However, the increase in the projected budget deficit would probably be fairly modest. In the next decade (i.e., from 2020), CBO has estimated the law would reduce the federal budget deficit by about 0.5pp of GDP, so repealing it would add a similar amount to long-term deficit projections. In the current decade, the fiscal effect of the legislation is close to neutral, so while repeal could increase or decrease the projected deficit in a given year, over several years there would be little effect on the projected budget balance. But it is also worth noting that while many of the provisions enacted in the ACA were extraordinary, some of the savings provisions enacted were fairly routine. For example, Congress enacts changes (usually reductions) in Medicare payments to health care providers once every few years. Were the entire law to be repealed, it seems likely that at some point in the next several years Congress would recapture the savings from at least those Medicare-related policies if they were struck by the court along with the rest of the law.

Q: If the court strikes some or all of the law, would it change the size of the "fiscal cliff" at year end?

A: It would reduce it slightly. The ACA was estimated to reduce spending and increase tax revenue by $46bn in 2013. This is mainly the result of new taxes on income over $250,000 and the implementation of Medicare payment cuts. If the court opts to strike down the entire law (scenario three above), this fiscal restraint would not occur and the deficit would rise. However, in the other scenarios in which the law is upheld in part or in whole, it is unlikely that any of the items in the ACA that affect the fiscal stance in 2013 would be affected by the decision.

Q: If the law is upheld, are changes to the law still possible?

A: Yes, either as a result of the election, a fiscal agreement in 2013, or both. If Republican presidential candidate Mitt Romney wins the White House in November, changes to the health care law--and broader entitlement programs--are possible regardless of what the court decides this month. If Republicans hold at least 50 seats in the Senate following the election and maintain control of the US House, they could pass legislation to limit or repeal the coverage expansion enacted under the ACA (the Vice President would in that case cast the tie-breaking vote), since most of those provisions could be modified using the "reconciliation" procedure that is available through the congressional budget process. That said, not all of the provisions could be dealt with using a simple majority in the Senate. The coverage mandate and other regulatory issues would most likely require 60 votes in the Senate to repeal under congressional rules and thus would be more difficult to change.

In addition to the election, there is also a possibility that the health law could be reopened during the fiscal debate that is likely to take place in 2013, assuming that the "fiscal cliff" is temporarily extended past the end of the year into the spring or summer of 2013. At that stage, Congress looks likely to debate tax reform and potentially entitlement reforms, in an effort to reach a broad-based fiscal agreement, similar to Bowles-Simpson. While this is far from guaranteed, any such agreement would almost certainly include health reform among its components, and if so it would be very difficult to meaningfully address health spending without at least indirectly reopening a few of the provisions of the ACA.

 


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Mon, 06/25/2012 - 09:18 | Link to Comment Mad Mad Woman
Mad Mad Woman's picture

ACA decision will not be today. Any remaining deisions (6) will be handed down Tuesday & Thursday this week. SCOTUS will save ACA for the last day of session.

Mon, 06/25/2012 - 09:26 | Link to Comment MillionDollarBonus_
MillionDollarBonus_'s picture

Is it really surprising that libertarians are against affordable healthcare? Almost every act which is intended to make peoples' lives better, improve the economy or increase equality, libertarians are against it. Libertarians were also against the Jobs Bill, which was intended to get Americans working again and reduce unemployment, and TARP, which stimulated the economy by creating thousands of American jobs. Is it me, or do libertarians literally hate everything decent, wholesome and good in the world?

Mon, 06/25/2012 - 09:31 | Link to Comment kralizec
kralizec's picture

Yes, it is you.  Conservatives and maybe even a few conservative Democrats still living join with Libertarians in opposition against socialized medicine under Federal coercion.  But then that is just OK for you liberals, isn't it?!

Mon, 06/25/2012 - 09:36 | Link to Comment bobnoxy
bobnoxy's picture

So I'm guessing you clear thinking conservatives and Libertarians, on the conviction of your principles, will refuse your Social Security and Medicare, and will insist your parents do too?

Mon, 06/25/2012 - 09:51 | Link to Comment dizzyfingers
dizzyfingers's picture

"So I'm guessing you clear thinking conservatives and Libertarians, on the conviction of your principles, will refuse your Social Security and Medicare, and will insist your parents do too?"

BIG BROTHER does not allow this.

Mon, 06/25/2012 - 09:53 | Link to Comment bobnoxy
bobnoxy's picture

Huh? You can't opt out of paying, but you can opt out of collecting since it's collective money paying today's benefits, not the money a retiree put in, saved in Al Gore's lock box. Sure, you can refuse benefits. They'd love it if you did, and I'd have a lot more respect for you too, not that it means anything to you, of course.

Mon, 06/25/2012 - 10:21 | Link to Comment ms1408
ms1408's picture

"collective money paying today's benefits"

Actually, today's benefits are being paid by unborn children, since spending programs are funded by debt. Not that it means anything to you, of course.

Mon, 06/25/2012 - 11:34 | Link to Comment bobnoxy
bobnoxy's picture

So today's benefits are being paid for by non-existing people? Er...let me work on that a bit. Okay I did. That's just plain Libertarian idiocy. Per usual.

Mon, 06/25/2012 - 12:09 | Link to Comment ms1408
ms1408's picture

"So today's benefits are being paid for by non-existing people?" 

Yes. The money is borrowed. Debt is repaid in the future, not present. Children are born in the future, and they will be left with the debt.

http://en.wikipedia.org/wiki/Debt

Mon, 06/25/2012 - 10:23 | Link to Comment tarsubil
tarsubil's picture

"You can't opt out of paying, but you can opt out of collecting..." 

 

What a deal! In the future, the option of opting out of collecting will become required. What a country!

Mon, 06/25/2012 - 10:03 | Link to Comment kralizec
kralizec's picture

Thanks for confirming your pro-government coercion stance.

As to your childish diversion I suppose a phase out of other coercive acts in place is beyond your mental capacity to process.

Mon, 06/25/2012 - 10:07 | Link to Comment bobnoxy
bobnoxy's picture

If you can understand it, I'm sure anyone can. It's just so fucking stupid when you think it through, that's all, and you don't. Hey, I'd be the first to opt out of Social Security.

And when your parents are living in their cars, I'm sure some profit maximizing, unregulated contractor will give you a great deal on the addition to your house so you can accept responsibility for them and move them right in.

Then I'm sure some unregulated, profit maximizing health care company will sell you a $200, one hour class on how to wipe their asses with dignity. Which is where your ideas take us eventually.

Saddle up, Pardner.

Mon, 06/25/2012 - 10:20 | Link to Comment kridkrid
kridkrid's picture

What do you feel when you write a sentence like "and when your parents are living in their cars...".  Does the possibility that you are nothing more than a pawn in the system creep in, at all?  The need for government to take care of us... to take care of you... your parents, my parents... where does that come from?  How does it become so pervasive that to suggest otherwise is not only wrong, but abhorrent and sadistic?  

The con that you have accepted is no different than the con that those who you believe to be "on the other side" have come to accept.  "They hate us for our freedom... we fight them there so we don't have to fight them here... the shining city on the hill"... or any of the rah-rah, false patriotism garbage accepted by those on "the other team"... it's the same false narrative.  

If I don't support your narrative, I hate old people and poor people.  If I don't support the other narrative, I hate America.  Nice racket.

Mon, 06/25/2012 - 10:24 | Link to Comment ms1408
ms1408's picture

So people who haven't saved for their retirement now depend on social security? Who's fault is that? Their's, or our unborn children's?

Mon, 06/25/2012 - 10:44 | Link to Comment bobnoxy
bobnoxy's picture

It's their fault, of course, unless they simply didn't earn enough to save, like our heros in the military, your favorite, dedicated grade school teacher, the cop that has the hands to get you out of trouble your hands can't handle, or the people who built the sewers system that keeps your toilets flushing, making your life a lot better.

Okay, let's do it your way. Let them die in the fucking street when they're old and too poor to afford housing, like so many of today's vets? And when it's your parents, move them in, pay for their hip replacements, their meds, food, clothing...or let them die in the streets.

Hey, they're your parents. In your Lbertarian Paradise, no one will care about them but you. And I'm not even sure about that.

Mon, 06/25/2012 - 11:00 | Link to Comment kridkrid
kridkrid's picture

Unfortunately, what we have created is the worst of both worlds.  We have created the belief that the government can and should take care of us, but will come to find quickly that it can't.  All of the time spent assuming that the government will and can... will be forever lost.

If it makes you feel any better... it's not even really the government's fault... it's the monetary system.  The inability for government to be all things to all people was clear in the late 60's and early 70's... we could not be both a military empire and a welfare state... so the restraint on the growth of the government... convertibility to gold... was removed.  Everything since 1971 has been an inflation of a bubble... a global bubble, levered up so many time and in so many ways that we live today in a completely absurd world.  We are in our wile-e-coyote state, high above the spot where we will ultimately fall.  It's anyone's guess what that will look like when we get there.

Mon, 06/25/2012 - 11:09 | Link to Comment bobnoxy
bobnoxy's picture

''Unfortunately, what we have created is the worst of both worlds.  We have created the belief that the government can and should take care of us,''

Yeah, and who were those idjits that led us to believe in a government of, for and by the people anyway?

Mon, 06/25/2012 - 11:36 | Link to Comment kridkrid
kridkrid's picture

clockwork.  Again... you are no different from those who you feel are so different... when in doubt, claim the authority of the founders.  Both "sides" do it... it's meaningless and very selectively applied.  Cognitive dissonance much?

The government that we have today is nothing close to what any of the founders would have envisioned.  None of them.  

Mon, 06/25/2012 - 12:26 | Link to Comment LoneCapitalist
LoneCapitalist's picture

and who were those idjits...  Yes, I believe it was Thomas Jefferson who signed the S. Sec. act into law. No, wait, actually it was much later.

Mon, 06/25/2012 - 22:51 | Link to Comment StychoKiller
StychoKiller's picture

"If Congress can employ money indefinitely to the general welfare, and are the sole and supreme judges of the general welfare, they may take the care of religion into their own hands; they may appoint teachers in every State, county and parish and pay them out of their public treasury; they may take into their own hands the education of children, establishing in like manner schools throughout the Union; they may assume the provision of the poor; they may undertake the regulation of all roads other than post-roads; in short, every thing, from the highest object of state legislation down to the most minute object of police, would be thrown under the power of Congress... Were the power of Congress to be established in the latitude contended for, it would subvert the very foundations, and transmute the very nature of the limited Government established by the people of America." - James Madison

The founders were neither Socialist nor Progressive.

Mon, 06/25/2012 - 11:31 | Link to Comment ms1408
ms1408's picture

Ok, let's extend these principles and see where they lead:

"heros in the military, your favorite, dedicated grade school teacher, the cop that has the hands to get you out of trouble your hands can't handle, or the people who built the sewers system that keeps your toilets flushing, making your life a lot better."

And to think African slaves were provided with food, transport, work and accomodation, yet they refused to appreciate any of it.

 

"Let them die in the fucking street when they're old and too poor to afford housing"

Old people who have kidney poisoning by no fault of their own should get to steal kidneys from their children. Oh, you think that's immoral? So you're saying they should just die in the streets of kidney failure?

 

"Hey, they're your parents. In your Lbertarian Paradise, no one will care about them but you."

So you're saying that children should care about their parents, yet parents are entitled to borrow and spend until their children are born into unpayable debt? So, in other words, you hold children to a higher moral standard than adults?

Mon, 06/25/2012 - 10:07 | Link to Comment knightowl77
knightowl77's picture

Why? we pay everyday into Social Security and medicare...how are the two related at all??????????????????? They're not

Mon, 06/25/2012 - 10:09 | Link to Comment bobnoxy
bobnoxy's picture

Because your money was spent. The money you collect will come from other people, pure Socialism, no?

Mon, 06/25/2012 - 10:39 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

No, it will come from the state which has already extorted that money from generations present and future, regardless of whether I choose to take it or not. And as an enemy of the state, I will gladly make my contribution towards bankrupting it.

Mon, 06/25/2012 - 10:53 | Link to Comment bobnoxy
bobnoxy's picture

You sound like a real patriot. Divided, your country falls, making it a great place for you to live, and doing the work outside forces probably couldn't. Super duper fucking smart there.

Mon, 06/25/2012 - 11:35 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

'Patriot'? My 'country' is today nothing more than a socio-political construct with no meaning for me whatsoever. It's a right shit place to live due to this very fact and the government that enforces it.

Mon, 06/25/2012 - 10:35 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

I don't know about America, but over here, given the choice between the subsidised treatment of the NHS and paying more for a private clinic, I'll choose the latter every time, as the former could very leave you with irreparable physical damage, not to mention simply kill you.

Mon, 06/25/2012 - 11:51 | Link to Comment DosZap
DosZap's picture

I don't know about America, but over here, given the choice between the subsidised treatment of the NHS and paying more for a private clinic, I'll choose the latter every time, as the former could very leave you with irreparable physical damage, not to mention simply kill you.

Yep, the UK admitted that over 150,000 people die from lack of care in their system yearly.

Mon, 06/25/2012 - 11:01 | Link to Comment Disenchanted
Disenchanted's picture

 

 

Cut me a check today* for the entire amount that I and my employers have paid in on my behalf for over 40 years, plus give me an opt out choice on any further FICA deductions from my present and future paychecks, and I'll walk away into the sunset no questions asked(in other words I won't feel 'entitled' to any 'socialist' payments once I reach 62, 66 1/2, 70 or whatever).

 

Deal?

 

*They can take it out of the billion$ of US tax dollars going to Israel each year(or from the 'Defense' Budget). They won't miss it, and I was never given a choice on that either.

Mon, 06/25/2012 - 09:43 | Link to Comment MillionDollarBonus_
MillionDollarBonus_'s picture

If you wonder why libertarians are almost universally hated by decent, objective and open-minded people across the world, here is just a small list of the feelings that libertarians invoke in people:

  1. Anxiety
  2. Anger
  3. Insecurity
  4. Sadness

Until libertarians start considering peoples' feelings, decent people are going to continue to reject their ideas, and rightly so.

 

Mon, 06/25/2012 - 09:46 | Link to Comment bobnoxy
bobnoxy's picture

If they took five minutes to think through their ideas, they'd run just as far from all that dopiness too! But then, they don't really have a cohesive set of ideas anyway. Just some basic outline of less government and more freedom, while their hero, Ron Paul, keeps voting to restrict what control a woman has over her own body.

Weird.

Mon, 06/25/2012 - 09:58 | Link to Comment Chump
Chump's picture

Bwahahahaha...you don't even realize you're agreeing with a parody of yourself! Priceless...

Mon, 06/25/2012 - 10:00 | Link to Comment bobnoxy
bobnoxy's picture

And that, my friends, is what passes for clear headed Libertarian thinking!

Mon, 06/25/2012 - 10:06 | Link to Comment kralizec
kralizec's picture

"Until libertarians start considering peoples' feelings, decent people are going to continue to reject their ideas, and rightly so."

LOL!

Mon, 06/25/2012 - 10:07 | Link to Comment TWSceptic
TWSceptic's picture

'And that, my friends'

 

You have friends here?

Mon, 06/25/2012 - 10:13 | Link to Comment fuu
fuu's picture

Max really was your best one so far. I predict this one doesn't last that long at all.

Mon, 06/25/2012 - 10:06 | Link to Comment CaptainObvious
CaptainObvious's picture

You've only been a member of ZH for 12 weeks and 3 days, so it is possible you don't know this, (and I'm giving you the benefit of the doubt here instead of calling you a dumbass like you truly deserve) but MDB does satire.  You did not find a fellow progressive in MDB. 

Furthermore, Ron Paul isn't voting to restrict control over a woman's body...rather, he is saying, and has been saying for years, should you care to do your research instead of repeating liberal media talking points, that abortion is a states' rights issue and not a federal government issue.  As an OBGYN by trade, of course he doesn't believe in abortion, duh.  But his strong adherence to the principles of libertarianism means that he won't legislate against it.

Mon, 06/25/2012 - 10:16 | Link to Comment bobnoxy
bobnoxy's picture

Regardless of how long I've been in here, I can read, and Ron Paul consistently votes against abortion right. You could look it up, you know?

Paul voted in favor of the federal Partial-Birth Abortion Ban Act of 2003. Yes, the FEDERAL partial birth abortion Ban.

As just one example.

Mon, 06/25/2012 - 10:25 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

So he opposed the legalisation of infanticide. So what?

Mon, 06/25/2012 - 10:38 | Link to Comment bobnoxy
bobnoxy's picture

Let me guess. Another idiot that believes that the right to life begins at conception and ends at birth?

Mon, 06/25/2012 - 11:17 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

Rights are concepts existing in the human mind, and begin or end wherever we want them to . You are the only moron here for being under the delusion that there is any objective status of a right, and thus a true or false perspective on where the 'right to life' begins or ends.

 

As for where life begins, it doesn't begin. It continues, from one cell to the next, from one organism to another, from ages lost in the mists of time and into the future.

 

 

Mon, 06/25/2012 - 15:11 | Link to Comment Goldilocks
Goldilocks's picture

Hand of Hope The Story Behind The Picture
http://michaelclancy.com/

Fetus hand reaches out
http://www.famouspictures.org/mag/index.php?title=Fetus_hand_reaches_out

Baby Samuel Reaching out of the Womb
http://thornwalker.com/babyhand/babyhand.html

Mon, 06/25/2012 - 10:29 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

Under the Intact D&X method, the largest part of the fetus (the head) is reduced in diameter to allow vaginal passage. According to the American Medical Association, this procedure has four main elements.[3] Usually, preliminary procedures are performed over a period of two to three days, to gradually dilate the cervix using laminaria tents (sticks of seaweed which absorb fluid and swell). Sometimes drugs such as pitocin, a synthetic form of oxytocin, are used to induce labor. Once the cervix is sufficiently dilated, the doctor uses an ultrasound and forceps to grasp the fetus's leg. The fetus is turned to a breech position, if necessary, and the doctor pulls one or both legs out of the cervix, which some refer to as 'partial birth' of the fetus. The doctor subsequently extracts the rest of the fetus, leaving only the head still inside the uterus. An incision is made at the base of the skull, a blunt dissector (such as a Kelly clamp) is inserted into the incision and opened to widen the opening,[4] and then a suction catheter is inserted into the opening. The brain is suctioned out, which causes the skull to collapse and allows the fetus to pass more easily through the cervix. The placenta is removed and the uterine wall is vacuum aspirated using a cannula.

Mon, 06/25/2012 - 10:21 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

Bodies are not owned except under slavery. As such, the body within her womb is not owned by the mother nor by anyone else, and is not her own.

Mon, 06/25/2012 - 10:30 | Link to Comment bobnoxy
bobnoxy's picture

So it's okay for Ron Paul to assume control over a woman's, or your body, and that's a central belief in Libertarian philosophy of more freedom and less government? And if I don't own my body, who does? See why I think the whole thing is so poorly thought out, or not thought out at all?

It's like those dumb ass teabaggers willing to fight to the death to keep the government's hands off their Social Security and Medicare. Just plain stoopid.

Mon, 06/25/2012 - 10:43 | Link to Comment kridkrid
kridkrid's picture

The "problem" with libertarians isn't the divide on abortion... that one is easy to get your arms around... and frankly, not a very interesting debate.  It comes down to whose life... the unborn child or the mother.  I think both sides can claim the mantel of "libertarianism"... it's a very legitimate disagreement.

The problem with libertarians is really around the use of force.  Here is a good debate... anarchist vs. minarchist.  http://www.youtube.com/watch?v=2gK2xB9F9Ag - Jan is the "libertarian" here... losing badly, really, to the anarchist.

Mon, 06/25/2012 - 11:06 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

The problem with the 'debate', and the reason why it will never be concluded, is that it's not about deciding for the truth or falsehood of a matter, because the issue is at heart one of assumed values.

I value the life of the healthy unborn child over the desire of any woman to end that life.

Those who support abortion value the latter over the former. To me such thinking is beyond the absurd, but be that as it may, what I think here is not 'wrong' or 'right', but a fundamental value of mine, and I have no compunction whatsover against curtailing the 'freedoms' of females to see it realised.

Mon, 06/25/2012 - 11:27 | Link to Comment kridkrid
kridkrid's picture

Yeah... I agree, for the most part, though not strongly.  It's odd... sometimes I think I'm the only person who doesn't feel strongly one way or another on abortion.  I don't think abortion is a slippery slope... I can see both sides and can understand why each side feels as strongly as they do.  I'm weird this way, I think.  

Mon, 06/25/2012 - 11:55 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

An abortion here and there matter little to me. I've simply had enough of the absolute selfishness and reckless irresponsibility of modern 'Westerners'. In this age of contraception in forms from medical procedures, to condoms, to pills, the reason for the number of abortions carried out is simply unfathomable to me, unless I ascribe it to just that: absolute selfishness and reckless irresponsibility. Abortion shouldn't have to be legislated. The moral values, motherly instincts and fatherly authority inherent in each and every healthy society in human history would be enough to make it unthinkable for most women to want to commit infanticide of a perfectly healthy child. Apparently, these no longer exist. In their place we have thoughtless indulgence, emancipated whores, and emasculated apes. And we wonder why our civilsiation is crumbling about us.

Mon, 06/25/2012 - 12:10 | Link to Comment kridkrid
kridkrid's picture

I guess, perhaps, I think less of people than you do.  I suppose I have no reason to believe that people would be any less reckless than they are.  But I can find no fault in anything you have said here.

Nice post and thanks for the exchange.

Mon, 06/25/2012 - 12:51 | Link to Comment bobnoxy
bobnoxy's picture

I'm guessing this comes from someone with the sheer mental might to believe in Noah's Ark and the whole Garden of Eden story, or that the Earth is 6,000 years old? Or that people who work on Sunday should be killed because after all, it's in the Bible?

Mon, 06/25/2012 - 13:17 | Link to Comment Liposuction
Liposuction's picture

No.  Yours is a non-sequitur.  Values != Theology

If contraception exists, there is a byproduct of conception that contraception prevents.  The byproduct is a human baby, and since there is no third party intervention between conception and birth that causes the byproduct to become a baby, conception creates a human baby.  Sex is chosen at conception, with no third party intervention.  If a human does not choose to end his or her own life, and I can't take that life at 1 or 3 or 17 or 18 or 30, then it stands to reason that I shouldn't take that life before vaginal birth.

It's all quite easy to reason through.  You don't have to believe in the flying spaghetti monster to believe that innocent life is precious.

Mon, 06/25/2012 - 13:27 | Link to Comment blunderdog
blunderdog's picture

You'll have very little difficulty asserting the State's authority to require birthing as soon as the technology exists to remove the mother from the process.

In other words: rather than fighting over words and definitions and laws and all that other meaningless horseshit, pro-lifers should just build an external womb for unwanted children.  Once a pregnant woman has an option OTHER THAN carrying an unwanted baby to term, it'll be more easily justifiable for the State to seize the unborn child and raise it appropriately.

Or maybe they could be auctioned off to the people who are so concerned with the fetus's survival to help pay for the incubation costs.  Who knows.  I think the logic has to be something like, "any human embryo conceived by a resident of any US territory is a future taxpayer, thus preventing him/her from being born is theft from the State."

Point is: the problem is that right now, if you don't want to grant the State enormous power over the pregnant woman's freedom to decide what to do with HER BODY, you have to provide some other option.  Even if the government completely outlaws certain medical procedures AND builds sufficient apparatus (like public medical records, etc) to make such laws enforcable, women will be able to find ways not to carry unwanted babies to term.

Thu, 06/28/2012 - 06:15 | Link to Comment MeelionDollerBogus
MeelionDollerBogus's picture

You're an idiot. The invention of the condom is almost as important as the invention of nuclear energy to society. Both save lives & improve quality of life. Forcing children be born into poverty and forcing that sex spread disease by having no contraception is total insanity.

Something is very very wrong with your head. Here, try a cure

Mon, 06/25/2012 - 10:53 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

So it's okay for Ron Paul to assume control over a woman's, or your body, and that's a central belief in Libertarian philosophy of more freedom and less government?

No. It's alright by me for those to whom we have delegated authority to mandate control over a homicidal maniac exercising his bodily freedoms, yes, as it is alright to stop infanticidal females and doctors breaking their Hippocratic oaths from doing the same. A central belief is the right to life which overrules all other rights or freedoms excepting where that right itself threatens the lives of others.

And if I don't own my body, who does?

You imply a false dichotomy. Nobody does. There is no legal writ declaring anyone's ownership of any human body, and as such, no ownership.

See why I think the whole thing is so poorly thought out, or not thought out at all?

Yes, I do see why you think as you do. It's because you are a halfwit.

Mon, 06/25/2012 - 15:30 | Link to Comment blunderdog
blunderdog's picture

You should map out some enforcement mechanics if you want some objections to become more obvious. 

Personally, I don't care too much about what's done with the legislation, because no one can ENFORCE anti-abortion law.

Any State that got serious about it would see what a nightmare it is.  "Honor system" legislation doesn't work.

Wed, 06/27/2012 - 08:00 | Link to Comment MeelionDollerBogus
MeelionDollerBogus's picture

it's not infanticide if the child is not yet developed or born.

Unborn children are not people and killing them is right and honorable for the other choice is that the woman suffers poverty or a deadly pregnancy and only that woman and her doctor can decide.

Those who stop abortions a woman wants to have should be shot in the face and gutted. You treat the woman with the same disrespect by forcing decades of her life to go as you say. You should otherwise be forced to pay for all costs of all women and their children who are forced not to have an abortion.

YOU make the choice YOU pay for it forever. That's fair.

Mon, 06/25/2012 - 13:09 | Link to Comment Liposuction
Liposuction's picture

Get your government out of my womb, except when politically beneficial to my socialist views!  Then it's all aboard the big gov train with non-stop service right through my vajayjay!! Woowoo!

Wed, 06/27/2012 - 07:58 | Link to Comment MeelionDollerBogus
MeelionDollerBogus's picture

within the womb it's not a body until far far late into the pregnancy. Before that moment it's body parts, organs, and are all owned by the mother no less than one's own lungs, bladder, heart or veins

Mon, 06/25/2012 - 14:44 | Link to Comment jonan
jonan's picture

bobnoxy = entitled elitist hypocrite

have fun coming off that oxycontin high and back to reality...where debt matters and has real implications...

Mon, 06/25/2012 - 10:10 | Link to Comment knightowl77
knightowl77's picture

and where are "people's feelings" listed n the Constitution?????

Which article is that in again?

Mon, 06/25/2012 - 12:11 | Link to Comment Jethro
Jethro's picture

MDB, if my sense of sarcasm were a separate entity, it would have a man crush on you.  I laugh at your posts almost every single time.  Well done!

Mon, 06/25/2012 - 22:59 | Link to Comment StychoKiller
StychoKiller's picture

Those "feelings" come about when the Socialist/Progressive comes to realize that NO ONE wants to pay their living expenses as well as their own!  Here's a feeling that Socialist/Progressives need to get in touch with:  Responsibility!

Mon, 06/25/2012 - 09:36 | Link to Comment duo
duo's picture

The mandate is bad enough, but being forced to buy from a cartel that can't even operate over state lines and lives on price fixinig, isn't exactly what the consitution had in mind.

Mon, 06/25/2012 - 09:37 | Link to Comment fuu
fuu's picture

"Is it me, or do libertarians literally hate everything decent, wholesome and good in the world?"

They love you though.

Mon, 06/25/2012 - 09:47 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

Is it really surprising that libertarians are against affordable healthcare?

Yes. It would be surprising. Since libertarians are against state health care funded by taxes coerced from citizens against their will under threat of violence, not 'affordable health care'.

Mon, 06/25/2012 - 09:48 | Link to Comment Lebensphilosoph
Lebensphilosoph's picture

Is it me, or do libertarians literally hate everything decent, wholesome and good in the world?

Such as theft? You know, like income taxation?

Mon, 06/25/2012 - 10:01 | Link to Comment JPM Hater001
JPM Hater001's picture

"Is it me, or do libertarians literally hate everything decent, wholesome and good in the world?"

This isnt a complete list but:

puppies and kittens

porridge

Chevy Chase

Broccoli

You.

Mon, 06/25/2012 - 09:53 | Link to Comment tradebot
tradebot's picture

Thought it was SCROTUS...Supreme Court Ruling Of The United States

Mon, 06/25/2012 - 09:22 | Link to Comment nmewn
nmewn's picture
  1. Severability. If the court finds parts of the law unconstitutional, it must then also decide whether those aspects can be severed from the rest of the law, which would remain intact, or whether the entire law should be struck down. The most obvious provisions that are linked to the areas under review are the guaranteed issue and community rating requirements described above, which many view as inextricably linked to the individual coverage mandate.

Pelosi, in her infinite wisdom, decided to not have a severability clause.

If justice is real and the continuity of law means anything anymore...the entire thing sould be tossed out on its ear.

 

Mon, 06/25/2012 - 09:28 | Link to Comment kralizec
kralizec's picture

Agree 100%.

Unfortunately, the final decision will likely be colored by Kennedy's opinion.

Never has so much relied on so few.

Mon, 06/25/2012 - 09:31 | Link to Comment nmewn
nmewn's picture

I think Kennedy stayed for just this reason...not so much ObamaCare itself but to rein in the abuse of the Commerce Clause.

We'll see.

Mon, 06/25/2012 - 09:36 | Link to Comment kralizec
kralizec's picture

Commerce Clause abuse has been nefarious, Wickard should be overturned, and you would think that the threats to the justices by Obama and his brow-beating at SOTU shows would have gotten their hackles up and strengthened their spines!

I guess we are about to find out.

Mon, 06/25/2012 - 09:51 | Link to Comment Dr. Engali
Dr. Engali's picture

Kennedy has been hard to predict when it comes to expanding the powers of the state. If I were to guess he would rule against he individual mandate but support the rest of the law.

Mon, 06/25/2012 - 09:59 | Link to Comment kralizec
kralizec's picture

I pray you are wrong, but fear you are right.

Mon, 06/25/2012 - 10:00 | Link to Comment DaveyJones
DaveyJones's picture

That's a big "if" nmewn

I love using the words "strike" and "severability" when talking about this act. It helps get the anger out. 

Mon, 06/25/2012 - 10:58 | Link to Comment nmewn
nmewn's picture

Dealing with a tropical storm and power outages down here...on my day off of course...lol.

Yes, it is a big IF.

One of the benefits of just laws is its continuity, without it, we might as well turn the whole thing over to un-elected bureaucrats and regulators and call it a day.

The individual mandate is a part of the funding mechanism...millions of new forced insurance contracts to private enterprises or a fine to be paid to the government...if that isn't fascism I don't know what it is. To even have the threat of using the force of government to act in commerce written into a law shows the depths of depravity behind it.

At no other time in our history has the citizen been forced to engage in commerce or face a fine...fined for doing nothing.

Its remarkable.

Next it will be forced buying of Chevy Volts or pay a fine to government but at least we'll know where the goverment and our selected officials stand ;-)

Mon, 06/25/2012 - 10:14 | Link to Comment mayhem_korner
mayhem_korner's picture

 

 

Good observation, nmewn.  To me, the law is effectively neutered once the individual mandate is tossed.  Whether or not SCOTUS puts in ink that the entire law is stricken, it will have no teeth without the mandate - and the statist will be none too happy that their pathway to complete socialization of health care has been derailed (for now).

 

Mon, 06/25/2012 - 11:13 | Link to Comment nmewn
nmewn's picture

Even now the statists are mulling over the idea of tossing it back to the states with a complete loss at SCOTUS...in their hearts they knew it was an over-reach to begin with. Ramming it through in the dead of night, closed door meetings with health insurance companies, deemed passed, tricks & gimmicks...it was a joke within a farce. 

It would have made Hugo Chavez blush.

Mon, 06/25/2012 - 10:28 | Link to Comment tarsubil
tarsubil's picture

LOL. They will throw out just a portion in direct violation of this simple and long understood principle. They will do it to add to the confusion. I'm just running with the idea that they tend towards more confusion.

Mon, 06/25/2012 - 11:17 | Link to Comment nmewn
nmewn's picture

Lawyers love confusion...no offense to Davey ;-)

Mon, 06/25/2012 - 23:02 | Link to Comment StychoKiller
StychoKiller's picture

As I recall, Pelosi didn't even read the bill before voting on it!  Bwahahahahahaha!

Mon, 06/25/2012 - 09:26 | Link to Comment MFL8240
MFL8240's picture

The court is now becoming a polititcal football.  This act is unconstitutional on its face and there is no severability cluase hence it should go away in its entirety.

Mon, 06/25/2012 - 09:51 | Link to Comment Ms. Erable
Ms. Erable's picture

SCOTUS has been a political footbal since FDR - the New Deal was voided by SCOTUS twice before FDR could pack the court with justices that would approve it (two of whom had a combined total of two weeks' experience on the bench prior to confirmation). He also proposed adding another 6 justices after the first overturning of the 'law'. If you can, watch recordings of the Borke and Thomas confirmation hearings; confirmation has nothing to do with adherence to the constitution - just adherence to particular political ideologies.

Mon, 06/25/2012 - 09:28 | Link to Comment Seize Mars
Seize Mars's picture

You know I hate to rain on everyone's parade, but the idea that the Supreme Court passes judgement on a law's Constitutionality is...unconstitutional!

You don't need the court to tell you that you have a bad law.

The American government was established with clear boundaries on the power of the three branches. Judicial Review of laws for their consitutionality was not a power granted to the court. A court case - Marbury v. Madison in 1803, caused the Supreme court to - I shit you not - grant itself these powers.

You can't have one of the three branches granting itself more power! That's full retard.

I don't care what the Supreme Court says. They are a bunch of corrupt lawyers just like their friends on Capitol Hill. It's a bad law, and the only hope is for states to nullify it.

Mon, 06/25/2012 - 09:37 | Link to Comment DOT
DOT's picture

34 States must agree to resist the Federal power (and fore go the money) Exact language will be required to restrain the usurpation of Individual Rights and State prerogatives.

Mon, 06/25/2012 - 09:34 | Link to Comment Cole Younger
Cole Younger's picture

I don't see how the government can force you to buy anything..If the mandate is not struck down, then you definately don't work for yourself, you work for the government...Why bother working?

Mon, 06/25/2012 - 09:41 | Link to Comment Seize Mars
Seize Mars's picture

How can the government force you to buy something? Easy! By using...force!

They force you to pay a third of your income to them, so they can fund wars and torture. If you don't like it, they will send you to prison, by using force. They are going to force us to do whatever they want to, until the day arrives when we start resisting force.

Capisce?

Mon, 06/25/2012 - 09:50 | Link to Comment Clint Liquor
Clint Liquor's picture
“A government is like fire, a handy servant, but a dangerous master.”

George Washington

Mon, 06/25/2012 - 09:57 | Link to Comment tradebot
tradebot's picture

They also force you to buy your own property back every year in property taxes...at gun point if need be...

Mon, 06/25/2012 - 09:58 | Link to Comment kridkrid
kridkrid's picture

It's amazing the things we have come to accept quite naturally, seemingly free of any kind of cognitive dissonance (general population).  Income tax as merely the responsibility of a citizen vs. bondage to a system, for example.  Yet people rally around the argument that the government can't force us to buy insurance.  People are so manipulated, even when they find themselves on the correct side of a position.  And they are there for a reason... controlled chaos of a country perfectly divided.  Like a scale in perfect balance is so easy to move with the slightest push, the support and opposition to most things serve the same sort of purpose.  

Mon, 06/25/2012 - 09:43 | Link to Comment kridkrid
kridkrid's picture

You already work for the government... you are only fooling yourself if you believe it to be any different.  Even if you were able to get yourself "off of the grid"... you would still be doing it on land on which you would be taxed.  The harder you try to sever the relationship, the more suspect you would become.  Try, for example, to get around the use of federal reserve notes as the mechanism for exchange.  We have an illusion of freedom, when we are really just cogs working to support the empire.

Mon, 06/25/2012 - 09:56 | Link to Comment Sofa King Confused
Sofa King Confused's picture

You are exactly right especially on the land part.  Way back when before the common law came to the US you could buy your land or home under allodial title which meant when you payed it off it was yours with no taxes ever.  When the US adopted the British common law system everything changed.

Mon, 06/25/2012 - 09:47 | Link to Comment Hugh_Jorgan
Hugh_Jorgan's picture

It can't. Nor should it providing welfare or unemployment, or most of the other things it does. "Promote the general welfare" should have never been written into the preamble of the Contstitution. It was only a crack, but Progressives have widened it into the front door to the entitlement class and it is has become the primary focus of Federal Government slowly over the past 100 years. It is ludicrous.

Mon, 06/25/2012 - 10:22 | Link to Comment mayhem_korner
mayhem_korner's picture

 

 

The preamble doesn't grant or restrict any power, but is intended as a recitation of the intended result of the form of government outlined by, and the government powers enumerated in, the Articles of the Constitution. 

But you are correct, the "living Constitution" statists continue to inject and interpret things that do not exist (and were clearly not intended as well documented in the Federalist Papers).  Promoting the general welfare was intended as the result of limiting government's intervention, not the reverse.  But, like the "separation of church and state," "right to privacy," etc., the statists use the courts to mold what is into what they think it ought to be.

That, in my view, is why the SCOTUS ruling here will at best forestall what these folks eventually will do.

Mon, 06/25/2012 - 09:54 | Link to Comment Shizzmoney
Shizzmoney's picture

Totally. I've seen my corporate healthcare take a cut in the first 2 years, rising at an average of 19%.

Plus, I had to go to the ER to take care of a health issue, and got billed $2K for it.  I HAVE HEALTH INSURANCE. 

I would of been better off quitting my job, then goign to the ER, and getting that shit for free.

Why not just go to single payer, and cut out the middle man?  I know it's putting too much faith into government as the middle man; but at least you are not drawing dead like you are against corporations.

Either way, the defense of the middle man between me and my doctor, either corporate of government, really tilts the shit out of me.

Mon, 06/25/2012 - 10:10 | Link to Comment toady
toady's picture

Agreed! Thank you!

But prepare to be junked ...

Every time I express similar thoughts here I get beaten for being a socialist/communist sympathizer.

Mon, 06/25/2012 - 10:23 | Link to Comment knightowl77
knightowl77's picture

single payer results in rationing of care....

If the Gov't budgets "X" dollars for health care, they will decide how that money is spent on which treatments, and which patients....

80year old granny may not get that transplant, someone else with severe health problems might get denied alternative therapies...

 

In the UK and Canada their are waiting lists for routine screenings...When care is rationed, everybody gets care, but they get less of it and they want longer for it.

Mon, 06/25/2012 - 10:23 | Link to Comment sschu
sschu's picture

then goign to the ER, and getting that shit for free.

If you think health insurance and health care are are expensive now, just wait until it is free!  

sschu

Mon, 06/25/2012 - 13:30 | Link to Comment blunderdog
blunderdog's picture

Government can't effectively force you to buy anything, and the original legislation didn't do so. 

What it did was assess a tax-penalty if you declined to buy something, and that's something that's been done many times in the past.

Mon, 06/25/2012 - 09:34 | Link to Comment Rusticus
Rusticus's picture

"Goldman believes that the outcome is fairly unpredictable and that many market participants probably are relying too heavily on the oral arguments in trying to predict the outcome of the case."

 

Fucking joke, like GS doesn't know what the outcome will be. Frontrunning.

Mon, 06/25/2012 - 09:36 | Link to Comment Disenchanted
Disenchanted's picture

 

 

The health care act mandates purchase of corporate health care insurance, and was pretty much written by a 'former' WellPoint exec.. Considering SCOTUS stance on corporations(equal rights with real people) how do you think this will play out?

 

FDL Fact Sheet: The Truth About the Health Care Bill
Mon, 06/25/2012 - 09:54 | Link to Comment Disenchanted
Disenchanted's picture

 

 

 

The revolving door spins faster on healthcare reform

(Glenn Greenwald - July 2010)

subheading:

 

The Obama administration hires a former VP of the nation's largest private insurer to implement the plan

further down:

 

In other words, implementation of the massive healthcare bill just enacted by the Congress will be overseen by a former high-level executive of the nation’s largest private health insurer.  As Marcy Wheeler writes:  ”It’s a nice trick: send your VP to write a law mandating that the middle class buy shitty products like yours, then watch that VP move into the executive branch to ‘oversee’ the implementation of the law.”  Indeed, Fowler played a crucial role in shaping the healthcare bill to ensure there was no public option and to compel every single American to purchase the products of the private healthcare industry (including those of her former employer).  As Politico put it last year:  ”If you drew an organizational chart of major players in the Senate healthcare negotiations, Fowler would be the chief operating officer.”  It was Fowler who was literally writing the healthcare bills for Baucus which, at least at the time, progressives found so objectionable.

 

 

Mon, 06/25/2012 - 10:05 | Link to Comment kridkrid
kridkrid's picture

I'm surprised that Gleen Greenwald isn't featured prominantly on this site.

Mon, 06/25/2012 - 15:33 | Link to Comment blunderdog
blunderdog's picture

He's considered a "librul" by many regulars here who consider themselves "libertarians."

It's funny stuff.

Or, well, maybe it's that he's gay....

Mon, 06/25/2012 - 09:36 | Link to Comment dwdollar
dwdollar's picture

Putting too much faith in the Supreme Court to deal justice can only lead to BIG trouble down the road.

Mon, 06/25/2012 - 09:38 | Link to Comment dbTX
dbTX's picture

ACA is going down, otherwise why all the shucking and jiving at the whitehouse?

Mon, 06/25/2012 - 09:43 | Link to Comment Sauk Leader
Sauk Leader's picture

Since Barry is on the road today talking about gay mexicans and whatnot I am sure Jay Carney wore an extra undershirt or two so the sweat doesnt show as much when he gets up there and runs in circles for 20 min.

Mon, 06/25/2012 - 09:38 | Link to Comment partimer1
partimer1's picture

Waiting this long for a decision either way lost the power of surprise.  It doesn't mean a damn thing to anyone anymore.  Its all baked in the cake either way. 

Mon, 06/25/2012 - 10:20 | Link to Comment toady
toady's picture

Yep.

I started thinking, if the mandate is overturned, stocks go down, as dumb money won't be forced into insurance companies, but what if....

Then I remembered that the vampire squid would already have all possible manipulations in place.

Mon, 06/25/2012 - 09:38 | Link to Comment Clint Liquor
Clint Liquor's picture

If it is upheld, it will be one giant step for Collectivism and one big kick in the nuts for Individualism.

Mon, 06/25/2012 - 09:50 | Link to Comment Shizzmoney
Shizzmoney's picture

In terms of the SCOTUS decision....anything that dents the bottom line and stock of United Health Care, BCBS, and Cigna.....I'm all for.

The mandate will never work here; it doesnt work in Massachusetts, and that's in a state with decent unemployment!  When you give control of pricing to a corporate, private entity......you are asking to get your wallet finger fucked.

I live under the mandate...and still can't afford health care. 

Mon, 06/25/2012 - 09:52 | Link to Comment Dr. Engali
Dr. Engali's picture

Affordable health care ....what a joke of a name. Ever since this screwy law was passed our companies healthcare costs have risen over 50%

Mon, 06/25/2012 - 09:54 | Link to Comment dizzyfingers
dizzyfingers's picture
FDL Fact Sheet: The Truth About the Health Care Bill http://firedoglake.com/fdl-fact-sheet-the-truth-about-the-health-care-bill/

The FDL health care team has been covering the health care debate in congress since it began last year. They have put together a fact sheet to help readers sort through the myths and facts of the health care bill:

Myth Truth 1. This is a universal health care bill.

 


The bill is neither universal health care nor universal health insurance.

Per the CBO:

  • Total uninsured in 2019 with no bill: 54 million
  • Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Insurance companies hate this bill

 


This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009.

 

The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.

3. The bill will significantly bring down insurance premiums for most Americans.

 


The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.

Annual premiums in 2016, status quo / with bill:

Small group market, single: $7,800 / $7,800

Small group market, family: $19,3oo / $19,200

Large Group market, single: $7,400 / $7,300

Large group market, family: $21,100 / $21,300

Individual market, single: $5,500 / $5,800*

Individual market, family: $13,100 / $15,200*

4. The bill will make health care affordable for middle class Americans.
   The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.

 

A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.

5. This plan is similar to the Massachusetts plan, which makes health care affordable. Many Massachusetts residents forgo health care because they can’t afford it.

 

A 2009 study by the state of Massachusetts found that:

  • 21% of residents forgo medical treatment because they can’t afford it, including 12% of children
  • 18% have health insurance but can’t afford to use it
6. This bill provide health care to 31 million people who are currently uninsured.

 


This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies. 7. You can keep the insurance you have if you like it.   The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.

Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.

8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.

 

 

There is insufficient evidence that employers pass savings from reduced benefits on to employees.

 


9. This bill employs nearly every cost control idea available to bring down costs.

 


This bill does not bring down costs and leaves out nearly every key cost control measure, including:

 

  • Public Option ($25-$110 billion)
  • Medicare buy-in
  • Drug reimportation ($19 billion)
  • Medicare drug price negotiation ($300 billion)
  • Shorter pathway to generic biologics ($71 billion)
10. The bill will require big companies like WalMart to provide insurance for their employees

 

 

The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage. 11. The bill “bends the cost curve” on health care.

 


The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019.

 

“Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.

In 2009, health care costs were 17.3% of GDP.

 Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)

Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)

12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition. Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012

 

Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.

13. The bill prohibits dropping  people in individual plans from coverage when they get sick. The bill does not empower a regulatory body to keep people from being dropped when they’re sick.

 

There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.

14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.   The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state.
Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level. 15. This bill will stop insurance companies from hiking rates 30%-40% per year.

 


This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country. 16. When the bill passes, people will begin receiving benefits under this bill immediately

 


Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014.

 

Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.

17. The bill creates a pathway for single payer.

 


Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer.

 


 Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.

18 The bill will end medical bankruptcy and provide all Americans with peace of mind.

 


Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.

 

  • In 2009, 1.5 million Americans declared bankruptcy
  • Of those, 62% were medically related
  • Three-quarters of those had health insurance
  • The Obama bill leaves 24 million without insurance
  • The maximum yearly out-of-pocket limit for a family will be $11,900 (PDF) on top of premiums
  • A family with serious medical problems that last for a few years could easily be financially crushed by medical costs

*Cost of premiums goes up somewhat due to subsidies and mandates of better coverage. CBO assumes that cost of individual policies goes down 7-10%, and that people will buy more generous policies.

Documentation:

  1. March 11, Letter from Doug Elmendorf to Harry Reid (PDF)
  2. The AHIP Plan in Context, Igor Volsky; The Max Baucus WellPoint/Liz Fowler Plan, Marcy Wheeler
  3. CBO Score, 11-30-2009
  4. “Affordable” Health Care, Marcy Wheeler
  5. Gruber Doesn’t Reveal That 21% of Massachusetts Residents Can’t Afford Health Care, Marcy Wheeler; Massachusetts Survey (PDF)
  6. Health Care on the Road to Neo-Feudalism, Marcy Wheeler
  7. CMS: Excise Tax on Insurance Will Make Your Insurane Coverage Worse and Cause Almost No Reduction in NHE, Jon Walker
  8. Employer Health Costs Do Not Drive Wage Trends, Lawrence Mishel
  9. CBO Estimates Show Public Plan With Higher Savings Rate, Congress Daily; Drug Importation Amendment Likely This Week, Politico; Medicare Part D IAF; A Monopoloy on Biologics Will Drain Health Care Resources, Lancet Student
  10. MaxTax Is a Plan to Use Our Taxes to Reward Wal-Mart for Keeping Its Workers in Poverty, Marcy Wheeler
  11. Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS (PDF)
  12. ibid
  13. ibid
  14. ibid
  15. Health insurance companies hang onto their antitrust exemption, Protect Consumer Justice.org
  16. What passage of health care reform would mean for the average American, DC Examiner
  17. How to get a State Single Payer Opt-Out as Part of Reconciliation, Jon Walker
  18. Medical bills prompt more than 60 percent of U.S. bankruptcies, CNN.com; The Patient Protection and Affordable Care Act Section?by?Section Analysis (PDF)
Mon, 06/25/2012 - 09:55 | Link to Comment Ned Zeppelin
Ned Zeppelin's picture

Court will uphold most if not all of the healthcare law.  Rational relationship test is all the Administration had to satisfy. Those who think it is illegal for Congress to make you do things or pay money need to stare at their Form 1040 for a few minutes.  Fight fought long ago.  Not saying it's right, but your remedy is political, not judicial.  And we all know what an effective remedy it is to appeal to your congressman. Especially if you bought and paid for them with campaign contributions. 

Mon, 06/25/2012 - 10:01 | Link to Comment dwdollar
dwdollar's picture

Even if they do strike it down, what you said afterward is 100% right on.

Mon, 06/25/2012 - 10:16 | Link to Comment Pchelar
Pchelar's picture

Agreed.  If you look at the bigger picture you can see where this is going.  Of course it all started way back with the income tax, but if you draw a thread from the Citizens United case giving what amounts to corporate control over the political process, the next step would naturally be to use the power of govenment to force us to buy something frm a private corporation.  Once that precedent is set, you will see all manner of "individual mandates" that will benefit the corporations who are capable of donating the most money to political campaigns. 

Mon, 06/25/2012 - 10:32 | Link to Comment knightowl77
knightowl77's picture

Didn't they have to amend the Constitution to make income taxes legal??? That would be the 16th Amendment

 

I believe they would have to amend it again to mandate health insurance

Mon, 06/25/2012 - 11:17 | Link to Comment covert
covert's picture

all of it must be ruled as entirely unconstitutional.

http://covert.ias3.com/expose/

Mon, 06/25/2012 - 10:02 | Link to Comment therearetoomany...
therearetoomanyidiots's picture

THis is a pile of horse shit.   The idea that this will prevent an increase in the deficit or somehow reduce the deficit over time is simply fantasy. 

Fuck Goldman. 

Mon, 06/25/2012 - 10:14 | Link to Comment rsnoble
rsnoble's picture

Looks like there's gona be a lot of people paying $700 a year because they can't afford it. Of course they won't have $700 either so go to jail. What's affordable to the millionaires in congress? $500 a month? Pelosi said a fair punishment for someone that won't buy it is 10 years in prison and a $250,000 fine.

Fuck the US gov't.

Mon, 06/25/2012 - 10:39 | Link to Comment Oldwood
Oldwood's picture

Fear of losing the good life has us all in a trap. Lots af cool toys without having to work too hard and to live forever! Like the Greeks say, "if we could only find someone to pay!"

Mon, 06/25/2012 - 10:58 | Link to Comment Whats that smell
Whats that smell's picture

Get the insurace co's out provide a base level of care for everyone, example if you want a tooth pulled no novacaine,

If you have cancer or heart trouble go home and die if you do not have the money.

Dr's fees would go down if the Gov't were not letting them bill like a bunch of bandits.

Mon, 06/25/2012 - 12:03 | Link to Comment CaptainObvious
CaptainObvious's picture

Nope.  The only way doctor's fees will go down is if all insurance is suddenly outlawed.  Then people would actually care what they are being charged since they have to pay the entire bill and not just a co-pay, so they would then start shopping around for the best deal.  What's that called again?  Oh yeah, a free market...

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