[Rondec]

I still don't understand why the solution wasn't something like "Medicare for all" except that there is a really strong insurance lobby.

I think it is clear that the individual mandate will be thrown out and just as clear that the law is meaningless if everyone is not included in the insurance pools. The justices seemed very preoccupied with the idea that young, otherwise healthy people would be forced to buy something that they didn't want, but that is the way insurance works. You have to have people who don't use as much health care combined with people who use a lot of it, in order to keep rates reasonable. If everyone in a pool uses 10,000 dollars a year then that is the minimum that that insurance can cost.

At the same time, off loading the cost of uninsured patients and government insured patients (Medicare and medicaid both pay less than cost) onto commercially insured patients is totally unfair as well.

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Last edited by Rondec; 03-29-2012 at 07:10 AM.

[jeffkrol]

I still don't understand why the solution wasn't something like "Medicare for all" except that there is a really strong insurance lobby.

I think it is clear that the individual mandate will be thrown out and just as clear that the law is meaningless is everyone is not included in the insurance pools. The justices seemed very preoccupied with the idea that young, otherwise healthy people would be forced to buy something that they didn't want, but that is the way insurance works. You have to have people who don't use as much health care combined with people who use a lot of it, in order to keep rates reasonable. If everyone in a pool uses 10,000 dollars a year then that is the minimum that that insurance can cost.

At the same time, off loading the cost of uninsured patients and government insured patients (Medicare and medicaid both pay less than cost) onto commercially insured patients is totally unfair as well.

I question the insurance lobby myself.. Medicare for all would still need an expansive network of administration and ins. co's should be happy w/ raking in all that "processing fees".. Besides there investment portfolios are huge.
They seem to be content to bite the hand that feeds them for a percent or 2 of more profit.. Yet taking on much more work (sales ect)..........

preoccupied with the idea that young, otherwise healthy people would be forced to buy something that they didn't want,

i found the encouragement of "gaming the system" quite offensive..... yet I understand why they do it...Problem is it can become a nightmare.. IF you wait till you are sick you could be slammed out of coverage in the future. not the smartest game plan..

[GeneV]

I still don't understand why the solution wasn't something like "Medicare for all" except that there is a really strong insurance lobby.....

A strong insurance lobby and a strong belief among many that this would be "socialism."

The individual mandate has to be there because of the removal of pre-existing condition exclusions. Removal of the pre-existing condition exclusion is central to allowing insurance to be purchased outside of an employer. (Other groups have just about been eliminated). Other groups (chambers of commerce, etc.) have all but disappeared because they became the dumping ground for the sick and unemployed. It is indeed a thorny problem once the decision was made to stay with a primarily private insurance program.

[Nesster]

I think this was one of the better comments from the Justices:

Justice Ruth Bader Ginsburg said she found the debate over health care similar to an earlier era's argument about the Social Security retirement system. How could Congress be able to compel younger workers to contribute to Social Security but be limited in its ability to address health care? she wondered.

"There's something very odd about that, that the government can take over the whole thing and we all say, Oh, yes, that's fine, but if the government wants to preserve private insurers, it can't do that," she said.

Court: What's left of health law without mandate? - Houston Chronicle

[Rondec]

A strong insurance lobby and a strong belief among many that this would be "socialism."

The individual mandate has to be there because of the removal of pre-existing condition exclusions. Removal of the pre-existing condition exclusion is central to allowing insurance to be purchased outside of an employer. (Other groups have just about been eliminated). Other groups (chambers of commerce, etc.) have all but disappeared because they became the dumping ground for the sick and unemployed. It is indeed a thorny problem once the decision was made to stay with a primarily private insurance program.

I guess it was more of a rhetorical question. From a Republican standpoint, I think that the individual mandate is in line with classical "conservative" thinking. That is to say a law pushing people towards individual responsibility. The problem with folks playing the system, running without any insurance coverage, hoping that they don't have any expensive illnesses, is that when they get expensive illnesses a high percentage just don't pay.

I understand that politically the Democrats didn't want to give Republican fodder to call them socialists. But Republicans are going to do that anyway, so why not push through a global health reform law with a single party payer (the government) and be done with it. I think it would have a lot more legal standing than the current law.

[jeffkrol]

The problem with folks playing the system, running without any insurance coverage, hoping that they don't have any expensive illnesses, is that when they get expensive illnesses a high percentage just don't pay.

justice Scalia seems to think it is just fine.. As I said it gets worse in older individuals who may need to carry private insurance. Does anyone want to pay thousands of dollars and have an insurance company now claim thier heart condition is pre-x and will not pay a penny?? Compounding a problem......
Uninsurd by age


uninsured by income:


http://aspe.hhs.gov/health/reports/05/uninsured-cps/index.htm#income

That the uninsured comprise non-trivial percentages of middle and upper income individuals is surprising. Those with incomes above 300% of poverty should generally find employer insurance affordable. Data from employers shows that average single coverage premiums for employer sponsored insurance represent 2.0% of income at 300% FPL, and average family coverage premiums represent 4.7% of income for a family of four at 300% FPL (with a higher percentage for smaller families).

Everyone is gaming the system.........



So the most "freeriders" are white middle class single adults.................

for mikemike.. and for later......
http://reason.com/archives/2012/03/29/why-the-health-insurance-mandate-is-immo

[Parallax]

I still don't understand why the solution wasn't something like "Medicare for all" except that there is a really strong insurance lobby.

Apparently, you do understand why.

Eliminating insurance companies would seriously impact the politicians' finances/percs.

[GeneV]

I guess it was more of a rhetorical question. From a Republican standpoint, I think that the individual mandate is in line with classical "conservative" thinking. That is to say a law pushing people towards individual responsibility. The problem with folks playing the system, running without any insurance coverage, hoping that they don't have any expensive illnesses, is that when they get expensive illnesses a high percentage just don't pay.

I understand that politically the Democrats didn't want to give Republican fodder to call them socialists. But Republicans are going to do that anyway, so why not push through a global health reform law with a single party payer (the government) and be done with it. I think it would have a lot more legal standing than the current law.

Harry and Louise come to mind.

[kswier]

The issues that cause healthcare to be so expensive in the US vs. other countries isn't the greediness of insurance companies and the ACA if it is allowed to stand won't bring us in line with the cost structures of other countries, it won't even come close. Just as doing nothing and letting your body fight off an illness is the appropriate medical treatment, doing nothing and letting the free market resolve a supply and demand imbalance can be an appropriate policy position and one which requires no action by congress if the ACA is struck down. If Romney is the nominee and the law is struck down, all he will need to do is promise that he will do nothing to revive the ACA.

I see a couple of arguments against this:

In my mind, the goal of the Affordable Care Act (ACA) was not to bring down the total cost of healthcare. The goal was to allow those who do not have money to purchase healthcare, so that they did not have to lose their house when their medical bill were due. In doing this it was projected that we would see a moderate drop in the price of healthcare. I think the problem of drastically bringing down the price of healthcare still needs to be solved. The republicans have not put a plan forward that would give those who doe not make much money the ability to afford healthcare (and thus they do not have a solution to the entire problem, and I have not heard any republican solution that would dramatically lower the cost of healthcare).

Large entitlement programs cannot be left up to the states. If medicare was a state run program (say in all the blue states), all senior citizens would move to the states that had it and businesses would move away (to avoid taxes). States do not have the ability to limit the people who move their (protect their borders), and they do not run their own economies (they have no mechanism for keeping business planted in their state) . So this solution also does not solve the problem.

[jeffkrol]

I see a couple of arguments against this:

In my mind, the goal of the Affordable Care Act (ACA) was not to bring down the total cost of healthcare. The goal was to allow those who do not have money to purchase healthcare, so that they did not have to lose their house when their medical bill were due. In doing this it was projected that we would see a moderate drop in the price of healthcare. I think the problem of drastically bringing down the price of healthcare still needs to be solved. The republicans have not put a plan forward that would give those who doe not make much money the ability to afford healthcare (and thus they do not have a solution to the entire problem, and I have not heard any republican solution that would dramatically lower the cost of healthcare).

Large entitlement programs cannot be left up to the states. If medicare was a state run program (say in all the blue states), all senior citizens would move to the states that had it and businesses would move away (to avoid taxes). States do not have the ability to limit the people who move their (protect their borders), and they do not run their own economies (they have no mechanism for keeping business planted in their state) . So this solution also does not solve the problem.

also for mikemike the relief on those that have the health care ax hanging over them removed could NEVER help our society heal and be more productive.. Buggy whips were always more convenient and expedient......The "human element" must be exorcised.........