Challenges to the Health Care Law
http://thedianerehmshow.org/shows/2011-02-03/challenges-health-care-law
Last night Senate Democrats defeated an attempt by Republicans to repeal President Obama’s health care legislation. The vote went strictly along party lines, though both parties joined forces to repeal an unpopular tax provision on small businesses. In January, House Republicans voted to repeal the act. Earlier this week, a federal judge in Florida ruled the law void, bolstering those trying to overturn it. It’s the fourth suit to have been decided. Two ruled part or all of it unconstitutional while the other two upheld it. Twenty more cases are pending. We'll discuss what this means for the future of health care reform.
Guests
Mary Agnes Carey
senior correspondent with Kaiser Health News. She's most recently served as associate editor for CQ HealthBeat, a daily report on health care policy. She has also served as Capitol Hill Bureau Chief for CQ.
Julie Rovner
health policy correspondent for NPR, author of "Health Care Policy and Politics A-Z," and contributing editor for National Journal Daily.
Jeffrey Rosen
professor of law at the George Washington University and legal affairs editor of "The New Republic." He's the author of "The Supreme Court," "The Most Democratic Branch," "The Naked Crowd," and "The Unwanted Gaze."
Comments
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Just curious who your guests are in reference to "...exploration of private funding in public schools" sent in your tweet. - Thanks!
America corporate interest is too entrenched in the American way of life. The obvious answer from my point of view is to expand medicare. With young people involved the overall cost should be affordable for everyone. Our single payer system here in Canada is not perfect but I've never had a bill and it is the best type of security. It seems to me that America the brave does not have the courage to do the right thing for its citizens anymore. Your system of government has become too corrupted for politicians to even make the children of your nation a priority. Things must change or America will loose its standing in the world.
Why does the media seem to ignore the fact that repeal votes have been more bipartisan than the votes that originally passed the legislation? When media uses this term, as well as partisan, does it reflect an underlying liberal bias?
Car insurance requirements are a state mandate, not federal. This is why courts believe the federal gov is overstepping.
Rather than fining someone who cannot provide proof of insurance, if the Health Care law gave taxpayers who could provide proof a tax deduction, would this withstand constitutional scutiny? Sure it would be an unaffordable budget buster but it might quiet conservative critics.
Why don't Dems talk about the fact that auto insurance is mandated? You don't have to own a car, ok, but we are protecting ourselves against others and visa versa. Same with Health Insurance.
This massive expansion of Govt will SAVE money? How much you wanta bet?
John, states may or may not require insurance if one CHOOSES to drive on government provided roads. You can own an auto and drive it on private property without insurance.
More and more states in effect do not require insurance as they have failed to enforce their laws against irresponsible often illegal alien drivers. Instead, they have forced responsible drivers to purchase uninsured motorist add ons.
The trouble with the government trying to make decisions on health care, is that they are not involved in health care. I am an RN and have been taking care of patients for 30 years. Technology that allows us to save or extend lives has increased greatly and is expensive. Also a lot of money is wasted on families emotions, they are not ready to see a loved on go and therefore we spend 10's of thousands of dollar per patient per day to keep them alive until the family is "ready". There are far too many issues to go into here, but government is also ignoring the American attitude of "I have a right to eat what I want, smoke if I want, spend all my time on my couch if I want. " Then expect the healthy, working people to pay for their care. These habits start in childhood. Now lets see the government fix that!
What is the argument for why the fed govt can require Americans to contribute to social security and medicare, but can not require Americans to have individual health insurance?
The Republicans are wasting precious time and money (taxpayer money) trying to repeal the Health Care bill both in Congress and the Courts. Why aren't they as concerned about the important issues ... say like creating jobs?
It seems a bit hypocritical to me solely based on politics.
If only the individual mandate is overturned by the Supreme Court, would the rest of the law still stand, regardless of the impact on insurance companies? If so, it seems like insurance companies would go under, and that it could lead to a strong push for a "Medicare for all" kind of program.
What I don't get is how people whose employers offer healthcare--no matter how good/bad the plans are--are FORCED to pay for healthcare, yet people whose employers don't, or are unemployed, get it for free. The fair way would be to add a federal sales tax that goes into a healthcare bank that covers EVERYONE'S healthcare. If you're in poor health or are a smoker/obese maybe your co-pay should be a bit higher.
This way would also be more fair because illegal immigrants pay sales tax (unlike income tax) so participating citizens won't be footing the bill.
Has these methods not been explored?
bariordan, I agree with much of your analysts. I think the under lying problem is the recipients of HC services are not the payers. Of course they choose to spend other peoples money on a slim chance of having their loved one around longer.
Congress can't "make people" buy health insurance? Set aside for a moment the moral obligation not to make your medical care a burden to society. The millions who were drafted into military service during the first 200 years of the Constitution might argue that Congress can make people do anything.
Let's establish a "Conscientious Objector" threshold, and see who has the nerve to apply...
Why isn't it against my constitutional rights to pay via taxes, for those who don't have health care, fall ill then run to emergency rooms and can't pay?
Please explain the notion of "Severability" in the context of the new law NOT containing a severability clause (I've been told) and if this is true, it seems that the entire law has to be dealt with instead of various sections of it. The challenges by the FL court is focused on only the requirement to buy insurance. Based on my understanding of severability, this challange can not stand since it violates the tenants of severability.
Thanks
Healthcare in this country is too reactive. Why not reward people for living healthy lifestyles,
with lower premiums as do some auto insurance agencies.
The fundamental problem with the healthcare law is we have a lot of lawmakers who themselves dont understand the american healthsystem.
I am a pharmacist and i can tell you a lot of wealthy people cant afford their health bills. If anyone thinks they are okay with their healthcare ask them how many of them can pay for dialysis without goverment help.I guess less than 1% of the American population can do this.
The law must stand else we will do unto our health what our nonsensical education budget cutting is doing to our kids.
Robin, it does seem obvious, doesn't it? We seem to feel that the need to keep insurance companies profitable is more important than providing health security for people (especially children). thanks for your comment.
All this talk about how the courts may interpret the Constitution is frustrating... Why don't Democrats simply seek to AMEND the Constitution so that there's no question about these issues? I understand it is very difficult to accomplish a Constitutional Amendment, but isn't that the point? Huge issues like these should be subject to that extra scrutiny and associated laws should be more difficult to pass.
Clay
Warren, MI
Arguing the mandate in the law is like asking why one should go to the courts for arbitration.
Why are the republicans really against health care for our citizens?
Does it not save money for all the big corporations that fund and heavily influence the politicians?They must surely spend billions collectively to insure their employees.
Why are the judges allowing technical shades of grey to interfere what what is best for the population at large?
What is the true reason?
What are the opponents really scared of?
BTW "Rule of thumb" expression came from a law that stipulated you could not beat your wife with a stick larger than your thumb.
The ACA is not health care reform, it is insurance regulation. Congress, and for the most part Republicans, have succeeded in framing the discussion around "insurance" rather than focusing our broken health care system. Insurance (managing the transfer of wealth from the people to medical providers) using risk-managing, for-profit corporations is the most inefficient way to finance health care. America needs a single payer system (universal expansion of Medicare & Medicaid) administered by not-for-profit claims administrators. This is the most financially efficient and would not provide windfall profits to the medical-industrial complex.
Americans need to stop being distracted by the smoke and flashing lights and look at the man behind the curtain.
How would the constitutionality of the single purchaser system compare to the constitutionality of the present ACA?
what about single payer?
I fear the Press & media is unrepresentative re: the Health Care issue. 29 other narions have less expensive, higher quality & universal health care for all citizens. We have the Most expensive for the least perecentage of citizens. And the diference is a Partisan, purely partisan WAR.
Obama is a job killer? One side lies, the press repeats the lies. The Reform does not kill jobs! In fact it will create between 30-60,000 new jobs BEFORE Doctors, just to begin propviding non ER services to 39 million more patients.
Cost CANNOT go higher. We currently kill 10s of thousands @ year without preventive or intime medical care. Check W.H.O statistics!.
Would a public option have saved expenses & provided more free choice? Yes, thats why it got killed. The Insurance Co. would lose OPTIONS. Thats news!
One of your guests was asked why there is such a difference between how many European countries deal with health care insurance and how we do in the U.S. My understanding is that, after the destruction of many hospitals, clinics, and doctors' offices during World War II in Europe, governments had to step into the breach and set up national health care systems to deal with the widespread problems. America was spared that physical destruction of facilities. Additionally, with the returning G.I.s, many skilled and looking for work, the U.S. government passed laws that allowed businesses to compete for good employees by offering a company-paid medical insurance benefit that would not be taxed as income. Canada, being part of the British Commonwealth, followed the British system. The U.S. went its own way, and we've come to accept that our employer-paid system (even if the employer is the individual) is the norm.
Change is threatening, and the resistance we're experiencing now is caused a great deal by fear of change, not because our current system is the "norm" compared to most other countries.
Single-payer administered through Medicare is the best, most-fair method of funding and making sure that all Americans receive health care. In addition, many people are unaware that Federally funded health clinics are available in many communities around the country. They are known as Federally Qualified Heath Centers (FQHCs) and are supported through grants. They are not "free" clinics, but they charge users based on their ability to pay. Those who are currently un-insured and under-insured, in addition to those who have insurance should be encouraged to use these facilities rather than hospital emergency rooms. These clinics are also often in high-need Health Professional Shortage areas and benefit from the National Health Service Corps program which provides scholarships and loan repayment plans to students enrolled in accredited medical, dental, nurse practitioner, certified nurse midwife and physician assistant training. I am on the Board of Directors of the Detroit Community Health Connection, which is an FQHC. We operate five clinics in the city of Detroit, have been in existence for over 20 years, and are accredited by the Joint Commission on Accreditation of Healthcare, just like most major hospitals (many private physicians and clinics do not have this accreditation). I think it would be a great service if the Diane Rehm Show would explore the FQHCs. For more information, contact Health Resources and Services Administration (HRSA), which oversees and funds FQHCs.
It seems to me that we need to be a little bit draconian. If you get sick and it turns out you could afford health insurance or that it was available to you, then sorry - you don't get care.
As a US citizen we are required to pay for benefits that we enjoy, roads, libraries, schools etc. My state requries drivers purchase liabilty auto insurance. Requiring citizens to be responsible and participate in the cost of their health care seems reasonable to me. I have worked in health care for decades, I know that 30% of my hospital bill is my payment for care provided to others who do not pay for their care. Our small rural hospitals are in danger of closing due to unpaid care.
I am already forced to pay for health care. With every single paycheck I am forced to pay for health care for seniors, the poor, the disabled, veterans, etc. So why are so many people up in arms about the idea of now having to pay for their own health care.
If there are those who really, really don't want to be covered by health insurance, then they shouldn't have to be. But I shouldn't have to cover them with my raised premiums. If they opt out from being covered (even when government subsidies make it affordable) then they need to understand that if they go to the hospital, they opted out and should be turned away.