SCOTUS hears arguments for/against Healthcare bill

[AlphaFrog]

I've seen sources saying we will have mandatory health insurance requirements, and others that say that part was not upheld. Does anyone know the real deal on that?

[justgo_withit]

Originally Posted by AlphaFrog

I've seen sources saying we will have mandatory health insurance requirements, and others that say that part was not upheld. Does anyone know the real deal on that?

It sounds like Chief Justice Roberts started out by saying "No, the federal government cannot force people to get health care" and those in the room jumped the gun and assumed that meant it was deemed unconstitutional, but he then continued with "but, the federal government absolutely has the right to tax those who don't have it". I believe the whole law was upheld.

[DeltaBetaBaby]

http://www.healthcare.gov/law/timeline/

Here's a good overview of the whole shebang, for whomever was asking upthread.

[DeltaBetaBaby]

Originally Posted by Beryana

I am making my comment (example) without actually knowing all the minute details of what is required to be considered 'insurance' per this mandate (like auto insurance that require certain minimum coverages?). I had 'insurance' a few years ago when I fell and hit my head on the floor. bruised my brain and knocked my spinal fluid production and absorption out of whack until it affected my vision (turns out I had 4x the normal level). Well, had to see specialists and all that with head MRIs. Turns out my 'insurance' only covered $100 of the office visit, $100 of the spinal tap, and $100 of the MRI - basically $300 of an approx. $6000 bill - which I'm still paying on 5 years later!

Personally, there needs to be tort reform before mandating everyone has to have insurance (or concurrent reforms/mandates). The insurance industry is even more 'broken' and not much is being done other than to make everyone buy their product of pay a tax penalty. . . . (The ENTIRE healthcare system is disfunctional!)

WTF does tort reform have to do with anything? You had crappy insurance, and it didn't cover stuff.

[Kevin]

Originally Posted by DeltaBetaBaby

WTF does tort reform have to do with anything? You had crappy insurance, and it didn't cover stuff.

A lot of folks are in favor of tort reform, but they don't have a clue what it means.

[LAblondeGPhi]

Originally Posted by Beryana

I am making my comment (example) without actually knowing all the minute details of what is required to be considered 'insurance' per this mandate (like auto insurance that require certain minimum coverages?). I had 'insurance' a few years ago when I fell and hit my head on the floor. bruised my brain and knocked my spinal fluid production and absorption out of whack until it affected my vision (turns out I had 4x the normal level). Well, had to see specialists and all that with head MRIs. Turns out my 'insurance' only covered $100 of the office visit, $100 of the spinal tap, and $100 of the MRI - basically $300 of an approx. $6000 bill - which I'm still paying on 5 years later!

Personally, there needs to be tort reform before mandating everyone has to have insurance (or concurrent reforms/mandates). The insurance industry is even more 'broken' and not much is being done other than to make everyone buy their product of pay a tax penalty. . . . (The ENTIRE healthcare system is disfunctional!)

That is terrible, and I'm sorry that you have to go through that. I agree with you that many aspects of the healthcare system aren't working, and I'm particularly angered to hear about folks who HAVE coverage (in many cases, damn expensive coverage) and are still saddled with massive bills after a catastrophic incident.

What I would ideally like to see is a universal healthcare system that ensures a basic, free, level of coverage for all Americans, administered through a combination of private and public entities. For those who want a faster or fancier policy, they can purchase it, or have their employer provide it as part of a compensation package. And by "faster", I don't mean that you get your transplant or emergency surgery faster, I mean that you get your non-emergent doctors appointment with your preferred physician scheduled sooner. I mentioned that this law is not perfect, but I believe it is a step in the direction of universal healthcare, which would NEVER have passed if it were attempted in one fell swoop.

Many folks may be asking "what about cost?", and I think that's a very valid question. While I'm loathe to talk about life-saving technology that's "too expensive" to administer, I think there can be cost savings that we could realize through streamlined billing and files management, greater focus on early prevention and intervention of serious acute and chronic diseases, somehow reigning in the obesity epidemic, and a realistic, human approach to end-of-life and palliative care.

I heard a doctor on NPR recently say that money could be saved in many practices if doctors were allowed more time with each individual patient rather than sending them off to diagnostic tests right away. Instead, she argued, doctors are squeezed to see as many patients as possible in a day, so it's more cost-effective for them to see a patient for 5 minutes and then send them off to a multi-thousand dollar diagnostic test, rather than spend 30 minutes with the patient to narrow down the possible issues. (Those in the healthcare industry - please pipe up here; I've been fortunate to not have many of these rushed doctor visits and therefore can't vouch for this phenomenon personally).

I also recall President Clinton giving a speech a few years ago where he said that Canada spends less per capita on health care than we do in the U.S., and that their administrative costs per dollar were about half of what ours are (it was something like $0.15 to our $0.30 on the dollar spend in admin costs). This is purely remembered information, and I welcome corrections.

I think that we have a lot of public services like police, fire protection and education that are centered around the idea that our society is better served when each individual has certain protections and opportunities. To me, access to affordable, humane healthcare should be one of the primary pillars of a system that provides opportunity to "life, liberty and the pursuit of happiness".

[LAblondeGPhi]

Originally Posted by AlphaFrog

I've seen sources saying we will have mandatory health insurance requirements, and others that say that part was not upheld. Does anyone know the real deal on that?

The individual mandate was upheld, but as an issue of federal taxation, which is different than how it was originally presented by Congress/The Obama Administration (I think it was originally argued as constitutional under interstate commerce?).

[DeltaBetaBaby]

Originally Posted by LAblondeGPhi

Many folks may be asking "what about cost?", and I think that's a very valid question. While I'm loathe to talk about life-saving technology that's "too expensive" to administer, I think there can be cost savings that we could realize through streamlined billing and files management, greater focus on early prevention and intervention of serious acute and chronic diseases, somehow reigning in the obesity epidemic, and a realistic, human approach to end-of-life and palliative care.

Here's an example of a cost problem that is easily fixed:

I was having stomach problems, and fell into the demographic at high risk for Crohn's. I went to the doctor, and he said that he wanted to do a colonoscopy. He then explained that the insurance company won't let him do that unless he put me through cheaper tests first. He also said that the cheaper test always comes back "inconclusive -- do the colonoscopy", so I should just go ahead and schedule the colonoscopy right away.

So, in the doctor's opinion, the cheaper test was NEVER able to rule out Crohn's, but the insurance company mandated that I have the cheaper test anyway. That is really dumb.

ETA: I honestly don't know who was right, between the doc and the ins. co. Insurance companies obviously want cheaper tests, but there are also doctors who over-treat. The point is that there are conflicting incentives, here, and best practices in medicine need to be the winner.

[IUHoosiergirl88]

http://www.buzzfeed.com/daves4/peopl...e-of-obamacare

I'm posting this out of sheer amusement...people ACTUALLY threatening to move to Canada (land of what they're running from, might I add) because of this ruling. Ignorance is bliss, right?

[TonyB06]

Originally Posted by AlphaFrog

I've seen sources saying we will have mandatory health insurance requirements, and others that say that part was not upheld. Does anyone know the real deal on that?

Congress, as it does presently, can offer money to the states to expand Medicaid and can attach conditions to such grants. But Congress cannot penalize states that choose not to participate in aspects of programming by taking away their existing Medicaid funding.

[Beryana]

Originally Posted by DeltaBetaBaby

WTF does tort reform have to do with anything? You had crappy insurance, and it didn't cover stuff.

But I had insurance - which isn't what this whole 'healthcare' debate is about?! How many people don't have insurance in this country?! Having insurance or not doesn't mean much if you still can't afford to go to the doctor when it is necessary (or can't afford the fees charged for tests which you pretty much HAVE to have because of various conditions/illnesses).

And tort reform (and insurance industry reform) have a LOT to do with this whole mess called a 'healthcare system'. . . .

[Beryana]

Originally Posted by IUHoosiergirl88

http://www.buzzfeed.com/daves4/peopl...e-of-obamacare

I'm posting this out of sheer amusement...people ACTUALLY threatening to move to Canada (land of what they're running from, might I add) because of this ruling. Ignorance is bliss, right?

I'm actually moving to England for school - and looking forward to being in the national health insurance system. I know that some of my medications are not covered (and not readily available there so I'm bringing them with), but from talking with other Americans there, they say it is a really good system for the basics (with a wait for non-emergency surgeries, etc).

[Kevin]

Originally Posted by Beryana

And tort reform (and insurance industry reform) have a LOT to do with this whole mess called a 'healthcare system'. . . .

Do tell? Can you explain that one? I know the Chamber of Commerce types claim this is true, but any sort of peer-reviewed study of the whole system has found that malpractice liability has a small to negligible effect on healthcare cost.

That aside, do you not think that patients should be able to sue medical providers who kill and maim them due to professional negligence?

[PeppyGPhiB]

Originally Posted by Beryana

And tort reform <snip> have a LOT to do with this whole mess called a 'healthcare system'. . . .

No it doesn't. That's just what some politicians would like everyone to believe. You know what does, though? People going to the hospital for basic and emergency care who don't have insurance. Congress already mandated that hospitals care for patients regardless of coverage or none - they made their bed, now they need to lay in it! Do you know how much emergency surgery costs? People with insurance have overpaid to make up for the people without insurance. THAT is what drives costs up, not the few people suing doctors for doing things like amputating the wrong leg.

[PiKA2001]

Originally Posted by LAblondeGPhi

That is terrible, and I'm sorry that you have to go through that. I agree with you that many aspects of the healthcare system aren't working, and I'm particularly angered to hear about folks who HAVE coverage (in many cases, damn expensive coverage) and are still saddled with massive bills after a catastrophic incident.

What I would ideally like to see is a universal healthcare system that ensures a basic, free, level of coverage for all Americans, administered through a combination of private and public entities. For those who want a faster or fancier policy, they can purchase it, or have their employer provide it as part of a compensation package. And by "faster", I don't mean that you get your transplant or emergency surgery faster, I mean that you get your non-emergent doctors appointment with your preferred physician scheduled sooner. I mentioned that this law is not perfect, but I believe it is a step in the direction of universal healthcare, which would NEVER have passed if it were attempted in one fell swoop.

Many folks may be asking "what about cost?", and I think that's a very valid question. While I'm loathe to talk about life-saving technology that's "too expensive" to administer, I think there can be cost savings that we could realize through streamlined billing and files management, greater focus on early prevention and intervention of serious acute and chronic diseases, somehow reigning in the obesity epidemic, and a realistic, human approach to end-of-life and palliative care.

I heard a doctor on NPR recently say that money could be saved in many practices if doctors were allowed more time with each individual patient rather than sending them off to diagnostic tests right away. Instead, she argued, doctors are squeezed to see as many patients as possible in a day, so it's more cost-effective for them to see a patient for 5 minutes and then send them off to a multi-thousand dollar diagnostic test, rather than spend 30 minutes with the patient to narrow down the possible issues. (Those in the healthcare industry - please pipe up here; I've been fortunate to not have many of these rushed doctor visits and therefore can't vouch for this phenomenon personally).

I also recall President Clinton giving a speech a few years ago where he said that Canada spends less per capita on health care than we do in the U.S., and that their administrative costs per dollar were about half of what ours are (it was something like $0.15 to our $0.30 on the dollar spend in admin costs). This is purely remembered information, and I welcome corrections.

I think that we have a lot of public services like police, fire protection and education that are centered around the idea that our society is better served when each individual has certain protections and opportunities. To me, access to affordable, humane healthcare should be one of the primary pillars of a system that provides opportunity to "life, liberty and the pursuit of happiness".

In regards to the bold maybe we should get away from seeing the doctor for minor illnesses and rely more on nurses and PA's for our treatments of minor illnesses and check-ups. IIRC that's what they do in Canada. They also make a smaller salary compared to American health professionals.