The Power of the SCOTUS II: "Release the Kagan!"

[WeWantMore]

Well, if nothng else, everyone all-around seems to admit the government could do single-payer without any risk of it being unconstitutional. So I pretty much hope they strike this one down, because that's clearly the next logical step.

Yup. Another reason, like 5 mn has been saying, that I don't know if a loss is a bad thing politically for Obama. Fires up a whole lot of people for single payer, I imagine.

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

Either way, you are forcing people to buy something. That is the problem. That is the overstep of Congress. This was proven during FDR's reign, and I seriously mean reign, that fascist dictator.

On the other hand the medical facilities are required to provide a service for no payment if the person hasn't got insurance. I always wonder how that is legal. It would be unethical and amoral to not do so, of course, but where is the argument to force someone to give something for free? If they refuse they are legally liable.

[Kepler]

Re: The Power of the SCOTUS II: "Release the Kagan!"

a decision against healthcare may just result in taking one of the GOP's biggest november talking points off the table

From a purely political POV GOP operatives probably hope some part of the health care plan stands so they can run against it forever, like abortion.

If it's a 5-4 decision then both sides are animated by the election as setting up future SCOTUS picks.

Is it really cut and dried that single payer has no Constitutional issue? It doesn't have the funding problem of a Mandate, but I would expect the usual suspects to insist that it's not a Constitutionally-delineated power, and the usual suspects to insist that it's implied, and then have that fight.

[FreshFish]

Re: The Power of the SCOTUS II: "Release the Kagan!"

On the other hand the medical facilities are required to provide a service for no payment if the person hasn't got insurance. I always wonder how that is legal. It would be unethical and amoral to not do so, of course, but where is the argument to force someone to give something for free? If they refuse they are legally liable.

The challengers addressed this question straight on during Tuesday's oral arguments: they contended that the problem of people defaulting on their medical bills was a serious one that deserved proper attention.

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

Either way, you are forcing people to buy something. That is the problem. That is the overstep of Congress. This was proven during FDR's reign, and I seriously mean reign, that fascist dictator.

The challengers addressed this question straight on during Tuesday's oral arguments: they contended that the problem of people defaulting on their medical bills was a serious one that deserved proper attention.

That is nice to know. That hasn't gotten any coverage that I heard. (Haven't had time to catch up on a lot of it.)

[FreshFish]

Re: The Power of the SCOTUS II: "Release the Kagan!"

Well, if nothng else, everyone all-around seems to admit the government could do single-payer without any risk of it being unconstitutional. So I pretty much hope they strike this one down, because that's clearly the next logical step.

It may seem like a technicality, however "single" payor will never work.
a) the person receiving the service is the "single" payor. No way.
b) the government is the "single" payor. Economically impossible.

You need at least two "payors" for it to be economical. The person receiving the service MUST have some "skin in the game" or there is no reason to be judicious. You can't seriously propose that every aspirin, every band-aid, every tube of Neosporin, be covered 100% with no coinsurance and no deductible, can you? Elective plastic surgery okay too?

Whenever unlimited wants and limited resources get into a wrestling match, guess who always wins in the end?

It seems to me that we have to include some kind of incentive to people to use resources responsibly. I'm all for surcharges for smokers and overweight people, for example; they cost more to treat and if they change their ways we are all better off, why not give them some financial reason not to burden the rest of us with their lack of self-discipline?

[Kepler]

Re: The Power of the SCOTUS II: "Release the Kagan!"

b) the government is the "single" payor. Economically impossible.

The UK, Canada, Australia and Taiwan are single payer, so it is clearly not "economically impossible." Cost control is similar to a fire department or a police department -- there are triggers and scope conditions and fines for abusing the system.

[FlagDUDE08]

Re: The Power of the SCOTUS II: "Release the Kagan!"

On the other hand the medical facilities are required to provide a service for no payment if the person hasn't got insurance. I always wonder how that is legal. It would be unethical and amoral to not do so, of course, but where is the argument to force someone to give something for free? If they refuse they are legally liable.

It has to do with the Hippocratic Oath that medical professionals take.

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

It has to do with the Hippocratic Oath that medical professionals take.

Duh. But the hospital is not a Dr or other medical provider. They are force to give away service for free. I wan't arguing the morality but why were they legally required.

[FlagDUDE08]

Re: The Power of the SCOTUS II: "Release the Kagan!"

Duh. But the hospital is not a Dr or other medical provider. They are force to give away service for free. I wan't arguing the morality but why were they legally required.

Perhaps it has to do with any contracts between the hospital and the staff? Maybe the doctors require some means to exercise this oath without breaking the contract they have with their hospital, and this is the best way they had of doing so? I'm unfamiliar with medical contracts and unions.

Either way, those who live by the system get screwed, and those who abuse the system win.

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

Perhaps it has to do with any contracts between the hospital and the staff? Maybe the doctors require some means to exercise this oath without breaking the contract they have with their hospital, and this is the best way they had of doing so? I'm unfamiliar with medical contracts and unions.

No. The hospital, Dr, provider, nurse, whatever is negligent if they do not provide care when they could have. It has nothing to do with an oath. A few yrs ago some of the hospital ERs started refusing patients and that was quickly squashed with a bunch of legislation and court cases. Wish I could remember an exact instance but it was all over the news as a trend that needed to be stopped because the hospitals were discriminating against the underserved.

Obviously the real choice wouldn't be to deny care. I don't think you would find many who would take that route but to be able to be sure it was reimbursed would be nice. It burns my but that someone assumes they won't need care but knows they won't be turned away if they do. No need to worry about the finances of it until it is too late. Then my $ go to pay for their folly.

[FlagDUDE08]

Re: The Power of the SCOTUS II: "Release the Kagan!"

No. The hospital, Dr, provider, nurse, whatever is negligent if they do not provide care when they could have. It has nothing to do with an oath. A few yrs ago some of the hospital ERs started refusing patients and that was quickly squashed with a bunch of legislation and court cases. Wish I could remember an exact instance but it was all over the news as a trend that needed to be stopped because the hospitals were discriminating against the underserved.

I think it comes down to what the ruling cited as the reason for why they were the way they were (you could say "the judge said so", but usually the judge has reasoning behind his/her decisions). It almost seems like you had already answered my question, claiming doctor's negligence.

[FreshFish]

Re: The Power of the SCOTUS II: "Release the Kagan!"

The UK, Canada, Australia and Taiwan are single payer, so it is clearly not "economically impossible." Cost control is similar to a fire department or a police department -- there are triggers and scope conditions and fines for abusing the system.

The evidence from Canada and the UK seem very clearly to indicate that their are two payors; the people receiving the service pay by waiting in line for months for procedures that in the US are performed in weeks. The UK also has explicit rationing which also is a form of "payment" by the service recipients.

If we go to "single payor" in the US we'll see a lot more of Royal Pains situations in real life. I'm already planning a side business in case single-payor does pass here: hiring people to wait in lines on behalf of busy rich people.

Also, if the US does transition to a single-payor system, where will innovation come from? That would be a huge social cost. I'm not willing to have my children and grand-children do without scientific advancement so a few people can pat themselves on the back by appreciating how clever and progressive they are.

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

The uninsured here don't get surgery/service at all unless on an urgent basis. There is no mechanism to take care of them at all. At least the other countries address the problem in some way

[leswp1]

Re: The Power of the SCOTUS II: "Release the Kagan!"

The evidence from Canada and the UK seem very clearly to indicate that their are two payors; the people receiving the service pay by waiting in line for months for procedures that in the US are performed in weeks. The UK also has explicit rationing which also is a form of "payment" by the service recipients.

If we go to "single payor" in the US we'll see a lot more of Royal Pains situations in real life. I'm already planning a side business in case single-payor does pass here: hiring people to wait in lines on behalf of busy rich people.

Also, if the US does transition to a single-payor system, where will innovation come from? That would be a huge social cost. I'm not willing to have my children and grand-children do without scientific advancement so a few people can pat themselves on the back by appreciating how clever and progressive they are.

Lots of innovation not from here. OUr system is so constricted with regulations a lot of stuff happens overseas where they can afford to OK things faster. Lots of the meds we are getting here have been in Europe for yrs.