People need health care, not health care insurance

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Fareed Zakaria:

Curbing the cost of health care

Many liberals believe that the Affordable Care Act — Obamacare — is unpopular only because most Americans don’t understand it. There is some truth to this: Studies show that the core provisions of the bill are more popular than the bill itself. But there’s also a reason, rooted in reality, why many Americans worry about Obamacare — its cost.

Most Americans have health care. What they worry about is the cost of insuring 20 million to 30 million more people. Unless the meteoric rise of health-care costs is slowed, a big expansion of coverage might well remain unpopular, no matter how it is explained.

Republican alternatives to Obamacare, such as Rep. Paul Ryan’s plan, don’t bother with expanding coverage, which is a mistake because they leave in place a broken insurance model in which people can freeload. But most do have a strategy to control costs — get consumers to pay for more of their health care. The basic idea is intuitively appealing. Markets produce efficiencies; they presumably would do the same thing in health care.

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People aren’t “freeloading”, they are opting out. If you are young and healthy and only see the doctor for annual check-ups and occasional minor injuries and illnesses, paying $1000 month for health insurance is a bad bet. Whether we privatize or socialize the cost of health care we still need to control it.

We spend twice as much (or more) per capita on health care as other industrialized nations. ObamacareTax does nothing to address that disparity. The problem isn’t that health care is inaccessible, it’s that it’s unaffordable.

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Poll Dancing

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Gallup:

Americans Issue Split Decision on Healthcare Ruling

Americans are sharply divided over Thursday’s Supreme Court decision on the 2010 healthcare law, with 46% agreeing and 46% disagreeing with the high court’s ruling that the law is constitutional. Democrats widely hail the ruling, most Republicans pan it, and independents are closely divided.

[...]

When asked what they want Congress to do now that the high court has upheld the 2010 law, 31% say they would repeal the law entirely and 21% would keep the law in place but repeal parts of it. A quarter of Americans swing in the other direction, saying they would like Congress to pass legislation to expand the government’s role in healthcare beyond what the current law does. Thirteen percent want to keep the law in place and do nothing further.

Views on this question are highly partisan, with 65% of Democrats coming down on the side of maintaining, if not expanding, the law, and 85% of Republicans coming down on the side of repealing it, either in whole or in part. Independents are more evenly divided, with 40% in favor of keeping or expanding the law and 49% in favor of repealing all or part of it.

[...]

Four in five Americans tell Gallup they will take candidates’ views on healthcare reform into account to at least some degree when voting for major political offices this fall. This includes 21% who say they will vote only for a candidate who shares their views on healthcare reform and 59% who say healthcare will be just one of many important factors they will consider when voting. A relatively small 12% say healthcare reform will not be a major factor in their vote.

[...]

Nearly two-thirds of Americans see politics as having a heavy hand in the ruling, possibly reflecting a knee-jerk belief among Americans that politics is always a factor. Alternatively, it could specifically reflect the fact that eight of the nine justices voted in politically predictable ways. Or it could reflect a belief on the part of some Americans that Chief Justice John Roberts’ decision to side with the four liberal justices may have been influenced by the substantial political implications of the case.

In any event, 64% of Americans say politics played too great a role in the court’s decision, while 29% disagree. The vast majority of those who disagree with the decision, 84%, believe politics played too great a role, but so do nearly half of those who agree with the decision, 47%.

Accordingly, 80% of Republicans believe politics played too big a role, compared with 67% of independents and 47% of Democrats.

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But wait! There’s more!

Repeal Obamacare

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Election day is November 6th.

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BREAKING NEWS – OBAMACARE RULED CONSTITUTIONAL

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The U.S. Supreme Court ruled that the insurance mandate in the Affordable Care Act is constitutional.

Today is the big day!

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Shortly after 10 am Eastern time today the fate of Obamacare will be announced.

I’m gonna go out on a limb and predict that SCOTUS will strike down the mandate as unconstitutional. That’s a death sentence even if they don’t throw out the rest of the Affordable Care Act.

I freely admit that I may be guilty of wishful thinking. I think Obamacare is a bad program and Congress needs to start over and do it right. Either way it will not be good for Obama.

There are a lot of opinions flying around about this topic, but like I said a long time ago there are only five opinions that count. Those five opinions belong to whoever makes up the majority of the Supreme Court decision.

Supreme Court justices serve as long as they want to. They can’t be fired, and though technically they can be impeached as a practical matter they are untouchable. We can’t even cut their pay.

They are literally a law unto themselves. They make their own rules and follow or ignore those rules as they please. They aren’t bound by precedent, and they have on more than one occasion reversed earlier rulings. The rules of ethics don’t apply to them.

They choose what cases they will hear and ignore the rest.

But they are, by far, the smallest branch of our federal government. They have no means of enforcing their rulings. Besides themselves they have only some clerks and administrative staff, as well as some bailiffs to protect them and keep order.

So why do we listen to them?

Tradition. Because the system works, mostly. Because nobody has come up with a better way.

Thomas Paine said, “In America the law is king.” Those nine black-robed justices are the king’s high priests. Or, as the late Justice Robert H. Jackson once said, “We are not final because we are infallible, but we are infallible only because we are final.“

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Ezra Klein is an idiot

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Ezra Klein:

How Republicans made it possible for the Supreme Court to rule against the mandate

But permission structures aren’t just for elections. Over the past two years, the Republican Party has slowly been building a permission structure for the five Republicans on the Supreme Court to feel comfortable doing something nobody thought they could do: Violate the existing understanding of the Commerce Clause and, in perhaps the most significant moment of judicial activism since the New Deal, overturn either all or part of the Affordable Care Act.

The first step was, perhaps, the hardest: The Republican Party had to take an official and unanimous stand against the wisdom and constitutionality of the individual mandate. Typically, it’s not that difficult for the opposition party to oppose the least popular element in the majority party’s largest initiative. But the individual mandate was a policy idea Republicans had thought of in the late-1980s and supported for two decades. They had, in effect, to convince every Republican to say that the policy they had been supporting was an unconstitutional assault on liberty.

[...]

When this campaign began, it was unthinkable that the Supreme Court would indulge it, even if some on the Supreme Court were sympathetic to its aims. “There is a less than one-per-cent chance that the courts will invalidate the individual mandate,” Kerr said at the time. Today, it’s entirely thinkable that the Supreme Court will indulge it, and that means that the members of the Supreme Court, who care deeply about protecting their institution’s legitimacy, are free to rule in whichever direction they want. We’ll find out what direction that is on Thursday.

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Unthinkable? Ezra really needs to get out more. There were a lot of people (myself included) who thought the Obamacare mandate was unconstitutional right from the start.

This kinda pisses me off because Ezra is impugning my profession. I actually have a lot of respect for judges. SCOTUS may be a lot of things but they generally aren’t political. Ideologues, yes, political no.

I’m not saying I always agree with their decisions, because I don’t. Right now we have four SCOTUS justices that are very conservative and another that is moderately conservative. That’s no secret. But how come no one ever questions the integrity of the four “liberal” justices?

What lawyers want from judges more than anything else is consistency. In a given set of circumstances you want to know what the judge will do. That way you can make plans and give good advice.

Right now the only inconsistent SCOTUS justice is Anthony Kennedy. He is usually the swing vote in every 5/4 decision.

US v. Lopez, 514 U.S. 549 (1995) was the first SCOTUS decision since the New Deal to set limits to congressional power under the Commerce Clause of the Constitution. Kennedy, Scalia and Thomas were all part of the majority in that decision.

If SCOTUS strikes down all or part of Obamacare it will be because they decided it was in excess of the Commerce Clause. If SCOTUS upholds the individual mandate it will extend congressional power farther than ever before. Either way, it will have nothing to do with any “campaigns.”

BTW – John W. Smart stole this post from me and posted it first.

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Fool me once, won’t get fooled again

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David “Spoony” Atkins:

No one is going to save you fools, again

Here we go again.

We now know that the Obama Administration traded away the public option in order to gain support from the hospital industry for the Affordable Care Act. And we know that it traded away, among other things, the importation of cheaper drugs to PhRMA in order to secure their support for the bill.

Some of these details were known long ago, of course. Good policy was scuttled in order to secure industry support. The question is why it was done, and whether it could have been done any other way.

[...]

The Affordable Care Act barely squeaked through with a minimum number of votes as it was. Had either PhRMA or the hospital industry come out against the bill to the tune of hundreds of millions of dollars in ads against those who considered voting for it, it would never have had a prayer of passing. The blessing of PhRMA and the hospitals was a necessary condition for the passage of any bill, which is part of why single-payer was never on the table in the first place.

Replacing Barack Obama with a “stronger progressive” won’t solve this problem, because the problem lies with the system, not with the person in the Oval Office.

The power to defeat PhRMA and the hospitals won’t come from the top down. It will come in two ways: 1) from the bottom up via progressives rolling them over state by state; and more importantly 2) through campaign finance reform that prevents them from threatening the careers of every politician in Washington if they don’t get their way.

[...]

What we do about that is up to us. It’s not entirely clear what the strategies for success will be, but the strategies for failure are obvious: waiting for a progressive savior who will never come because the structures of politics no longer allow it, and assuming that decentralized and disorganized angry people power will magically bring about change.

It’s going to be a long, hard slog. And it’s going to take organizing on a variety of fronts, chief among them campaign finance reform, that don’t seem to immediately impact the problem. But if one wants to cure a disease, it’s important to treat the underlying problems, not just the symptoms. But no one is going to save us from this morass but ourselves.

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Been there, done that, Dave.

We organized. We saw the value of the internet and formed online communities. We blogged, we donated, some of us went to Yearly Kos/Netroots. Then one day a small clique of online activists decided they were smarter than everyone else and that democracy was too inefficient to accomplish their goals. They decided that Obama was The One, and that those evil Clintons and their low-information supporters needed to be purged from the Democratic party.

You were one of those online activists, Dave. So was your blog-mate Digby. We were the people you screwed over.

So fuck off, Dave.

Cordially,

The Klown

p.s. You guys sold us out during the heath care reform debate too – you decided that single payer wasn’t doable so you put all your effort into the public option – just like Obama told you to do. He fucked you over the same way you fucked us over.

With a track record like yours, I’d be too embarrassed to be giving anyone advice. Especially to the people who were right all along.

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Another misogynist Republican

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Oh, wait – she’s a Democrat:

I Wouldn’t Have Voted for Obamacare If I’d Known About HHS Regulation

Former Democratic congresswoman Kathy Dahlkemper, a Catholic from Erie, Pennsylvania, cast a crucial vote in favor of Obamacare in 2010. She lost her seat that November in part because of her controversial support of Obamacare. But Dahlkemper said recently that she would have never voted for the health care bill had she known that the Department of Health and Human Services would require all private insurers, including Catholic charities and hospitals, to provide free coverage of contraception, sterilization procedures, and the “week-after” pill “ella” that can induce early abortions.

“I would have never voted for the final version of the bill if I expected the Obama Administration to force Catholic hospitals and Catholic Colleges and Universities to pay for contraception,” Dahlkemper said in a press release sent out by Democrats for Life in November. “We worked hard to prevent abortion funding in health care and to include clear conscience protections for those with moral objections to abortion and contraceptive devices that cause abortion. I trust that the President will honor the commitment he made to those of us who supported final passage.”

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Where do I start? Her naivete in trusting Obama? The idea that religions can impose their views on standards of medical care? (Imagine if we let the Christian Scientists do that.)

Or the fact that all pro-lifers aren’t GOPers and/or men?

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Two years too late

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Occupy Protesters Interrupt Chamber Of Commerce Health Care Event

Protesters disrupted a U.S. Chamber of Commerce event on health care today, interrupting speaker Scott Serota, the CEO of Blue Cross & Blue Shield. Chanting “we are the 99 percent,” the protesters stood at the luncheon event and used a “human microphone” technique to read a statement about how the “the one percent in the health care industry” is only interested in profit “at the expense of human suffering and preventable death.” The protesters decried the influence that the health insurance industry wielded in the debate over the Affordable Care Act, and called for “Medicare for all” or a “single payer health system.”

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Wrong forum, wrong date. They should have been protesting in Washington a couple years ago.

Meanwhile:

Supreme Court to Hear Case Challenging Health Law

The Supreme Court on Monday agreed to hear a challenge to the 2010 health care overhaul law, President Obama’s signature legislative achievement. The development set the stage for oral arguments by March and a decision in late June, in the midst of the 2012 presidential campaign.

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I’m not going to make any predictions on the outcome, but whichever way it goes will be bad for Obama.

If Obamacare is upheld, it will remind people about the most unpopular piece of legislation since . . . uh, . . . forever. Even Prohibition was popular when it first passed.

On the other hand, if it is struck down it will be a stinging defeat for Obama’s signature policy achievement.

That’s why Obamanation is praying that Mitt Romney is the GOP nominee.

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