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So hospitals shouldn't be required to treat critical patients? It's OK for people do die because it costs them/you some money? If that's not your position please let me know, but that's how it comes across.Your core concern regards critical patients not being able to get health care, right?
Is it better for them not to get it because they can't afford it or because hospitals are bankrupt?Here's an alternative, how about raising the number of job opportunities compared to the number of laborers? That way, the working wage will go up and people will be able to have more money to pay for health care?
First off, the whole bankruptcy "issue" is highly overstated. The hospitals have a way to recoup their losses (and even benefit from them by showing a loss when it comes to tax time). Is it the right way to do it? Not really, but the system is what it is, and I don't believe ending EMTALA is the correct way to go.
It's just funny that people are so opposed to a public option...that's the model we're currently operating under to a certain degree: hospitals raise rates on other services in order to cover the losses incurred by EMTALA patients, thereby causing those with insurance (and their employers) to foot the bill.
And how will businesses create more jobs? If the recession has taught businesses one thing it is that they can do more with less. I think they have found (rightly) that they were overemploying. There was little to no interruption in operations when layoffs happened. Why make jobs when they're not needed?
I know that there are a number of people here that know more about this stuff than I do.
Basically, one judge (so far) has ruled that the Health Care Bill (or at least part of it) is unconstitutional. So what does that mean right now? And what does that mean in the long term?
It means the Supreme Court will eventually rule on the law. Many provisions of this law are delayed into taking effect. Many have seen premiums for health insurance rise already with the portions of the law that has already gone into effect. This is expected to continue. The law in its current form also is anticipated to cause health insurance companies to drop individuals from coverage.
When you over-regulate an industry the industry goes away. Which was the goal of the bill in the first place. Many Democrats (Obama included) didn't want the bill that passed. They wanted single-payer (which is another way to say they wanted government ran health care). So they wrote a bill with the intent to crush the industry.
Mid-term, it is likely that the Supreme Court will rule against the law or possibly revoked in two years.
Long-term there are too many variables. There's elections to be held. There's the impact this will have on insurance companies, the busiensses who actually pay premiums on behalf of employers, the businesses who ask for waivers from the law, and the impact on people who pay all or part of premiums.
There are ways to reduce health care costs and premiums, but those were not included in the bill, because that was not the true goal of those passing it. One way would be to open health insurance to competition across state lines. And that would likely be something that Congress does have the power to do.
It seems to me the whole Constitutional issue could be avoid simply by levying a tax, and using that to fund universal health care. Not saying that is a good idea (or a bad one), just that it would address the legal issue in this case.
The whole "you'd let someone die if costs too much?" question is suppose to elicit an emotional response, but let's think about this rationally for a second.
How much is another week of life worth to you?
$1? Sure.
$10? Yup.
$100? ...Yeah, ok.
$1000? ....Maybe.
$10,000?
$100,000?
$1,000,000?
$10,000,000?
.
.
.
And keep in mind, any money spent to extend your life is money that can't be spent on other things, like immunizing children, better pre-natal care, fixing a broken arm, fighting cancer, aids/hiv drugs/treatments, etc.
Anyone who thinks you can ignore the money issue when it comes to health care is living in a fantasy world (one I'd love to live in, Star Trek Universe yeah!). The fact is even with government run health care, considerations have to be made, is this expense ultimately worth it? And sometimes they say, "No, we are not going to pay for an expensive treatment because it will not significantly improved the patient's life."
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It seems to me the whole Constitutional issue could be avoid simply by levying a tax, and using that to fund universal health care. Not saying that is a good idea (or a bad one), just that it would address the legal issue in this case.
It would avoid Constitutional issues. Well, at least obvious ones. There's still a lot of debate on exactly what "General Welfare" means. But that's a whole other debate, really.
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You can not own or operate a vehicle on any square inch of dirt, public or private in the State of New Jersey, and I think every other state unless you have insurance or are covered by someone else's. Period. And culturally Americans DO consider the ability to drive a mandated right. That's why it's almost unheard of for anyone to be stricken of a license, despite declining ability to drive unless they actually go out and kill someone with their car. There are people out there driving... who literally should not be behind a wheel with thier impaired senses... who are issued updates regularly and still have licenses... because they've been lucky enough not to kill someone....yet.I guess it means at least one judge in America can read the Constitution. Nothing in the document gives government the power to mandate anyone to be forced to buy a service or product.
And don't bring up auto insurance. No one is required to buy it, only people who wish to enjoy the privilege of operating a motor vehicle on public roads need to buy insurance. And driving isn't a right, it's a privilege.
In Texas (and some other states), you don't need a license to operate a farm truck if it never leaves the farm for public roads, sans license. It doesn't even need to be registered or insured.
But then, Texas isn't New Jersey. Texas doesn't think everything you own, nor every dime you earn, belongs to the state (with the state being nice enough to let you use the vehicle or keep some money).
I like your new governor, by the way. He's moderate enough to not be insane, but conservative enough to correct a bunch of Corzine's mistakes.
The whole "you'd let someone die if costs too much?" question is suppose to elicit an emotional response, but let's think about this rationally for a second.
How much is another week of life worth to you?
$1? Sure.
$10? Yup.
$100? ...Yeah, ok.
$1000? ....Maybe.
$10,000?
$100,000?
$1,000,000?
$10,000,000?
.
.
.And keep in mind, any money spent to extend your life is money that can't be spent on other things, like immunizing children, better pre-natal care, fixing a broken arm, fighting cancer, aids/hiv drugs/treatments, etc.
Anyone who thinks you can ignore the money issue when it comes to health care is living in a fantasy world (one I'd love to live in, Star Trek Universe yeah!). The fact is even with government run health care, considerations have to be made, is this expense ultimately worth it? And sometimes they say, "No, we are not going to pay for an expensive treatment because it will not significantly improved the patient's life."
I'd argue this is an unfair setup because it puts a specific amount of money on a specific length of time as related to being alive. I've seen this argument made before, and while it is based in reality to an extent for certain situations, it's just as unfair as the original argument it was made to counter.
I'd argue this is an unfair setup because it puts a specific amount of money on a specific length of time as related to being alive. I've seen this argument made before, and while it is based in reality to an extent for certain situations, it's just as unfair as the original argument it was made to counter.
I wasn't trying to "counter" any argument, just point out that if you are trying to elicit an emotional response, you might not be thinking of things rationally. Things are much more complex than what they appear at first glance and everything is interconnected. A decision here effects decisions elsewhere.
As for "certain situations", sure, but those situations happen regularly (not for individuals but for the industry). I had a guy I worked with that got a type of cancer. And before they would treat it with some procedure (he had insurance), he had to "prove" that he was healthy enough for the insurance company to justify the expense (so this isn't just a problem with government run "death-panels" it happens in the private industry too). Extension/quality of life and cost are very much weighted against each other on a daily basis. This isn't being "heartless", is it heartless to want to be able to help 1,000 people by not wasting a bunch of money on 1 person that probably won't benefit from it?
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Then all you need is a fixed 50% Tax on all Corporation and Business income above $100,000, and 50% Tax on all private income above $30,000 to pay for it.I don't want to comment on this because I'm pretty sure you're being completely sarcastic, right? It seems obvious that you're being sarcastic but this is the internet and it's hard to judge tone so I wanted to make sure.I'm being Serious. You want the Good Life, you fix the problem for everyone, and make it better for yourself in the long run. If people are no longer sick and desperate, there will be less of them committing crimes.
If you can fix health, it fixes the other problems too.Yes, because cutting everyone making $40k a year down to $20k a year won't make them desperate at all, neither will ensuring that everyone with student loans who can't find a high paying job will suddenly be defaulting on their loans. What about the loss of buying power when suddenly half of your income is gone, who is out pumping cash into the economy if they can't afford to live on their suddenly worthless $50k per year job?
** spoiler omitted **...
That is because you didnt understand what I'm suggesting. I'm suggesting that the first thirty tousand dollars of your personal income be tax free - and the surplus subject to 50% Tax to pay for free medical. That way everyone pays the Same Tax for the same benifit.
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So hospitals shouldn't be required to treat critical patients? It's OK for people do die because it costs them/you some money? If that's not your position please let me know, but that's how it comes across.Your core concern regards critical patients not being able to get health care, right?
Is it better for them not to get it because they can't afford it or because hospitals are bankrupt?Here's an alternative, how about raising the number of job opportunities compared to the number of laborers? That way, the working wage will go up and people will be able to have more money to pay for health care?
Address the Nursing Shortfall by forcing every potential Doctor to train as a Nurse first - and get five years work as a Nurse - before becomming a Doctor.
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And that means all doctors are more than five years older than they would have been otherwise. Doctors already spend an inordinate amount of their life getting the education necessary to perform their job - and must spend a long time afterward paying off the loans they took out to get the education, in many cases. Surgeons will have at least 5 fewer years of having steady hands and clear eyesight they need to perform delicate operations.
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It's worth noting that judicial opinions, much like the legitalative process in the Obama plan are falling along party lines. Judges who are ruling against the Health plan are elected Republicans and those for it are generally elected Democrats.I know that there are a number of people here that know more about this stuff than I do.
Basically, one judge (so far) has ruled that the Health Care Bill (or at least part of it) is unconstitutional. So what does that mean right now? And what does that mean in the long term?
I don't know whether I know that much about any of it, and IANAL, but my impression that it doesn't mean much, at least not in the short term. The provision in question was (IIRC) to take effect in 2014. It's virtually guaranteed to hit the Supreme Court before then, and I think any long-term implications will come of what is decided when it does.
I do believe that even supporters of the law would largely agree that it no longer makes sense without mandatory insurance for all.
I've noticed this as well -- but why? What do the judges have to gain (at this point) siding one way or the other (as opposed to which way is "right")?
Bella Sara Charter Superscriber
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I've noticed this as well -- but why? What do the judges have to gain (at this point) siding one way or the other (as opposed to which way is "right")?
Partly, it's that they see their decisions as "right".
But, if you want the less idealistic view, it's because it increases their chances of being appointed (or re-appointed) to other judicial positions (such appointments being determined by legislators who are much more politically oriented). No Supreme Court justice in recent years has been appointed because they were a moderate without a political bias.
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Partly, it's that they see their decisions as "right".
But, if you want the less idealistic view, it's because it increases their chances of being appointed (or re-appointed) to other judicial positions (such appointments being determined by legislators who are much more politically oriented). No Supreme Court justice in recent years has been appointed because they were a moderate without a political bias.
I guess it's hard for me to see "right" strictly being along political lines.
I guess that it also kind of surprises me that it's taken this long for someone to stand up and make this statement. Just sitting there and not making a statement seems fairly "moderate". From your line of reasoning (and I agree with it), I think I'd want to be the first one to not be "moderate" on something this big.
In my little world of finance, I came across this as one of the reasons recently as to why rates have started going up. And I found that kind of odd since (at least directly) the two things have little to do with each other. The reason for it (as near as I can tell) is that the public feels that this is a "good move" and therefore has a little more faith in what the government is doing and is therefore willing to invest a little more agressively. (There's probably a lot more to it, but that's a quick "Moff Rimmer" assessment.)
I'm still trying to wrap my head around long term effects of this. It almost feels like it will be (largely) overturned, we will be back to where we were before this document and no one will actually notice that nothing was done.
And I can't tell if that's "good" or "bad".
Then all you need is a fixed 50% Tax on all Corporation and Business income above $100,000, and 50% Tax on all private income above $30,000 to pay for it.I don't want to comment on this because I'm pretty sure you're being completely sarcastic, right? It seems obvious that you're being sarcastic but this is the internet and it's hard to judge tone so I wanted to make sure.I'm being Serious. You want the Good Life, you fix the problem for everyone, and make it better for yourself in the long run. If people are no longer sick and desperate, there will be less of them committing crimes.
If you can fix health, it fixes the other problems too.Yes, because cutting everyone making $40k a year down to $20k a year won't make them desperate at all, neither will ensuring that everyone with student loans who can't find a high paying job will suddenly be defaulting on their loans. What about the loss of buying power when suddenly half of your income is gone, who is out pumping cash into the economy if they can't afford to live on their suddenly worthless $50k per year job?
** spoiler omitted **...
That is because you didnt understand what I'm suggesting. I'm suggesting that the first thirty tousand dollars of your personal income be tax free - and the surplus subject to 50% Tax to pay for free medical. That way everyone pays the Same Tax for the same benifit.
Ah, ok I misunderstood you then. Still not sure how well that solution would work but it wasn't as disastrous as what I thought you had suggested.
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Bella Sara Charter Superscriber
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I guess it's hard for me to see "right" strictly being along political lines.
I agree. The political parties consist of alliances of competing factions, which may not always share the same interests, and are often cobbled together in an opportunistic fashion. I have a very difficult time imagining that one of them has the correct answer to every issue, or that there even is a correct answer to every issue (as opposed to a balancing of the harms and benefits, as with most things in life).
Sadly, I believe we are in the minority.
I'm still trying to wrap my head around long term effects of this. It almost feels like it will be (largely) overturned, we will be back to where we were before this document and no one will actually notice that nothing was done.
It's hard to say if it'll be overturned and, if overturned, if that will really be a limitation on the powers of the federal government, or just the judiciary passing political judgment on an isolated piece of legislation they don't like. There's always a certain inevitability to the status quo, but the current expansive powers of the federal government really dates back to the New Deal. Early on in the Great Depression, the court struck down a large number of social programs as not being within the power of the federal government. Eventually, that changed, and the commerce clause was used to expand federal power dramatically. I can't imagine we'd go back to the pre-New Deal limits on the federal government, which I just don't see as practical for a modern nation state, but what do I know.
With the current composition of the Supreme Court though, I don't think it's impossible that things will change.
Plus, I'm pretty cynical with regards to cases resolved on procedural basis, which is what this is. The challenge is based on the federal government's power to enact health care reform, but that's just an excuse to get it in front of a court. To me, this is the court passing judgment on the merits of the legislation in the form of upholding the challenge on the power of the government to enact it. This is not unique in any way to this particular case, it's just the way the courts work generally. The ends will drive the decision, and the means are only a cloak to get the judiciary to consider those ends.
But, cynicism aside, there is still the broader question on the appropriate limits of the federal government that is something the judiciary is charged with determining. If there are new limits on the federal government imposed in connection with this case, that could have significant consequences on other federal programs. So, it could well be that the ends (and the means) really are the limitation of federal power, a question the court should determine, and this particular piece of legislation is the most appropriate vehicle for that question.
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It's hard to say if it'll be overturned and, if overturned, if that will really be a limitation on the powers of the federal government, or just the judiciary passing political judgment on an isolated piece of legislation they don't like. There's always a certain inevitability to the status quo, but the current expansive powers of the federal government really dates back to the New Deal. Early on in the Great Depression, the court struck down a large number of social programs as not being within the power of the federal government. Eventually, that changed, and the commerce clause was used to expand federal power dramatically. I can't imagine we'd go back to the pre-New Deal limits on the federal government, which I just don't see as practical for a modern nation state, but what do I know.
You forgot the best part: The Supremes were intimidated into allowing FDR to do what he wanted by dint of FDR threatening to expand the SC to fifteen justices and nominating people who would do what he wanted. The existing justices didn't want their power diluted and caved in.
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Bella Sara Charter Superscriber
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You forgot the best part: The Supremes were intimidated into allowing FDR to do what he wanted by dint of FDR threatening to expand the SC to fifteen justices and nominating people who would do what he wanted. The existing justices didn't want their power diluted and caved in.
Yes and no. While it's true that an amendment increasing the size of the court was circulated, I believe the court's stance changed due to the composition of the court during the period in which that amendment was being considered and the increasing desperation brought on by the Great Depression. The above strikes me as a particularly partisan view of what happened.
The court packing bill would've required amending the Constitution and was horribly unpopular. As far as I know, there wasn't any real chance of that amendment passing and was widely perceived as FDR attempting to bully the court into going his way. I'm doubtful that a judge changed his stance because of the existence of the amendment.
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You forgot the best part: The Supremes were intimidated into allowing FDR to do what he wanted by dint of FDR threatening to expand the SC to fifteen justices and nominating people who would do what he wanted. The existing justices didn't want their power diluted and caved in.Yes and no. While it's true that an amendment increasing the size of the court was circulated, I believe the court's stance changed due to the composition of the court during the period in which that amendment was being considered and the increasing desperation brought on by the Great Depression. The above strikes me as a particularly partisan view of what happened.
The court packing bill would've required amending the Constitution and was horribly unpopular. As far as I know, there wasn't any real chance of that amendment passing and was widely perceived as FDR attempting to bully the court into going his way. I'm doubtful that a judge changed his stance because of the existence of the amendment.
Actually, there's no need for a constitutional amendment. The Constitution doesn't set the number of justices, Congress does, though a judiciary act. All FDR had to do was convince the Dem senate and congress to pass an act. That's it. That Congress didn't pass the act is irrelevant.
And when did popularity ever effect what a president does? The health care bill was unpopular (53% disapproval) before it was passed. T
I still assert FDR and the Supremes had a staring contest and the Supremes blinked. Maybe they figured he'd have a better Congress in '38.
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Bella Sara Charter Superscriber
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Actually, there's no need for a constitutional amendment. The Constitution doesn't set the number of justices, Congress does, though a judiciary act. All FDR had to do was convince the Dem senate and congress to pass an act. That's it.
Ack. You're right. Not sure why I had it in my head that it was an amendment.
I still assert FDR and the Supremes had a staring contest and the Supremes blinked.
But, I still disagree with this. I just don't think anything is ever that simple, particularly in politics. It's like answering "what's the cause of the Civil War" with "slavery."
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Actually, there's no need for a constitutional amendment. The Constitution doesn't set the number of justices, Congress does, though a judiciary act. All FDR had to do was convince the Dem senate and congress to pass an act. That's it.Ack. You're right. Not sure why I had it in my head that it was an amendment.
But, I still disagree with this. I just don't think anything is ever that simple, particularly in politics. It's like answering "what's the cause of the Civil War" with "slavery."
I still assert FDR and the Supremes had a staring contest and the Supremes blinked.
We'll have to agree to disagree there. I don't know why the Supremes would suddenly flip their position (and things got objectively worse after they did and didn't knock out some stuff) if they weren't afraid of losing some power.
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Bella Sara Charter Superscriber
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We'll have to agree to disagree there. I don't know why the Supremes would suddenly flip their position (and things got objectively worse after they did and didn't knock out some stuff) if they weren't afraid of losing some power.
Our mutual friend Wikipedia has some color on the issue and offers alternate explanations. For whatever that's worth.
Edit: And, just to be clear, I'm not defending or justifying the court packing bill. I think there are additional factors that influenced history, and the court packing bill may have been one of those factors, but it was by no means the only factor. Plus, the "FDR bullied the court" bypasses a discussion of what limits should be on federal power altogether, a question that many people struggled with during a very difficult time (and continue to struggle with today). Making it into the same old "us v. them" makes it into a conflict rather than a discussion and debate.
Making it into the same old "us v. them" makes it into a conflict rather than a discussion and debate.
Somebody call me?
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As someone who works for an EMS agency (and has worked in the past for a private hospital), there are a few angles I see here.
1: As a For-Profit organization, the company I work for is out to make money. That means, in a nutshell, hurt, sick, psychotic, or otherwise compromised people are the core of the revenue stream. Non-Emergency transportation counts for the majority, mostly because it actually gets paid for.
2: The government cannot provide the level of service that a private company can. Simple fact. None of the municipalities we serve have the resources to staff enough ambulances, EMT's, Paramedics, Air-Ambulance staff, and the like to serve the public. Without the basis of "calls for cash" that underlies the system, many people in the community would be without the means to get to dialysis, cancer-treatment centers, physical-, speech-, and similar therapies. A good number of people would simply die where they were, when injured, sickened, or exposed to some toxin.
3: The current healthcare system works for 2 kinds of people. A: The very wealthy, who can afford ridiculous insurance premiums, get incredible discounts on things like drugs, diagnostic treatments, and preventative medicine. B: The very very poor, who, by means of state-funded welfare programs, get very similar treatment to A, but generally have to wait until they are sick or injured to get treated.
There is a huge gap in the middle there, with some able to scrape by on the bare minimum coverage, others who do without things like new clothes (buying secondhand or receiving donated materials) or transportation (taking public transit in my area is unreliable, to say the least), or work 2-3 jobs just to make sure their kid gets his asthma medicine.
I am not sure if there is a "everybody wins" solution available here. I do know that the Federal Government, the absolute KING of wasting money frivolously, is NOT the person I want to make decisions regarding my health and well-being.
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Bella Sara Charter Superscriber
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(Edit)...and don't even think about a change in corporate law. It will never happen...ever. Assassination, torture, blackmail, civil war and the use of chemical/biological/nuclear weapons will be used to prevent that from happening...period.
Job security! Huzzah!
In short...you don't count at all and never will...so this entire thread is pointless.
You know what I like best about you, Sieglord?
Your optimism.
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It will appear rather in the luminous robes of flaming patriotism; it will take some genuinely indigenous shape and color, and it will spread only because its leaders, who are not yet visible, will know how to locate the great springs of public opinion and desire and the streams of thought that flow from them and will know how to attract to their banners leaders who can command the support of the controlling minorities in American public life.
They have absolutely NEVER exhibited any benevolence whatsoever, AT ALL
People do not benefit from free markets because of benevolence. You can not correctly interpret the past or frame potential future results if you use inapplicable parameters.
In every industry, benevolence is a trivial side note, if present at all.
Good businesses want to please you JUST ENOUGH to get you to do business with them and not their competitor.
However, this remains true under ANY economic system. Even under a single payer system it would remain true. Only under single payer, the happiness of the patient would become 100% meaningless. The doctors and middlemen would only need to make the single payer happy.
The "dying in the streets" screed has been run before. It was wrong then, it is wrong now. It would continue to be wrong in a free market future.
In gross, highly simplified terms, there are two reasons for this. First, those selfish business owners know that letting that happen costs more than preventing it. They want to maximize their profits, so the path of least cost prevails. Second, human culture still exists in parallel with economy. And benevolence IS a big part of human culture. And free market systems actually present the LOWEST barriers for non-business charity.
Their is no Utopia. People will get sick and die under single payer and under free markets.
I don't expect to change minds. But, reality won't re-align itself to serve wishful thinking either.