Supreme Court rulings

[redandguilty]

Pleasantly surprised for several reasons on the healthcare ruling. The commerce clause argument didn't fly. Change is going to happen. People are going to get covered. And Roberts was the swing! A "W" appointee! Maybe partisanship doesn't drive everything he does!

But long term I can't see this plan being sustainable/I think we've been lied to about projections. If the individual mandate was critical to the funding of the system, then that means they think the poor and middle classes are going to make up the difference. It's a lot of money, I don't believe it can hinge on money collected from the lower end of wealth curve.

 

[Michchamp]

...
But long term I can't see this plan being sustainable/I think we've been lied to about projections. If the individual mandate was critical to the funding of the system, then that means they think the poor and middle classes are going to make up the difference. It's a lot of money, I don't believe it can hinge on money collected from the lower end of wealth curve.

From CNBC:

Stocks of hospital companies moved sharply higher on the decision, including HCA Holdings (HCA) and Community Health Systems (CYH).

Stocks of drug companies and medical device makers are slightly lower for the day as analysts sort through the Supreme Court's ruling. Stocks of the biggest insurance companies are also lower.
​

Guessing this means any gains hospitals, the existing uninsured, and anyone with a prior condition are coming at the expense of drug companies and insurers. If that's the case, I don't feel sorry for them... they've been sucking billions out of Federal & state gov'ts for decades.

if this plan is sustainable, that's why: to a small extent, in addition to funding itself from whatever people are now required to buy insurance, it's eliminating a source of unfair and extraordinary profits...

 

[redandguilty]

If the plan is sustainable, I sort of expect there to be an effort down the road to allow premium healthcare plans than don't have to stick to the preexisting conditions rules...unless it's already in there somewhere.

 

[Michchamp]

If the plan is sustainable, I sort of expect there to be an effort down the road to allow premium healthcare plans than don't have to stick to the preexisting conditions rules...unless it's already in there somewhere.

wait, what? due to the law, the rules are now that insurers can't exclude customers due to pre-existing conditions. they have to cover treatment.

why would you want to buy a "premium" plan that allowed them to deny you coverage for something pre-existing? or am I not understanding what you wrote?

 

[elrod817]

wait, what? due to the law, the rules are now that insurers can't exclude customers due to pre-existing conditions. they have to cover treatment.

why would you want to buy a "premium" plan that allowed them to deny you coverage for something pre-existing? or am I not understanding what you wrote?

Yes, that is correct...no more exclusions for pre-existing conditions which is great for any diabetics out there.

I'll let red speak for himself, but I'm guessing that by premium plan he means not in cost, but in benefit. 'X' amount of dollars less for healthy individuals.

 

[Michchamp]

keep in mind that insurance costs in the US have been off the charts for years, and are PER CAPITA higher than countries that provide universal healthcare to all citizens.

any reforms that cut into profits are NOT examples of government overreaching, just as the pre-Affordable Care Act health regime in the US was NOT an example of the "free market" in operation as much as it was an example of health care lobbyists writing rules that allowed them to feed off corporate wealthfare from the gov't.

all these large insurers & drug companies have market power, and are realizing monopoly-esque profits at the expense of the people and their tax dollars. reforms that counterbalance this are unquestionably good except for a very select few... I'm sure you can figure out who those few are.

 

[redandguilty]

wait, what? due to the law, the rules are now that insurers can't exclude customers due to pre-existing conditions. they have to cover treatment.

why would you want to buy a "premium" plan that allowed them to deny you coverage for something pre-existing? or am I not understanding what you wrote?

What you wrote is my understanding of how it's written, but if that's the case, what's to stop people from buying the cheapest plans they can find and then upgrading to top shelf insurance if they develop expensive problems? Seems like this will force all healthcare to go to the same level. Better healthcare insurance would lose money unless they have some protection from that kind of behavior. If we need the individual mandate to protect from people waiting until they get sick to buy insurance, then we'd need the same thing to protect different levels of coverage.

 

[Michchamp]

What you wrote is my understanding of how it's written, but if that's the case, what's to stop people from buying the cheapest plans they can find and then upgrading to top shelf insurance if they develop expensive problems? Seems like this will force all healthcare to go to the same level. Better healthcare insurance would lose money unless they have some protection from that kind of behavior. If we need the individual mandate to protect from people waiting until they get sick to buy insurance, then we'd need the same thing to protect different levels of coverage.

but if they develop expensive problems after buying insurance... it's not a pre-existing condition.

I am okay with all healthcare being at the same level, but that will never happen. Come on... you think something about this ruling will fundamentally change human nature?

bottom line is, this increases coverage at the expense of the insurers and drug companies, and the portion of the population that could afford it, but will not buy it. I think the benefits outweigh the gains; and if more people are covered and live healthier because of it, the overall benefits to society outweigh the immediate costs. That's the plan at least. I don't think any of us casual observers really know how this plays out.

This person certainly doesn't.

 

[redandguilty]

but if they develop expensive problems after buying insurance... it's not a pre-existing condition.

I am okay with all healthcare being at the same level, but that will never happen. Come on... you think something about this ruling will fundamentally change human nature?

bottom line is, this increases coverage at the expense of the insurers and drug companies, and the portion of the population that could afford it, but will not buy it. I think the benefits outweigh the gains; and if more people are covered and live healthier because of it, the overall benefits to society outweigh the immediate costs. That's the plan at least. I don't think any of us casual observers really know how this plays out.

This person certainly doesn't.

No, I don't think human nature will change. And if people that buy cheaper healthcare packages develop chronic conditions, they will upgrade to better, more expensive packages. The condition is preexisting to the new program. But this behavior would make premium healthcare packages unprofitable for the same reason that requires the mandate of the current Obamacare law. All healthcare insurance races to the bottom.

 

[tinselwolverine]

Now, I'm hearing a pundit or two saying that now that the mandate is structured as a tax, any test of its constitutionality, under the mechanics of the law as it exists, can not actually be proceeded into until the tax is actually levied and collected - I don't know if this is true, but that's what one or two of the talking heads said.

So maybe this will all be revisited, assuming the law survives beyond the next election.

 

[Michchamp]

No, I don't think human nature will change. And if people that buy cheaper healthcare packages develop chronic conditions, they will upgrade to better, more expensive packages. The condition is preexisting to the new program. But this behavior would make premium healthcare packages unprofitable for the same reason that requires the mandate of the current Obamacare law. All healthcare insurance races to the bottom.

okay good. maybe it gets us to a single payer, universal system by default.

conservatives should be okay with that. only the strongest survive. no cheating death by paying for better doctors, or jumping ahead in the organ donor lists... if it's your time to go, well, that's just God's Will.

 

[redandguilty]

okay good. maybe it gets us to a single payer, universal system by default.

conservatives should be okay with that. only the strongest survive. no cheating death by paying for better doctors, or jumping ahead in the organ donor lists... if it's your time to go, well, that's just God's Will.

If technology was static, that would be fine. It's bad for funding research though.

 

[redandguilty]

Now, I'm hearing a pundit or two saying that now that the mandate is structured as a tax, any test of its constitutionality, under the mechanics of the law as it exists, can not actually be proceeded into until the tax is actually levied and collected - I don't know if this is true, but that's what one or two of the talking heads said.

So maybe this will all be revisited, assuming the law survives beyond the next election.

Could be. I've heard someone claim that the current court likes to rule more narrowly than they have to. Someone else said it's their job to be a narrow as possible. I don't if it is or isn't. Seems like a good idea though.

 

[redandguilty]

okay good. maybe it gets us to a single payer, universal system by default.

conservatives should be okay with that. only the strongest survive. no cheating death by paying for better doctors, or jumping ahead in the organ donor lists... if it's your time to go, well, that's just God's Will.

Also, in the meantime, the race to the bottom could really suck for everyone who isn't rich.

 

[TheVictors]

I still don't understand how it is morally just to profit from the misery and illness of the people. My dad's battle with Leukemia has cost our family hundreds of thousands of dollars ...Aetna can go fuck itself and the Insurance lobby is one of the most powerful in the nation. Good Physicians are leaving medicine because of the beauracracy and bullshit and debt they're running because of malpractice insurance.

What happened to wanting a healthy and well-informed people and seeing that as a moral imperative and not a for profit opportunity?!

/rant

 

[zoombabyzoom]

^this

 

[redandguilty]

I still don't understand how it is morally just to profit from the misery and illness of the people. My dad's battle with Leukemia has cost our family hundreds of thousands of dollars ...Aetna can go fuck itself and the Insurance lobby is one of the most powerful in the nation. Good Physicians are leaving medicine because of the beauracracy and bullshit and debt they're running because of malpractice insurance.

What happened to wanting a healthy and well-informed people and seeing that as a moral imperative and not a for profit opportunity?!

/rant

The government should tax for and subsidize healthcare directly. Only a law written by health insurance companies would require everyone to pay, everyone to be covered, and they get a cut of all of it. Why a set of private companies deserve a perpetual share of this money is beyond me.

 

[redandguilty]

I wonder...could the government tax people that don't eat broccoli? That was part of the talking head argument before the ruling, but nothing I've read refutes the idea, so long as it's a tax (you don't have to call it a tax, it just has to be a tax. That's part of the decision.)

 

[redandguilty]

Interesting, the 4 liberals thought the act was fine based on the Commerce Clause, but Roberts was against the idea. From Ginsberg:

In the Social Security Act, Congress installed a federal system to provide monthly benefits to retired wage earners and, eventually, to their survivors. Beyond question, Congress could have adopted a similar scheme for health care. Congress chose, instead, to preserve a central role for private insurers and state governments. According to THE CHIEF JUSTICE, the Commerce Clause does not permit that preservation. This rigid reading of the Clause makes scant sense and is stunningly retrogressive.

 

[TheVictors]

The government should tax for and subsidize healthcare directly. Only a law written by health insurance companies would require everyone to pay, everyone to be covered, and they get a cut of all of it. Why a set of private companies deserve a perpetual share of this money is beyond me.

In 1994 there was a Michigan State ballot initiative that was being touted as "lowering your auto insurance" and was very well received by the people, according to early polls. Only it turned out that the proposal (something like "Proposition D") was being pushed by the Auto Insurance lobby so that in the case of an accident, there would be no medical liability and in the end, while there would be a temporary decrease in premiums, the proposal had nothing that wouldn't prevent future increases all the while eliminating any medical coverage in the case of an accident.

So after having laws passed that mandate everyone MUST have auto insurance, these same insurance companies were trying to reduce their liability in terms of claims.

By the time the measure came up for a vote it was soundly defeated.

Because it wasn't about "lowering premiums" at all, it was about reducing what Insurance companies had to pay in the case of someone paying premiums every month and actually filing a claim.

Michigan Citizens Lobby helped get that defeated and I knocked on A LOT of doors in metro Detroit to help.