Americans, incl. large majority of Democrats, think mandate unconstitutional.

[tpfkaw]

Obama: Mandate is "not a tax."

[Beet]

Obama: Mandate is "not a tax."

Yeah, that is probably the worst interview I have ever seen Obama do. He was defensive, emotional, operating on a political plane and didn't even seem to be listening to what Stephanopoulos was saying. Towards the end I think he realized he wasn't doing well when he said 'my opponents think everything is a tax...', just getting frustrated.

[SteveRogers]

Unfortunately the mandate is probably unconstitutional, if only because it was written poorly to avoid the political fallout from creating a new "tax." If the law had created a small tax surcharge that you happened to be exempt from if you bought health insurance, there probably wouldn't be a problem. Instead the law establishes a small penalty for not buying health insurance. The effect is literally the exact same in both cases, but the latter is on much shakier ground constitutionally

[greenforest32]

I wouldn't be against the neoliberal profit mandate being struck down.

Single-payer > private health insurance

[Okay, maybe Mike Johnson is a competent parliamentarian.]

by whom?  by 72% of US voters polled randomly?  I doubt that.  But that's not a point I'm going to argue with you because I don't have the data to back that up.  What we do know is that The People recognize that they're being forced to do something by the government.  They don't like it.  They have a right not to like it, and although they might not all be lawyers, they have an inkling of idea that this bill is very, very wrong.  I'm not a lawyer either, and I could be wrong about this, but it really stinks.  And I am not alone.  Moreover, it doesn't necessarily depend upon the supreme court to do its job.  If we can install a GOP congress and president--and there's a chance, however slim, that we may be able to do this--then it won't come to that.  But if it does come to it, I"m not so sure that you can predict that the federal court can't be convinced that it is unconstitutional.  For example, many lawyers are already on the record saying that it violates the commerce clause.  I don't think that at least one wealthy opponent to the law will have trouble contracting at least one of those lawyers.  Big Brother, of course, will have its own highly-paid lawyers, but that's not always a guarantee of their success, fortunately.

'Known' wasn't necessarily the right word. Nullification has been doctrinally unconstitutional in the immensity of Supreme Court precedent on the subject for well over a century. Closer to two.

[Lief 🗽]

I wouldn't be against the neoliberal profit mandate being struck down.

Single-payer > private health insurance

What does that have to do with anything? Obamacare > the current system.

[angus]

'Known' wasn't necessarily the right word. Nullification has been doctrinally unconstitutional in the immensity of Supreme Court precedent on the subject for well over a century. Closer to two.

That's fine.  I'm not preaching violent insurrection anyway--if a group really intends to nullify a law, I suspect that it should be prepared to back it up with arms, if necessary.  I was simply noting the willingness of entire states, via their legislatures, to do whatever they can legally do to end Obamacare.

Clearly this is either not something the public understood well as it was being enacted, or has changed its mind about.  In the democratic domain, laws might reflect the will of the people.  If they do not, then the people should change them.  I'm hoping for a democratic resolution rather than judicial oversight.

[Okay, maybe Mike Johnson is a competent parliamentarian.]

It's quite frankly not about something the public has ever understood well at any point in the process.

[greenforest32]

I wouldn't be against the neoliberal profit mandate being struck down.

Single-payer > private health insurance

What does that have to do with anything? Obamacare > the current system.

The current system is failing and we could have killed it off when we were reforming. "Obamacare" is a give-away to the industry that will allow their for-profit basis to exist for that much longer before they rightfully die out.

Weak reform just like a weak stimulus.

[angus]

It's quite frankly not about something the public has ever understood well at any point in the process.

Indeed.  When even members of congress claim that they can't be bothered with reading their own exceedingly long bills, why should the public?

However, the public has understood that we have been told for years that we spend more than 15% of our aggregate GDP on medical services and health care.  The public has understood that this expenditure, as a fraction of the aggregate GDP, has been increasing.  The public now is made to understand that actions taken by the congress will not only exacerbate that problem, but also force people to make purchases of products that they might not otherwise have bought. 

[Okay, maybe Mike Johnson is a competent parliamentarian.]

Yes, and public health care would actually be much cheaper than that. There are of course ideological reasons one might oppose it, but it would be cheaper than trying to regulate dozens of moving parts of ostensibly 'private', highly corporatist 'markets' at once.

[angus]

Yes, and public health care would actually be much cheaper than that.

I think this could be done, but it is not what the grossly-misnamed Patient Protection and Affordable Care Act does.  The bill is a mixture of stopgap measures that promises to increases the budget deficit by $562 billion.  Well, the exact figure is a moving target.  Republicans put it a 700 billion over the first ten years while Democrats put it at 230 billion.  Obviously it depends upon what assumptions one makes.  Ostensibly, it was meant to provide insurance to the uninsured, but even there it fails since it leaves 23 million people uninsured who are allowed to opt out of the mandate.  

It's a bad bill, Nathan.  You can proclaim the glories of socialized medicine if you want, and I'd agree with you that such a program does have its advantages, and I'd argue with you that it also has some disadvantages.  But in any case that's not what this monstrosity of a bill is.  The PPACA is a series of complicated reforms to an existing structure, which is already a mixed public/private market.  It was also enacted in an underhanded manner.  You should not try to rationalize the fact that 72% of people in a wealthy, relatively well-educated nation see it for what it is:  bad legislation.

[Хahar 🤔]

I don't think there's a single person here who thinks that it's good legislation. The only good thing about it is that it's better than what came before.

[Beet]

the Dems' worse nightmare is to have Obamacare upheld by the SCOTUS.

The country's worst nightmare would be a partial overturning.  Must carry combined with the elimination of the personal mandate would destroy the individual insurance market, and yet would be so popular initially that it could not get repealed until said market was destroyed, with all the consequences thereof.

We're not going to get real change unless there is a crisis. Arguably the worse things get, the more it create political consensus that something must be done and will push Congress to enact something that controls costs. The reason they haven't already is because it is too unpopular. There is too much inertia. The real worst nightmare is a return to the 2008 status quo of ever rising costs and increasing numbers of uninsured, with politicians cowed from reforming health care by 1994 and 2010. What's needed is a total overhaul of the entire system from the ground up, and destruction of the individual market would help bring that about.

[Jacobtm]

The mandate is in fact an awful idea.

Medicare for everyone, full coverage, and price controls would be much more straightforward and less constitutionally difficult.

[angus]

The mandate is in fact an awful idea.

Medicare for everyone, full coverage, and price controls would be much more straightforward and less constitutionally difficult.

One problem that I assume Obama and the congress wanted to deal with before they got sidetracked and enacted the PPACA was the fact that once the baby boomer retirements really start to kick in, we'll have unsustainable deficits under the current system.  I assume that we'll eventually still have to deal with that problem.  It may be that price controls become necessary.

[Jacobtm]

One problem that I assume Obama and the congress wanted to deal with before they got sidetracked and enacted the PPACA was the fact that once the baby boomer retirements really start to kick in, we'll have unsustainable deficits under the current system.  I assume that we'll eventually still have to deal with that problem.  It may be that price controls become necessary.

Well every other rich country has LOWER health-care costs than us, so an actual ''government takeover'' of healthcare would help in reducing our expenditures on health.

Price controls are how many countries have standardized the process. All doctors have a price schedule, and whatever procedure, test, or evaluation they do has a pre-set amount that the doctor is reimbursed.

[angus]

One problem that I assume Obama and the congress wanted to deal with before they got sidetracked and enacted the PPACA was the fact that once the baby boomer retirements really start to kick in, we'll have unsustainable deficits under the current system.  I assume that we'll eventually still have to deal with that problem.  It may be that price controls become necessary.

Well every other rich country has LOWER health-care costs than us, so an actual ''government takeover'' of healthcare would help in reducing our expenditures on health.

Price controls are how many countries have standardized the process. All doctors have a price schedule, and whatever procedure, test, or evaluation they do has a pre-set amount that the doctor is reimbursed.

Be careful, that's inductive reasoning at best.  We have exceedingly high health costs for a number of reasons including, but not limited to, the fact that we lead terribly greedy, indolent lives, the fact that we are gluttons, and the fact we insist upon using the extend the lives of a handful of people by a few (very miserable) months or a few (even more miserable) years at great cost. 

Having said that, yes some form of price controls would no doubt alleviate the costs.  It's a tricky business, though.  The Price Theorist in me says that it will lead to shortages in services.

[Jacobtm]

Be careful, that's inductive reasoning at best.  We have exceedingly high health costs for a number of reasons including, but not limited to, the fact that we lead terribly greedy, indolent lives, the fact that we are gluttons, and the fact we insist upon using the extend the lives of a handful of people by a few (very miserable) months or a few (even more miserable) years at great cost.  

Having said that, yes some form of price controls would no doubt alleviate the costs.  It's a tricky business, though.  The Price Theorist in me says that it will lead to shortages in services.

Analyses have regularly shown that something like 20-25% of our healthcare costs are just administrative costs above and beyond the average of what every other rich country pays. Our system has a lot to do with our costs.

Of course, the unhealthy lifestyle most Americans lead has to do with that too, which is a separate issue.

The Price Theorist in you is ultimately wrong. I suggest reading The Healing of America, a book in which the author travels the world to recieve treatment for a bum shoulder, seeing other countries' health-care systems from the inside. Throughout the world, governments put price controls on medical services and the people in those countries have easier access to healthcare than Americans do.

Doctors don't make as much money, insurance companies don't make as much money, the country spends less money on healthcare, and people get better treatment and more access. It's worldwide.

http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346

[angus]

Analyses have regularly shown that something like 20-25% of our healthcare costs are just administrative costs above and beyond the average of what every other rich country pays. Our system has a lot to do with our costs.

Of course, the unhealthy lifestyle most Americans lead has to do with that too, which is a separate issue.

The Price Theorist in you is ultimately wrong. I suggest reading The Healing of America, a book in which the author travels the world to recieve treatment for a bum shoulder, seeing other countries' health-care systems from the inside. Throughout the world, governments put price controls on medical services and the people in those countries have easier access to healthcare than Americans do.

Doctors don't make as much money, insurance companies don't make as much money, the country spends less money on healthcare, and people get better treatment and more access. It's worldwide.

http://www.amazon.com/Healing-America-Global-Better-Cheaper/dp/1594202346

yes, administrative costs are among those to which I allude when I said "among other things."  Also, there's generally inefficiency in billing, which has also been a subject for my ranting:

https://uselectionatlas.org/FORUM/index.php?topic=148227.msg3182258#msg3182258

I can't comment on the book you referenced because I haven't read it.  I'll try to get around to taking a look at it, or something by that same author, but remember that the specific shortages resulting from the price ceilings may not be what the author is measuring. 

[Okay, maybe Mike Johnson is a competent parliamentarian.]

Yes, and public health care would actually be much cheaper than that.

I think this could be done, but it is not what the grossly-misnamed Patient Protection and Affordable Care Act does.  The bill is a mixture of stopgap measures that promises to increases the budget deficit by $562 billion.  Well, the exact figure is a moving target.  Republicans put it a 700 billion over the first ten years while Democrats put it at 230 billion.  Obviously it depends upon what assumptions one makes.  Ostensibly, it was meant to provide insurance to the uninsured, but even there it fails since it leaves 23 million people uninsured who are allowed to opt out of the mandate.  

It's a bad bill, Nathan.  You can proclaim the glories of socialized medicine if you want, and I'd agree with you that such a program does have its advantages, and I'd argue with you that it also has some disadvantages.  But in any case that's not what this monstrosity of a bill is.  The PPACA is a series of complicated reforms to an existing structure, which is already a mixed public/private market.  It was also enacted in an underhanded manner.  You should not try to rationalize the fact that 72% of people in a wealthy, relatively well-educated nation see it for what it is:  bad legislation.

Oh, no, I entirely recognize that it's terrible, terrible legislation. That's not what I'm disputing. I'm disputing, narrowly, the constitutional question, on which I disagree with you. I completely agree with you that the PPACA itself is largely terrible, but as Xahar said I'm not exactly eager to return to the 2008 status quo even so.

[All Along The Watchtower]

Opinion polls are a laughably unscientific and easily manipulated way of measuring things.

[batmacumba]

The way this is being dealt is quite stupid. Take care or you folks will end with a problematic system, like ours.

[Frodo]

The way this is being dealt is quite stupid. Take care or you folks will end with a problematic system, like ours.

How can Brazil have a worse system of health care than ours? 

[batmacumba]

The way this is being dealt is quite stupid. Take care or you folks will end with a problematic system, like ours.

How can Brazil have a worse system of health care than ours?  

It doesn't get enough funding and It's organization makes any attempt to properly managing completely inane. So, there really is something better than yours: poor people have an option. And many are saved because of It. But lots die on the lines, waiting for care, or the poorly supplied infirmaries. Physicians avoid working for It because of conditions and revenue.
If you're going to finnaly build a public healthcare system, I guess you'll want to build a proper one. Or else, you're giving ammunition to your adversaries.