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Texas Judge Strikes Down Obama’s Affordable Care Act

Lafayette

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From the NYT: Texas Judge Strikes Down Obama’s Affordable Care Act as Unconstitutional

Excerpt:
A federal judge in Texas struck down the entire Affordable Care Act on Friday on the grounds that its mandate requiring people to buy health insurance is unconstitutional and the rest of the law cannot stand without it.

The ruling was over a lawsuit filed this year by a group of Republican governors and state attorneys general. A group of intervening states led by Democrats promised to appeal the decision, which will most likely not have any immediate effect. But it will almost certainly make its way to the Supreme Court, threatening the survival of the landmark health law and, with it, health coverage for millions of Americans, protections for people with pre-existing conditions and much more.

In his ruling, Judge Reed O’Connor of the Federal District Court in Fort Worth said that the individual mandate requiring people to have health insurance “can no longer be sustained as an exercise of Congress’s tax power.” Accordingly, Judge O’Connor, a George W. Bush appointee, said that “the individual mandate is unconstitutional” and the remaining provisions of the Affordable Care Act are invalid.

When the Supreme Court upheld the mandate as constitutional in 2012, it was based on Congress’s taxing power. Congress, the court said, could legally impose a tax penalty on people who do not have health insurance.

But in the new case, the 20 plaintiff states, led by Texas, argued that with the penalty zeroed out, the individual mandate had become unconstitutional — and that the rest of the law could not be severed from it.

The Justice Department’s response to the case was highly unusual: though it disagreed with the plaintiffs that the entire law should be struck down, it declined this year to defend not just the individual mandate, but the law’s provisions that protect people with pre-existing conditions.

More than 500 million men, women and children of the European Union are covered today by a National Health Care insurance program. The first of which was established just post-WW2 in the UK.

When will Uncle Sam ever learn that national health-care is a basic human right? If the DoD can defend the nation against invasion of an enemy, why should the Dept. of Health not defend defend us against disease and ill health ... ?


PS: How does health spending in the U.S. compare to other countries?
 
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RabidAlpaca

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The claim that some people just don't need healthcare is complete nonsense. We're all highly vulnerable bags of soft meat that will at various points throughout our lives need maintenance. The people without insurance will still show up to an ER when they have an issue, and it will be up on the rest of us with insurance to cover their bill. Requiring everyone to have insurance was a way to insure that everybody pays at least something, because we all need it, no matter who you are.

We pay about double per capita what other modern nations pay for healthcare, yet rank nowhere near the top in quality of care, healthcare outcomes, life expectancy, and are near dead last in percentage of citizens covered among other western nations. This is a step further away from affordable healthcare. There is no successful healthcare system in the world that operates anything like what the Republicans are wanting.
 

Crovax

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The claim that some people just don't need healthcare is complete nonsense. We're all highly vulnerable bags of soft meat that will at various points throughout our lives need maintenance. The people without insurance will still show up to an ER when they have an issue, and it will be up on the rest of us with insurance to cover their bill. Requiring everyone to have insurance was a way to insure that everybody pays at least something, because we all need it, no matter who you are.

We pay about double per capita what other modern nations pay for healthcare, yet rank nowhere near the top in quality of care, healthcare outcomes, life expectancy, and are near dead last in percentage of citizens covered among other western nations. This is a step further away from affordable healthcare. There is no successful healthcare system in the world that operates anything like what the Republicans are wanting.

Wrong.

The fact is the entire insurance industry is a scam that is only held up by the govt and the banks. Think about how many things you would buy insurance on if you wernt forced to?

The only way insurance works is if the majority of people get less benefits than what they paid for.
 

RabidAlpaca

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Wrong.
The fact is the entire insurance industry is a scam that is only held up by the govt and the banks. Think about how many things you would buy insurance on if you wernt forced to?
The only way insurance works is if the majority of people get less benefits than what they paid for.

Nope. All people need healthcare throughout their lives. That is a fact.
 

RabidAlpaca

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Healthcare but not health insurance

When it can cost up to 10k for a broken leg or over 100k for cancer, everyone needs health insurance, just as everyone who wants to drive is legally required to have liability insurance. You can not point to one successful example of a country using the Republican style healthcare system. I guess Somalia is pretty close, it's very "everyone for themselves" and their system sucks.
 

ttwtt78640

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The claim that some people just don't need healthcare is complete nonsense. We're all highly vulnerable bags of soft meat that will at various points throughout our lives need maintenance. The people without insurance will still show up to an ER when they have an issue, and it will be up on the rest of us with insurance to cover their bill. Requiring everyone to have insurance was a way to insure that everybody pays at least something, because we all need it, no matter who you are.

We pay about double per capita what other modern nations pay for healthcare, yet rank nowhere near the top in quality of care, healthcare outcomes, life expectancy, and are near dead last in percentage of citizens covered among other western nations. This is a step further away from affordable healthcare. There is no successful healthcare system in the world that operates anything like what the Republicans are wanting.

What to those on Medicaid (expanded or standard) pay in premiums, deductibles or co-pays? PPACA is basically a half measure which adds a bit more income redistribution to the mess of having 'private' businesses be publicly funded. There is no successful healthcare system in the world that operates like PPACA.

When the answer to question of "How much does performing medical procedure X result in the care provider receiving?" has no dollar amount answer then you have a problem. That answer is now "It depends on which federally approved medical care insurance plan (if any) the patient may have been assigned".
 

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if everyone gets kicked off of the ACA because of this idiot's decision, the silver lining is that it's a step towards real universal coverage. it's a dumb way to do it, but we are the US, so that's sort of par for the course. we tend to have to make a lot of regular people suffer a lot before we can make any kind of real progress.
 

Helix

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When it can cost up to 10k for a broken leg or over 100k for cancer, everyone needs health insurance, just as everyone who wants to drive is legally required to have liability insurance. You can not point to one successful example of a country using the Republican style healthcare system. I guess Somalia is pretty close, it's very "everyone for themselves" and their system sucks.

when i was gigging regularly, it seemed like we would play at least a show a year to raise money for someone with cancer. the whole town would get together to raise money for someone who had crushing debt because they were unlucky enough to get sick. after a while, i started asking myself "why is this a thing?" in other countries, people just go to hospital if they get sick or hurt. that was one of steps away from my libertarian delusions.
 

ttwtt78640

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When it can cost up to 10k for a broken leg or over 100k for cancer, everyone needs health insurance, just as everyone who wants to drive is legally required to have liability insurance. You can not point to one successful example of a country using the Republican style healthcare system. I guess Somalia is pretty close, it's very "everyone for themselves" and their system sucks.

Are auto liability insurance premiums publicly subsidized for low income drivers and prohibited from varying based on actuarial risk factors (aka pre-existing conditions)? Be careful when you say "just as" when it is far from an accurate analogy.
 

RabidAlpaca

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Are auto liability insurance premiums publicly subsidized for low income drivers and prohibited from varying based on actuarial risk factors (aka pre-existing conditions)? Be careful when you say "just as" when it is far from an accurate analogy.

I can point to dozens of examples around the world where the healthcare system I advocate for outperforms ours at a much cheaper cost. You can't point to any successful example of the system you advocate.
 

ttwtt78640

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I can point to dozens of examples around the world where the healthcare system I advocate for outperforms ours at a much cheaper cost. You can't point to any successful example of the system you advocate.

I can do the same for K-12 educational systems - simply because gov't X does something well does not mean that gov't Y will do so. You mistake an objection to proposal X (say adding PPACA) to endorsement of the current mess.

Let's get back to your mandatory auto liability insurance analogy - if one is caught driving without that mandatory auto insurance they can (and often do) go to jail and/or have their vehicle confiscated (impounded). Would you accept that as a reasonable way to treat those that do not pay for medical care insurance yet seek medical care treatment?
 

RabidAlpaca

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I can do the same for K-12 educational systems - simply because gov't X does something well does not mean that gov't Y will do so. You mistake an objection to proposal X (say adding PPACA) to endorsement of the current mess.

Let's get back to your mandatory auto liability insurance analogy - if one is caught driving without that mandatory auto insurance they can (and often do) go to jail and/or have their vehicle confiscated (impounded). Would you accept that as a reasonable way to treat those that do not pay for medical care insurance yet seek medical care treatment?

No, because you can't opt-out of being a human. Literally everybody needs healthcare. You pretending they don't and that some Americans simply don't want healthcare isn't compatible with reality.
 

Crovax

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When it can cost up to 10k for a broken leg or over 100k for cancer, everyone needs health insurance, just as everyone who wants to drive is legally required to have liability insurance. You can not point to one successful example of a country using the Republican style healthcare system. I guess Somalia is pretty close, it's very "everyone for themselves" and their system sucks.

Hmm 100k sounds expensive.

If you take the $4500 that is spent between me and my employer put in into a personal HSA and let it compound for 20 years that’s over $150k. Seems like a much better plan for holding people personally responsible for their own healthcare. Then you wouldn’t have people running to the doctor every time they get the sniffles
 

RabidAlpaca

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Hmm 100k sounds expensive.

If you take the $4500 that is spent between me and my employer put in into a personal HSA and let it compound for 20 years that’s over $150k. Seems like a much better plan for holding people personally responsible for their own healthcare. Then you wouldn’t have people running to the doctor every time they get the sniffles

And if you had gotten cancer in your first years of working you'd be **** out of luck because you didn't have 100k and you live in a dystopian American society where if you can't pay you die (in conservative wank-off fantasy land). I truly don't understand how you think that's a desirable situation.
 

Donc

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kinda looks like Reps got themselves into a pickle here. They better come up with a solution to the pre-existing condition dilemma. :2wave:

<Ruling to strike down health law puts GOP in a quandary. >


<WASHINGTON — A federal judge's ruling that the Obama health law is unconstitutional has landed like a stink bomb among Republicans, who've seen the politics of health care flip as Americans increasingly value the overhaul's core parts, including protections for pre-existing medical conditions and Medicaid for more low-income people.>

<But Republicans, still stinging from their loss of the House in the midterm elections, are facing a fresh political quandary after U.S. District Judge Reed O'Connor said the entire 2010 health law was invalid.>

<Warnings about the Texas lawsuit were part of the political narrative behind Democrats' electoral gains. Health care was the top issue for about one-fourth of voters in the November election, ahead of immigration and jobs and the economy, according to VoteCast, a nationwide survey for The Associated Press. Those most concerned with health care supported Democrats overwhelmingly.>

<Two top House Republicans issued diverging statements.>

<Majority Leader Kevin McCarthy of California said "Obamacare is a broken law," but added, "I am committed to working with my colleagues on both sides of the aisle to make sure America's healthcare system works for all Americans.">

<The third-ranking GOP leader, Louisiana Rep. Steve Scalise, praised the judge's ruling and made no mention of working with Democrats, whom he accused of "running a fear-mongering campaign" to win control of the House last month. >

https://www.msn.com/en-us/news/poli...-gop-in-a-quandary/ar-BBQYuyB?ocid=spartanntp
 

jaeger19

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I can point to dozens of examples around the world where the healthcare system I advocate for outperforms ours at a much cheaper cost. You can't point to any successful example of the system you advocate.

Yeah,, not if you compare apples to apples.
 

jaeger19

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if everyone gets kicked off of the ACA because of this idiot's decision, the silver lining is that it's a step towards real universal coverage. it's a dumb way to do it, but we are the US, so that's sort of par for the course. we tend to have to make a lot of regular people suffer a lot before we can make any kind of real progress.

Actually its much much much worse than "everyone getting kicked off the ACA".

If the ACA gets declared unconstitutional... it would be a HUGE blow to medicare. to Medicaid.. to communities that have healthcare as a prominent employer.

Basically the ACA did way more than just expand Medicaid, and private insurance subsidies. IT also did major fixes to medicare.. established rates and so forth.

That's why they could not repeal it.
 

RabidAlpaca

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Yeah,, not if you compare apples to apples.

There are no other apples to compare. Nobody in the world runs a healthcare system like the US. We pay the most per capita of any country in the world yet rank nowhere near the top in quality of care, have tens of millions of Americans completely uninsured and tens of millions more who take on debt for medical procedures. You can't point to one successful healthcare system in the world that successfully does the nightmare system the Republicans want us to have.
 

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Actually its much much much worse than "everyone getting kicked off the ACA".

If the ACA gets declared unconstitutional... it would be a HUGE blow to medicare. to Medicaid.. to communities that have healthcare as a prominent employer.

Basically the ACA did way more than just expand Medicaid, and private insurance subsidies. IT also did major fixes to medicare.. established rates and so forth.

That's why they could not repeal it.

it will probably be overturned on appeal.
 

jaeger19

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There are no other apples to compare. Nobody in the world runs a healthcare system like the US. We pay the most per capita of any country in the world yet rank nowhere near the top in quality of care, have tens of millions of Americans completely uninsured and tens of millions more who take on debt for medical procedures. You can't point to one successful healthcare system in the world that successfully does the nightmare system the Republicans want us to have.

Exactly.. which means that if you want to compare systems and costs, you have to control for things like the fact that America doesn't pay for physician education publically.

While other countries do.. which means that their costs in healthcare are lower.. but that cost is just shifted into their education system.

Or for example retirement. Other countries like France let people retire early if they are in a hard physical job... but the US doesn't. So while the French say avoid higher costs by avoiding repetitive injuries. they increase their costs in retirement spending.

And then you have to compare what systems pay for and what they do not.

We spend a lot more.. yet we also have a lot more when it comes to coverage than most single payer countries. Our Medicaid and Medicare..and most private insurance cover way more than most single payer government insurances in other countries. For example Canada single payer government doesn't pay for outpatient medications or home health. Medicaid and Medicare do.

Then there are differences in our demographics.. we tend to be more obese.. have more stress, work longer hours, and have more comorbidities than other countries.
 

jaeger19

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it will probably be overturned on appeal.

I figure. The decision is out of left field when it declares the whole law is unconstitutional just because the individual mandate is removed. That piece is not essential to the rest of the law.
 

RabidAlpaca

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Exactly.. which means that if you want to compare systems and costs, you have to control for things like the fact that America doesn't pay for physician education publically.

While other countries do.. which means that their costs in healthcare are lower.. but that cost is just shifted into their education system.

Or for example retirement. Other countries like France let people retire early if they are in a hard physical job... but the US doesn't. So while the French say avoid higher costs by avoiding repetitive injuries. they increase their costs in retirement spending.

And then you have to compare what systems pay for and what they do not.

We spend a lot more.. yet we also have a lot more when it comes to coverage than most single payer countries. Our Medicaid and Medicare..and most private insurance cover way more than most single payer government insurances in other countries. For example Canada single payer government doesn't pay for outpatient medications or home health. Medicaid and Medicare do.

Then there are differences in our demographics.. we tend to be more obese.. have more stress, work longer hours, and have more comorbidities than other countries.

No, we don't have "more coverage" than UHC countries because we actively deny Healthcare to tens of millions of Americans who can't afford it. We have the worst levels of coverage of any western nation. We have the most rationed healthcare system in the west.

And yes, we're fatter, unhealthier and don't live as long as everyone else, and that has a lot to do with our piss poor Healthcare system. Stop trying to defend our failures.
 

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Are auto liability insurance premiums publicly subsidized for low income drivers and prohibited from varying based on actuarial risk factors (aka pre-existing conditions)? Be careful when you say "just as" when it is far from an accurate analogy.

Women are given lower auto insurance rates because on average women are a lower cost (risk), they cause fewer accidents.

That’s fine, but I’ll bet if men were given lower health insurance rates than women there would be hell to pay.
 
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