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From WashPo: Politics Judge strikes down Obama health law insurance subsidy

Lafayette

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Judge strikes down Obama health law insurance subsidy in victory for House GOP

Excerpt:
A federal judge struck down a portion of President Obama’s signature Affordable Care Act health law Thursday, ruling that Obama exceeded his authority in unilaterally funding a provision that sent billions of dollars in subsidies to health insurers.

In a 38-page decision, U.S. District Judge Rosemary Collyer of the District put her ruling on hold pending the administration’s certain appeal. Her decision sided with the U.S. House of Representatives, which brought the lawsuit challenging more than $175 billion of spending after a party-line vote by House Republicans in July 2014.

The House GOP argued that the administration’s decision to subsidize deductibles, co-pays and other “cost-sharing” measures was unconstitutional because Congress rejected an administration request for funding in 2014. Obama officials said they withdrew the request and spent the money, arguing that the subsidies were covered by an earlier, permanent appropriation.

House Republicans have tried repeatedly, without much success, to repeal parts or all of the health-care law, holding dozens of votes on the matter over the past five years. Thursday’s ruling may represent their most significant victory in trying to dismantle the ACA. The ruling, if upheld, could undermine the stability of the program because of the added financial burden it would place on insurers, health policy experts said.

Under the ruling, in order for the subsidy payments to be constitutional, Congress would be required to pass annual appropriations to cover the subsidies’ cost.

At stake is whether the subsidy “can nonetheless be funded through the same, permanent appropriation. It cannot,” Collyer wrote, referring to the provision in question.

“None of [the administration’s] extra-textual arguments — whether based on economics, ‘unintended’ results, or legislative history — is persuasive,” added Collyer, who was appointed to the bench in 2003 by President George W. Bush.

The judge’s logic drew a quick rebuke from White House press secretary Josh Earnest, who called the lawsuit a new low in the battle over the controversial health-care law and predicted that the ruling would be overturned by the courts because it charted new ground in the separation of powers between presidents and Congress.

Evidently, the Replicants have nothing better to do than keep sniping at ObamaCare, one of the more fundamental necessities of a developed nation. Every Social Democracy (meaning all of the EU, with almost twice the population of the US) on earth has a National HealthCare System. The purpose of which is to keeps costs affordable by mandating practitioner/pharmaceutical prices and avoiding privatized insurance. Even our neighbor Canada!

Except the US, and the rude consequence is real and tangible in terms of life-span. As described here: Average HC costs versus Life Span.jpg

Note from the above that Americans have a life-span that is about 3-years less than that of the EU countries!
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Lafayette

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From the Atlantic: What If America Had Canada's Healthcare System?

Excerpt:
Earlier this year, the Commonwealth Fund released a ranking of 11 developed countries' healthcare systems. The American one, the world's most expensive, ranked dead last. As I wrote at the time, the U.S. scored poorly on managing administrative hassles for both doctors and patients, avoiding emergency-room use, and reducing duplicative medical testing, among other things.

To be fair, the Canadian system didn't fare much better, coming in 10th out of 11. Still, according to a new interactive released by the Commonwealth Fund and based on the earlier report, if Americans had Canada's healthcare, we might see some surprising gains in our quality of life and reductions in our healthcare expenditures.

First, the good news: 5,400 fewer babies would die in infancy, and we'd save about $1.3 trillion dollars in healthcare spending. (The green blocks on the right show the number of dollars or lives saved, while the red blocks on the left show the expenditures or deaths that would still happen.)

PS: "ER" in the US makes for interesting TV-shows, but such health-care is far too little and far, far too late for such a large population ...
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Lafayette

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What American Healthcare Can Learn From Germany

Excerpt:
Under Obamacare, the U.S. healthcare system is starting to look more like Germany's. Here's what Germans do right—and how Americans could do even better.

... the bill was paid by the Barmer GEK sickness fund, one of about 160 such nonprofit insurance collectives in the country. Every German resident must belong to a sickness fund, and in turn the funds must insure all comers.

They’re also mandated to cover a standard set of benefits, which includes most procedures and medications. Workers pay half the cost of their sickness fund insurance, and employers pay the rest. The German government foots the bill for the unemployed and for children. There are also limits on out-of-pocket expenses, so it’s rare for a German to go into debt because of medical bills.

Sound familiar?

It should, since this is very similar to the health-insurance regime that Americans are now living under, now that the Affordable Care Act is four years old and a few days past its first enrollment deadline.

All Americans are now required to have health insurance or to pay a fine, and insurers cannot deny coverage to anyone regardless of pre-existing conditions. Obamacare has also created subsidies for those who can’t afford to buy health insurance and has implemented limits on out-of-pocket costs.

There are, of course, a few key differences. Co-pays in the German system are minuscule, about 10 euros per visit. Even those for hospital stays are laughably small by American standards: Sam payed 40 euros for a three-day stay for a minor operation a few years ago. Included in that price was the cost of renting the TV remote.

And nearly five million Americans fall into what’s called the “Medicaid gap” in states that aren’t expanding the government health insurance program for the poor. These individuals make too much to qualify for the state’s existing Medicaid program (typically just a few thousand dollars a year for childless adults), yet too little to qualify for the federal government’s subsidies to buy health insurance on the new exchanges, so they will remain uninsured.

Even I, living in France, am a bit surprised with the above explanation. Here in France, coverage is not 100% assured by the National Healthcare System (NHS)*. But this is a French quirk. The French complain about everything and will quickly overfill hospitals with their health-complaints were the cost-of-treatment free, gratis and for nothing.

So, they are reimbursed 70% of each visit to see a medical practitioner if they think they have a medical problem. That visit costs them a "whopping" 23 euros, and they are reimbursed 17 euros!

If a real-sickness ensues, then the NHS pays nearly all total costs. Still, there is a private top-up medical insurance that is very popular and costs only 100 /150 euros a month.

All of which means what? That the costs are not insurmountable, so people go to see their treating doctor sooner - and as regards some illnesses, the sooner detected, the better!

*Otoh, in the UK healthcare is indeed assumed totally (100%) by its NHS.
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Lafayette

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Commonwealth Fund assessment of various national health systems:
e6ceec50d.png


Healthcare costs are far too high in the US, because its system remains "privatized"; which is therefore an "additional tax" you pay for genuflecting at the altar of Private Medicine.

So what does "privatized" mean? This: Base Costs were set by a negotiation between Private Insurers (on behalf of HC-practitioners and particularly BigPharma*) and the Obama Administration, which was obliged (by the Replicants) to accept the pricing-structure extant to pass ObamaCare. This was done in order to make sure both the Insurers and BigMed/BigPharma maintain their current pricing-margins on their health-care revenues.

And still the Replicants are not happy, as witnessed from the first of the posts in this thread ... !

*See WSJ article here.
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Judge strikes down Obama health law insurance subsidy in victory for House GOP

Excerpt:


Evidently, the Replicants have nothing better to do than keep sniping at ObamaCare, one of the more fundamental necessities of a developed nation. Every Social Democracy (meaning all of the EU, with almost twice the population of the US) on earth has a National HealthCare System. The purpose of which is to keeps costs affordable by mandating practitioner/pharmaceutical prices and avoiding privatized insurance. Even our neighbor Canada!

Except the US, and the rude consequence is real and tangible in terms of life-span. As described here: View attachment 67201292

Note from the above that Americans have a life-span that is about 3-years less than that of the EU countries!
_________________________________

Number one, that others do it is not an argument for us doing it. Second, we aren't a social democracy. People who want to live that way are free to emigrate to any social democracy of their choosing and live like parasites if they want. Third, Obamacare is not comparable to what they have anyway. And finally, if Canadian or European style health care is superior to what we have, then politicians who believe in it should make the case. And they should be honest about how it works and what it will cost.

Oh, and just so you know, if your real goal is to socialize medicine here in the US, then you should be on the side of those who want to dismantle Obamacare. Its in the way.
 

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Here's the thing... some think that single payer is the way to go... Look at all the countries doing it well... Then the question becomes, how long are you willing to wait when you need care? Will you accept an 18 - 20 week waiting period before you begin treatment for something as common as Kidney Stones? Do you know what the waiting period for that in the US is? I've had kidney stones twice. The first time my treatment began within hours. Not weeks, not days, but hours. The second time I had to wait until Monday when diagnosed on a Friday. I can't even imagine waiting 18 weeks even with meds.
 

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MY GUESS: The ruling will be overturned on appeal...and if it goes to the Supreme Court...they will confirm the appeal decision.

America SHOULD be moving toward what is termed "socialized medicine"...and we should be doing it years ago.
 

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MY GUESS: The ruling will be overturned on appeal...and if it goes to the Supreme Court...they will confirm the appeal decision.
The ruling makes complete sense, so I agree that some liberal judge will strike it down.

America SHOULD be moving toward what is termed "socialized medicine"...and we should be doing it years ago.
Then you should support anything that dismantles Obamacare. All Obamacare ever was was a step from where we were to where you would like to see us go. We took the step. We wont take then next step until Obamacare shows itself to be inadequate for the task. Think of it this way, if Obamacare is a rousing success, there will never be a need to move beyond it.
 

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Judge strikes down Obama health law insurance subsidy in victory for House GOP

Excerpt:


Evidently, the Replicants have nothing better to do than keep sniping at ObamaCare, one of the more fundamental necessities of a developed nation. Every Social Democracy (meaning all of the EU, with almost twice the population of the US) on earth has a National HealthCare System. The purpose of which is to keeps costs affordable by mandating practitioner/pharmaceutical prices and avoiding privatized insurance. Even our neighbor Canada!

Except the US, and the rude consequence is real and tangible in terms of life-span. As described here: View attachment 67201292

Note from the above that Americans have a life-span that is about 3-years less than that of the EU countries!
_________________________________

If the $175 Billions was spent unconstitutionally, shouldn't they have to be paid back by those acting against the Constitution?
 

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Here's the thing... some think that single payer is the way to go... Look at all the countries doing it well... Then the question becomes, how long are you willing to wait when you need care? Will you accept an 18 - 20 week waiting period before you begin treatment for something as common as Kidney Stones? Do you know what the waiting period for that in the US is? I've had kidney stones twice. The first time my treatment began within hours. Not weeks, not days, but hours. The second time I had to wait until Monday when diagnosed on a Friday. I can't even imagine waiting 18 weeks even with meds.

Don't be such a darned wailing wimp and wait your turn. A little pain will put mettle in your character. ;)
 

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MY GUESS: The ruling will be overturned on appeal...and if it goes to the Supreme Court...they will confirm the appeal decision.

America SHOULD be moving toward what is termed "socialized medicine"...and we should be doing it years ago.

Why would you think that? The legal argument sounds solid enough. Politics might stand against it, but we do not really want judges to make political decisions to circumvent good law.
 

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Commonwealth Fund assessment of various national health systems:
e6ceec50d.png


Healthcare costs are far too high in the US, because its system remains "privatized"; which is therefore an "additional tax" you pay for genuflecting at the altar of Private Medicine.

So what does "privatized" mean? This: Base Costs were set by a negotiation between Private Insurers (on behalf of HC-practitioners and particularly BigPharma*) and the Obama Administration, which was obliged (by the Replicants) to accept the pricing-structure extant to pass ObamaCare. This was done in order to make sure both the Insurers and BigMed/BigPharma maintain their current pricing-margins on their health-care revenues.

And still the Replicants are not happy, as witnessed from the first of the posts in this thread ... !

*See WSJ article here.
______________________________________

The costs are high in the States. That much is true. That does not argue for public health care, though. Take the UK. I lived there. I wouldn't want that system. It was horrible as soon as you left credit card medicine.
 

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MY GUESS: The ruling will be overturned on appeal...and if it goes to the Supreme Court...they will confirm the appeal decision.

America SHOULD be moving toward what is termed "socialized medicine"...and we should be doing it years ago.

Not saying that it won't happen that way but what makes you think that it will be overturned on appeal? The make up of the court that will hear it?
 

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Don't be such a darned wailing wimp and wait your turn. A little pain will put mettle in your character. ;)

I always used to say that I was hardcore. <thumps chest, coughs> Rough, tough, US Army. Then I got kidney stones. I was on my knees in the bathroom. That is not where you want to experience that kind of pain. I cannot imagine waiting weeks for care. I have a friend who lives in Greater London. He told me that he had to wait 16 weeks but they gave him some good mess and he was off work (paid). I can't imagine being on meds that long or off work that long.
 

Lafayette

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That does not argue for public health care, though.

So sorry that your anecdotal experience with the UK healthcare system was sooooo bad.

Ask me why I am nonplussed.

Take the UK. I lived there. I wouldn't want that system. It was horrible as soon as you left credit card medicine.

I too have lived in the UK, for five years. It was just fine, except for the wait times ...
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The ruling makes complete sense, so I agree that some liberal judge will strike it down.

It is your right to suppose that a "liberal" judge will strike the ruling down...because it makes sense.

That does not make sense...but it is your right not to make sense.


Then you should support anything that dismantles Obamacare.

That comment is bumper sticker mentality.

Obamacare will eventually form the base of a single payer system that will approximate socialized medicine in this country. WE WILL EVENTUALLY CATCH UP TO THE REST OF THE INDUSTRIALIZED WORLD IN THAT RESPECT.

All Obamacare ever was was a step from where we were to where you would like to see us go. We took the step. We wont take then next step until Obamacare shows itself to be inadequate for the task. Think of it this way, if Obamacare is a rousing success, there will never be a need to move beyond it.

Obamacare can be a rousing success...and we will still have to "move beyond it."

It is a very modest step in the right direction...but it is a modest step.
 

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Why would you think that? The legal argument sounds solid enough. Politics might stand against it, but we do not really want judges to make political decisions to circumvent good law.

The legal arguments overturning it on appeal...will also sound solid.

Conservative America has been trying to defeat this very modest step in the right direction for years now. The entertainment value of their silly attempts have pretty much worn out...so, I say, "Be done with it."

We'll see if my guess about what will happen is correct.
 

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Not saying that it won't happen that way but what makes you think that it will be overturned on appeal? The make up of the court that will hear it?

I think it will be overturned on appeal...because almost all of the law has been looked at carefully...and the courts have ruled that it is sound.

We'll see if I am correct...and if I am, the appeals judges (who have a much better knowledge of the applicable law than I)...will tell us why it is overturned.
 

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If the $175 Billions was spent unconstitutionally, shouldn't they have to be paid back by those acting against the Constitution?

You joking? Weird sense of humour.

This is the sole opinion of a judge, appointed by a Dunderhead PotUS, who is having a joy-ride on the ObamaCare controversy. Yet another one eager to show her allegiance "to the cause".

And to think, taxpayer money is being spent on such nonsense.

Have a look at how Banana Republic political mischief works in South and Central America, then we can talk about its Replicant-analogy in the US ...
________________________________
 
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You joking? Weird sense of humour.

This is the sole opinion of a judge, appointed by a Dunderhead PotUS, who is having a joy-ride on the ObamaCare controversy. Yet another one eager to show her allegiance "to the cause".

And to think, taxpayer money is being spent on such nonsense.

Have a look at how Banana Republic political mischief works in South and Central America, then we can talk about its Replicant-analogy in the US ...
________________________________

Other than her being appointed by a 'dunderhead' do you have any substantive, intelligent objections to her ruling?
 

Lafayette

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BIG PHARMA SHYSTERS

Number one, that others do it is not an argument for us doing it. Second, we aren't a social democracy.

1) Any market-economy in a functional democracy is always improvable. For the moment, Americans have not had the full-story told to them about how effing-expensive America's health-care is - especially as concerns the financial rip-off conducted by both BigPharma and the salaries of HealthCare practitioners*.

2) We were not born idiots to assure the immense salaries/stockoption-benefits of Pharmaceutical company chieftains. And yet, that is exactly what is happening.

3)Why not discuss Social Democracy as an alternative? Rather than remaining hidebound by the fiction that whatever works for Uncle Sam works for the rest of the world - no questions asked. (Sheer idiocy, that one.)

*Three facts that escape you:
1)Their salaries are comparatively humongous (see here and here), and
2)They are costs imputed to Corporate Net Income that we, the sheeple, pay as Consumers in a supposedly competitive market-economy that is rigged against us. So, we are the victims of these shysters.
3) In National Healthcare Systems, pharmaceutical prices are mandated and imposed upon BigPharma - and not in the US.
____________________
 
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BIG PHARMA SHYSTERS



1) Any market-economy in a functional democracy is always improvable. For the moment, Americans have not had the full-story told to them about how effing-expensive America's health-care is - especially as concerns the financial rip-off conducted by both BigPharma and the salaries of HealthCare practitioners*.

2) We were not born idiots to assure the immense salaries/stockoption-benefits of Pharmaceutical company chieftains. And yet, that is exactly what is happening.

3)Why not discuss Social Democracy as an alternative? Rather than remaining hidebound by the fiction that whatever works for Uncle Sam works for the rest of the world - no questions asked. (Sheer idiocy, that one.)

*Three facts that escape you:
1)Their salaries are comparatively humongous (see here and here), and
2)They are costs imputed to Corporate Net Income that we, the sheeple, pay as Consumers in a supposedly competitive market-economy that is rigged against us. So, we are the victims of these shysters.
3) In National Healthcare Systems, pharmaceutical prices are mandated and imposed upon BigPharma - and not in the US.
____________________

I get that you wealth obsessed liberals focus only on what other people make, but there is no industry more heavily regulated in the US (with the possible exception of the banking industry) than the health care industry. That the union of big business and big government has been lucrative for the businesses involved is evidence of what happens when leftists are put in charge of things. No reason to blame the companies for following the rules laid out by the government. And certainly no reason to allow the government to take an even larger role.
 

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I always used to say that I was hardcore. <thumps chest, coughs> Rough, tough, US Army. Then I got kidney stones. I was on my knees in the bathroom. That is not where you want to experience that kind of pain. I cannot imagine waiting weeks for care. I have a friend who lives in Greater London. He told me that he had to wait 16 weeks but they gave him some good mess and he was off work (paid). I can't imagine being on meds that long or off work that long.

My wife says, kidney stones are the test you cannot pass.
 

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So sorry that your anecdotal experience with the UK healthcare system was sooooo bad.

Ask me why I am nonplussed.



I too have lived in the UK, for five years. It was just fine, except for the wait times ...
___________________________

Actually it is more than anecdotal and compares pretty well with the situation in Germany, where I've looked at social medicine in economic and sociological detail.
 

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The legal arguments overturning it on appeal...will also sound solid.

Conservative America has been trying to defeat this very modest step in the right direction for years now. The entertainment value of their silly attempts have pretty much worn out...so, I say, "Be done with it."

We'll see if my guess about what will happen is correct.

You mean you think that it is okay to dedicate $178 Billion subsidies in perpetuity outside the Congressional budget? That is off the wall.
 
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