Supreme Court Hearing on the Affordable Care Act
http://thedianerehmshow.org/shows/2012-03-22/supreme-court-hearing-affordable-care-act
Next week the Supreme Court will hear oral arguments on the Affordable Care Act. The Act is perhaps the most significant piece of domestic legislation since the creation of Medicare in 1965. The decision has the potential to greatly impact future federal legislation for generations to come. Reflecting its significance, the court has scheduled six hours of oral arguments. And more briefs have been filed than in any other case in the court’s history. At the center of the arguments is the so-called "individual mandate". Opponents of the mandate say it’s unconstitutional. The government says it has precedent on its side. But what really matters is what the court rules.
Guests
Joan Biskupic
Legal affairs editor for Reuters News. She has written biographies on Sandra Day O'Connor and Antonin Scalia.
Ron Pollack
executive director of Families USA, a national non-profit organization for health care consumers.
Carrie Severino
chief counsel and policy director, Judicial Crisis Network
Comments
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Being born in a hospital and/or receiving childhood mandated immunizations welcomes you to the healthcare system. Does that not include "almost certainly" all of us?
I understand how competition among health care companies will control cost, but how is the Affordable Care Act going to control the actual medical costs themselves?
Quoting Oct21 "Ron Pollack believes there is a magic money pot out there."
As opposed to those who don't get insurance then have to declare bankruptcy because they can't afford their bills. Where do you think the money comes from to bail them out?
With reference to the caller who " saw a D.O. on the QT" after he found the charge for an uninsured patient too high at the Cleveland Clinic: The problem with the negotiated fee at the smaller office comes if this DO also provides care through most insurance companies, which contractually require that their insureds charges be paid for at a rate discounted from 'the usual and customary fee.' The doctor commits fraud, according to most laws, if an uninsured gets a break - because that break chnges the usual and customary fee -and we are threatened with huge penalties if we do attempt to give someone a break. The larger offices and health care systems are under great scrutiny for this.
Of course it's not fair to the individual! This is why an itemized ER bill looks exorbitant, but the actual money paid by an insurance company to a hospital is vastly less, sometimes 10% or less of the bill on paper.
Comments about mandated health care are not necessarily valid in that we already have mandated health care through Medicare and Medicaid, funded by mandated taxes.
Would not the administration cost of federal programs be reduced by bring all the programs, Medicare, Medicaid, and the Affordable Health Care Act, under one umbrella organization?
Would the actual cost of health care be eventually lowered through payment limits from the Federal Government?
If I don't have a car and don't drive I don't have to have car insurance. Many state also have a provision that if you are rich enough, you can self insure. With health insurance, even if I am in excellent health and have no current need for medical care, I must still buy insurance.
How is this mandate different than Social Security? Could I opt out of paying for that if this is struck down?
Of course Congress can regulate healthcare. If 17% of our GDP isn't considered "commerce", I don't know what is.
Problem #1. Single payer was taken off the table by timid Democrats.
#2. Single payer was not implemented.
#3. The stupid 'comprimise' forces people to support the needless health insurance industry
I do not support a mandate as it is very flawed..first it requires individuals to support beliefs that they are severely counter to, such as requiring mormons to join a group that supports blood products use and transfusions , the individual will now subsidise illegal activities such as drug trafficers by providing health care for their victims as oppposed to them subsidising their damages , we would support self inflicted wounds such as cigarette use , drug use and , alchohol abuse , and liability from dui's.. it also subsidizes food processers who push unsuitable foods to children and uneducated masses.. such as the slimeburgers , sugarry drinks, the cigarettes and alchoholic beverages, also weapons, unsafe products , toxic energy drings , unsafe vehicles, and negligent acts, etc.
Secondly we buy products with our feet... if we dont like the price we go somewhere else.. for example if i went to the emergency room for getting wood chips in my eye the Er would charge me $2500 but the local eyecare place i went to only charge $50 for a cleaning Rx and sufficient care.. Insurance medicalgroups and mandates have increased costs by 2000% in this case. mandates drive up costs .
I have not heard a comment about those who say there is not a mandate for the federal government to make us pay for something, but I keep thinking about social security. I am not given the choice whether to get retirement from the government or privately, it just comes out of my pay no options given. I was driving so couldn't get this question asked while you were on the air. I love to listen to your program. Thank you.
mancuroc wrote: Quoting Oct21 "Ron Pollack believes there is a magic money pot out there."
"As opposed to those who don't get insurance then have to declare bankruptcy because they can't afford their bills. Where do you think the money comes from to bail them out?"
All these conversations about ever expanding federal government overreach will fall to the wayside when no one will buy U.S. debt. So you believe in the magic money pot too, what a shock.
Why can't we think out of the box?
Consider paying Hospitals and Physicians for caring for the uninsured an
equivalent in dollars what medicare/medicaid would pay for their care
as equivalent in dollars as tax reductions? We all pay a tremendous
amount for corporate taxes each month. This would be an incentive
for both Hospitals and Physicians to see and care for the uninsured.
They come to our doors and receive health care!
Richard Prager MD FCCP
max4252@bellsouth.net
What is the law forcing those of us who are insured and/or hospitals covering the irresponsible when they show up to the emergency room without coverage? Currently, if you have low income and little in the way of assets, there is not much incentive to carry coverage. If the worst happens and you need medical services, you just show up and then walk away from your debts by declaring bankruptcy.
If this were changed there would probably be a lot less opposition to the individual mandate to carry coverage.
Diane this was such a good show!!! VERY INFORMATIVE! Also I was very glad that, for this show, you did not bring someone in from some conservative think tank to dispute, contradict and lie about everything that was presented. Give them their own show with 2 other conservatives!!!!I predict the court will rule unfavorably because 5 of them do not know what it is like to be a struggling working joe! or if they did they have forgotten!
@jim wells It would be a start! Maybe as time goes on we could make it what it should be!!!! especially if we could rise up and vote all the conservatives out of office. I actually laughed hearing that the plaintiffs who were so dead set against the mandate that they attached their name to the suit are now bankrupt because of health issues...talk about karma!!!!!!
Agree with billtmore: Thanks for not wasting our time with so-called conservatives who feel entitled to their own so-called facts. Excellent and timely show.
billtmore wrote:" predict the court will rule unfavorably because 5 of them do not know what it is like to be a struggling working joe! or if they did they have forgotten!"
Their job is to interpret if the law conforms to the Constitution, not endorse flights of fancy for feel good pop culture schemes.
thanks35 wrote: "Agree with billtmore: Thanks for not wasting our time with so-called conservatives who feel entitled to their own so-called facts. Excellent and timely show".
Ron Pollack did just that, except it was to your liking as a so-called liberal.
Hey oct21
You get real.....affordable access to health care IS promotion of the general welfare of us all!! you ain't destroyed ANY argument..infact you make ours stronger!!
Single payer system is the only way to deal with skyrocketing costs, but it is not possible because our elected officials are so beholden to corportate interests that they don't even discuss it.
Their were excepttions, but they were voted out of office, e.g., Dennis Kucinich and Alan Grayson.
Their constituents believed the propaganda that we are being fed by insurance companies and others who reap huge profits as long as insurance companies control our health care.
The Affordable Care Act is just kicking the can down the road.
Some of us love winter, and miss it. You and much of the media have used words and statements about how wonderful the warm weather has been. We don't all feel that way!
Love your shows.
Tim Werner
Traverse City, MI
hybeerian, You need to educate yourself as to the meaning and ORIGINAL intent of the U.S. Constitution. I am pretty certain you avoid anything that contradicts your desires for the rightful role of the federal government in our lives and that is a pity. I would first suggest looking at the meaning of the word "welfare" at the time the constitution was enacted.
The issue is about competing rights. On one side, "The government can't force individuals to buy health insurance." On the other, "The insurance companies won't let individuals buy coverage at any cost." I'd like to hear more coverage of the rights of Americans who insurance companies won't sell a policy to, who had a insurer rescind their policies, who work part-time so don't qualify for employer health coverage, who lose their job and insurance because employers downsize or go bankrupt, and all those formerly responsible citizens whose only option became...a government program. Even under the ACA, insurers are finding legal loopholes...many stopped offering individual child policies when they were mandated to cover pre-existing conditions in children, but grandfathered in healthy children who already had policies.
Independent Observer posted this: "If I don't have a car and don't drive I don't have to have car insurance. Many state also have a provision that if you are rich enough, you can self insure. With health insurance, even if I am in excellent health and have no current need for medical care, I must still buy insurance."
Your analogy is flawed, in my opinion. To make the analogy to car insurance accurate, you would need to say that, "If I don't have a body and am not alive."
Keep in mind that the only car insurance required is liability coverage. Liability coverage is required to ensure that, if you are responsible for injury or damage, you can meet your financial obligations to others. Health insurance is the same. If you are sick or injured and are rushed to the hospital, health insurance guarantees that you can meet your financial obligations to those providing you with needed medical services.
I have no objection to allowing those with sufficient assets to go without health insurance. Of course, those with sufficient assets to meet a potential medical emergency (the floor would probably have to be at least $1,000,000) are the least likely to go without insurance. For them, insurance premiums are small change, but a major medical emergency could be financially devastating.
Hi Diane, How has the insurance weighed in on this. The ACA as it stands now will greatly benefit them as tax payer dollars will be subsidizing the premiums of at least 1/6 of the population. If the mandate is struck down the insurance company will be in great trouble as the young and healthy will not cover themselves and this skews the pool. I know they can't lobby the Supreme Ciourt, but I'm sure they've been in touch with elected officials, but the main stream media hasn't covered it. Debbie Christensen Los Lunas, NM 505 865-4070
Two points: 1) If you HAVE insurance, you don't have to do ANYTHING under this law. 2) If you are too poor to afford individual insurance (and the costs right now are outrageous) you will receive help from the government. These critical points need to be emphasized.
DOES THE "OBAMA-CARE" LEGISLATION REQUIRE THAT ALL AMERICANS MUST "PURCHASE" HEALTH INSURANCE? OR, DOES IT REQUIRE THAT ALL AMERICANS MUST "HAVE" INSURANCE COVERAGE? {Part 1}
Many Americans already do not purchase health insurance, or do so at a discount through an employer or association or through their state or through the federal government. (One may quibble, whether or not taxes that pay for healthcare are a form of purchase). Taxes may purchase healthcare in one form or another, e.g. Medicare, Medicaid, VA, Tricare, etc.
Although the effect of legislation requiring all Americans to have heathcare insurance coverage is that many will necessarily purchase private insurance in order to fulfill the coverage requirement, the letter of the law (if it is phrased in terms of "possession" of a healthcare coverage policy) may not violate the Constitution, as in principle, no business is required to charge a fee or premium for service, though as a practical matter, the apparent raison d'etre for business is to profit by charging premiums or fees.
As a reductio ad absurdum, consider that, while the purpose of commerce may be to obtain profit, there is no legal requirement prohibiting industry from giving away their produce. If anything, we live in a world of private industry advertising "free, free, free" all the time! Of course in reality nothing is free, but, while some may rightly point out that government-paid healthcare is not free and may be too expensive, neither is individual or corporate paid healthcare free nor without expense (often shifting costs directly or indirectly to those, who will afford little or even no coverage).
{Part 2} ONE MAY MAKE A STRONG ARGUMENT THAT BY THE GOVERNMENT CREATION OF MEDICARE ADVANTAGE PLANS in tandem with a failure to legislate MOOP protection into Traditional Medicare or to subsidize private purchase of MediGap insurance for the poor (suggested decades ago by President Richard Nixon), that THE MEDICARE PROGRAM IS BEING DESTROYED. MOOP (Maximum Out Of Pocket) protection, provided for prior to 2010 in many MediGap policies, sets an annual ceiling of out-of-pocket financial responsibility to the covered individual in terms of Medicare Beneficiary co-payments or co-insurance for Medicare covered medical expenses.
MOOP protection means that assets such as one's home and bank accounts are significantly protected from the financial impact of medical catastrophe, such that homelessness of the disabled and elderly may be prevented. Medicare Advantage Plans (often at a zero-dollar premium) provide MOOP protection. The effect of this "free" value-added benefit is to undermine Traditional Medicare and MediGap, as Traditional Medicare does not offer MOOP protection, and MediGap policies no longer offer MOOP protection (only one or two MediGap policies post-2010 now offer full or partial MOOP protection).
{Part 3} I serve in the private insurance industry as an independent insurance agent, and I specialize in Medicare insurances. It is my obligation to help my clients make their best choices in terms of what is available in real time. It disturbs me deeply to look into the future, which looks increasingly like the destruction of Medicare, the disenfranchisement of at least one-third of our population from healthcare and from employment opportunities that are real and not merely theoretical, and which harbingers a dramatic continued increase in homelessness across the nation.
There are those, who, by engaging in the creation of these societally destructive conditions, seek to destroy our nation in the guise of reclaiming the nation. If they succeed, they will at best drive our nation into a Dickensian reality; at worst, they will drive our nation into civil war.