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.



Readers' comments
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It may be that everyone is looking too far into Roberts' motivations - it may be personal for him. He may have supported the law due to his epilepsy - he knows that if he weren't a Justice, he wouldn't be able to secure an individual health insurance policy either.
Over the years, I have had enjoyed reading The Economist reader's comments but it shows those days readers are just commenting the thread without intuitively thinking the bigger questions.
Why do the Repubicans not support the health reform?Only to show that they don't agree with the president? In-fightings between the two parties are amazingly huge.Why bother with these things.
"Voters hold an even dimmer view of the law’s constitutionality."
Since when is the general public Constitutional Scholars?
That's exactly the problem. Everyone thinks he or she is an expert.
Jiang,
What a good common sense Q you asked!! It is so obvious. But that somehow requires a debate. And more debate, and more debate. . . . Why don't we just have a mob rule and the only test anyone ever needs is who is a bigger mob. Strange!
Ashbird (Fènghuáng?),
I think we have that right now… :-)
I think the problem is that these “experts” draw their learning from the deceptive specious (good-looking) arguments used by the various special-interest groups and partisan political parties. The “experts” are really just being manipulated in their views.
Also, of course, the “experts” may be more selfish than not on their own. The deceptive specious arguments are probably just only cultivating this selfishness in us.
In this reply; I’m trying to NOT SAY that: either we are provided no protection from deceptive specious arguments (because of free-speech rights), or we have too much democracy, or we simply don’t exercise our democratic rights faithfully, honestly, and righteously.
Well, it comes down to the Giant Echo Chamber that passes for rational debate in America. A think tank develops an attack reasoning, it is picked up by the (Republican) politicians, amplified ad nauseum on Fox News, and lo and behold, you have a large block of under-educated or uniformed voters regurgitating what they've been hearing from their "team". So, Jiang Tai Gong, you are absolutely right. Voters have no clue on the law's constitutionality beyond what they've been fed from their political masters.
Perhaps it is because the Constitution is only 6 pages long, and was written so that everyday people could understand it.
Heres the basic problem with universal healthcare, like European debt mutualization it incentiveses bad behavior or moral hazard.
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The people who are most likely going to use insurance will probably be least likely to pay for it (yes there is a direct correlation to drug abuse, obesity and other chronic diseases with income)
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So people trying to stay healthy will be stuck with the bill. Basically universal healthcare rewards people for being unhealthy and punishes those who are healthy by making them pay the most for their good behavior.
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Universal healthcare like any form of socialism always rewards bad behavior and is unsustainable. It only works if you enjoy stagnation and horrible healthcare universally.
And this is different from any insurance system, public or private?
I see you fail to understand how basic insurance works.
if you get cancer I hope you think very carefully about what you've done to get cancer. Then everyone can see you as a cautionary tale - that guy's bad behaviour led to him getting cancer - let's not be like him.
Of course we know human health is by no means a meritocracy, and as an Australian, who has the benefits of universal health care, I wouldn't give it up. And soon, neither will you.
Your original post describes essentially the situation before AHA, and which the Act goes some way to fixing: because people who are "most likely to use insurance" are "least likely to pay for it", their healthcare services are subsidized by those people who do pay for healthcare insurance. It seems to me that you support what AHA is trying to do, while thinking that it does the exact opposite of what it does (which precipitates your opposition to it).
The problem with your argument is that universal healthcare without universal insurance (the problem you describe) is essentially the system before AHA. The individual mandate compels people to pay for insurance so that others don't subsidize the uninsured. The Act also makes insurance more affordable and coverage more universal; thus the Act is an attempt to fix the problem you describe.
What part of spreading risks most widely is not understood?
Being sick is hardly fun. The idea that universal coverage per-se rewards unhealthiness is just moronic.
Everyone gets sick and dies. In the area of health insurance the largest pool is the cheapest, and that is you get with universal coverage.
Do you really think that people avoid unhealthy behavior if it's expensive? Or practice healthy living for the cost savings? I'm quite certain human beings don't work that way. Being healthy is its own reward.
That's borne out, in fact, by the large number of countries that outpace us in health care outcomes even as they enjoy universal healthcare. If their health care systems are so stagnant, why are they beating us?
"Here´s the basic problem with universal healthcare, like European debt mutualization it incentiveses bad behavior or moral hazard."
People do not purposefully fall sick.
And even if some people are more careless with their bodies than others, that is out of general character flaws, not out of thinking "The Government will treat my lung cancer, why should I stop smoking?". Such people will take poor decisions with or without Government involvement in Health Care.
Their is no such thing as "sickness" moral hazard.
Hyun,
Where your post fails is in understanding how the Europen universal health care systems work (as well as the 'debt mutualization'-your incorrect term not mine). When you have universal health care, the systmem is incentivised towards lower cost, which comes from better living. These systems proactively work for preventative care rather than simply reacting to health issues when they arise. People (that's other human beings for all right-wingers reading this) also live in a system where they are encouraged to work and stay healthy and so they can contribute more to supporting the system. When they can afford health care when they first need it, the seek that care before their health has degenerated significantly, which then would cost more--as well as feel worse. This is what I call a win-win situation healthier, happier individuals who contribute to supporting lower health care costs.
"yes there is a direct correlation to drug abuse, obesity and other chronic diseases with income"
It's an inverse (negative) correlation, not a direct one. You can check any public health book, and see obesity and drug abuse do not exacly increase with income. In the US obesity is negatively correlated with income. Same with alcohol and drug abuse.
health insurance companies pay actuaries (and i have several friends -- with whom i attended college) who are now actuaries to do one thing, determine the probability of payout. furthermore, these insurance companies have insurance in the case they have to pay excess payouts (the re-insurance market).
that said, and as someone pointed out, it is in the best interest of insurance companies to promote preventive medicine, may not be in the best interest of the medical or pharmaceutical group.
your statement "people staying healthy will foot the bill", is actually what the bill intends to counteract. if i am an insurance company and only insure "healthy people" then i guarantee minimal payouts, which ensures exhorbitant profits for my pocket, however, in so doing, i fail to serve the purpose of insurance -- risk mitigation.
hence for the insurance model to work as it is intended, there is a NEED for some people to fall sick; this does one of two things-- forces insurance companies to promote healthy living; forces insurance companies to find ways to persuade the medical and pharmaceutical groups to lower or contain costs. hence for all you "invisible hand theorists", the free market (and not the evil government) actually works to rein in costs.
as far as the poor being obese, with chronic deseases, and drug abuse...what planet do you live on? rush limbaugh -- a millionaire, was addicted to prescription drugs... there are tons of obese rich people all over the world; chronic desease (diabetes, leukemia, cancer, etc) do not examine one's tax return before afflicting said person.
I don't know how does health care system in Australia works, but in The Netherlands we do have something similar to Obamacare and it;s not working at all:
-the cost or the care raises each year both as percentage of the GDP as well as individual contribution
-as health care is not a real market (MD's are privates and not employees of hospitals) the cost side is rising while the cost cut is oriented to "cutting the use of healthcare". In other words you need to die in order to see a MD.
I've been paying compulsory health care insurance my whole life and I wish we had the pre-Obama system. Covering my "use of care" with own savings would have been way cheaper!
Where in Europe does universal health insurance incentivize lower cost? Explain it to the Dutch. Our health care costs are rising exponentially.
1.Due to high prices of care there is no way prevention, but the opposite: the access to health care is being restricted each year
2.We have the image of a rich nation, yet the costs of healthcare amount between 10 and 20% of the net income a month per family.
3.Universal health care incentivizes unefficiency in the system and bad performance at all levels.
I feel pitty for Americans. Used to like Obama...
Your argument lost all its credibility when you suggested income is a function of drug abuse, obesity and disease... Couldn't be further from the truth. Drug abuse, obesity and disease is a function of income.
You're also describing the current system so I'm not sure what you're trying to prove. Many "socialized" healthcare programs are sustainable and more effective than the program currently in place.
With your ideologies, we should just get rid of emergency services as well. All social programs are bad.
Republican.... Democrat.... Who cares? There is no reason why any person in America shouldn't be able to go the doctor and seek medical help. Of course there are going to be individuals who milk this new policy for what it is, but there is also a person's life who will be saved because they haven't had health care ever! I have not read one comment that looks for the positive in this situation. Instead people are kibitzing over things that do not even affect them. People who are complaining probably have had health care their whole lives and have never had to be denied by a dcotors office because they coudn't fit the bill. Stop being two faced and be thankful for what you have.
I don't kibitz over the future bankruptcy of my country.
Yes, it would be wonderful for everyone to have "free" healthcare.
Except it really isn't free.
We have a very imperfect system right now. Many improvements are needed. This bill takes most of the imperfections, especially the high cost ones, and commands/coerces its way across our entire society.
The new law has many feel good aspects to it, that the country simply cannot pay for, and it will bankrupt our country. Unlike a personal bankruptcy, a bankrupt country could mean tremendous losses in all areas of our lives.
As someone that works in Healthcare and interacts with Doctors every day, this is a terrible law, but worse for Obama's re-election. As a conservative, I am pleased with the ruling because I am certain Obama will lose the election with significant help from this ruling. The choice is very clear in this election. Good luck with unemployment and corporations hording cash. Most Physicians dislike the law and anyone not drinking the cool aid knows that most people will get "less" healthcare for their money. 90% of the population will get inferior care to help 10% of the population. No tort reform and 16,000 new auditors to tax and fine the population. How does that improve healthcare? Obama now owns this law and the economy.
What an incredibly reprehensible sentiment. You're saying that you think the law will be detrimental to the economy, healthcare, etc. Ok fine, you just don't have the right facts. But to go further and say good, I'm glad the people will suffer...
How can you wish this on fellow citizens? In no political situation would I EVER hope that someone not get healthcare they need, much less an American, so that a politician can look bad. You are a disgrace.
Darkbloom
I am sorry to offend, I never said I want anyone to suffer, and yes I may be a disgrace, but time will tell who is right. I want everyone to be cared for, but I want my mother and family to receive the best possible care and have little trust that more government will improve healthcare. I supported and wanted our president to succeed for the best of my family and the country but significantly oppose his vision. If my opinion is foolish then you should not be offended.
you just are ok with them suffering because they can't pay. Oh It get it.
Ok, so what you meant to say was... I don't think the law will work, but I hope for the sake of the country that it does work. And as a side note I hope Obama isn't re-elected.
Just realize that your first post had some truly awful implications.
"no tort reform and 16,000 new auditors..."
Studies of tort reform have uniformly concluded it does little to control costs. I happen to support tort reform, but I'm not under the illusion that it is a silver bullet, or even one of the main paths to cost control.
As for the auditors, they are their to correct an obvious, glaring market failure that is driving up costs. It's called adverse selection. Look it up!
I don't think that was the point, but the same one that was always my own. Nobody opposes finding solution for the ten percent that has problems. But why destroy and degrade the system that works fine for the remaining 90%? Because democrats always have these huge wet liberal dreams that they have to force on all of us even if that takes away the freedom of millions. It's part of their tyrannical way of thinking.
And yes the excellent medical services that we enjoy will deteriorate. I used to dislike Obama for his arrogance, opportunism, lack of principles. Now I simply hate him with all my heart. The affront to our individual liberties has no comparison in history. And no, bush wiretapping is not comparable. People need government for defense because individuals can't protect the country; but we can take care of our healthcare.
His original point was that politics should go above health care, and by health care I simply mean the well-being of all American citizens. That is wrong no matter which way you look at it. Democrat, Republican, lefty, righty ― we should all be of the same opinion that there is absolutely no benefit that can be derived from ailing citizens. End of story.
Now for the rest of your point. I can see why your username is "Thatseasy" because you broke down a complex issue into bite-sized chunks of nonsense. It's NOT easy and can not be oversimplified. Excellent medical services? Works fine for 90% of us? I'm glad you are fortunate enough to have this experience with health care, but you do not speak for the majority.
And if giving everyone health care while lowering costs is an "affront to our individual liberties," then sign me up. If we have to pit liberty against the health of the nation, then you're probably not using the correct definition of liberty. No comparison in history? You need to review US history.
Let's say I was POTUS, and I thought public safety was the #1 issue. I got some studies together and found that gun owners killed more burglars than non gun owners. Makes sense, right? And investigating, pursuing, catching, and incarcerating burglars is expensive, and that cost is shared by society. So, by the very same logic as Obamacare, I mandate that everyone must buy a handgun on pain of penalty/ tax. I get it through Congress and now the SCOTUS has to say it's ok.
Is this still a good idea? Do you want this?
What many on the Left (and some on the Right) don't realize is that the goals of Obamacare are irrelevant - the process is. Obamacare might be perfect in all it's details, glorious in it's drive to protect the poor and elderly (It's not), and it still doesn't matter.
Precisely my point in the point below ...great minds think alike :)
Or you could look at it in terms of car insurance. A mandate to have it in order to drive means that the victims of any accident get covered.
You bring up the gun example because you think it is ridiculous. It is, but you are missing the point. There are a million ridiculously bad policies that Congress might pursue that are nevertheless constitutional. Our protection against such abominations is not the constitution, but the good sense of elected officials and the political pressure they feel from their constituents.
Congress could tax people for not owning a gun. Congress could also impose a 99% marginal tax rate on income starting at 10,000 dollars.
But it won't.
Your analogy would be correct only if there was no such thing as the police, and no universal taxes on society that pays for the police. I believe that there are penalties on not paying your property and sales taxes which go to the county, which in turn pays for the police (as well as the fire brigades and garbage removal services). Your analogy thus reinforces the argument for AHA.
That´s an excellent point Teacup. Car insurance in California has been customary by law for many years now (about twenty).
What´s the difference between forcing people to purchase car insurance and health insurance.
The fact that such a clear example has not been discussed could be proof of the hold the 16 % of GDP Health as a Business lobby has on American politics.
Or it could mean you are smart.I think both.
Congratulations we now have healthcare for all in the US. We needed something other than what we had. But are we sure we wanted this way ? Insurance companies are frothing at the lips with a solidified customer base. This has never been about healthcare and those who think it is are sadly mistaken. This was simply a vehicle to test the powers of the federal government and a dangerous precedent has now been set. Those who are celebrating today are indeed myopic. Remove the issue of healthcare for one minute, remove your partisanship for a minute also- do you really believe this type of power won't be used in the future? What if it is was a right leaning policy at heart ( not that the right would ever force anything upon the whole nation, would they? What happens when a conservative policy gets to piggy back off of this legislation ( mandated 401k type vehicles to relieve the burden of social security for example) I would imagine very few of you would be celebrating the power of government then? Pandoras box has been opened and it is not a question of "if" but more like when the next item will be forced down our throats and have a tax set in place for non participation. And I would love to see when that is challenged the SCOTUS will have no choice but to vote precisely the same way and I will surely enjoy the more liberal Justices having thier hands tied behind their backs and forced to let a conservative item the same exact way. Today every.American lost in the long run and it will be time before we even see the full ramifications of this precedent.
I fail to see why you see this as an enormous precedent. If the Supreme Court had ruled that the commerce clause supported the individual mandate, I could possibly have agreed with you. However, in all cases, if the majority of voters dislike this law, all they need to do is vote for a congressperson, senator, or president who will overturn it. I hope for our sake as a nation that they aren't that stupid, but time will tell.
You fail to see the importance of allowing the central government to tax you on a non action? You say this now when it has to deal with an issue you agree with but a time will come when a similar law will be passed that you don't agree with and then tell me you are hood with it then, govt grew stronger left and right. Essentially the whole commerce vs tax discussion is legal symantics and now the govt has a loophole if you will to force a behavior. Enjoy the ride!
Exactly. I remember when bush proposed something that looked like social security privatization.i personally liked the idea for me. I knew I could make some decisions with my money and invest it wisely. Yet, I also thought of the millions of people, uneducated, disabled, old, etc that wouldn't be able to do that and thus be the object of abuses by others "experts" and so forth. The risks for those cases were too big to allow.
The democrats immensely opposed the idea calling it "gambling" - certainly an exaggeration, but like Death panels with an implicit truth to it. Bush of course was proposing the idea for those who wanted it, and those who preferred the old system to keep it. But the bottom line is that the public opposition won the day, the subject was dropped and democracy respected.
Not so with obamatax. The thing was jammed like tyrants impose things. By force. No matter how many polls, elections, protests, etc occurred. The thing still was jammed. Whether I find the obamatax fine or partially acceptable is not the point. The precedent created is of enormous consequences. Next time conservatives are in power, I won't mind if they catch in fire all illegals and dismantle the SS. Certainly the democrats won't have any moral or constitutional standing to stop them.
There's a big problem with the argument that Congress shouldn't penalize people for doing nothing when it comes to health care. Those people who don't get insurance, but could afford to, still want healthcare when they're ill. Its not like they go into the woods and make some herbal tea and don't burden the system. They end up pleading poverty, declare bankruptcy etc and everyone else pays in higher premiums. I would argue that infringes on my liberty as a responsible person with health insurance. We all have to get car insurance for a similar moral reason, why is health different?
The difference is that you have to buy a car to buy car insurance.You could take the bus, ride a train, walk, bike, or buggy (Amish) to and from and never pay car insurance. However, now the very act of existing and doing nothing is in effect a crime.
If you took the same thinking but for another issue, what would you think? Everyone takes up police resources, right? And it's been proven (or at least I could cook up enough stats and studies to make it seem proven) that private gun ownership reduces the burden of police. Is it ok when I become POTUS to mandate everyone to buy a gun?
"However, now the very act of existing and doing nothing is in effect a crime."
If you are driving up my insurance costs because you're taking advantage of the system, yes, it should be a crime. If you're a middle-class family with the ability to pay for insurance and don't and plan on relying on emergency room care and emergency services you should pay for it. Someway. Somehow. Period.
Your car insurance analogy doesn't work. Unless you don't buy insurance and expressly hang a sign around your neck saying 'Don't ever treat me for anything under any circumstance' your sucking the system. The uninsured drives up the cost of health insurance about $1K a year for family's like mine.
Why should I pay for your 'liberty' to have a heart attack?
Yeah that pretty much sums up what I was thinking. People always want treatment when they're sick so the "existing and doing nothing argument is now a crime argument" doesn't work.
Your logic is a tad faulty. In no way does lacking health insurance now constitute "a crime". Our culture is full of financial incentives and disincentives. For example, you are penalized on your taxes if you rent and don't own a house (inability to claim a mortgage deduction). Now you are penalized if you don't have health insurance. I can more support the penalty for not having health insurance, as those who lack health insurance absolutely cost me money.
This is why Obama is my presidential candidate pick! It is almost as though people are choosing to simply ignore the facts for just another chance to whine about Obama. I really hope some of you that have such a huge problem with "Obamacare" have planned out every disease and ailment for your entire life, otherwise if your insurance company denies you life-saving treatment, it is your own fault. If your children, in college, can't afford insurance and become sick for any reason, you are the ones that can look forward to paying massive out of pocket expenses since they can't just stay on your own policy. God forbid any of you get a nasty form of cancer, which is usually growing in the body 10 to 14 years before it is detected(preexisting), and need some rare expensive treatment that your insurance company denies because of age or income limits. I find it amazing, no really, amazing that the Republican party has convinced a large part of AMERICA that insurance companies have OUR best interests at heart. Not so long ago, EVERYBODY was complaining about soaring premiums and the dreaded "sorry that isnt covered" rejections that were frequently used to deny benefits! Medicare has been shown to be the MOST efficient and cost effective medical insurance in the county. Medicare's administrative costs are between 2%-6% depending on who you ask, while private insurance costs are between 17% and 25%. You are paying higher premiums to cover these costs which obviously include advertising, profits and multi-million dollar salaries. I for one trust the government do administer health insurance that I do the big private Insurance Companies. The only problem I have with the new law is that I don't feel people should be eventually fined for not having insurance, and that is a small detail that can be changed. It just really upsets me that so many people can ignore the benefits of this new health care law. My aunt, who recently died after a long battle with Lupus, would still be alive today if she were not denied the treatment that would have saved her life, from her insurance company. Hopefully those of you that oppose new healthcare law don't have to go through the experience my family has, otherwise I believe a lot of people would feel differently.
Did you really just say Medicare is efficient and cost effective. Waiting months to pay doctors and then shorting them is neither efficient nor "cost effective," only cost manipulative. How could you wish that system on the whole country?
Also, you assume that if we didn't have universal healthcare and employer-provided insurance that we'd actually pay the same sticker price for healthcare out of our pockets. If you have a finite resource and everyone has unlimited funds to pay for it, the price will be out of reach if you end up uninsured. Our system was insane, yes. But that's because prices were driven up by everyone with insurance to the detriment of everyone without (until they go to the ER). If nobody had insurance from their employer, they would be more price-sensitive and actually use discretion when getting healthcare.
Obamacare is here to stay
Do dah, do dah
Do dah, do dah....? I sure wish this was simply some fictitious movie but alas its now reality.
It's a horror flick. We're all going to get medical attention when we need it!
AAAAAAAAAAHHHHHHHHH!!!!!!!!
And, we're going to have to actually pay for it!
AAAAAAHHHHHHHHH!!!!!!!!
And forced to pay for it even if we don't need it!
It will be when the govt leans right and passes a law that taxes you for not having a 401k, gun, etc...enjoy the loss of freedom to not participate without penalty bc it will happen, don't be so myopic and start looking at the big picture.
"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."
Did The Economist happen to read the dissent, which argued to overturn the entire ACA on logic that is specious at best?
President Obama already had stimulus in place when he went after health care. Health care didn't make Republicans any more recalcitrant because that is an impossible task. He is quite frankly lucky he got anything done at all.
As long as economists continue to give the anarchist supporters of "austerity" intellectual cover you can't turn around blame politicians for listening to them. Until there is at least some semblance of consequences for being repeatedly and disastrously wrong, the blame for the misery of unemployment lies firmly at the feet of Friedman, his disciples and everyone who has refused to call out their quackery.
i never understood why people want their healthcare run by the same people that run the DMV.
Health Insurance companies run the DMV?
government runs the DMV, obamacare is government. there are no stupid questions - just stupid people. thanks fpr proving that last point.
"obamacare is government"
Not really. A single-payer system like they have in many industrial Western countries is "government". Obamacare is probably the most market-oriented plan to achieve something like UHC. At least that's the gist of what Romney and the Heritage Foundation used to say when the promoted it.
Isn't Medicare both extremely popular and actually directly run by the government? (unlike Obamacare, which actually just forces us to pay private insurance companies)
lol, you do know that "Obamacare" is not gov't healthcare, right? It's a mandate that you purchase *private* health insurance, provided by *private* companies along with more regulations for those *private* health insurance companies. Who's stupid again? Yeah.
DMV is run by your state government. Look at your Federal government - the military - the most agile / professional / advanced in the world... thats your federal government. NASA, the fist government agency in the world to the moon. You may wait a llittle while in line if you still go to the post office but it is still the least costly stamp in the world for the best delivery of any postal service in the world. Your Federal highway system - do you enjoy the privilege of driving on it or should every single road be a private toll road ??
Yes,Medicare is popular and government financed, too bad it's not fiscally sustainable.
The government also runs the military, may be we should privatize it too..
obamacare is government healthcare, you do have private companies, but they are heavily regulated, thats the whole point of obamacare, I guess you didn't get the message
And indeed many European countries have a highly regulated private system. Germany for one.
We Koolaid drinkers want the government to run our lives for us, because we are too stupid to do it ourselves. This way, the whole country will be as efficient as the Post Office!
...because I have full coverage, unlimited care, no pre-existing condition limits, no lifetime pay-out limits and a maximum co-pay of about $10 per prescription. Oh, and if I don't like the coverage, I can campaign to get the bums thrown out and someone who changes the health system the way I want elected.
That's why I like the government to run my healthcare. I love the UK's NHS and I've lived in the USA - I know how you don't even realise how shitty your healthcare is, even with "good" insurance.
Now after digesting the first talks and opinions, Im starting to see clearer on this whole thing.
Roberts rejected the mandate as for is inconstitutional; but renamed it a "tax" which is constitutional. The tax will now be a mandate on non existing commerce. The interesting part is that by calling it a "tax" it now will provoke the usual reaction to tax raising. Since we can vote against higher taxes, this will be a good issue to raise more money by those rich folks, using their United Citizens rights to fight it.
The good thing is that now, Dems/Liberals cant argue against Citizens United as a "political/partisan" decision, because they now got what they wanted from a "fair" SCOTUS.
That Roberts is indeed a genious. This is gonna get better. Keep in mind that the American people has rejected this thing everytime was given a chance to judge it (VA, NJ, MA, 2010, public polls, etc).
So now it will be a fight between "Citizens United" court ruling supporters vs "Obamaca" court ruling supporters.
So, we should stick with the arguement that Citizen's United was a decision that was both incredibly stupid and destructive to democracy instead? I'm okay with that.
It's now your choice, America!
That is, between one politician who taxes Americans to receive health insurance, or -
A politician who merely mandates it!
The choice, America, is yours! :)
Roberts hits the jackpot-commerce clause jurisprudence goes back to 1905 (if not before) and Tea Party types are energized to go to the polls to make sure that they aren't forced to buy vegetables. Pure genius!
Low and behold, the stupid public and Obama,s crappy messaging on a crappy bill still have passed thru the Supreme Court.
Single Payer is still the way to go. Roberts was not arrogant enough to have his place in history tarnished by ideology of the lunatic far right.
Now the Dems need to clean up all the Republican lies so the public understands the plan.
I can hear the Republicans howling like dogs all over the place :) :)
We all knew that Roberts is a Marxist, and a Kenyan Socialist all along. :)
I think they will call him a traitor and try and impeach him shortly.
Eat it Republicans !
Your a bunch a sore losers !
You state these in obvious jest, Faedrus; but don't be surprised if they adopt them as their mantra - and if many Americans believe them.
On the contrary, he is a Realist! LOL:-)
David W. Nerubucha
Nairobi, Kenya
Jesting? Whose jesting? :)
Actually, my Rightwing neighbor cornered me this evening, and said essentially the same thing.
You know what they say: "Never let a good conspiracy theory die an easy death". ;)
If these people were merely obsessed with conspiracy theories, they wouldn't worry me very much: it would be easy enough to dismiss them as the hate-driven fruitcakes and cranks that they are. It is their ability to weave neatly together a combination of half-truths (e.g., Obama's borrowing record), simplistic vacuities (e.g., "taking our country/freedoms back...") and outright fabrications ("Obama the communist, born in Kenya/Indonesia") as facts that makes them quite dangerous, especially with a very effective propaganda outfit like Fox News behind them. Never, ever underestimate the ability of groups like this to poison the political discourse irreparably - or worse.
Unfortunately, the ACA doesn't address the flood of pre-existing opinions that run roughshod on any rational discussion these days.