Why the Supreme Court Should Kill ‘Obamacare’

[Better Believe It]

March 26, 2012
Finally Getting it Right?
Why the Supreme Court Should Kill ‘Obamacare’
by DAVE LINDORFF

The US Supreme Court has a chance to do the people of America a big favor, perhaps atoning at last for its shameful betrayal of the electoral system in 2000 when a conservative majority stole the Florida, and national election, for George W. Bush, and for the liberal-led and equally shameful betrayal of fundamental property rights in the Kelo v New London case that, in 2005, upheld the public theft of private homes in Connecticut on behalf of a government-backed resort development. The court can atone for these betrayals by declaring the ramshackle, corrupt, hugely expensive and cynically misnamed Affordable Care Act to be unconstitutional.

The act, pushed through a Democratic Congress by President Obama in 2010, is a disaster, a cobbled-together set of measures that was fatally corrupted by the insurance lobby and other parts of the nation’s medical-industrial complex, which leaves millions uninsured, continues to tether workers to their employers like indentured servants, and undermines the Medicare program, which should be the cornerstone of a real health reform.

By killing this monstrosity of political expedience and lobbyist strong-arming, the Supreme Court’s conservative wing could give us a good chance to finally move the country to a real national health reform which would reduce costs substantially, provide quality health care to all, and finally drive a stake through the heart of the health insurance industry, the real “vampire squid” of American capitalism which has been sucking money out of American’s wallets and driving many into bankruptcy for decades (family health crises are the major single cause of bankruptcies and homes foreclosures in the country).

By killing the whole “Obamacare” law, the court will throw the system back into crisis mode, forcing the public and the political system to finally consider the only real answer: expansion of the Medicare program to cover everyone.

Read the full article at:

http://www.counterpunch.org/2012/03/26/why-the-supreme-court-should-kill-obamacare/


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FOR IMMEDIATE RELEASE
March 26, 2012

Contact:
Garrett Adams, M.D., president PNHP
Andrew Coates, M.D., president-elect PNHP
Oliver Fein, M.D.
David Himmelstein, M.D.
Steffie Woolhandler, M.D.
Mark Almberg, PNHP communications director, [phone], [e-mail]

Leaders of Physicians for a National Health Program, an organization of 18,000 doctors who advocate for single-payer national health insurance, released the following statement today:


Regardless of whether the Supreme Court upholds or overturns the Affordable Care Act in whole or in part, the unfortunate reality is that federal health law of 2010 will not work: (1) it will not achieve universal coverage, as it leaves at least 26 million uninsured, (2) it will not make health care affordable to Americans with insurance, because gaps in their policies will leave them vulnerable to bankruptcy in the event of major illness, and (3) it will not control costs.

Why? Because the ACA perpetuates a dominant role for the private insurance industry. That industry siphons off hundreds of billions of health care dollars annually for overhead, profit and the paperwork it demands from doctors and hospitals; it denies care in order to increase insurers’ bottom line; and it obstructs any serious effort to control costs.

In contrast, a single-payer, improved-Medicare-for-all system would achieve all three goals – truly universal, comprehensive coverage; health security for our patients and their families; and cost control. It would do so by replacing private insurers with a single, nonprofit agency like Medicare that pays all medical bills, streamlines administration, and reins in costs for medications and other supplies through its bargaining clout.

The major provisions of the ACA do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we’ve seen how comparable reforms in Massachusetts and other states have worked over the past few decades. They have invariably failed our patients, foundering on the shoals of skyrocketing costs – even as they have profited the big private insurers and Big Pharma.

The Supreme Court’s ruling is not expected until June. Regardless of how it rules, we cannot wait for an effective remedy to our health care woes any longer, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane cure for our health care mess: single-payer national health insurance, an expanded and improved Medicare for all.

******

http://www.pnhp.org/news/2012/march/health-law-constitutional-or-no-fails-to-remedy-ailment-doctors-group


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Pro-single-payer doctors: Health bill leaves 23 million uninsured
A false promise of reform
For Immediate Release
March 22, 2010

Contact:
Oliver Fein, M.D.
Steffie Woolhandler, M.D., M.P.H.
David Himmelstein, M.D.
Margaret Flowers, M.D.
Mark Almberg, PNHP, [phone], [e-mail]

The following statement was released today by leaders of Physicians for a National Health Program, www.pnhp.org. Their signatures appear below.

As much as we would like to join the celebration of the House's passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem - the profit-driven, private health insurance industry - this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:
•About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
•Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
•Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.
•The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
•People with employer-based coverage will be locked into their plan's limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
•Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
•The much-vaunted insurance regulations - e.g. ending denials on the basis of pre-existing conditions - are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
•Women's reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn't have to be like this. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid - a woefully underfunded program that provides substandard care for the poor - could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers' health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill's passage reflects political considerations, not sound health policy. As physicians, we cannot accept this inversion of priorities. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That's enough to cover all the uninsured and to upgrade everyone else's coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to "wait and see" how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.

Oliver Fein, M.D.
President

Garrett Adams, M.D.
President-elect

Claudia Fegan, M.D.
Past President

Margaret Flowers, M.D.
Congressional Fellow

David Himmelstein, M.D.
Co-founder

Steffie Woolhandler, M.D.
Co-founder

Quentin Young, M.D.
National Coordinator

Don McCanne, M.D.
Senior Health Policy Fellow

******

http://pnhp.org/news/2010/march/pro-single-payer-doctors-health-bill-leaves-23-million-uninsured

[elleng]

1. No.

[Better Believe It]

2. Did you read all three articles before posting?

If not, please read them and reconsider.

Thanks.

[mother earth]

140. I agree, I think think there's going to be one hell of a backlash they just don't see coming,

and SINGLE PAYER is inevitable. Single payer was the best option from the start, it was never on the table, and that was never right.
Single payer will come, it's the only option that serves real health care.

I can't R this enough, BBI, kudos to you! Single payer for all!

(Edited to say this reply was made in error to elleng, it's for Better Believe It)

[DJ13]

3. Yes

[ProSense]

4. Here's

why they shouldn't: http://www.democraticunderground.com/1002465815

Only a moron like Lindorff would be advocating the RW position.

[muntrv]

5. The White House should have pursued the Medicare-For-Anyone approach.

[karynnj]

98. They did not have the votes - and that is per Bernie Sanders

He said that there were about 10 votes in the Senate for single payer - which Medicare for all is.

[blue neen]

6. No.

Thanks to this law, my son was able to have insurance...a 25 year old with a pre-existing condition.

I do believe it can and will be improved upon.

[Better Believe It]

8. What's your opinion of the private insurance requirement of the law?

The writer responded to the types of concerns you've raised writing:

"How can it be a good thing to kill a program that at least eliminates things like the denial of insurance coverage because of “pre-existing conditions,” or the throwing people off of coverage when they get seriously sick?

Because these reforms have come at the cost of keeping the insurance industry central to the whole health financing process, when all it is in reality is a blood-sucking middleman that makes its money by figuring out ways to deny care to those it is supposedly “covering.”"

The Supreme Court might throw out the mandatory insurance provision while upholding other sections of the health law.

[Jackpine Radical]

10. If they throw out mandatory coverage, it will destroy the plan.

The whole system is based on a universal consumer pool.

[Better Believe It]

11. It's not a public option pool. It's a private for-profit insurance industry pool.

And to sum up the bottom line of what this law really represents I prefer calling it the Private Insurance Industry and Big Pharma Protection Act.

It was their lobbyists and political representatives who wrote the law to protect their private profit interests and motives.

This law has little or nothing to do with protecting and providing universal quality health care at cost to the entire public.

Only a single payer system can do that.

[Jackpine Radical]

13. I'm not particularly defending Obama's plan.

Just pointing out that it can't work at all with no mandatory participation.

I assure you, as a provider and consumer of health care, that I would far prefer a single-payer system.

I do think the Obama plan will collapse long before it reaches full implementation, largely because of conservative opposition. This will be just one more source of societal stress, and it may help wake some people up. Maybe eventually a true universal Medicare system will arise out of the ashes, since there will be nobody left with enough money to pay for their own.

[joshcryer]

15. States can adopt a public option as Vermont has done and Oregon is doing.

The pressure to make public pools is immense.

[Better Believe It]

16. Vermont health bill mislabeled 'single payer': doctors group

Vermont health bill mislabeled 'single payer': doctors group
Physicians for a National Health Program says draft legislation gives wide berth to private insurers, falls far short of single-payer reform

FOR IMMEDIATE RELEASE
April 7, 2011

Contact:
Garrett Adams, M.D., president PNHP
David Himmelstein, M.D., co-founder PNHP
Andrew Coates, M.D., board member PNHP
Mark Almberg, communications director, [phone], [e-mail]

The following statement was released today by the national board of Physicians for a National Health Program.

Health reform legislation initiated by Vermont Governor Peter Shumlin was recently passed by that state’s House of Representatives and awaits action in the Senate.

Many journalists and commentators have portrayed this bill as fully embracing the single-payer approach to reform. We write to clarify the views of Physicians for a National Health Program on the Vermont legislation.

We appreciate the enthusiasm for progressive health reform shown by Gov. Shumlin and the many dedicated single-payer supporters in Vermont. However, it is important to note that the bill passed by the Vermont House falls well short of the single-payer reform needed to resolve the health care crisis in that state and the nation. Indeed, as the bill moved through the House the term “single payer” was entirely removed, and restrictions on the role of private insurers were loosened.

In its present form, the legislation lays out in considerable detail a structure to implement Vermont's version of the federal reform passed in March of 2010, which would expand coverage by private insurers and Medicaid. However, it offers only a vague outline of the additional reform promised by the governor and Legislature at such time when states will be allowed to experiment with alternatives to the federal program in 2017 (or 2014, if the effort to move up the date succeeds).

The Vermont plan promises a public program open to all residents of the state in 2017, but even then it would allow a continuing role for private insurance. This would negate many of the administrative savings that could be attained by a true single-payer program, and opens the way for the continuation of multi-tiered care.

Within the public program, the plan would continue to lump together payments for operating and capital costs, allowing hospitals and the newly established Accountable Care Organizations (ACOs) to use funds not spent on care for institutional expansion. Meanwhile, those with operating losses would shrink or close even if they were meeting vital health needs. This would perpetuate incentives for hospitals and ACOs to cherry-pick profitable patients and services, and hobble the health planning needed to assure rational investments in new facilities and high-technology care.

Under the legislation, many patients would continue to face co-payments that obstruct access to care, and the bill makes no mention of expanding coverage of long-term care. The legislation fails to proscribe the participation of for-profit hospitals and other providers (e.g. ACOs and dialysis clinics), which research has shown deliver inferior care at inflated prices.

Finally, the bill offers no concrete funding plan or structure for the public program that it promises.

We applaud the sentiments expressed by the governor and legislative leaders and remain hopeful that the legislation’s rhetorical commitment to further reform will become a reality. We urge the Vermont Senate to address the shortcomings in the House bill.

Much work, including efforts to enact federal enabling legislation – and continued advocacy by single-payer supporters – will be needed in the years ahead to achieve Vermont’s goal of universal access to high quality, affordable care.

*******

http://www.pnhp.org/news/2011/april/vermont-health-bill-mislabeled-single-payer-doctors-group

[joshcryer]

20. It is already in place. It is being funded by people choosing the public option.

As more states adopt a public option the pressure for all states to adopt it will be so immense that it's not even funny. For-profit cannot compete with non-profit.

[Better Believe It]

56. So "It is already in place" Please post the fee and benefit schedule for it.

How much does the Vermont "public option" premium cost and what coverage are individuals and families entitled to for that fee?

[joshcryer]

110. Ahh, it was passed into law, but is not fully set up yet.

http://healthreform.kff.org/State-Exchange-Profiles/Vermont.aspx

[joshcryer]

22. I see you edited your post. I did not, in fact, say it was single payer. You were talking about...

...a public option. The public option is not single payer. Please stop the right wing rhetoric trying to muddle the two ideas.

[Better Believe It]

55. I didn't claim you said it was a single payer system. I quoted the doctors press release.

Please read it.

[Better Believe It]

57. "Please stop the right wing rhetoric" Why do you think the doctors organization is right-wing?

Ahhhhh .... because they don't support what I call the Health Insurance Industry and Big Pharma Protection Act and they promote single payer Medicare for All!

Of course!

That's right-wing rhetoric!

Is supporting an increase in the minimum wage also a right-wing demand?

[ProSense]

58. You might

find this interesting: http://www.democraticunderground.com/1002473175

[joshcryer]

109. Muddling single payer and public option is right wing rhetoric.

Everyone who supports a pragmatic public option considers it a practical and politically feasible path to single payer.

[cali]

78. actually, we may well end up with single payer here in Vermont

and no the continued (and limited participation of private insurance) does NOT negate that.

Sorry, I don't think that PNHP is on target here.

[joshcryer]

111. Yes the public option turns into single payer relatively easy, imo.

[Sgent]

71. No they cannot

States have no control over the health spending of most employers (50+ employees) or the federal government (fed employees, Medicare, Medicaid, etc.). This means that most of the efficiencies promised by single payer will not happen.

"Single payer" insurance without a mandate is essentially community rating -- which is why insurance in NY is 4X that of any other state.

I'm for a singly payer system on the federal level, but states just don't have the authority to implement a reasonable system.

[joshcryer]

112. Tell that to Vermont.

[Sgent]

122. I don't live in Vermont

but I went to their website where I had the option of 3 insurance companies, which cost $450-$550 / month -- with a pre-existing clause.

It seems much saner than in my home state, but its not single payer, it still has enormous overhead for insurance companies, doctor's / hospitals, etc.

[emilyg]

32. Was discussing this

with a friend tonight.

[ProSense]

9. You don't

understand. Some people hate Obama and Democrats more than they care about your son.

They'd rather see the RW win and the law and all its benefits dismantled rather than see this bill remain an achievement for the President.

[SidDithers]

44. +1...nt

Sid

[eridani]

34. Too bad for kids whose parents don't have insurance themselves, or

---can't afford to add them. This illustrates the morally degenerate principal value underlying "reform." If you have money, you deserve health care. If you don't you deserve less or none at all.

[shcrane71]

54. And what happens to the 20-something who turns 26 or 27?

What if that young person finds him or herself out of a job, or in a job that doesn't have insurance? Then that American is just as unlucky as the rest of the close to 50 million uninsured Americans.

One thing that I haven't heard discussed the skyrocketing costs of pharmaceuticals. I know several asthmatics who are going without medication because their out-of-pocket prescription expenses are $500.00 a month. This is with high-deductible health insurance. I've heard people working for fortune-500 businesses, in HR, trying to push more of their employees into high-deductible, HSA programs. Read: if you get sick, you'll probably end up bankrupt.

[girl gone mad]

88. Unfortunately, many people can no longer buy..

insurance for their children since insurance companies decided to stop selling child only policies in some states because of this provision. I'm glad you got to save money insuring your son, but it came at a cost.

[blue neen]

134. Excuse me? I wasn't saving money. I was saving my son.

It was not a child only policy==he was able to be covered under his dad's employer's insurance policy..."because of this provision."

[arthritisR_US]

7. All I can say is, don't let perfect be an

enemy of good.

[elleng]

12. Exactly, arthr.

Been waiting and struggling for HOW many years for SOMETHING? FINALLY have something, providing a lot of coverage for a lot of people.

[arthritisR_US]

17. That's my sense too. Build on it and make

it stronger and better for millions. Work towards making it the end product you ALL deserve and leaves no one out.

[Better Believe It]

76. How does one build on something the insurance industry and big pharma have a legal lock on?

When millions are forced to buy private health insurance with high deductibles, high co-pays and limited benefits?

[arthritisR_US]

90. Deductibles, co-pays and benefit limits

can all be legislated out. Those were all legislated into our health care act making them illegal.

[baldguy]

41. +1000

[Tomay]

120. Exactly

I don't think anyone is saying that Obama's plan is perfect, but it's better than what it's replacing, and nothing better is actually achievable right now. Politics is the art of the possible.

[joshcryer]

14. Uh, no, if it gets struck down then health care will be rail roaded.

It will not have a chance at all to be fixed, it will be considered a "failed experiment" and so on.

It will take decades to fix the problem, after many people die and suffer miserably.

It can, however, be fixed if it is allowed to take effect and people come to appreciate what it offers even with its failings.

[pnwmom]

19. +1000. n/t

[TheKentuckian]

37. Fix what? The underlying system is fully the existing system.

The most substantial "reforms" are a mandate for something like 85% of the working age population to buy from the company store, an individual mandate to buy a for profit product at the discretion and selection of our employers and a key to the treasury for the insurance cartel. To sweeten the pot their are a few pay to play features meant to smooth a few inhumane rough edges along with a little market for a heavily sequistered part of the population.

We still have overwhelmed states regulating, we still have massive pool fragmentation, we still have employers as the gatekeeper, we have about no price controls, cost controls are via tax dollar making up the gap, the insurance cartel is still our access point to healthcare and decide what care we may have and what medications and doctors we have access to, the delivery system is unchanged.

We have the same system, I guess you can say the Wealthcare and Profit Protection Act builds on the existing system, so I reckon we could build on this rotted pile of fail somemore but the foundation is rotton.

The biggest lie on both sides of the aisle is that we are getting a new healthcare system, it is not remotely the case. By no metric is it even passable as such.

Yeah, we can "build on" alright. We can increase the penalties for not taking coverage, add more tools for the IRS to get your money for the cartel, we can get the cartel more money out of the treasury, we can increase cost sharing, and tax benefits more.
"Fix it later" is sales spin, there are no structures to "fix" that we don't have today. The plan is an old Republican scam designed to prevent reform of any substance, and is certainly to reenforce the cartel not replace it.
This "intervention" is for the benefit of the cartel, without hundreds of billions of tax dollars and requirement to buy their "product" their suicidal model and some tough demographics threatened to bring the whole works down over the next few decades or less.

What we have to fix is the structure, adding a feature so the people don't kill the insurance execs here and there is not building.

[JoePhilly]

46. If the ACA is overturned Dems won't even think about National Healthcare for 50 more years.

It will become political suicide.

The GOP will then use this as its path to killing Medicare and Social Security.

[SidDithers]

59. +1...nt

Sid

[TheKentuckian]

77. Bullshit, for no other reason than the cartel cannot survive 50 years with their current model

They have to have compulsory customers and a rather large amount of tax dollars to make it. Otherwise, they will price themselves out of existence and as they do more and more will be forced to drop coverage because they simply cannot afford to do otherwise or get so little value out of their thousands per year of investment that taking their chances makes more sense.

The cartel doesn't have 50 years, they have 10-20 before the weight of the demographics swings too far and they don't have the subscriber base. CBO projects the Wealthcare and Profit Protection plan out at least that long and is designed to keep the golden goose laying her eggs.

[JoePhilly]

81. Democrats will be paralyzed, and do nothing.

As more and more fall into the ranks of the uninsured, the cost of that that gets passed on the government will increase, and the debt will rise. Medicare will be killed in response.

Meanwhile, the GOP, will turn its sites on medicare, and argue that the overturning of the ACA is the precedent for killing Medicare because people are "forced" to buy into it ... if you can create a tax to fund ACA, you can't have one to fund Medicare.

The stateless super rich will simply move on as the industry consolidates into fewer and fewer "providers".

Meanwhile, the democrats will be unwilling to mount sufficient support in the House or Senate to create national healthcare.

Rather than use the ACA as something to build on and extend, we'll go back to a point before HillaryCare was debated.

[joshcryer]

115. Of course it can't, but in the intrim people will die and suffer miserably. We agree.

You just don't grasp the implications of letting the cartel die out over 50 years (probably closer to 20-25). People will suffer unnecessarily. This is not a progressive view, to just cynically allow the system to collapse and hope for some Marxian material dialectics to fall into place. Totally dystopian if you ask me.

[TheKentuckian]

136. Proping it up to try and get a couple generations out of it, has no costs?

The accompanying destruction on our entire economy won't result in far greater and more widespread pain when the end finally comes?

Be serious, I'd be far less cynical if there was the slightest indication of using the little time this duct tape and spit job would buy to change course but there isn't which means it will fester and fucking explode.

I don't see punting an ever growing world of shit down the road so you don't have to live with the pain as any kind of nobility or virtue. I'm here too. I've got no magic shield or harbor to hide in during the shit storm and have no illusions about it being some speedbump, I just think it is better dealt with now than in a time of greater scaricity and far greater level of dependency. The insane percentage of the economy being ever dumped into the black hole is also discouraging for the prospects of the future being better able to tackle the task.

The crash will come. Be it in 10-20 years without this scheme or in 35-50 with it propping up the suicidal and predatory monstrocity. The choice is how far down the road and who pays the interest (aka whoever is holding the bag when the music stops) not whether there will be massive suffering but how much and what resources will be available to move forward.

[TheKentuckian]

138. Then it is our duty to make it suicide not to work for universial care.

Make it impossible to run as a Democrat otherwise and stick to hell and highwater.

You are also just incorrect, reality will dictate the mess be dealt with, the money isn't there to keep the game going anywhere near that long, at this rate before then healthcare will account for 100% of the economy, things will come to a head long before that. The only way this circus can stay open 50 years is compulsory customers and trillions of dollars over those decades from Uncle Sam to make up the difference in what they want to charge and what the people can pay.

We'd be lucky to get 50 years out of this model with the Wealthcare and Profit Protection Act to bolster it, no way without it.

[jeff47]

51. You're kind of obsessing over what it says today

The idea of expanding and "fixing" in the long run is to change it.

Here's what's going to happen over the next 20 years or so:

Exchanges get set up.

The ACA phases out the tax benefits for companies to provide health insurance. So gradually more and more people will end up on the exchanges.

More people on the exchanges provides cover for creating the public option in the exchanges. Especially when the private insurance companies abuse the system (and they will).

Since the public option is non-profit, it should be cheaper than the insurance companies. That will cause lots of people to choose it.

Those people won't die any more frequently than the people covered by private insurance, which will get rid of the irrational fear.

Result: De-facto single payer. Sure, it's a Rube Goldberg contraption, but it gets there.

[TheKentuckian]

86. What it says now is exactly what it is, Jeff.

I'm stuck on your second point, the law doesn't provide ramping to the exchanges at all. Cutting the tax benefit simply shifts more of the costs to the consumer. If your employer provides coverage you are required to take it and you are barred from the exchanges. All ramping efforts were beat back.

You are hoping that employers will give up the control and drop coverage and I see ZERO indication of any such intent. The resistence to cutting out the employers was intense in the movers and shakers level and every effort was repelled and even scoffed at openly.

The dots do not connect in the legislation and evaluating a law as it is written is far from an unfair way to judge it.
If the ingredients are flour, rice, and corn it is unreasonable to expect fried chicken to be the outcome.
Faith is for spiritual matters and personal relationships not laws, politics, and certainly not politicians.

This idea is decades old and designed with a purpose and it isn't some winding path to single payer, not even over decades.

It is not hopeless but it is clearly not the intent of the law. For any serious hope, employers will have to drop coverage en mass and that is not the plan right now and it will be some years to see enough change of heart to turn the tide.

My focus is on what is there because it is what is there. Obsession is not defined by primary focus on the observable universe.

[jeff47]

93. It's hidden in your 3rd sentence.

If your employer provides coverage you are required to take it and you are barred from the exchanges.

Employers provide coverage because there are large tax benefits for providing coverage.

Those tax benefits will disappear, since the ACA will add additional taxes on "Cadillac" plans. And the definition of "Cadillac" plan isn't indexed well, so essentially every plan will become a "Cadillac" plan over the next decade.

[joshcryer]

114. No it isn't. HHS's rules have completely changed the health care landscape.

There is only one outcome if the system is allowed to run its course.

[TheKentuckian]

139. Comedy GOLD!

Same delivery system, same gatekeepers, states still regulating, same access point (employers), same revenue streams (though augmented in some cases by Federal subsidies), no penalties other than possible exclusion from exchanges and no budget for enforcement=the same underlying system.

Hell, my man the insurance cartel still enjoys the only anti-trust exemption outside of MLB.

[Major Hogwash]

39. Absolutely agree with your assessment.

The idea is for them to kill this national plan by beating on it from the extreme right and from the extreme left.

Even though the idea of a national health care plan is favored by over 2/3rds of the country.

The same people that are hoping today that the Supreme Court rules against this national plan are the same people that were criticizing it 3 years ago.

[pnwmom]

18. I strongly disagree. The last thing Rethugs would go for, while they're trying

to get rid of Medicare altogether, is to create Medicare for all.

And the chance that we would have a 60 vote majority in the Senate and a majority in the house is tiny, no matter what we do between now and then.

[Better Believe It]

23. How many Democratic Senators would you need in the Senate to get 60 votes for single payer?

Without a mass movement demanding it during a deepening medical crisis probably about 130 Democratic Senators.



Well, they have really convinced us that 60 votes are now needed in the Senate to pass legislation, haven't they!

Well, we actually need 60 votes to end phantom Republican filibusters. And in truth not even 60 votes are necessary to end fake filibuster procedures.

[Proud Liberal Dem]

25. Single Payer is supposedly very popular among the public (so we keep hearing)

why can't we ride that groundswell of popular support all the way to the ballot box?

[Better Believe It]

60. Why won't Democratic Senators even co-sponsor Senator Sanders single payer bill?

The last time I looked I couldn't find any. Sanders was by himself.

I'll check later to see if the bill finally has any co-signers.

[Proud Liberal Dem]

84. Probably because most know/knew it's not going anywhere right now (and not even 2009-2011)

If so many people want it, then they need to beat the streets and get people in positions of power to do something about it. That's what more people whom were unhappy with PPACA should've done in 2010 instead of refusing to support Dems and/or not voting and letting the Republican Tea Party swamp most of the country and the US House of Representatives and try to tear PPACA apart even before it's been fully implemented. It's interesting that so many people can be for single payer for all yet still so many more are easily brainwashed into believing Republican lies that even the modest PPACA has ushered/will usher in "death panels" for granny, or that government has now taken control of 1/6 of the economy, or that we now have "socialized medicine" or government-run health care in this country. Single-payer is a worthy goal and I and most forward-thinking people support it but it's not going to be easy nor is it going to happen overnight..........unfortunately. We've got to keep electing forward-thinking progress-oriented people to government at all levels and make it difficult for Republicans to hold elective office and/or to govern in such a regressive manner. It will take time and effort but as long as we don't get apocalyptic about every defeat and we decide to redouble our efforts instead of giving up, we might actually win this fight IMHO.

[DonCoquixote]

21. When Social security was made

there were many that called "IT" a compromise, and though FDR was a fascist. That spirit is alive and well. Granted, not like Romney can run against this plan either, but they who want the perfect simply give evil the chance to make sure nothing ever gets started, period.

[eridani]

35. SocSec did NOT mandate purchase of retirement plans from Wall Street n/t

[DippyDem]

53. But SocSec did mandate withdrawals from your paycheck. n/t

[Better Believe It]

61. To cover a government, not private, retirement program.

[DonCoquixote]

97. And that changes

the fact that the extreme left fought FDR tooth and nail to get social security, or that they did not burn out LBJ, who made medicare?

[eridani]

99. It was the extreme left that guaranteed that Roosevelt had to come up with something

And what he came up with was a program run by the GOVERNMENT.

[DonCoquixote]

113. and you think

that this congress will allow that? But go ahead and see Obama fall so that Mitt can stuff the court with people that make Scalia look like a marxist.

[eridani]

121. Obama will make mincemeat of Mitt on health care no matter what the court decides

Mitt's MA reform is identical to Obama's, and Obama will not let him get by with denying that.

This "what congress will allow" horseshit is really sickening. It means that Dems can't think of a single thing to do other than to passively allow repukes to set the terms of the political battleground.

[DonCoquixote]

124. call it horseshit

but I have to hear people defend their democratic congressperson, even if it is someone like mary landrieu that demanded the oil rigs be open now, ecology be damned.

[eridani]

131. I'm not talking about any specific policy

I'm talking about setting the terms of the debate! Why do Dems have to be so fucking passive, accepting repuke framing as if it were inevitable that it should be the ground of all public discourse? Thank heavens for OWS--at least some people have the guts to stand up and start changing basic premises.

[Proud Liberal Dem]

24. In a perfect world

if "Obamacare" gets struck down, a bipartisan group of legislators would get together and come up with a better plan to replace it. As should be painfully obvious by now, we don't live in that particular world with the Republican Tea Party running amok. The fact that we BARELY got what we got should remove any doubts as to whether we could have gotten something better or even single payer. We should IMHO consolidate our gains under the new law, make sure the key benefits get implemented, then work like hell to get a progressive majority elected to Congress to help tweak the law and fix some of its flaws and perhaps make it into the single-payer system that we want. The Republicans want to destroy it completely and take us back to health care system as it existed on 03/22/10 and before and will not fix a g-d single thing! We need to mend the law NOT end it IMHO but the only way that will happen is if we get a progressive majority elected to Congress and/or state legislatures willing to do it. Let's stop sitting around talking about what we didn't get. Let's figure out what we want and elect people whom promise to deliver it!

[nadinbrzezinski]

26. And in this magic world

Medicare for all will be passed next day.

Wow!

[Better Believe It]

27. And how many Democrats are needed in the Senate to pass Medicare for All? 51? 60? 70? More?

[nadinbrzezinski]

31. If the congress and senate of 2008 did not teach you this

I don't think it can be done.

In an ideal world...alas we don't live in one.

And I am all for single payor, in the current environment it ain't happening.

[Better Believe It]

62. Do you think 80 Senate Democrats would be enough to get it passed?

It's possible that 20 or 30 of those Senators would be "centrists" opposed to Medicare for All.

Good luck with electing 50 progressive/liberal Democrats that support Medicare for All to the Senate!

You need a mass movement in order to accomplish anything in this country.

That's our history.

The politicians, Republicans and Democrats, can be pressured into doing things they would not normally support if there is a big enough movement demanding progressive changes.

Nixon supported affirmative action and he was a fricken bigot!

Some Republicans supported voting rights and civil rights laws in the 60's. They had to.

[nadinbrzezinski]

69. And we don't have that right now

Learn to read please. In the current environment it ain't happening.

[Better Believe It]

79. And when do you think 80 Democrats will be in the Senate?

All the polls indicate that the current environment among most people favors Medicare for All.

Of course the politicians bought and paid for by the health insurance industry are opposed to a single payer system or even a public option!

If Democratic politicians in Congress act on behalf of Wall Street and corporate America and don't support the public on Medicare for All and other issues do you advocate voting for those same politicians again, and again and again?

Now that's a winning strategy if I ever heard of one!

I'd call that banging ones head against a wall and hoping for a better outcome.

[nadinbrzezinski]

82. Once again, in the current environment it ain't happening

Yes, people favor single payer, yes by huge majorities. Show me the national MOVEMENT for it.

When you do, I will start listening.

(there is the begginings of one, from history not in my lifetime, it will take GENERATIONS).

Yup, let me join you.



It is declared unconstitutional not in my nephews children's lifetimes.

[Better Believe It]

101. It could take generations to achieve single payer if the insurance industry law is allowed to stand.

[nadinbrzezinski]

102. I prefer to live in reality

Potentialy the occupy movement could be the heart of such a movement. It s a lifetime movement, or a revolution, read a hot bullets and messy and all... I might add, I will not dare predict what will happen in such a scenario beyond probably the Balkanization of the US.

As to this law...it is well within how change happens in this country.

Good luck.

At this point I think we will continue to bang head, as no reason will work here.

Have a very good and long day.

[Better Believe It]

129. That "reality" accepts without a fight the domination of health care by Wall Street.

I don't think surrender to the insurance carriers and big pharma is a winning strategy.

[nadinbrzezinski]

133. In your imagination

But whatever...time to send you on a long vacation.

[elleng]

28. You got it, dear Nadin!

[Johonny]

29. +1

If people without health care is the trigger that is going to push for medicare for all solution and this state has existed for years and years. Why now? Why with a majority of conservatives in the house that don't even back a conservative health care bill and are pushing a budget the privatizes medicare should I or anyone think Congress would move towards a single payer system if the health care bill fails in court. More than that if the health care fails in court it will probably have broad ranging implications for the government to regulate interstate commerce.

[TheKentuckian]

100. Good. At least by what I assume your definition of regulate is.

Which seems to include compel and/or punish inactivity which is well beyond regulating activity entered into by free will.

It is one thing to tell me how fast I can drive on a particular road, it is another to tell me I must drive on a particular road, and yet another to tell me I must drive. Just to bring it up a notch the current argument seems to be that not only must you drive but that your employer will select your car for you but of course you will pay for it.

It is one thing to say, "TheKentuckian, if you are going to raise soybeans you have to deal with limits on your production or inspection of your product if it goes to market" and a wholly different critter to say "TheKentuckian, you have to grow soybeans" and even another to say "you have to grow soybeans but actually you have to pay Dave here to do it and provide his water, tools, seed, and whatever it takes to grow them" and still some other fucked up monster to tell me that my employer will be assigning a task outside work hours that I must complete in the interests of interstate commerce.

What doesn't at least impact interstate commerce? If you argue the power is unlimited, then what kind of government is created? How is that different than what we have fought for generation after generation to get away from?

Folks are arguing for the government to be able to dictate after tax spending and the ability to compel activity.

I almost hope some TeaPubliKlan makes us all buy employer selected firearms and porn with post tax dollars to teach some people a lesson...almost, I have no desire to be in any such arrangement regardless of the intentions or product.

I'm fucking astonished that so many find such things even remotely tolerable. The campaigning for unlimited power (sometimes unchecked power), I find against my grain to the point of being near feeling it is insane and certainly dangerously authoritarian. Particularly due to the high level of dangerous authoritarians in and around power in our country but also because history demonstrates throughout that such power attracts a bad lot.

Pleading for such a completely unbounded precedent and for so little in return, honestly is shortsighted and pollyanna, at best. I despise it and think it is idiotic big picture-wise from supposedly liberal people, it is a hard anti-self detemination move that GREATLY benefits from being seen through the lens of "healthcare" that is in no way whatsoever limited to "healthcare".

I really don't get it, what the hell is the thinking? Are we trying to be drones in a hive? Slaves? Serfs? Some new form of "small people" at the command of the state? Makes me fucking sick to tears.

[ProSense]

30. Well,

there is the "don't get sick plan"

...or we could simply apologize.

[Codeine]

67. That they actually believe that

is testimony to their complete denial of reality.

[cherokeeprogressive]

33. In the context of the Individual Mandate, it's not a "tax". The intent of a "tax" is to generate

revenue.

In this case, the only people who will be "taxed" will be those who don't enter into a contract the government INSISTS they enter into. That's not a tax, it's a punishment; a penalty if you will.

I think a majority of those who support the Individual Mandate tend to forget that we don't have a national government... we have a federal government.

Using Mass. as a precedent for the Individual Mandate doesn't work because a state CAN force its citizens to buy insurance. The federal government has no authority to force the citizens of all states to do anything that isn't already enumerated in The Constitution.

[jeff47]

52. The mandate is easily covered by the commerce clause. (nt)

[cherokeeprogressive]

126. You should have called the Supreme Court before they had their meeting today then.

That way they could have skipped the whole dog and pony show.

I'd be surprised if, in a reading of the opinion striking down the Individual Mandate one didn't stumble upon something to the effect of "The government cannot create commerce simply to have commerce to regulate".

[jeff47]

130. Actually, I found today's coverage to be far too "chicken little"

Scalia said bad things about the mandate!!!!

Ooo....surprising.

As for your argument, it has a pretty big error - medical and insurance commerce is already happening. There is no creation of commerce.

Realistically, this case will come down to two things:
-Kennedy decides to apply existing precedent and thus rules it constitutional. Or he goes Bush v. Gore and decides to rule in the face of precedent.
-Roberts lets his politics overrule his logic, or can't, much like his love of grammar caused him to botch the oath.

[jmowreader]

36. No. Fucking. Way.

If the PPACA is killed by the Supreme Court (which is not as likely as one would think, since the Heritage Foundation largely designed it; if a Republican president's signature was at the bottom of this exact law everyone on the right would brag about how this law "mandates you to take responsibility for your healthcare"; I think the major reason the Right is against the law is because the Democrats got it through, and Republicans are required to be against everything Democrats like. Hell, if Obama were seen on television eating hot dogs and apple pie while watching a baseball game, the Republicans would denounce hot dogs, apple pie and baseball.) it would be replaced by "GOPCare"--allowing health insurance to be sold across state lines. This of course would mean the health insurance companies would simply consolidate in either West Virginia or Pennsylvania, whichever one gave them the best tax treatment, because PA and WV are the two most expensive states to buy health insurance in because of all the coal mining they do there. They would almost certainly also remove the requirement that public hospitals treat anyone who walks through the door without regard to ability to pay.

The difference:

"ObamaCare": "You must buy health insurance."
"GOPCare": "You must buy health insurance from a company in West Virginia."

[DonCoquixote]

38. BINGO

Eever wonder why almost all credit card companies are in VA, AZ, DE or SD?, because those states wrote their laws to cater to the industry, which is a nice way of saying they became corporate bordellos. If you think they shall not do the same with health care, you are made.

Yes, the mandate sucks...I wish he never picked it up, however, let us not fool ourselves, despite the wishes we have, America is frankly too stupid, greedy and immature to even understand what single payer IS at this point. If the measure dies, all the people who go "yay, we can do single payer" will be deaf to the narrative which will be blasted "that people want da gbbt outta health care,and that Obama is too far left."

The right loves the Naders and hamshers, which is why they give them MONEY..The proper term is "useful idiots."

[FSogol]

50. Slightly OT, but what credit card company is in VA? n/t

[DonCoquixote]

89. Capital One and several others

They used to be Bank of Virginia before the name change.

[pampango]

40. Check out the "friend of the court" briefs (record number) in this case. Who's for and who's against

http://go.bloomberg.com/health-care-supreme-court/2012-03-01/health-care-primary-sources-statutes-court-opinions-briefs/

Merits Briefs for the Petitioners

Brief of the Department of Health and Human Services et al. regarding the Minimum Coverage Provision
Brief for the Department of Health and Human Services et al. regarding the Anti-Injunction Act
Reply Brief for the Petitioners on the Anti-Injunction Act

Amicus Briefs in Support of the Petitioners

Brief for AARP
Brief for American Nurses Association et al.
Brief for Blue Cross and Blue Shield of Massachusetts
Brief for Constitutional Law and Economics Professors
Brief for 104 Health Law Professors
Brief for Constitutional Law Scholars
Brief for Child Advocacy Organizations
Brief for the NAACP Legal Defense and Educational Fund, Inc. et al.
Brief for the California Endowment
Brief for the National Women’s Law Center et al.
Brief for Prescription Policy Choices et al.
Brief for the Jewish Alliance for Law and Social Action et al.
Brief for Health Care For All et al.
Brief for California Public Employees Retirement System
Brief for Law Professors Barry Friedman et al.
Brief for Lambda Legal Defense Fund, et al,
Brief for David R. Riemer and Community Advocates
Brief for Department of Health and Human Services et al.
Brief for the Governor of Washington Christine Gregoire
Brief for Health Care Policy History Scholars
Brief for Senate Majority Leader Harry Reid et al.
Brief for Small Business Majority Foundation, INC and the Main Street Alliance
Brief for State Legislators
Brief for the States of Maryland et al.
Brief for Service Employees International Union and Change to Win
Brief for Economic Scholars
Brief for the American Federation of Labor and the Congress of Industrial Organizations

Merits Briefs for the Respondents

Brief for the State Respondents on the Anit-Injunction Act
Brief for Private Respondents on the Anti-Injunction Act
Brief for the State Respondents on the Minimum Coverage Provision
Brief for Private Respondents on the Minimum Coverage Provision
Reply Brief for State Respondents on the Anti-Injunction Act

Amicus Briefs Supporting the Respondents

Brief for Citizens’ Council for Health Freedom
Brief for the Cato Institute et al.
Brief for Association of American Physicians And Surgeons, inc., and Individual Physicians
Brief for Judicial Watch, Inc.
Brief for American Catholic Lawyers Association, Inc.
Brief for the American Center for Law and Justice et al.
Brief for the American Legislative Exchange Council
Brief for American College of Pediatricians et al.
Brief for the American Civil Rights Union et al.
Brief for the Cato Institute
Brief for Gary Lawson et al.
Brief for the Catholic Vote and Steven J. Willis
Brief for Center for Constitutional Jurisprudence et al.
Brief for Citizens and Legislators in the Fourteen Health Care Freedom States
Brief for Citizens’ Council for Health Freedom
Brief for the Commonwealth of Virginia Ex Rel. Attorney General Kenneth T. Cuccinelli
Brief for Docs4patientcare et al.
Brief for Employer Solutions Staffing Group
Brief for Egon Mittelmann, Esq.
Brief for Former U.S. Department Officials
Brief for the Foundation for Moral Law
Brief for HSA Coalition, Inc. and the Constitution Defense Fund
Brief for John Boehner
Brief for the Landmark Legal Foundation
Brief for Liberty Legal Foundation
Brief for Members of the United States Senate
Brief for the Mountain States Legal Foundation
Brief for Oklahoma
Brief for Partnership for America
Brief for the Rutherford Institute
Brief for Senator Rand Paul
Brief for Stephen M. Trattner
Brief for the Thomas More Law Center et al.
Brief for Virginia Delegate Bob Marshall et al.
Brief for the Washington Legal Foundation and Constitutional Law Scholars
Brief for Authors of Origins of The Necessary and Proper Clause and the Independence Institute
Brief for Economists
Brief for the Independent Women’s Forum
Brief for the Tax Foundation
Brief for the Missouri Attorney General
Brief for Montana Shooting Sports Association
Brief for the American Life League
Brief for the Caesar Rodney Institute
Brief for Liberty University, Inc. et al.
Brief for Project Liberty

Amicus Briefs Supporting Neither Party

Brief for the Health Foundation of Greater Cincinnati regarding minimum coverage

Merits Briefs for Court-Appointed Amicus regarding the Anti-Injunction Act

Brief supporting vacatur

Amicus Briefs Supporting the Court- Appointed Amicus

Brief for Tax Law Professors
Brief for Mortimer Caplin and Sheldon Cohen

Amicus Briefs Supporting the Respondent regarding the Anti-Injunction Act

Brief for the Liberty University, Inc. et al.
Brief for the Cato Institute
Brief for the American Center for Law & Justice
Brief for Center for the Fair Administration of Taxes

[Better Believe It]

63. And what is the position of the health insurance industry and big Pharma? They wrote the law.

[joshcryer]

135. Wow, what strange bedfellows they have.

Thanks for the source.

[rucky]

42. If the court says the Federal Government can't mandate

people to buy insurance, wouldn't that ruling also apply to single payer?

I know that would be up for debate, but a ruling against the mandate certainly doesn't clear the path for single payer, either. I think there's some risk to the thought that the people opposing the mandate would throw their support behind single payer.

[laundry_queen]

85. That would be the biggest argument

for 'Medicare for all'. Government can make people pay taxes, and they can create programs to help people. If the SC rules they cannot force someone to buy insurance - now I'm wondering if there's a difference between forcing someone to buy for-profit insurance, or forcing someone to buy non-profit insurance and if the SC will distinguish between the 2 - then the only way Americans will get universal coverage is through government healthcare. Period.

[SidDithers]

43. Keep trying...nt

Sid

[FSogol]

45. Unrec. More RW BS. n/t

[mmonk]

47. I agree but unfortunately, both political parties are married

to corporations. Citizens United will close the door. We are a corporate state now by ruling of the Supreme Court (even if these jokes of justices in the majority won't admit it).

[Motown_Johnny]

48. Then just pass Medicare for all, there is no need to throw out

the current reform to do that.

This article is pure B.S. !

[JustABozoOnThisBus]

49. Kill ObamaCare now, and we, the right-wing Republicans ...

... will surely put a single-payer medical system in place. Because we care.

Trust us.



:heh-heh, suckers!:

[Ikonoklast]

64. Advocated by people that HAVE health care who want the system thrown into

"crisis mode", as if that will then *magically* make everything perfect because they say so.

Meanwhile, millions will suffer as it takes a generation to re-implement any type of health care reform.

What total bullshit.

Why hasn't that worked already?

The ACA will lead to an increasing demand for a public option, which in turn will lead to single payer eventually.

More right-wing friendly propaganda espoused by the left-wing "LET EVERYTHING FAIL AND SOCIALISM WILL NATURALLY ARISE!!" crowd.

As if the opposition to every type of public safety net from the Right will magically cease to exist.

[TheKentuckian]

92. Why and how is a system designed to prevent anything like single payer going to usher it in?

How is propping up the existing system (and it is the existing system) going to hasten its demise?

Mandating participation and hundreds of billions of tax dollars is no making the insurance cartel go away quicker than the suicidal model. Going as we were, a near majority would be priced out in a decade or so and the rate of growth so extreme that the economy as a whole would be unable to cope in another ten.

The Wealthcare and Profit Protection Act will, as it was designed to do, preserve and protect the existing for profit system.

Crisis mode would not create "perfection" but rather destabalize control and kill profits which would allow the potential for a systemic replacement over the next decade or two. Avoiding crisis mode, props up the predatory system. Avoiding the worst pains of crisis mode allows misconceptions about the system to continue to be brushed under the rug and for people to take nonsense on faith. No pain, no gain. Too many times no pain means no imepetus for gain.

"Curbing the worst excesses" allows for other excesses to continue but with less groaning, particularly among the fickled suburban crowd that is usually comfortable but starting the frey a bit. Make the cartel take their money and cover their kids and they will go along. Give the worst off of the working poor something to help with any tinges of guilt and the game can continue for the foreseeable.

There are middle grounds possible but not provided for in this law. This law's sole purpose is to continue the extraction without the mine crashing down on their heads.

Your why hasn't it happened already is simple. Most people not only have coverage but have no serious need under it. Such people simply want lower premiums, regardless of what they cover in actuality.

The picture changes with 40% with no coverage and the 60% slipping due to costs. Most people don't have a serious illness, a pre-existing condition, most never see the full cost of their premiums, most have no idea what is covered or excluded. Nor is it critical what is in and out of network. Most people pay their share right out of their check, go to a doctor one or twice a year, and maybe fill a couple of basic prescriptions. The structural problems and the pain they cause are not seen by most. This is why the basic premise of reform has substantial resistance, much more the actual details of the "reform" we have come up with.

All most people really want is a lower expense so that is why "selling across state lines" shit sells, and why high deductible and even junk plans have a following. Those same people are QUICK to cry for help when some actually has a problem that means they have to use their comprehensive coverage or fight to get the payer to get something covered...QUICK.
They change the fuck out of their tune when the reality of that 10k deductible, 70% coverage, and 20k out of pocket hits them in the face. Those without an out of pocket max, find themselves begging for charity and apply for medicaid, and/or "dying quickly".

[Jennicut]

65. It is this law or nothing.

No one is going to attempt another round of health care reform anytime soon, it is incredibly politically damaging. Cowardly yes, but logical if you are a politician. It is more complicated then taking a poll on single payer. Getting anything through congress these days is a monumental task and anyone that thinks otherwise is incredibly naive.

I have a pre-existing condition. I will take this law for now. It is not perfect. It is better then what we had before. Some people are angry about being forced to pay for for-profit health insurance. I get that. But some people are also not lucky enough to even qualify to buy that insurance unless health insurance companies are forced by law to cover those people. And this law relies on everyone being covered to pay for someone like me, who has type 1 diabetes. Therefore, there is a mandate. Single payer would be so much better. But I am not about to believe that somehow that will rise from the ashes of this law being struck down. Some people have nothing to lose from this law being gone while others are incredibly torn. If my husband lost his insurance, I have no guarentee that I would even be covered again. My insulin, strips, needles and lancets cost over $700 a month without insurance. No way I could even pay for that. I would skip checking my blood 4 to 5 times a day. As it is, I can't afford an insulin pump (a couple thousand, my insurance company won't help pay for it) even though I would be better off with one.

[Better Believe It]

66. Nurses: Health Care Crisis Will Continue No Matter How Court Rules

Read the National Nurses United news release at:

http://www.democraticunderground.com/1002477568

[K Gardner]

72. As a nurse, totally agree. Single payer is the only solution. n/t

[SidDithers]

73. But the belief that single-payer will rise from the ashes of a repealed ACA is insane...

single-payer will grow from an expanded and refined ACA. If ACA dies, so does any other attempt to provide healthcare for at least a generation.

Sid

[DonCoquixote]

95. and if congress could not get the ACA done right

what makes you think this nation is even capable of single payer? It can be done, but only after a successful program manages to come in first and say "hey see, socialism is not bad" even so, the mob will still fight, witness the medicare and ss using teabaggers who riot from their Medicare bought carts. No, this nation cannot make single payer without something lighter first. Yes America is too STUPID and GREEDY to do single payer directly. however, once they enjoy something lighter, than they will swallow more.

[Lisa D]

68. No.

[SOS]

70. Funny stuff

"By killing the whole “Obamacare” law, the court will throw the system back into crisis mode, forcing the public and the political system to finally consider the only real answer: expansion of the Medicare program to cover everyone."



A Democratic Congress and White House couldn't even get the Medicare age lowered to 55.

Mr. Lindorff seems to be under the absurd impression that Congress works in the interest of the American people rather than Wall Street.

He needs to wake up and smell the oligarchy.

[EFerrari]

74. Steffie Woolhandler was on Amy's show this morning.

http://www.democracynow.org/2012/3/27/healthcare_debate_as_supreme_court_hears

[ProSense]

80. Interesting

DR. STEFFIE WOOLHANDLER: Well, I want to say, our organization, Physicians for a National Health Program, did not take a position on the Supreme Court deliberations. Some of the members opposed the mandate and did weigh in in the amicus brief. Some were more ambivalent and felt that there was some good in the bill. What we all agree on, however, is that the bill is not a solution. It will leave 27 million Americans uninsured when it’s fully implemented. It’s going to leave tens of millions of Americans woefully underinsured, with gaps in their coverage like copayments and deductibles, so they’ll still be bankrupted by illness. And it’s not going to control cost. So we still need single-payer national health insurance regardless of what happens at the Supreme Court.

AMY GOODMAN: Do you care if the Supreme Court were to reject it, say the individual mandate is not constitutional?

DR. STEFFIE WOOLHANDLER: Well, the individual mandate is a very, very bad idea. The good parts of the bill are things like a Medicaid expansion, which does not require an individual mandate, some regulations on the insurance industry, which does not require a mandate. All of those could have been done without the mandate. The problem with the mandate is it’s telling people that they have to turn over their money to the private health insurance industry. There’s also $447 billion in taxpayer money that is going to be turned over to the private health insurance industry. So the bill is strengthening the position of the private health insurance industry, the very industry that’s responsible for $380 billion in wasted healthcare dollars on bureaucracy and paperwork.

[Uncle Joe]

75. The mandate is unConstitutional.

Thanks for the thread, Better Believe It.

[WinkyDink]

117. EXACTLY.

[JNelson6563]

83. Ah yes, the old "all or nothing"

As ineffective a mindset one can find.

Still it's good to see you still posting your usual anti-Dem stuff. A few constants in the world make it seem more stable than it really is.

Julie

[wyldwolf]

87. "forcing the public and the political system to finally consider the only real answer"

..and how long would that take?

The writer thinks the public is going to wake up the next day and say, 'oh shit, now what?'

In actuality it could take another generation or two to ever take up the issue again.

[spanone]

91. bullshit.

[mikekohr]

123. ditto that bullshit call

[librechik]

94. never ceases to amaze me that some folks believe the Right will suddenly come to their senses

if we are in crisis mode. That the urgent need will cause them to work together with Democrats to solve the problem rationally.

I wish that would happen but it is merely wishful thinking.

The Right will engineer crisis on purpose to profit from it. Their interests demand that they prolong crisis as much as possible in order to profit. Being faced with a system that will fail and kill thousands is just what they want and like. Their moronic devotees will revel in the misery because they will continue to blame it on the Left or Obama and use it to win elections. They will turn their followers against us for failing to do the impossible.

I think the only chance we have is to preserve the ACA with the mandate and use the law to gradually force private insurance companies out of the subsidy patient market. That;s the only way we can keep preconditions in the service and still move forward. I have every beleif that SCOTUS will help their corporate masters by saying yes to the mandate--after all, there is much profit to be made as the system transforms.

[lumberjack_jeff]

96. Meh. What do I care? My mom was natural born Canadian. Thus, I am Canadian too.

It's easy for me to give up.

[CBGLuthier]

103. I agree.

Unconstitutional boondoggle instead of real progress.

[B Calm]

104. Medicare for everyone is the only solution!!

[woo me with science]

105. We continue to feed the obscenely rich

with our children's lives. And the worst reason of all to try to put lipstick on this pig is because it is being pushed by a Democrat.

Wake up. Demand Medicare for all.

K&R

[ErikJ]

106. Obamacare NOW--until Medicare for all spreads from state to state

Single-payer will eventually spread from one state to all like it did in Canada. That's the only way. But until then we have half-assded Obamacare which is a hell of alot better than nothing.

[Better Believe It]

128. The United States isn't like Canada. Canada has a multi-party system and democratic elections.

So how do you see a single payer Medicare for All system being adopted in opposition to the federal law if it is upheld?

[Cali_Democrat]

107. What I fear is that ACA will be replaced with the status quo

and single payer will never happen.

What happens to the millions of people that would benefit from ACA if it's struck down and there's no single payer? They're essentially screwed, right?

[BlueDemKev]

118. Yes. It will be just like it was pre-2010.

[bornskeptic]

108. PNHP is a right wing tool.

Its agenda has always been to obstruct any feasible healthcare reform. I'm glad the ringleaders are finally coming out in the open about it.

[eridani]

132. I'm getting sick and tired of only gutless people defining "feasible"

Thank heavens for OWS--if our politicians are too gutless to challenge conservative premises, at least some citizens are not.

Amazing what happens when the terms of debate change--even repukes started walking back their attacks on OWS.

[WinkyDink]

116. If Congress wants to regulate the commerce of health, LET THEM DEMAND LOWER RATES FROM THE INSURERS.

[backscatter712]

119. Realistically, if ACA is overturned, health care reform of any kind is dead for decades.

The Republicans are perfectly fine with letting hundreds of thousands of people suffer and die for lack of access to health care.

They're sociopaths, and they think that amount of death and destruction is pretty damned useful for keeping the peasants in line.

If ACA is overturned, it may take a violent revolution before health care reform sees the light of day in America...

[Better Believe It]

127. If the health insurance industry bill is upheld, progressive health care reform is dead for decades.

The hospital profiteers, insurance carriers and big pharma will have a lock on health care and we shall suffer as a result.

[Bobbie Jo]

137. Horseshit.

Playbook, p. 251

Are we getting close to the end, or must we endure another runthrough?

We shall suffer as a result.

[cynatnite]

125. No...

This is a decent first step. It's not perfect, but it's on the road. I do think we will get single payer in the distant future, but for now, this will have to do. Over the years it will be tweaked and improved upon. Eventually, we will get the kind of health care coverage we all deserve.