JUNE 28th was a day of reckoning for the most important law of Barack Obama's presidency, and for the president himself. The Supreme Court was to decide the fate of Mr Obama's 2,700-page health reform. Oral arguments in March had not proceeded as Democrats had hoped. Mr Obama's lawyer choked on his water, faltered in his opening statement, then endured a battery of hostile questioning. Suddenly it dawned on Democrats that their most treasured achievement might die.
But when judgment day came the Supreme Court sided with Mr Obama, by five votes to four. John Roberts, the chief justice, joined the court's four liberals in upholding the Democrats' biggest legislative feat in decades. The law requires Americans to buy insurance or pay a penalty—the so-called “individual mandate”. That penalty, the court ruled, falls within Congress's power to tax. The court did impose a rider on the law's expansion of Medicaid, the federal-state health programme for the poor. But the decision is a huge relief for the president and his allies.
There was little doubt that had the Supreme Court overturned his reform, it would have been mortifying. Mr Obama would have been found guilty by the highest court in the land of an unconstitutional power grab. The president will naturally have something of a spring in his step for the next few weeks. But even so, the victory may be fleeting.
Mr Obama signed the Patient Protection and Affordable Care Act into law on March 23rd 2010. In doing so, he achieved what no other Democrat had: he moved America decisively towards universal health insurance. Within minutes, however, 13 states had filed suit against the law in Florida. Soon others sued elsewhere. The pioneers were joined by the National Federation of Independent Business, four private individuals and 13 more states. In November the Supreme Court announced it would hear the case.
The challengers insisted that the mandate would bring a “revolution in the relationship between the central government and the governed”. Under the constitution, Congress could no more compel Americans to buy health insurance than it could oblige them to eat broccoli or to buy American cars to support Detroit's manufacturers. Where, in other words, would this latest extension to the power of the federal government end?
The states also complained that the law's expansion of Medicaid—to childless adults with incomes of up to 138% of the federal poverty level—was unduly coercive. If they did not abide by the law's rules, they would lose their federal Medicaid money. It was, in effect, an offer states could not refuse.
Mr Obama's lawyers presented a more complex case. The constitution gives Congress the power to regulate interstate commerce. Health care is a huge, muddled industry in need of regulation. The sick pay exorbitant rates for insurance, or go without it. In 2009 50m uninsured people consumed health care they could not pay for; the tab was covered, unfairly, by those with insurance. The mandate is a proper way to fix these problems, the president's lawyers argued. What is more, the penalty for not buying insurance falls within Congress's power to tax—even though in 2009, Mr Obama and Democrats insisted the mandate was nothing of the kind. As for Medicaid, Congress regularly ties state funding to particular requirements.
The majority of the court sided with Mr Obama. Mr Roberts, writing the court's opinion, did not buy Mr Obama's commerce-clause argument. “Construing the commerce clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority,” Mr Roberts wrote.
But the mandate, the chief justice explained as he sided with the president's backup argument, may be considered a tax on those without insurance, and Congress has the power to tax. The law does not compel individuals to act; if they do not want insurance, they can simply pay the penalty. Mr Roberts then continued that the government may offer states money to expand their Medicaid programme. “What Congress is not free to do,” he wrote, “is to penalise states that choose not to participate in that new programme by taking away their existing Medicaid funding.”
Independent of the ruling's impact on health care, the decision fundamentally changes the politics of the Supreme Court. Ever since the five justices appointed by Republican presidents sided with George W. Bush in the disputed election of 2000, Democrats have liked to dismiss the court as biased against them. This argument was always suspect. The court votes 9-0 far more often than it does 5-4. But any claim that the court's Republican appointees will stop at nothing to impose their conservative agenda now seems ludicrous in the light of the chief justice's vote.
So health reform is safe in law, for the time being; but this still does not guarantee that it will be a success on the ground. Implementation of the reform has been patchy. Mr Obama's law requires states to create health exchanges, where individuals may compare and buy insurance, by 2014. Only two states have already set up exchanges, and only 13 more have started to create them. Despite the court's ruling, Republican governors will be in no hurry to follow suit. The Supreme Court may not have overturned the law, but Republicans still plan to do it themselves after ejecting Mr Obama from the White House.
Their effort will be helped by public opinion. Mr Obama sacrificed other initiatives—including more focused attention on the economy, not to mention immigration reform and climate legislation—for the sake of health care. But the main preoccupation of voters remains the economy. When asked by pollsters to name the issue that worries them most, only 5% or so volunteer health care. Jobs and the economy, in contrast, routinely score 50% or more.
When voters do consider health reform, they view it in an unfavourable light. Some 50% of the public dislike the law, while only 40% approve. Voters hold an even dimmer view of the law's constitutionality. According to a recent CBS News/New York Times poll, only 24% thought the court should uphold the entire law, 27% thought the mandate should fall and 41% thought the court should scrap the whole thing.
Diehard opponents of the law will probably be energised by the court's rebuff to them. Republicans have counted “NObamacare” as one of their most effective rallying cries over the past two years. Such chants will now be joined by the lacerating eloquence of the conservative justices' opinions. The ballot box in November, Republicans can now point out, is the only remaining path to repeal. Democrats waited for a decision on health care for over two years. The next period of uncertainty will, at least, be rather shorter.



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The switch in positions by Chief Justice Roberts, as well as the tortured logic used to rationalize a penalty as a tax bodes poorly for the legal and judicial systems. Clearly, Mr. Roberts faced extreme lobbying efforts by the media supporting President Obama, as well as from the bully pulpit of the presidency, and Mr. Roberts caved in. Recall also the public lambasting in Mr. Obama's most recent State of the Union address. Chief Justice Roberts seems to have abdicated his position as defender of the court's integrity and succumb to the pressure. The independence of the Supreme Court is now suspect.
Controversial cases are, most often, the ones that make it to the Court. One expects that the independence afforded justices by lifetime tenure would immunize them from pressure. In this particular case, Mr. Roberts behaved in contradiction to his long-held beliefs about the role of government relative to the citizenry.
Some have noted that the individual mandate is like auto insurance, but the apparent similarity actually points up the substantive distinction. One can elect to drive a vehicle and assume the fiscal and legal obligations. No one opting out of owning and driving a vehicle is compelled to buy insurance. Yet, with Obamacare, everyone pays, even if you do not want or need the provisions.
The legislation in question was repeatedly touted as not a tax. Yet, Mr. Roberts, supposedly deferring to the legislative process, substituted his own interpretation rather than forcing the Congress to clean up the provisions surrounding the funding. If it was a tax, then the Court could not have heard the motions until the act went into effect and someone was harmed by it.
The Economist's editorial stance seems to be quite at variance with the prevailing sentiment in the American public. Even after the legislation was approved by the Supreme Court, the preference of the electorate is that the Act be repealed for many reasons, including the huge increase in medical costs it will entail, the reduction of medical services that will occur, and the massive increase in public debt the act requires. The final straw seems to be be that the law is still unknown, especially with regard to the enormous number of regulations that remain to be written by unelected boards and agencies.
Most Americans, based on numerous polling companies, do not wish to become like Great Britain with their socialized medical system. I am one of those persons.
Funny how when it became the law that everyone had to have car insurance, no one threw a hissy fit, but when the Affordable Care Act appeared on the table, the GOP got their collective panties ruffled. People like Boehner, McConnel, and that other guy should be thrown out of office and replaced by this guy: http://youtu.be/zHteSbrZZ5U
Try this.
http://healthreform.kff.org/quizzes/health-reform-quiz.aspx
It is amazing that when Romney and other Republican "leaders" state publicly that Obamacare should be repealed that no reporters ever ask what their alternative will be to offer hope and assistance to the 50 million Americans who can not afford medical insurance or have a pre-existing condition that will kill them shortly. Perhaps they would like these people and their family members to go away quietly and find a dark corner to die and not bother the wealthy Americans who are happy with the status quo. I also wonder why religious leaders in the US have not come out and said a word of support for Obamacare or any other plan that will aid those most in need.
It is easy to divide the 2 groups of Americans who like or dislike the new ACA law.
Those who actually had inquired, and asked the basic question. "how this law affects me & my loved one?" - They like and approve the law.
Others who did not read, nor independently inquired about the law - they are the ones who disapprove the law.
You're joking, right?
How will the law hurt you personally?
I wish I would be joking. But I am not.
Informed people would not support a cause (or law) which clearly goes against their own interest.
Once we get rid of Obamacare we should get rid of Medicare and Social Security. I don't want my tax dollars being used to keep the old living longer than is natural.
Better yet.
Once we get rid of those ideologically driven people like you, who post ill informed comments about the SS & Medicare - then we all will be able to get alone.
SIR, SS and Medicare are funded from retirees own money, contributed from their paychecks when they were working - THIS IS NOT YOUR TAX DOLLAR.
This money is entrusted in the federal government, who acts as trustee.
Funded? Last I heard my tax dollars were keeping the system from going bankrupt. My hard earned dollars are being used to support the old, the sick, and the lazy.
The nerve of those elderly people staying alive! Let's just shoot them like a horse when they go lame. Your mother and father must be particularly proud to have hatched such a loving offspring.
I'm invoking Poe's law here.
"SIR, SS and Medicare are funded from retirees own money, contributed from their paychecks when they were working - THIS IS NOT YOUR TAX DOLLAR."
Well, no. Medicare and SS are paygo systems that transfer wealth from workers to non-workers. It has to be that way. You can't stick bread in a time capsule to be opened up 30 years later and eaten in retirement. Not even a house will last that long without significant maintenance. Your consumables largely must be produced more or less on demand shortly before the time you need them. All retirees can do is trade present labor now for a promise of present labor from someone else later. Social security and Medicare provide a framework to let them do that.
The "trust fund" is a farce. This is money the government owes to itself. When the bill comes due, exactly who is going to pay it?
On what planet is this true.
The amount of money virtually all retires pay into the system over a life time of work is used up in a few years.
After that time, every penny they get is from current working folk.
Considering the cost of medical care today this should be obvious to anyone who knows basic match, especially since seniors are the biggest consumers of extremely expensive medical care which easily can cost into the millions in a few short years. Should that care include covering something like a heart attack it will exceed that amount in a year - and that amount is well and above what most people pay into SS and Medicare in a life time.
The govt doesn't act as trustee as it doesn't invest the money into anything real.
Govt just sends current paycheck's "contribution" (it's a tax really) to retirees. It's even in the name: pay as you go.
Your intuition is in line with govt propaganda, but just because you honestly believe in propaganda, that doesn't make it true.
s.s. "contributions" are indeed people's own money: so why not.. just let them keep their own money?
Ah, but here is where liars and delusionals like you come in, trying to twist reality into what it is not.
"Some 50% of the public dislike the law, while only 40% approve. "
They need to also ask how many have a basic(or any) understanding of the law.
It's truly sad that in this supposedly richest nation in the world, basic health care for sick & the needy, is still hotly opposed by greedy, selfish & self-absorbed vested interest lobbies on the spurious & imbecelic pretext of 'government control'. The tragedy is they have the blind support of a vast crossection of misguided & infantile rightwing populace, who have everything to gain & only their vacuous delusions to lose, by supporting Obamacare.
What a mind-dumbing fiasco!
i love it....
Now that the SC has judged that Obamacare is only consitutional if the mandate is a tax and given that the word "tax" appears nowhere in the 2700-page law, surely the problem can't be fixed be simply going back and inserting the word "tax" at various points in the text. Or even by adding riders to that effect. If it is a new tax won't congress have to vote on it? If so, what are the chances of that happening anytime soon? It looks as if the chief justice has handed down a time-bomb.
Some clever Repub/tea party politician should do just that: "if SC says it's a tax, it's a tax, and so we have to debate about it in congress like we do debate over all taxes".
What happens when the individuals that work and carry the weight for everyone, decide they want a free ride too?????? The lazy and unmotivated keep getting encouraged to stay in their current situation and not seek a better life for themselves. And, if you cant afford a kid please dont have one, just because you can reproduce does not mean you should.
Have you been paying attention? "Free ride"? Who said anything about a free ride? Its not free.
And I'm not too worried about all the hard working people out there suddenly rushing out to sign up for a government option which provides only a federally mandated level of "minimum coverage" (like driving a fancy car with only liability insurance).
I dont think theres really anything to be afraid of.
It is up to the person to either pay penalised tax levi or health insurance. This is close to what other rich countries have been doing and it does not affect the efficiency of the country. On the other hand, the general well-being of the country does largely affect the efficiency. So if there are 5 million people in America are not covered to health insurance and 30% of them are sick, 1.5 million people won't be able to work.
Q: "What happens when the individuals that work and carry the weight for everyone, decide they want a free ride too?????? "
A: They will try living on welfare and unemployment, get kicked off the roles after a few years when benefits run out and then starve.
Honestly now, if it really is so grand to be a dead weight, I invite all our Republican associates here to demand the justice they clearly believe they are missing out on, and live off the public larder. I'll keep paying my taxes so you can eat. Enjoy!
What is basic function of Government ?
To supply Education , Health Care , Working Environment , Public Infrastructure , Legal Eco System on an really affordable and universal basis .
Lately , some of areas in America has gone against above principle .
See the state of affair of public transport system . Same is true for Public Health System.
Lately countries like Taiwan is providing quality healthcare at one third cost of USA as Japan is able to provide public transport system at one fifth cost .
For reduction of Health Care System ,We should benchmark our system against countries like Taiwan or Japan .As lately American Companies adopted Lean Manufacturing in Manufacturing space and now they are very successfully marketing their produce in countries like China.
( GM Motors)
Solution doesn't lie ,in raising taxes . This would be Short cut .
Solution lies in removing the wastage from our existing delivery system.
In India ,If clinic like AIIMS , Arvind Netralaya can provide world class treatment at five dollars per person why can't in Us at 50 dollars ?
We should review and try to innovate ,rather go for taxing etc.
As a student I researched healthcare models around the world, and would agree with the comment above. Taiwanese pay more in taxes but receive superior care. There out of pocket cost after taxes is zero. A medicare for all would be the best option for the United States.
All is needed to reduce cost of HC in US - cut down on enormous expenditure on HC administration, not delivery.
Health Care fraud is a bigger expenditure than administration. Some estimates put the figure at 10-20 cents for every dollar spent from Medicare expenses are fraud.
Senator Coburn - R (OK)
And how much value one puts on less stress, and anxieties - knowing that, in case of unexpected catastrophic illness, neither the Taiwanese, nor the German, French, Japanese, and other advanced countries, will lose his / her lifetime savings, or worse - forced to sell their homes to pay for a surgery and 3 day stay in hospital.
Unfortunately as anything else. In US everything is measured in Dollars & cents.
Much like a senior Canadian Administrator had said - comparing the HC system between US and Canada.
"Our business is HealthCare, and the mission is to maximize the number of our citizen stay healthy.
In US, HC is a business, designed to maximize corporate profit and shareholder value.
I couldn't agree more with your comments. And when that benchmark study of healthcare is performed, I suspect that an emphasis on preventive care vs. remedial treatments will come up high on the list, and right up there with it will be a recommendation to remove for profit insurers from the system who take 15-25% off the top and add no value to the system.
I think you are on the right track.
There are various muda( Wastages) in our existing HealthCare System .
1. No stress on preventive - No to junk food - require to re-educate the masses . See Japan - No body has wasteline more than 34 inches .I couldn't find trouser for myself in Japan as mine wasteline was 36 inches.
2. Remove wastages like insurance agencies.
3.Bench mark our legal laws against global standards ,try to reduce excessive paper work.
4. Quench the fire at initial stages . Visit to primary doctor on alternative month for routine checks .Catch and rectify the
problem on initial stages . Americans visit Doctors twice per year while Taiwanese visit forteen time. Americans spent 17% of GDP on Healthcare while Taiwanese spend only 7% of GDP.
5.Principle of 80-20. - 20 percent patients consumes 80 percent of Healthcare Budget. - Work systematically for containing the expenses - by outsourcing (like Arvind Netralaya , Bangalore ) - By adopting fugal technology - By spending more on R& D.etc.
Source?
Senator Coburn, whose name I cited in my comment.
But any claim that the court’s Republican appointees will stop at nothing to impose their conservative agenda now seems ludicrous in the light of the chief justice’s vote.
Really?
In his opening opinion the Justice sides with Justice Scalia, et al in dismissing the Commerce Clause argument.
By instead ruling it as permissible under tax powers he secures two outcomes, both partisan.
One, utilitarian. He saves his courts standing by avoiding further validation of (polled) majority public opinion that, as per the other constitutional branches, far from being aloof, it is influenced by and divided along partisan lines, with a sop to Conservatives by envoking their opprobrium towards new Taxes.
Second, he validates the new age Conservative constitutional argument of limited government, negating previous Commerce Clause rulings and precedent, by redefining Congresses regulatory powers under such as more limited than previously held.
Its a judicial Jedi mind trick. He both validates the newly minted States Rights constitutionalism and avoids trashing the courts standing any further.
IN OTHER WORDS, AFFORDABLE HEALTHCARE IS AN OXYMORAN!!
Moran? Sigh.
What is a moran?
It is a fruit from a Dr. Seuss book that the Lorax ate.
There is a strong suspicion that it may be you.
The bottom line is that Americans did not plan for their living to the average life expendency of 83 years. They have under saved and under planned, expecting the government to supply them with whatever they need. Unfortunately, this entitlement has two important possibilities. The government runs out of money and people are invited to 'end it all now'. In days gone by, people were sent to debtors prison and governments fell or adopted a technocratic form of government that made life very unpleasant. There are a number of examples of this around the world with the most well known being N Korea.
Most reject euthanasiia and quite rightly so. But when health care becomes impossibly expensive, and many think the time has arrived, there may be calls for permitting it to take place.
In case Americans think there is lots of liquidity to support the proposed medical services for thos who cannot afford it, there are estimates by responsible folk that the US debt liabilities are over $60 trillion. Meaning that someone is dreaming if they, at the age of 50 even, can expect there will be enough money to go around for their care by the time they get to 75. Entitlements are wonderful concepts if you can afford them. Suggested reading:
www.usdebtclock.org. Michael
Seems like Justice Roberts did this to Scalia, Thomas, and Kennedy: http://youtu.be/zHteSbrZZ5U
Universal health care for all U.S.A. citizens is the only method to ensure people retain and are aware of what level of health that is expected of them by the state.
What we are at loss about is the level of health care that is being offered by this Obama Care legislation?
Nobody can expect any health plan to pick up the tab on all of the health problems that an individual may confront. The plan would either go broke or the premiums would be non payable. So we would like to see some debate on what this health care plan calls basic health care and or what it is proposing to cover.
How do other countries manage to do so?
Lots of other countries have free healthcare, using various different mechanisms. The USA is not in its own little bubble; how do these other countries afford it?
this is another one of those "sky is falling" cry. The same group who opposes the new PeopleCare in US, also was yelling the country will go BK when SS & Medicare were enacted.
The Shepperd & the wolves.
They cannot! Governments and their institutions have been going further and further into debt, hoping that reality will never present itself. Well we realising now that health care in its present form cannot financially sustain itself, especially with the boomer bubble and longer life expectancy.
Doctors and the support staff have to make less. Management has to be cut back, many are self serving. Companies who provide services for hospitals from construction, maintenance and products charge WAY TO MUCH, because they can.
Understand, before the system comes crumbling down.
If the system stays the same, we users will have to pay for the expensive surgeries, and use the basic services for free.
Looking at the whole national debates and legal battles leading up to the Supreme Court decision, and the divided―, and unfavorable if any, ― public opinion regarding Obamacare、I cannot help wondering at American’s world-view regarding a state (a nation state, not one of the fifty States).
A world-view that a state is primarily a market place where commerce is the paramount value, and not a community of men where solidarity and mutual assistance should be its primary concern. I do not know of any case among OECD countries except USA in which a government was sued for unconstitutionality of the universal medical care.
“Construing the commerce clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority,”......just wondering, don't you have Imperative norms in the American legal system? For example laws compelling you to buy vehicle insurance, or to positively act when witnessing a crime...seriously genuinely curious, not being rhetorical or sarcastic.
There are laws in the various states that mandate that you must buy liability insurance on your vehicle and that you must be licensed if you operate your vehicle on the public roads. If you operate the vehicle on your own private property, neither is required. Operation on your own property is not uncommon in large farms and private forestry areas. You misunderstand the requirement. It may be prudent to insure your vehicle that is solely driven on your private property, but it is not required.
Except for certain caregivers, I know of no requirement or law that demands that one report a crime, witnessed or not. It is regarded as a civic obligation.
Thanks. Am a law student and was wondering the specifics in the american legal system between the distinction between prohibitive norms (you will not) and imperative norms (you will)..I imagine that requiring the purchase of insurance (health care) might have been construed under the latter. Then again am first year student :)
There are imperative norms such as registering for the draft, but they seem to be able to pass the "compelling state interest" test rather than the "rational" test. One could conceive of a mandate to have gun ownership that might pass the latter, but not the former at the current point in time. The "rational" test is a bit poorly named. It is basically a test of whether somebody, someplace, might consider it a good idea.
18 USC § 4 - MISPRISION OF FELONY
Whoever, having knowledge of the actual commission of a felony cognizable by a court of the United States, conceals and does not as soon as possible make known the same to some judge or other person in civil or military authority under the United States, shall be fined under this title or imprisoned not more than three years, or both.
However, that 1909 statue has been viewed by the court as requiring concealment. http://en.wikipedia.org/wiki/Misprision_of_felony The case in question is: http://openjurist.org/546/f2d/1225/united-states-v-johnson Specifically, the finding states that: "5
The factual basis of defendant's plea does not demonstrate the existence of "concealment," an essential element of the offense of misprision. The record of defendant's plea fails to reveal that he took " affirmative steps to conceal the crime of the principals." United States v. Daddano, 432 F.2d 1119, 1124 (7th Cir. 1970), cert. denied, 402 U.S. 905, 91 S.Ct. 1366, 28 L.Ed.2d 645 (1971); Neal v. United States, 102 F.2d 643, 649-650 (8th Cir. 1939). The mere failure to report a felony is not sufficient to constitute a violation of 18 U.S.C.A. § 4. Lancey v. United States,356 F.2d 407 (9th Cir.), cert. denied, 385 U.S. 922, 87 S.Ct. 234, 17 L.Ed.2d 145 (1966).
"
The opinion is: "The mere failure to report a felony is not sufficient to constitute a violation of 18 U.S.C.A. § 4." You must take affirmative actions to obstruct justice for this statue to apply to you; in specific, concealment of the crime. A fine line perhaps, but a line non the less.
Check out:
http://www.huffingtonpost.com/geoffrey-r-stone/the-broccoli-horrible-gin...
Two wins in a row should be enough to reverse the prevailent trend of Obama's campaign losing ground to Rommey's. Reps now find consolation in feeling more motivation to overturn the Act for an affordable health care after a decisive victory in november, that according to them will express the will of the people concerning the overgrown government and the soaring fiscal deficit that compromises the safety of coming generations like it never before had happened in the history of the country.
The suspention of deportations of young people under 30 year old had been a blow that shattered the Republican camp that had begun taking steps toward advancing a campaing proposal taking on the issue that before the energic meausure instaurated by the president, is left like a feeble would be not even worht considering before the acomplished fact produced by the presidential order, who benefits from the evidence that he delivers when it comes to keeping up his electoral promises to minorities.
The declarion of constitutionality of the health reform it is said that groups Obama in the select group of presidents that had changed the course of American history, with FD Roosevelt and coming shrot only to Abraham Lincoln.
Reps still hope that the sluggish recovery of the economy that would even become worst by the impact of the crisis in Europe may sink Obama's chance for reelection. Then they would be heading for a triumph in november getting ready to make a case agaist Iran even if takes made up, bogey arguments, to stir national feelings in order to gather a broad suppport.
The Republicans view life as starting at conception and ending at birth. The Democrats have this bizarre idea we should have a safety net for people even after they were born.
"Safety net"
as in not working for anything and then expecting everything be given to because you deserve it.
you're right I guess it is bizzarre these days to expect people to actually work.
Voting democract Give me my free stuff! tax other people and give me their money!
Of course we should encourage people to work. That said if for example somebody today is out of work and can't find work but needs medical care are you really going have them sit outside the hospital and die? I'm going to assume your answer is no. One possibility is having the hospital treat them poorly and at a loss and then pass the costs onto the rest of us (current laws dictate this). The alternative is to require them to be insured and paying into the system all along so when they show up for care presumably they have been paying into it, which is called Obamacare.
You're right, people should work, unless of course you already have lots of money, in which case you can pay other people to move your money around in a way that increases it.
Quite an equitable system, poor people should be left to die in a ditch because they didn't "earn" what they needed to live, while the rich (especially those who inherited their money) deserve to have everything they could possibly need; and pay extra low taxes as a reward for already having lots of money.
Of course they do. They expect that person to sit quietly outside the ER and wait for death, and to be thankful that we live in a country where they are getting their just desserts for being a poor, unemployed slob. Didn't you hear the crowd at the Ron Paul speech applauding this very ideal?
This idea that a safety net is the equivalent of being handed something for nothing is some of the most egregious bull that has come out of the GOP in recent years. As a society, we function best if all people are guaranteed a certain standard, namely life, liberty, and the pursuit of happiness (or property, depending on the item being cited). The Conservative movement here has managed to make these rights seem like a whiny liberal entitlement, and have thus convinced millions of poor and working class Americans to vote against their own self interest. Instead of "Wow, that guy has had some bad breaks, let's try to help him" we are now a country of "Wow, that guy has had some bad breaks, but so have I, and nobody cared about mine, so fuck him". It's sad, and sickening.
If you want to provide "safety net" (a broken analogy) to others, go ahead and do it - on your own.
Other people, including but not limited to me, do not have the duty.