Affordable Care Act Supreme Court Hearings this week

[scottw]

Originally Posted by zimmy

The tax payers are obligated to foot the bill of your medical costs if you are uninsured and get hurt.

are they?

I think it was Justice Breyer that made this broad suggestion yesterday as well, but I'm not sure that it is true...

I know a few people that were either injured or became quite ill needing cance treatments etc while uninsured....and the "tax payer" did not pay for their medical costs, most were covered/treated by help from charitable trusts through the hospitals, payment arrangements worked out through the various providers and on...I don't think that hospitals that admit patients or treat them in the emergency room can simply bill the taxpayer for services not paid by the uninsured....to suggest that anyone that needs medical services and can't pay for them at that time either out of pocket or through some form of insurance instantly places a financial burden on "the taxpayers" is...... "a stretch"

[PaulS]

Originally Posted by zimmy

The tax payers are obligated to foot the bill of your medical costs if you are uninsured and get hurt.

Originally Posted by scottw

are they?

I don't think that hospitals that admit patients or treat them in the emergency room can simply bill the taxpayer for services not paid by the uninsured....to suggest that anyone that needs medical services and can't pay for them at that time either out of pocket or through some form of insurance instantly places a financial burden on "the taxpayers" is...... "a stretch"

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

[Jim in CT]

Originally Posted by PaulS

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

"The insurance company pays."

I don't think that's true. If the patient is uninsured, how does the hospital know which insurance company to bill? You're saying that surcharge is passed on to all insurance carriers? Maybe. Anyone know for sure?

I'm guessing that hospitals write off a ton of uncollected (and never to be collected) medical bills from folks who can't pay.

This problem isn't getting solved no matter what happens. My objection ha snothing to do with paying for others, my objection is based on the unconstitutionality of it, IMHO of course...

[RIROCKHOUND]

Originally Posted by Jim in CT

"My objection ha snothing to do with paying for others, my objection is based on the unconstitutionality of it, IMHO of course...

So..
It's the right thing to do, but the wrong way to do it?

[Jim in CT]

Originally Posted by RIROCKHOUND

So..
It's the right thing to do, but the wrong way to do it?

In my opinion, yes. I don't think that people who get sick (through no fault of their own) should have to pay one cent more for medical costs than healthy people. None of us control who gets sick and who doesn't (for many diseases), so it seems fair that we share the costs. I just don't think you should ignore the constitution to do it.

Also, I would't apply this to people who choose to eat like pigs or smoke, they should pay the costs of their medical care.

It's a brutal problem, I don't pretend to have any brilliant insights...

[PaulS]

Originally Posted by Jim in CT

"The insurance company pays."

I don't think that's true. If the patient is uninsured, how does the hospital know which insurance company to bill? They don't, the state govern. sends out the $ based on the total uncompensated care and the amount of surcharge collected You're saying that surcharge is passed on to all insurance carriers? Maybe. Anyone know for sure?IT is passed onto any carriers doing business in that state.

I'm guessing that hospitals write off a ton of uncollected (and never to be collected) medical bills from folks who can't pay.I would guess so.

NY also has a surcharge to subsidize teaching hospitals.

[zimmy]

Originally Posted by PaulS

In a few states - like NY, they have a surcharge on claims to compensate hospitals for "uncompensated care". I think it is either a per monthly head count or a % of paid claims. The insurance company pays. It is built into the rate the insured pays.

In all cases, the bill is somehow paid. If the hospital covers it, it is passed on to everyone in their hospital bills. If the hospital uses the losses as a write-off- the tax revenues are made up somewhere else (or put on the credit card of our kids), if the insurance companies pay a surcharge- it affects our insurance rates.

In any case, I do think the constitutionality of the health care law treads a thin line, but so does passing off the cost of the uninsured to everyone else and that is established by prior practice for decades.

[spence]

Originally Posted by zimmy

In all cases, the bill is somehow paid. If the hospital covers it, it is passed on to everyone in their hospital bills. If the hospital uses the losses as a write-off- the tax revenues are made up somewhere else (or put on the credit card of our kids), if the insurance companies pay a surcharge- it affects our insurance rates.

In any case, I do think the constitutionality of the health care law treads a thin line, but so does passing off the cost of the uninsured to everyone else and that is established by prior practice for decades.

A good point made today on Morning Joe, have you every known anyone who didn't use health care in their lifetime?

David Brooks had a good opinion piece yesterday...

http://www.nytimes.com/2012/03/27/op...ef=davidbrooks

-spence

[RIJIMMY]

Originally Posted by spence

A good point made today on Morning Joe, have you every known anyone who didn't use health care in their lifetime?

David Brooks had a good opinion piece yesterday...

http://www.nytimes.com/2012/03/27/op...ef=davidbrooks

-spence

no, I dont.
Nor do I know anyone who didnt use food stores, some form of transportation, eat at restaurants or buy toilet paper.

[zimmy]

Originally Posted by RIJIMMY

no, I dont.
Nor do I know anyone who didnt use food stores, some form of transportation, eat at restaurants or buy toilet paper.

Do they pay the bill when they do those other things?

[detbuch]

Originally Posted by zimmy

Do they pay the bill when they do those other things?

Should all the state and local regulations, taxations, mandates, and ordinances that govern the sale and purchase of those other things be replaced by Federal mandates? Wouldn't that make it more uniform and fair, more equal, and even more affordable for all of us? Shouldn't state and local governments be eliminated and replaced by the Federal Gvt.?

[spence]

Originally Posted by RIJIMMY

no, I dont.
Nor do I know anyone who didnt use food stores, some form of transportation, eat at restaurants or buy toilet paper.

Big difference, with all of those items there are already set costs. The argument made by the Administration is that the price of health care is heavily influenced by how one pays for it.

-spence

[detbuch]

Originally Posted by spence

Big difference, with all of those items there are already set costs.

The price of all those items do not have a "set cost." A great portion of the costs are a result of various government regulations and taxes. The price of manufactured goods have built-in tax and regulatory costs that range all the way from the production or growth of the basic materials required to manufacture the final product including the regulations and payroll taxes and social security and medicare and local and state taxes that each of those producers pay and are part of the price of material they ship to the ultimate manufacturer, and the same costs are included in the companies that transport the materials to the ultimate manufacturer, and the same costs that the ultimate manufacturer has to pay its employees again all added to the cost of the product and often the same government costs that private shippers pay and are part of their fee to deliver to retail outlets and, finally, the retail outlet has the same types of governmental regulatory and payroll taxes, etc. that factor in to the final price of the product a great portion of which can be the accumulation of all the taxes and regulations payed along the way to manufacture and sale. It has been estimated that 50 to 60% of the price of manufactured items is in the taxes and fees paid overall. And various localities have different regulations and tax structures as well as differing levels of clientele for products so that prices of the same goods are different in different places, and there are sales and clearances and fluctuating economic conditions that affect the prices. Prices for most products have been rising lately due to multiplicities of factors, not the least of which is government intrusion

The argument made by the Administration is that the price of health care is heavily influenced by how one pays for it.

-spence

The price of health care is also very heavily influenced by government regulation and mandate. In the case of the Federal Government, much of the mandates are unfunded. It was the Federal Government, in the first place, that forced hospitals to accept emergency patients that have no insurance. It is Federal regulation and collusion that artificially raises the price of drugs to be much higher than necessary. And if the government thinks that a mandate can require uninsureds to pay for insurance, that means it believes that those people could have purchased insurance before the mandate, so it shouldn't have forced hospitals to accept them unless they payed for the uninsured health care they received just as any customer must pay for the product it buys in any other transaction. And the force of local laws would be sufficient for such transactions. As for those that cannot afford to buy insurance, won't their costs still be shifted to those who are insured, even if the government picks up the tab for them in which case the cost is shifted to the tax payer. And isn't the so-called shift in costs that occurs now overestimated--the article that I posted in the other thread relates a study that estimates the cost shift not to be $1,000 for an average policy, but an annual cost of about $80. So the government creates problems, then expands its power in order to "solve" the problems--in this case with a "solution" that is even more expensive for most, and in the same stroke changes the fundamental relation of the individual to the government. Government power expands, individual freedom contracts. But it is all for the better and is more efficient, and the power of government pervades into all aspects of our economic lives, which is virtually all aspects.

If all commerce can be "regulated" by the Federal Gvt., which this mandate would give it the power to do, I ask again, in this thread, for the fourth time, are States and the Constitution necessary? Are they not obstacles to efficient centralized government? Would it not be better to just abolish them?

[Jim in CT]

Originally Posted by spence

have you every known anyone who didn't use health care in their lifetime?

-spence

Once again you miss the point entirely. It doesn't matter, as far as the constitutionality of the law is concerned, that everyone will use healthcare at some point.

Everyone will die at some point. That doesn't mean the feds can mandate how we handle our funeral arrangements.

Everyone eats food. That doesn't mean the feds can mandate a healthy diet for all of us.

Spence, you need to seperate your love of Obama from the question of constitutionality. Just because this was Obama's idea, doesn't necessarily mean it's constitutional. Obama's agenda is not a litmus test for constitutionality. The number of people impacted by healthcare is absolutely, conmpletely meaningless to the Supreme Court.

[scottw]

I feel bad for the Solicitor General...must be rough being laughed at in the Supreme Court when you are trying to defend landmark legislation...

someone mentioned Justice Thomas, I don't know about questions he asked or didn't ask but I'm sure he was wondering how it is possible that this legislation was signed by a President who some claim was a Constitutional scholar of some sort and sworn to uphold and defend the Constitution....passed by a Congress(needing every trick in the book employed) made up of many people with legal backgrounds and sworn, I think, to uphold and defend the Constitution,.... and now argued by a guy who, I guess, is supposed to have some knowledge of what he is arguing with regard to the Constution....

[spence]

Originally Posted by Jim in CT

Once again you miss the point entirely. It doesn't matter, as far as the constitutionality of the law is concerned, that everyone will use healthcare at some point.

It matters because if people are going to use health care they are going to participate in interstate commerce regardless if they're paying for it or not. If everybody is participating then there's no real argument that someone can really opt out.

Jim, I actually read the entire transcript from yesterday...have you?

-spence

[Jim in CT]

Originally Posted by spence

It matters because if people are going to use health care they are going to participate in interstate commerce regardless if they're paying for it or not. If everybody is participating then there's no real argument that someone can really opt out.

Jim, I actually read the entire transcript from yesterday...have you?

-spence

Spence, in your previous post, you didn't make a reference to the Commerce clause. you implied that the individual mandate was justified because of how many people participate in healthcare. I was reacting to what you posted.

[detbuch]

Originally Posted by spence

It matters because if people are going to use health care they are going to participate in interstate commerce regardless if they're paying for it or not. If everybody is participating then there's no real argument that someone can really opt out.

Jim, I actually read the entire transcript from yesterday...have you?

-spence

No, most health CARE is not interstate. Some products that are used may have crossed state borders and such products can be "regulated"--whatever that means. But the actual care, unless the hospital is straddling a border, is usually intrastate, not interstate. A great deal of health care is only consultative with no products being used or exchanged. In any event, the B R O A D, expansive, "interpretation" of "commerce," "regulate,." and "interstate," is not justified in the text of the Constitution, neither was it intended according to the extant documents of ratification and explanations given in letters and statements later by the founders. But that is, apparently, not important to you. Valid arguments about what such broad interpretation and the power it grants to the Central Government, and the fundamental change in the relation between the citizen and the government also seem to be of no importance to you. What seems to matter only is a solution to a problem regardless of what precedence that solution gives to government to "regulate" every aspect of our lives. No matter even that much of the problem is created by government in the first place--the same government that presumes to fix it. Nor does it seem to matter to you that the solution, along with the train of solutions over the past 70 years, destroys the foundation, the structure of limited, representative government built specifically to ensure individual lilberty, and replaces the structure with an amorphous, unlimited administrative apparatus. An apparatus that will replace individual sovereignty and more "efficiently" solve all our "collective" problems. I ask again, of what use are 50 different State governments and an unadhered to Constitution to such an apparatus?

[scottw]

Originally Posted by spence

It matters because if people are going to use health care they are going to participate in interstate commerce

-spence

it was statements like these and other tortured definitions of convenience that found the Solicitor General being laughed at on the floor of the Supreme Court the last few days.

from : MOTHER JONES

Obamacare's Supreme Court Disaster
—By Adam Serwer

The White HouseSolicitor General Donald B. Verrilli Jr. should be grateful to the Supreme Court for refusing to allow cameras in the courtroom, because his defense of Obamacare on Tuesday may go down as one of the most spectacular flameouts in the history of the court.

Sounding less like a world-class lawyer and more like a teenager giving an oral presentation for the first time, Verrilli delivered a rambling, apprehensive legal defense of liberalism's biggest domestic accomplishment since the 1960s—and one that may well have doubled as its eulogy.


that's from BIG Obamacare supporters