Is U.S. healthcare reform constitutional? If not, what have we accomplished, really?

It seems constitutional for states to do so. Almost all require you to buy car insurance to drive. Mortgage lenders can require yuou to purchase private mortgage insurance if they aren’t absolutely sold on your credit-worthiness. Neither of those practices are unconstitutional, and they go on under the same Constitution you are referring to.

The Primacy clause has been challenged numerous times and has always stood those challenges. There is 220 years of case law to support the idea that the duly enacted laws of congress trump any state law. We don’t have to get passports to travel across state lines. We don’t need immigration approval to move from state to state.

I certainly don’t claim to be a constitutional scholar, but those who are, even many among Republicans, are warning that this move to sue to rescind healthcare improvements is going to fail, is going to waste a massive amount of taxpayer money in failing, and is being done for purely partisan political reasons.

@ETpro I would say that driving a car on roads (which affects other people) is a privelege, not a right, and requiring insurance in order to be licensed is not the same kind of Constitutional issue that @kevbo is asking about. Your personal health, on the other hand, doesn’t affect people in the same way, you have a right to not seek healthcare, in my opinion, no matter what your physical condition.

On that note, however, the health of the population DOES affect us, in that we as a community of Americans choose to take care of those without healthcare. It costs all of us, for those who don’t have it. The question is, is it someone who is intentionally not seeking it, or someone who just can’t pay? For the former, screw them, lol. But the latter, do we have a responsibility as a society to help take care of them? I think we do. But that said, I have no idea how those people who couldn’t pay for it before can possibly pay for it now.

@ ETpro, the counter argument is that no one is required to own a car or house.

Furthermore (from the link provided above):

The otherwise uninsured would be required to buy coverage, not because they were even tangentially engaged in the “production, distribution or consumption of commodities,” but for no other reason than that people without health insurance exist. The federal government does not have the power to regulate Americans simply because they are there. Significantly, in two key cases, United States v. Lopez (1995) and United States v. Morrison (2000), the Supreme Court specifically rejected the proposition that the commerce clause allowed Congress to regulate noneconomic activities merely because, through a chain of causal effects, they might have an economic impact. These decisions reflect judicial recognition that the commerce clause is not infinitely elastic and that, by enumerating its powers, the framers denied Congress the type of general police power that is freely exercised by the states.

The reason behind requiring health insurance is that’s the best way to control cost for all people. Private insurers base the price they charge on the level of risk an individual poses of costing them a huge cash outlay at any given time. If you are a single individual—not part of a group—and you want to buy insurance it is very expensive because the risk is spread over one person. I’m old enough for Medicare now, but before I qualified, for my small business Blue Cross was $2,700 a month and I have no preexisting conditions and haven’t even been in a hospital except to visit other people since I was 21 and had an appendectomy.

If you let all they young, healthy people opt out so they can party more hardy or save more of their income, then you are left with a pool of older, sicker people and costs go up.

When one of those younger, healthier people suddenly contract cancer, or fall down their stairs and break a leg of back, they are off to the emergency room. That’s the most expensive possible place to get care. And when they cannot pay, the bill falls on the rest of us. We pay for them to be free to gamble. And so it indeed does affect us all just as allowing people to drive without insurance affects us all.

Which part of the constitution would this go against? I’m confused.

Interesting about the fine. People don’t have to sign up for Alberta Health but then se responsible for their own bills. A couple who drank massive amounts of alcohol had opted out. then one day he can’t wake he up and brings her to ER. her skin is bronze colored so jaundiced. She was in liver failure so pivate room, couple of specialists, many drugs. I head the husband begging the finace woman to backe date it!! She didn’t. They will be paying that bill for a long time!!

Obama taught Constitutional Law At Chicago Law School. Pretty sure he has a better idea of what is going on then some yokel bloggers. All the lawsuits will be dismissed and you will pay for them so a wanker can try to score political points
.

@gemiwing That is really the central question. It is not unconstitutional for something to be politically unpopular among a certain segment of the population. If it were, taxes would certainly be unconstitutional. You can be fined for not paying taxes too.

I see nothing that this bill does that is beyond the powers given to Congress in the Constitution. I believe the primacy clause makes it ridiculous for individual states to claim they are going to opt out.

@gemiwing, … requiring individuals to purchase health care exceeds the federal government’s authority to regulate interstate commerce… requiring states to participate in a health insurance exchange, as envisioned by the bill, violates state sovereignty.

@kevbo I don’t think they’re going to get far with that argument, then.

The commerce rule is a long, long, long long shot.

”...this view is by no means widespread, even on the right. Numerous constitutional scholars say the mandate is well within the scope of what the court has defined as commercial activity—pointing to the 2005 case, Gonzales v. Raich, in which the Supreme Court found that the federal government could criminalize the growth and possession of medical marijuana, even when it was limited to within a single state, on the grounds that doing so was part of an effort to control the interstate drug trade.”

http://tpmmuckraker.talkingpointsmemo.com/2010/03/could_scotus_be_the_death_panel_for_health-care_reform.php

“Jack Balkin, a constitutional law professor at Yale Law School, extends that argument. In a recent blog post, he notes that in the Raich case, Justice Scalia found that Congress can use the Commerce Clause to regulate, as Balkin put it, “even non-economic activities if it believes that this is necessary to make its regulation of interstate commerce effective” (itals TPM’s). People who don’t buy health insurance, Balkin argues, aren’t simply “doing nothing,” as Rivkin, Barnett et al. claim. These people pass on their health-care costs by going to the emergency room, or buying over-the-counter cures. “All these activities are economic, and they have a cumulative effect on interstate commerce,” writes Balkin.”

from the same post.

@kevbo It’s going to have its months amdnmonths in court thanks to a bunch of sore losers. It’s going to lose in court. Mark my words. And right-wing nut jobs are already talking about resorting to violence to get their way of they can’t win at the ballot box.

Universal healthcare is a right in every other industrialized country on Earth. Our system you seem so determined to keep unimproved is ranked #37 in healthcare outcomes and is only #1 in costs per capita. Why is this worth destroying our nation to keep healthcare cost going up at an unsustainable rate and make sure it’s not available to 47 million Americans and that 45,000 of them die each year because they don’t have health insurance or it gets canceled when they get sick.

@ETpro, real universal healthcare is extending Medicare to cover everyone (or something similar). This isn’t universal healthcare.

Barring that, the weights of the “pro” arguments above do add up, and I don’t doubt it will hold water if that’s the agenda. I was unaware of the counter-arguments cited. Thanks all!

I’m not personally determined to keep U.S. healthcare unimproved. I’m skeptical of this law resulting in meaningful reform.

@kevbo Please do not assume that, by defending the bill’s constitutionality I am somehow arguing that it’s the perfect solution. I do believe it is way better than the status quo. I believe it should be strengthened and improved. But that wasn’t the question here.

It is completely Constitutional under the general welfare clause of the Constitution of the United States.

We have accomplished:

Allowing people to keep their insurance if they switch jobs
Reducing the out of pocket cost for the vast majority of Americans
Disallowing insurance companies to drop paying consumers because of an illness
Disallowing the denial of insurance to the people who most need it for a pre-existing condition
Covering 32 million people who currently have insurance, and making the insurance of the 50 million underinsured work better for them

You make under 88 grand, you get a tax credit to help you buy insurance, the less you make, the more you get, giving you no reason to not obtain it, making the penalty irrelevant to anyone unless they’re just being a contrarian prick.

Any money you make over and above 200k for individuals or 250k for couples (which reperesents about 1–2% of the population) is taxed at an additional .9%, but don’t worry, because every penny over and above 106,800 is still exempt from the 6.2% social security tax that the other 96% of the population pays.

This whole argument is grasping at straws, a last ditch effort to scare the hell out of the blind followers once more by taking the focus off what it does and trying to find any way to keep the corporate profits high for the insurance companies who are fueling this unfounded hysteria.

Has anything the Government ever done really been successful? This is a Tax Payers eternal nightmare. My great grandchildren will be negatively effected by this ludicrous
Congressional act.

All this question means is that the corporate Republicans will do anything to protect their bosses and care nothing about the citizens they claim to represent.

@ETpro The part I have a problem with is I can choose to drive a car or not and not have to buy car insurance. I have a choice on whether to buy a home and take a mortgage that may or may not require me to buy mortgage insurance. Now for the first time in the history I am going to be forced by my government to do something whether I like it or not.

Something terribly wrong with that picture.

@Cruiser Did you register for the draft? It’s federal law, yes?.

Wow, you guys are missing one major point, and building arguments with shoddy foundations as a result.

Good health is a human right; not a privilege. The constitution protects human rights.

@gemiwing No, I didn’t as it was not a requirement for me at that time. Even if it was required I would not have a problem as I would be happy and proud to serve our country.

@squirbel “Good health”?? That is stretching it a bit and missing the point big time. Yes you are guaranteed a right to a standard of living adequate for the health and well-being and medical care, but I don’t see or recall seeing anything that makes health insurance a right? In America you are given a free education, and within that opportunity you have the choice to study hard get a good education that then further offers you the choice to find a good job and earn a good salary which then allows you the choice to either purchase health insurance or not!! You don’t NEED health insurance to get good medical care. In fact I bet many Doctors would prefer you pay them in cash to avoid the lengthy complicated process of getting reimbursed from the insurance company. Further more “good health” as you characterized it is another “choice” we are afforded in the fine country. Aside from obvious birth defects, it is entirely up to you if you want good health or not. You are free to smoke or not smoke, drink or not drink, exercise or not exercise. eat right or consume fast food junk that will at some point virtually guarantee an unhealthy life.

I just don’t see where or why we should no longer have a choice in the matter of whether we want health insurance or not? Again I don’t need to have health insurance in order to have access to top medical care and having health insurance does not guarantee me good health. An active healthy lifestyle will do that for me free of charge.

@Cruiser – I did not, anywhere in my statement, make mention of insurance.

@Roby – Please give that worn-out ‘What has the government *EVER done right?’* argument the burial it so desperately deserves. People who rely on this argument seem to ignore the fact that many of those who supported the healthcare reform initiative also have children, but manage to see the benefits it will provide for all.

Likewise, the health insurance versus car insurance argument is fraying around the edges. You’re comparing apples to paperclips.

@Cruiser – The difference is that an active healthy lifestyle won’t guarantee that you don’t face some completely unexpected or unforeseen medical emergency that you won’t be able to afford and that, because you chose to remain uninsured, will be passed onto the rest of us by default.

It’s health insurance reform, not health care reform. The health care will be the same. Taxing to provide services is what the government is all about – it’s as constitutional as taxing to support a standing army.

@JeanPaulSartre, that’s exactly what this is not (except for the “Cadillac” plans). I’m not saying I’m for or against in this case, just noting that it’s not a straightforward tax to provide services.

@kevbo I agree. But invading another country and calling it protecting ourselves is a little vague too. It’s all about who gets to define terms. It’s constitutional because it passed a constitutional process, basically. The fashion in which taxes are levied has always been a bit… er… “flexible” I’m afraid.

Of course it isn’t. There is not one word in the Articles that gives the government the power to force you to buy a product or face a penalty. Regarding the auto insurance argument-You do not HAVE to drive. If you choose not to drive, you do not need the insurance. The mandate to by insurance is conditional on your choice to drive. There is no choice regarding purchasing health insurance.

@Rufus_T_Firefly That may very well happen and I’m sure it does but at least in those situations that person or family has some skin in the game. At that time things go belly up for them they will have sacrificed all that they have paying their bills as best they can. That is no way a free ride by any means. So if I choose to not buy health insurance I do so willingly and by choice knowing full well some day I will be faced with medical cost. It would be a calculated decision and if and when that moment arises it will be dealt with accordingly and if my assets don’t match the demand either payment arrangements are made, loans taken out or assets are liquidated or any combination of the above. If the medical need gets worse than that, on to Medicare and other state aid I guess. The system has worked for these uninsured that part is not the part that is broken it is the out of control costs that is and you certainly don’t fix it by forcing people to buy insurance.

I notice that most are equating health insurance with car insurance. Of course, you can choose not to drive and avoid the expense. I would equate health insurance more with the portion of our taxes that go to police and fire protection. You are mandated to pay those taxes for service that you will probably not directly use.

The point is that the police department takes care of most crime so that it doesn’t affect the ordinary citizens life, property, and freedom. The fire department may not be called to your house but to your neighbors. If nothing was done, your house would burn too and it doesn’t matter if your neighbor is rich or poor; whether they follow fire safety rules or not.

The same appliess to health care. If everyone pays, premiums should be lower because the pool is bigger. If insurance companies are properly monitored and regulated this will hold true. If the Republicans have their way and do away with regulations, price will rise to become a major part of our economy and the poor will be priced out. Regulation is the key.

@Roby What has the Government ever done right? It built the most powerful, freest, greatest nation on earth. It has kept foreign invaders at bay for 220 years and continues to do so today. It built the US Post Office System, Transcontinental Railroad, the National Park System, the TVA, Grand Coolie Damn and many more vital energy projects, the Interstate Highway System, the Air Traffic Control System, NASA. Take all those out of our nation and where do you think we would be had we waited for private enterprise to do all that for us?

Gubment haters love to complain about the USPS as being terrible and proof private enterprise excels at everything it touches. This has been preached so loud and long it’s become a meme. But it is a load of bat shit as well. It isn’t true. The USPS is more reasonably priced at handling just about every class of package and letter. It is the only service that makes daily stops to comprehensive routed across the country. A letter still costs $0.44 and typically goes cross country in 3 days. The cheapest letter delivery by a private carrier is $13.44.

Here is a calculator you can use to see for yourself. Anything that fits in the standard sized Post Office “If it fits it ships” boxes is an incredible good deal compared to UPS, FedEx or DHL, but even odd-sized packages are still far less expensive by USPS.

@ETpro A bit of an unfair statement there. When the USPS was cut loose from the Gov there were given all the assets and cash at the time of the change over to the tune of 3 billion dollars. Nothing like free start up cash and capital that you don’t have to ever payback. It also appears they get U.S. government appropriations to the tune of $500—$700 million dollars biannually whatever that means. Not exactly a business model of a company that wouldn’t have a distinct advantage over it’s competition now is it.

Also if the UPS and FED were able to offer postal service could you imagine a for profit company staying in business long with the agonizing slow window service we now get?? I’ll let John Boehner answer this one….“HELL NO”! And as far as the single stamp being a good deal how do you really know since no one can directly compete with that service. Open up competition and I bet we could get not only a better deal but better service as well.

@Cruiser I don’t think that you are comparing like enterprises. First of all UPS and FEDEX don’t have drop off windows like the post office. As for comparing delivery service, there are many low population where only the post office goes, the other package companies simply designate a place where you can pick up your packages. The don’t support anything like letter delivery that costs less than $10 let alone less than $1.

The post office is the official delivery service for registered mail, they go out of their way to hire veterans, and they deliver when the other services halt everything but next day deliveries during bad weather.

Now you can print your own stamps and drop off your letters in a myriad of letter boxes across the country. The other services stripped off the most lucrative parts of the post office system while the post office soldiers on. There is no comparison and I think we need to stop privatizing services that were mandated by law. Privatizing the post office is just as bad as privatizing prisons, police, and the military. Not only is is unconstitutional it is morally wrong. It is just another example of corporations sucking profit where there should be none.

@Cruiser The Gubment Evil crusaders will always hem and haw and arm-wave rather than face cold hard facts. Shows just how deep in their souls thier hate has been driven by the likes of Rush Limbaugh. And even if you don’t listen to him, if you are tuned in to his wavelength, he and Michael Savadge and Ann Coulter and their ilk have an effect on you.

The SUPS was set up in 1971 and the last year the USPS accepted a public subsidy was 1982, 28 years ago. Nearly all big corporations come into being with money they are “given” by the sale of securities. @Roby stated that the Government can’t do anything well. That is patently untrue but widely believed.

Here are additional examples. What would a military of the full power of the US Military cost us isf we outsourced the entire operation to Blackwater? How corrupt and dangerous would such a corporation be? How long till Eric Prince declared himself Dictator for Life to save us from the Evil Gubment that gave him the money and power to do it? How would you like to outsource Police and Fire protection. Anyone too poor to have prepaid need not apply in time of need. And let’s outsource public education so we can step back into the wondrous days when only the privileged few could give their children the advantages of an education. Wouldn’t this be such a wonderful land if we could only kill off the evil Gubment?

We desperately need to have a public debate in this country about what should be done by government at local, state and federal levels and what should be the domain of private enterprise alone. We need to debate that because we need to decide that we actually must set taxes at a rate that pays for the government we need in 29010 instead of the one that would have done OK in 1810. But we can’t begin to even rationally discuss such a think when a large block of our population refuses to even deal with the facts of what government does well and should do because some right-wing belief system clouds their vision.

@Ron_C Sorry there but if you read my answer I used the word “were” as in if they were able to offer first class service they would have that kind of service and UPS does have their UPS stores all ready to go!

@ETpro That’s funny but I got my numbers off of the USPS 2003 and 2005 year end statements. I wonder how they got there then??? I don’t even want to touch your statement at what the Government does well. When was the last time you stood in line to get a license for anything?? Kudos though on the open rational debate thought as impossible as that sounds.

@Cruiser when UPS stores open in every city and village, when they offer mail service for less than a dollar, I will agree that the post office should be closed down. Until them, I support my local postal carrier.

Right on ETpro! Great answer!

So, if you don’t buy healthcare insurance and you have a life-threatening illness of injury and end up exhausting your life savings, loans and any other options. At that point, covering any additional medical costs with Medicare or any other state aid STILL becomes a burden on the taxpayers who have already paid into the new system… and you’ve paid out more in commercial insurance co-pays than you would had you gone the national healthcare route. The taxpayers still lose out and your additional costs cost more for taxpayers to cover after the fact. It would be a hell of a lot easier to just get with the program, join the pool of risk with everyone else and save money all the way ‘round. Meanwhile we can all work toward improving the new system to make it a better fit for the nation.

@Rufus_T_Firefly great answer. I don’t understand a system where a company provides no service, rakes 20% off the top, and has the right to throw anyone they want out of the system. This is a very bad business model and it shows in comparisons of the quality of our care compared to any industrialized country in the world.

@Cruiser I am glad you brought that up in specific. The USPS receives about $100 million annually from taxpayers to compensate it for government mandated free mailing privileges such as Congress and other government agencies being able to mail to their constituents without cost.

@ETpro I forgot about the “franking privilege” Any congressman can mail anything anytime for free. Hence we get those spiffy hand-outs at election time.

@Ron_C – Thanks. I guess I still cannot understand why people are willing to pay higher insurance premiums in order to keep things running the way they have been even though everyone who does so is getting financially reamed in the process. Capitalism does work and it has it’s benefits, but there are limits as to how far it can help a society evolve and the profit gods don’t give a flying fcuk what else happens as long as the coffers get filled on a regular basis. Insurance costs have done nothing but rise in the last thirty years and are expected to rise even further in the near future. It just seems right to reform the system and get everyone involved to lessen the drain on our already-staggering economy. Especially when, as some profess, they’d rather take their chances, spend more on their insurance during the interim and finally, if forced, they’ll grudgingly become willing to go to Medicare or some other state agency where they will ultimately become the ‘drain on the system’ that they feared in the first place.

Dang @ETpro you are good! ;)

@Rufus_T_Firefly I can’t find a downside to a single payer system. It takes the burden off of business since they no longer have to provide insurance but can if they want to provide and employment incentive. It allows individuals to start businesses without the worry of paying to protect their family, it becomes non-profit so we immediately save the 20% of current costs, it gives taxpayer leverage if they don’t like the way payments are administered. It encourages small community hospitals and discourages large hospital conglomerates that must make a profit. It equalizes pay for doctors and medical support staff. The extra available money allows for scholarships to train doctors and nurses. The saving and operating efficiency opportunities are amazing. The only people that lose are the CEO’s of large insurance and drug companies and the congresspeople that live off of them.

All of the right people win for a change.

@Ron_C – I agree completely. If only we hadn’t had to waste so much time and energy defending single-payer system against the fear-mongers, disinformation artists and all of the other insurance company shills, we’d be celebrating it’s passage instead of having settled for a watered-down plan without a public option.

@Rufus_T_Firefly YEP!

@Cruiser My friend, coming from you that is gratifying. :-) And I do thank you for bringing it up, as that fact is often missed and leads to public misunderstanding of the decent and necessary job the Postal Service does. Yeah, I’ve had to stand in line a time or two, but all in all, they are a good lot doing tough work that benefits us all. And they certainly are not the poster boy for governmental waste and incompetence. I have a few favorites for that category, but the USPS is on the other end of the scale.

@Ron_C As a small business owner who has to struggle with the cost of heathcare, and who has watched as jobs continue to fly offshore ebcause every other nation exempts their corporations from usch costs and it makes it tough for us to compete globally, AMEN!!!

It is just that Obama knew the entrenched interests that would fight that are currently insurmountable.

@ETpro – I have to say that I support the USPS, as well. They do a horribly monotonous and grueling job all year round. The only thing I wish they’d do different is to get rid of all the useless, resource-wasting junk mail. I probably throw away at least five or six pounds of various junk mail every week.

@Rufus_T_Firefly I wonder if they even make money on junk mail at its rates?

@ETpro – I would imagine so. I know they offer discounts on larger quantities. I can’t imagine that it costing them that much more to deliver a few extra pieces of junk mail if they’re already going house to house anyway.

Also, the business that buy send these bulk mailings are probably making a profit, otherwise they probably wouldn’t bother.

@Rufus_T_Firefly Then I guess just keep sending it and I;ll keep the recycling man in a job. :-)

I disagree that you don’t have to buy car insurance, first of all. It is a legal requirement to have liability insurance on your car. The reason for this is to be able to pay for the damage you might do to someone else.

Requiring health care is the same thing. You will damage the economy if you refuse to be insured and then are sidelined by a serious illness or injury. Just like you’re forced to buy insurance to protect others from yourself in case you have a car accidnet, you are being forced to buy insurance to protect others from yourself in case you get sick.

@dalepetrie – I think the point they were going for was that if one doesn’t own a car, you don’t have to buy auto insurance, although in this day and age, it is highly unlikely that most people in the U.S. won’t own at least one car. However, everyone has a body and shit happens, often without notice or a full bank account, so having affordable, regulated health insurance seems like a good idea to me.

@Rufus_T_Firefly “regulated health insurance seems like a good idea to me” I completely agree. We have thirty years of unregulated insurance and have seen a steady decline in health with a corresponding rise in cost. Like I said the whole business model is wrong, there is no justifiable reason for health insurance companies except profit. Anyone that supports that model believes in insurance for only the rich and healthy. That is totally un American and puts us right back in to medieval times with Lords and Serfs. There were very few Lords and many Serfs and Serfs were expendable.

The only other option would be, if someone did not want to buy health insurance, to have them carry a card stating this. Then, if they went to a doctor or hospital, they would be denied treatment altogether if they couldn’t pay for it. We could call it the “Die in the Street Card.”

Like Swift’s “modest proposal,” this is not acceptable in a civilized society.

@Dr_Dredd I like the “die in the street” card. They should be, first, issued to Republican members of Congress.

Single payer would be semi-morally acceptable, when I would pay my taxes, I would know that that segment is actually helping people, almost as direct as charity. It’d have to be entirely funded from a specific tax or I can see it adding the debt back up. If the government had heat on its back to pay the bills, and pay them from that singular reserve, and to never borrow to replenish, or loan money from the reserve it would be auto checked and balanced. Have fun getting politicians to vote for something so obvious, transparent and fool proof.

Though I’d still seek to earn enough to be independent and would quickly turn down generic care for a private doctor. I’m still plain old opposed to a mandatory health care “tax” or fee of any sort, and I’d feel not the slightest of remorse for not paying.

This is a short ass period of time we got cooking here, and I’m not gonna spend any of it taking other people’s money they earned, when I’m furious to see how much of what I earn go.

I’ve tried and tried and tried to care about health care reform just enough to not be entirely opposed to the system down to every nut and bolt. Fuck it, if the ER can’t help little uninsured me, and I’m a few greenbacks short, I’m not really going to have any emotions to any degree in regards to any of this when I cease to exist.

Time is money. So when I spend the hours slaving away to then have a friggin’ third of my paycheck removed, knowing that my entire check will be sunk into bills that are too large and frequent for me to get a frozen pizza on a Friday night without screwing myself, knowing how repulsed I’d be if I were to actually see what each and every cent was spent on, I feel quite ill.

What your doing is forcing everyone to get healthcare and if they can’t afford it you subsidize it.
Healthier people = better people
I’m from Canada and while we still have homeless people it still shocks me that whenever I go to the US i still see outright poverty. With this new system you keep private healthcare and everyone gets it.

@Boombip Sounds great and all but would cutting out the middleman, leaving hospitals to earn their own funding and pay their doctors? Those they normally turn away would become their lifeblood, their nourishment. When they’ve got to operate like a business, they’ve got to compete like a business. People seem to get really scared of privatization, but with knowledge of the voting power of your dollar it’s usually better off. Competition only helps the consumer,

@Anon_Jihad Single Payer would be my choice except that we already have so much invested in the private insurance industry. But we will probably have to find some way to compensate the owners of that industry and flod it into a government operation at some time. It is simply far more efficient.

However, single payer has nothing to do with who your doctor is or who owns the hospitals. Wen you conflate the two, you are thinking of socialized medicine like the UK has. Canada has a single payer system, where the government acts as the insurer. They, unlike the UK, have private doctors and hospitals just as we do. ANd they get better healthcare outcomes we do at nearly half the cost while covering all their people instead of leaving nearly 50 million uninsured.

So if I want a less socialized system I should move to Canada? As while their system isn’t perfect, it’s way less invasive and direct?

@Anon_Jihad I do not know where you live now, but if it is the USA, our system has definitely not been socialized. The final healthcare reform bill passed the Congress this evening. You will wake up tomorrow morning to find the same doctors, hospitals and insurance companies around. No black helicopters will be swooping down to impose iron-fisted government control on them.

@ETpro And until 2014, they won’t be doing anything different, either. They’ll still be denying people for pre-existing conditions, doing policy recissions, etc.

@Dr_Dredd That is true.

@Dr_Dredd That’s not my understanding—the policy recission and pre-exisitng conditions parts of the bill are in effect now.

@ETpro, @Dr_Dredd, & @andrew – you’re all somewhat right, here’s the deal:

By the end of June 2010, the government is supposed to have established high risk pools that people can buy into if they’ve been rejected by insurance companies while attempting to buy individual coverage. The insurance will cap the annual out of pocket at $5,950 for individuals and $11,900 for families. This pool is temporary and is only to exist until 2014 when private insurers will actually be banned from denying someone based on a pre-existing condition. Also this year, insurance companies will not be able to drop you if you develop a health condition, nor will they be able to set yearly or lifetime limits on coverage. Unfortunately, I do understand that the fines for breaking this rule are something to the effect of $100 a day, which is chump change vs. covering someone’s cancer care expenses.

When the full force of the package kicks in as of 2014, not only will insurance companies be unable to deny you for pre-existing conditions, but they can’t charge you more because of health issues, or your gender or race (but they will still be able to charge you more based on your age, where you live, and certain risk factors like smoking).

And what might turn out to be the biggest boon of the entire thing, next year, health insurance companies will be required to spend 80% of what they collect in premiums from individuals and small business on actually providing health care services to the insured. In other words, the ability to profiteer will be capped starting in 2011.

There are a number of other changes having to do with long term care, clinical trials, extending the age of dependent minors’ coverage, medicare rules, transparency (basically setting up a website to help people navigate health insurance offerings, etc.).

So, really nothing today, but by July if you don’t have coverage through your employer it will be easier to get it if you’re sick, and the situations in which your insurance company can charge you more or cancel your coverage will get fewer and fewer over the next 4 years.

@dalepetrie Thanks. Even better than I had expected.

http://tpmcafe.talkingpointsmemo.com/talk/blogs/a/m/americandad/2010/03/an-open-letter-to-conservative.php

@squirbel That’s priceless. So true. I’m one of those that used to be a Republican. I still don’t think I left the GOP, the GOP left me. They lurched way to far to the right.

@ETpro I’m surprised no one saw this coming. When you have a presidential candidate that says he wants to kill government then proceeds to do just that, this is the result. When Reagen ran for president was when I quit being a Republican. I don’t believe that I am that smart. What I can’t believe that people were so stupid then act surprised when everything falls apart.

@Ron_C That’s what pushed me over the line as well. I was a Californian at the time and already knew he was a cracker barrel crank with the charm and wit to con people. I could see that he was put in place by a fabulously wealthy elite who controlled the Republican Party in order to shift the laws and tax code toward channeling ever more of the nation’s wealth to a tiny group of oligarchs who already held a good deal of it. And that is exactly what happened.

@ETpro I believe that Reagen was not only a bad president, he was evil. He and that faschist creep, Oliver North supported terrorist gangs in south America and fired the air traffic controllers showing their contempt for democracy, workers, and ordinary citizens.

@Ron_C You won’t get any argument from me. I think Reagan did more harm to the US than any other President in our history. Before he took office, we had been slowly but steadily paying down our national debt from the New Deal and WWII. When he slashed taxes for the wealthiest Americans by 60%, the debt began to immediately skyrocket. He is the only US president in 200 years to have tripped the national debt in just two terms. His embrace of don’t-tax-just-spend has led us to be teetering on $13 trillion in debt (nearly our annual GDP). And his deregulation and “Government isn’t the solution to the problem, government is the problem” philosophy has gutted institutions that served us admirably ever since the Great Depression and turned America into a politically charged, divided state that is nearly ungovernable now.

@ETpro yeah, its a hard decision selecting the worst president ever. I am having trouble deciding whether it was Bush Jr. or Reagen.

@ETpro & @Ron_C – Yeah, those two hold the number one and two spots on my list as well. Don’t get me wrong, I liked Ronald Reagan as an actor, but not as a president and certainly not as some kind of pseudo-conservative political messiah. George, however, brought out nothing but rage and utter contempt.

Bush Jr. is a more visible target, but I think Reagan did more damage overall.

@Dr_Dredd you are right, Reagen was a stealth destroyer of American life. Jr. was just an inarticulate figurehead for the economic takeover of the country and the surpreme court just made it all legal.