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Author Topic: If the healthcare law is overturned, universal healthcare is dead forever  (Read 2690 times)
Mr.Phips
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« on: March 23, 2012, 03:10:54 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats. 
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« Reply #1 on: March 23, 2012, 03:38:59 pm »
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Think a Republican Congress is ever going to pass universal healthcare? 

Yes, of course Smiley)

They will propose it and pass it Smiley) Certain things are pretty much inevitable. Of course, they will have to tie themselves into all sort of contortions to pretend they are not doing it.
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« Reply #2 on: March 23, 2012, 03:41:15 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats. 
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.
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« Reply #3 on: March 23, 2012, 07:21:23 pm »
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Nothing is 'dead forever'
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« Reply #4 on: March 23, 2012, 07:25:30 pm »
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This might help keep everything in perspective.
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« Reply #5 on: March 23, 2012, 07:33:53 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats.  
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.

This.  The reason why the bill's constitutionality is being questioned is because of the individual mandate.  The court can strike it down, but I don't see how this would prevent Democrats from passing NHC in the future, especially if they propose something that doesn't include an individual mandate.
« Last Edit: March 23, 2012, 07:35:26 pm by Senator Scott »Logged



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« Reply #6 on: March 23, 2012, 07:45:05 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats.  
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.

This.  The reason why the bill's constitutionality is being questioned is because of the individual mandate.  The court can strike it down, but I don't see how this would prevent Democrats from passing NHC in the future, especially if they propose something that doesn't include an individual mandate. 

What will prevent Democrats from passing healthcare in the future is clever REpublican gerrymandering.  Unitil Democrats can break up GOP gerrymanders in the big states, there chances of getting a House majority, let alone one big enough to pass universal healthcare are slim to none.  Obama and the DNC royally screwed the Democrats in 2010 when they refused to focus on state legislative races.  2010 really was do or die for Democrats. 
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« Reply #7 on: March 23, 2012, 08:33:05 pm »
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It should be noted that the individual mandate is the only method for getting anything near universal health care that has ever come anywhere close to political acceptability or having been pushed in both parties. The only alternative is directly government funded health care, so it would take a dramatic shift to the left by the GOP to make that possible.
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« Reply #8 on: March 23, 2012, 10:00:09 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats.  
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.

This.  The reason why the bill's constitutionality is being questioned is because of the individual mandate.  The court can strike it down, but I don't see how this would prevent Democrats from passing NHC in the future, especially if they propose something that doesn't include an individual mandate.  

What will prevent Democrats from passing healthcare in the future is clever REpublican gerrymandering.  Unitil Democrats can break up GOP gerrymanders in the big states, there chances of getting a House majority, let alone one big enough to pass universal healthcare are slim to none.  Obama and the DNC royally screwed the Democrats in 2010 when they refused to focus on state legislative races.  2010 really was do or die for Democrats.  

Both parties have gerrymandered quite a bit with their majorities, so I don't think redistricting will be a huge factor for the next ten years.  Even if it does prevent the Democrats from retaking the House, I certainly wouldn't think it means universal healthcare is "dead forever".  At the very minimum, we should get a public option someday, maybe.
« Last Edit: March 24, 2012, 10:28:41 am by Senator Scott »Logged



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« Reply #9 on: March 23, 2012, 11:31:43 pm »
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It should be noted that the individual mandate is the only method for getting anything near universal health care that has ever come anywhere close to political acceptability or having been pushed in both parties. The only alternative is directly government funded health care, so it would take a dramatic shift to the left by the GOP to make that possible.
I think the essentialness of the individual mandate to this type of system is overblown - at least so long as employer based plans remain the norm.
« Last Edit: March 23, 2012, 11:34:10 pm by shua, gm »Logged

  

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« Reply #10 on: March 23, 2012, 11:37:15 pm »
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Nothing is 'dead forever'

Of course not. Mr. Phips just seems to like overdramatizing things.
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« Reply #11 on: March 25, 2012, 12:44:03 pm »

If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats.  
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.

This.  The reason why the bill's constitutionality is being questioned is because of the individual mandate.  The court can strike it down, but I don't see how this would prevent Democrats from passing NHC in the future, especially if they propose something that doesn't include an individual mandate.  

What will prevent Democrats from passing healthcare in the future is clever REpublican gerrymandering.  Unitil Democrats can break up GOP gerrymanders in the big states, there chances of getting a House majority, let alone one big enough to pass universal healthcare are slim to none.  Obama and the DNC royally screwed the Democrats in 2010 when they refused to focus on state legislative races.  2010 really was do or die for Democrats.  

Both parties have gerrymandered quite a bit with their majorities, so I don't think redistricting will be a huge factor for the next ten years.  Even if it does prevent the Democrats from retaking the House, I certainly wouldn't think it means universal healthcare is "dead forever".  At the very minimum, we should get a public option someday, maybe.

In any case, it wasn't gerrymandering, but filibustering that killed any hope the Democrats had of passing any sort of single payer plan.  They had enough of a House majority in 2009, that single payer could have passed there, but not enough of a Senate supermajority.
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« Reply #12 on: March 25, 2012, 01:16:53 pm »
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I'm with Beet on this one.  Not only in American political discourse, but the world over, there are only two routs to universal coverage, a national system funded through taxation, or a multipayer system backed up by mandates.  You can't finance pre-existing conditions, catastrophic care, long-term care for chronic illness or elder-care, ect., without everyone being in the insurance pool. 

On the other hand, you can't finance universal coverage without some strong mechanisms in place that control health care cost inflation.  If the mandate are overturned by SCOTUS, and we don't want cost controls and we don't want a national system either, then, in the short term, we won't have universal coverage  And we'd be saying, in effect, that we would rather ration tens of millions of people out of health care coverage entirely than ration procedure and medicine coverage for everyone in the pool, and this is one thing that, to my mind, is just disgraceful about our system.  But, on the other hand, if we don't want any of these three things listed above, then the steady increase of costs added to the demographic trends of the U.S. will bankrupt us anyway. 

There have been some proposals floated recently about insurers offering pre-existing conditions coverage in exchange for continued enrollment (incentivizing buy-in), and of course there is always the tax-subsidization for premium costs route.  But I'm not sure how to work the details of the former, and in the case of the latter, without dramatic measures taken in cost inflation management, that solution would be headed to the same abyss everything else is.
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« Reply #13 on: March 25, 2012, 01:54:23 pm »
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A case can be made that the SCOTUS decision is all sound and fury signifying very little. First, it is quite likely that if the mandate is struck, the whole law will not go down with it - SCOTUS will sever. Second, the mandate in place is 1) (i) ludicrously small in the amount of the "fine," and (ii) to get the votes the Dems had to excise any enforcement mechanism, so while you are supposed to pay the fine, there is no sanction if you don't (it's the honor system baby). 

So we are back to where we started. Irrespective of what SCOTUS does (which as a practical matter won't mean much probably), Obamacare will collapse of its own fiscal weight. It just doesn't pencil, either on the revenue side as outlined above, nor on the cost side. Congress will have to revisit the issue as the specter of insolvency becomes ever more pressing, and folks start chatting about the quality of the full faith and credit guarantee of the US Treasury in a more insistent manner.  And it seems that we might have to get that close to the abyss before the matter is revisited. Sad.
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« Reply #14 on: March 25, 2012, 01:56:12 pm »
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If the Supreme Court does overturn healthcare reform, Democrats and liberals might as well close the book on efforts to ever get universal healthcare.  The reason is that Republicans have drawn themselves a near lock on control of the House and Democrats are not likely to get 60 Senate seats again anytime soon.  Think a Republican Congress is ever going to pass universal healthcare?  Forget about it.  This is do or die for Democrats.  
The PPACA isn't universal healthcare anyway, so I don't see how this is relevant.

This.  The reason why the bill's constitutionality is being questioned is because of the individual mandate.  The court can strike it down, but I don't see how this would prevent Democrats from passing NHC in the future, especially if they propose something that doesn't include an individual mandate.  

What will prevent Democrats from passing healthcare in the future is clever REpublican gerrymandering.  Unitil Democrats can break up GOP gerrymanders in the big states, there chances of getting a House majority, let alone one big enough to pass universal healthcare are slim to none.  Obama and the DNC royally screwed the Democrats in 2010 when they refused to focus on state legislative races.  2010 really was do or die for Democrats.  

Both parties have gerrymandered quite a bit with their majorities, so I don't think redistricting will be a huge factor for the next ten years.  Even if it does prevent the Democrats from retaking the House, I certainly wouldn't think it means universal healthcare is "dead forever".  At the very minimum, we should get a public option someday, maybe.

In any case, it wasn't gerrymandering, but filibustering that killed any hope the Democrats had of passing any sort of single payer plan.  They had enough of a House majority in 2009, that single payer could have passed there, but not enough of a Senate supermajority.

This is true.
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Sam Spade
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« Reply #15 on: March 25, 2012, 02:04:52 pm »
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A case can be made that the SCOTUS decision is all sound and fury signifying very little. First, it is quite likely that if the mandate is struck, the whole law will not go down with it - SCOTUS will sever. Second, the mandate in place is 1) (i) ludicrously small in the amount of the "fine," and (ii) to get the votes the Dems had to excise any enforcement mechanism, so while you are supposed to pay the fine, there is no sanction if you don't (it's the honor system baby). 

So we are back to where we started. Irrespective of what SCOTUS does (which as a practical matter won't mean much probably), Obamacare will collapse of its own fiscal weight. It just doesn't pencil, either on the revenue side as outlined above, nor on the cost side. Congress will have to revisit the issue as the specter of insolvency becomes ever more pressing, and folks start chatting about the quality of the full faith and credit guarantee of the US Treasury in a more insistent manner.  And it seems that we might have to get that close to the abyss before the matter is revisited. Sad.

Probably right on this one.  But no one ever thinks the abyss is there until we already halfway falling down it.
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« Reply #16 on: March 25, 2012, 02:32:25 pm »
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The issue is that our employer-based health care system appears to be collapsing faster than a future collapse of Obamacare (through higher government expenditures, is it?) could take place. I think we have a ways to go before we get to the abyss of the bond market vigilantes deciding government has to get out of the healthcare business for non-olds, and in the meantime, so much else will have changed that many options will have to be on the table for a solution.

http://seattletimes.nwsource.com/html/health/2017814967_webinsure23.html

The share of people with employer-provided health care has fallen from 67% to 58% between 2000 and 2010. Some of it is due to the recession, but I don't know if we've ever seen a significant rebound in coverage associated with higher employment.

Obamacare won't collapse in a vacuum. It's a given that whatever emerges from its ashes, if it collapses spectacularly, won't be the status quo ante because the status quo ante is doing a fine job of dying on its own. What will we have?

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« Reply #17 on: March 25, 2012, 03:17:57 pm »
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Yes, the status quo is collapse city too, which is what in part ironically drove Obamacare.  It was getting to the point that medical subsidies were squeezing money out of other programs the Dems hold dear. Buried in the mass of verbiage that nobody read at the time, there is this little rationing system that has been put in effect for Medicare down the road. Actually it is Medicare that is really sinking us, and the rap on Obamacare was that it was just putting lighter fluid on the fire, rather than containing it.

So the hunt continues as to how to ration, without anyone discerning, at least for a period of time, that in fact the emperor has no clothes.  It is all in the packaging.

I admit I have a bias here. I hate long wait times to get medical services, so rationing that way just does not suit my demanding self-centered little personality.
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« Reply #18 on: March 25, 2012, 07:16:15 pm »
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I admit I have a bias here. I hate long wait times to get medical services, so rationing that way just does not suit my demanding self-centered little personality.

You're not the only one, Torie.  One reason the U.S doesn't have universal coverage yet is that getting it would require people who already have insurance and providers to give up some privileges that they've become used to, and no one in the U.S really wants to give up anything.  But that time is marching toward us when we won't have much of choice.  On lots of fronts, not just this one.

The thing is, I don't believe that the only alternatives with health care are either longer wait times or what we've got now.  The Bismarck system counties that I lived in didn't have long wait times; indeed, for some specialist care, getting services was even faster than it is here.  But, I digress.
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« Reply #19 on: March 25, 2012, 07:41:06 pm »
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The thing with the SCOTUS decision regarding the Obamacare mandate, as Mr. Philps indicated at the top of the thread, is that, if they decide to strike it down, that closes the door to any model of universal coverage that would be implemented through a mandate.  That means, as far as I can tell, that the only route left to universal coverage would be a national insurance system, which, to my mind (others on the forum may disagree), doesn't work as well as the multipayer Bismarck system, which features mandates.  That's to say that, in thinking about this thread, defending Obamacare specifically wasn't my main concern; my concern was rather which doors we may be leaving open or closed in terms of future reforms way may have to make. 
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« Reply #20 on: March 25, 2012, 07:49:52 pm »
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We already have long wait times to see doctors. Not sure what people are getting at. The medical field has the worst customer service model ever.
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« Reply #21 on: March 25, 2012, 07:57:03 pm »
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Bismarck was just a stooge of Bill Ayers, anvi. Just be thankful that you escaped whatever totalitarian hell-hole you used to live in and arrived at the land of freedom (fries). Smiley

On another note, this article chronicles just how fringe a Constitutional challenge to the mandate was deemed at the time of the law's passage- even by conservative and libertarian legal experts. This is a classic case of asking ma [SCOTUS] 'cause you didn't get the answer you wanted from pa [democratic political institutions].
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« Reply #22 on: March 25, 2012, 08:53:40 pm »
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Bismarck was just a stooge of Bill Ayers, anvi. Just be thankful that you escaped whatever totalitarian hell-hole you used to live in and arrived at the land of freedom (fries). Smiley

On another note, this article chronicles just how fringe a Constitutional challenge to the mandate was deemed at the time of the law's passage- even by conservative and libertarian legal experts. This is a classic case of asking ma [SCOTUS] 'cause you didn't get the answer you wanted from pa [democratic political institutions].

If only they had packaged as a tax, where you raise taxes, and get it back as a tax credit if you buy insurance. The thing is, if the interstate clause reaches this, it reaches everything. Heck, you could be fined for not buying a Chevy Volt! So just strike the minor and toothless mandate since it is so easy to repackage it as a tax, and the law will be just about equally unworkable and bad, with or without the mandate, so just doing a severing does no real damage to the law itself. In short, there is no compelling public policy need quite yet for the commerce clause to swallow everything, and put the final nail into federalism as something mandatory rather than discretionary under the Constitution.  I think that is a killer and dispositive argument myself, if you work through the steps that way. 
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« Reply #23 on: March 25, 2012, 09:33:11 pm »
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So, let me get this argument straight, Torie.  On the one hand, the Obamacare mandate is so weak and toothless that allowing it to remain in the law or severing the rest of the law from it would make practically no difference.  That is supposedly the case, aside from penalty and tax credit issues, primarily because it has no enforcement mechanism, and so doesn't really function like a mandate anyway.  But, on the other hand, retaining the mandate would destroy the constitution because the mandate is far too strong; it would give the government carte blanche authority to mandate the purchase of any item in the name of regulating markets.  So, the very same mandate is too weak to make the legislation in question effective as regulation of the one market it was intended to regulate, but too strong for the commerce clause to bear the weight of because it threatens to give the government authority to force product-purchase in all markets.  Am I getting this right?  If so, how can a mandate be simultaneously so weak that it doesn't even require product purchase in the law in which it's found, but so strong that its authority could compel product purchase in every other market? 

Anyway, if SCOTUS agrees, then the implications are, I think, as I've stated above.  
« Last Edit: March 25, 2012, 09:55:48 pm by anvi »Logged

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« Reply #24 on: March 25, 2012, 09:55:25 pm »
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You got it anvi.  Alice is still very much alive. Well, it is not so much the integrity of markets, but preserving the idea that the states have some residual power vis a vis the feds (aka "federalism"). Not that I am in love with the idea of "states rights," but that is a whole other Pandora's box, about which I  yet again - have a host of my own arrogant little opinions.  But I have a license to be that way. Tongue
« Last Edit: March 25, 2012, 09:58:31 pm by Torie »Logged

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