Even the lawyers among you are coming around to the idea that SCOTUS will do whatever it wants with ACA, and then make up the reasons later. I wonder if they can do better than this:
We aren’t being asked to radically revise the Commerce Clause and throw out seven decades of law, and we won’t. But we know the founders never intended the Commerce Clause to allow the Federal Government to regulate everything on the planet. So we are going to accept Randy Barnett’s basically spurious exception to that basically spurious idea, and throw out the Affordable Care Act on the grounds that the Commerce Clause regulates “activity” (which we don’t really believe), but not “inactivity” (because, why not draw the line somewhere?).
If they throw out ACA, we’ll get single payer faster, but at the cost of a lot of suffering. And when that fight starts the GOP will suffer big losses in trying to oppose it. Waterloo city.
Someone give me one way the right has ever participated in relieving suffering.
And no, the death penalty doesn’t count.
Some days I think that way too. Most days I think we’re more likely to just get the suffering.
75 years from now instead of 80?
that’s a fine definition of originalism.
If they argued inactivity, at least it would be perfectly clear that they don’t know what the fuck they are talking about. So there is that. JOY….
If they throw out the ACA and a bunch of 22-26 year olds get tossed off their parents health insurance, it’s going to be interesting to watch what happens. There are going to be some irate middle class parents out there.
@fasteddie9318: Yes, I think reports of the demise of that suffering are being greatly exaggerated. We can and will go on like this…for a lot longer than would be conceivable in a sane and humane country.
I don’t think the Commerce Clause is supposed to confer unlimited power, and I do think there needs to be a principled distinction between the things Congress can regulate under the Commerce Clause and the things it can’t. Here is my proposal for a principled distinction: the things being regulated have to be commercial. Health insurance and health care are, in fact, commercial, so there you have it.
John M. Burt
The Five are the biggest menace to democracy right now, far more than the dying party which spawned them.
We need to contain them through a series of modest measures, such as an amendment that will give Congress power to override the Supreme Court with a two-thirds majority, term limits for Federal judges (12 years, maybe 20), and possibly expanding the Court to 13 Justices.
That last would have the fastest effect, but is probably difficult to achieve.
And all of these would require that we have a 2/3 majority of pro-Constitution people in both houses of Congress and in 3/5 of state legislatures. So let’s get to work.
Culture of Truth
Don’t necessarily disagree with doug, but we must deal with the fact that the Commerce clause limits federal power to commerical “activity”.
Oh wait, no it doesn’t.
No I am NOT coming around to that idea. Get yer facts straight.
I meant what I said and I said what I meant.
Why do you say we’ll get single payer faster if ACA is thrown out? I don’t see that at all. ACA moves us closer to single-payer in practical terms with, for example, the expansion in Medicaid. More importantly, it moves us ideologically closer to single payer with a commitment to universal (or near universal) coverage. And throwing out a major reform that barely got through as it was hardly creates better political incentives for members of Congress to try it again.
No, I think a loss here would massively set back the prospects for any kind of reform, including single payer. And I think we’re going to lose, 5-4. And yes, I’m a lawyer who’s been watching the Court closely for several decades, for whatever that’s worth (which admittedly is not much).
@John M. Burt:
So you want a two thirds majority to be able to rewrite the constitution? Bad, bad, bad, bad idea.
Culture of Truth
The commerce clause is a grant of power, not a limitation on it, and it’s pretty damn broad.
Unless you don’t like what the federal government is doing. Then it’s narrow.
I can’t believe anyone on this blog is naive enough to think that throwing out ACA means we’ll get single payer faster. I really can’t.
Exactly. And what if the entire law was struck down, and the Democrats found a way to finesse industry opposition (since they are just so brave), and started saying nice things about a federal public option, which I think had 60 to 70 percent approval rating during health care debate?
That would not be so bad. Though, that does not mean I subscribe to the idea that a total strike down would be a definite plus for Obama.
As for Commerce Clause, let’s see, we have an interstate health insurance and health care provider market that is slowly destroying itself (one of the most dire types of market failure, it is, when a market disappears itself). Forget the people who are irresponsible and can afford to buy health insurance but do not, there are certainly people who would like to buy insurance but cannot due to barriers to competition, preexisting conditions, and market failure due to unreimbursed care.
Most insurance and provider regulation is done at the state level, and inconsistent patchwork of regulation is part of reason for market failure.
How is that not a straightforward case for regulation of interstate commerce.
What are choices? Ban interstate commerce, feds force more uniform state regulation of insurance and providers, or feds institute national regulation and require near universal coverage. I don’t see how the third option is more extreme than the other two.
Of course it doesn’t matter that if you’re growing weed in your backyard with no plans to sell it – that was economic activity – but something that everyone uses is not economic activity.
DougJ, Head of Infidelity
You said you were getting nervous in that comment you linked to.
What luck, since we aren’t tyring to regulate everything on the planet! We are just trying to regulate how one industry (which is definitely commercial, interstate and already closely partnered with government) gets financed.
Forum Transmitted Disease
If Bush v. Gore didn’t chisel into your cortex that the Supreme Court can do anything they want anytime they want for any or no fucking reason at all, then you’re simply not capable of learning.
For those misguided idiots insisting that the Supremes tossing ACA will result in Medicare For All or single payer, wake the fuck up. That will never happen. You just got the best deal you’re ever going to get.
If we don’t get ACA we can kiss socialized medicine goodbye in this country for the next fifty years.
Culture of Truth
Q: “what about the problem of __________ ?”
Politician: “Let the states solve it!”
@DougJ, Head of Infidelity:
Saying I was getting nervous is a hell of a long way from “coming around to” the view you articulated in your post. In the comment I linked to I explained in detail why my nervousness does NOT get me there.
Sloppy arguing. Again.
The SCrOTUS had no problem using similar reasoning in Gonzalez v. Raich and Wickard v. Filburn.
The other occasions on which I’ve see this idea tossed out, it seems to be based on the idea that the chaos and human suffering which will result will be so bad that it will lead the electorate to look upon the actual authors of said chaosNsuffering(R), aka the GOP, with loathing and horror. So of course Congress will turn right around and enact legislation to stop the chaosNsuffering(R), just like all the other times they’ve done just exactly that in response to other GOP power grabs that caused chaosNsuffering(R).
This is the point in the argument where I pause and ask: all the other times = when, exactly did this happen in the past?
@Forum Transmitted Disease:
oh, fuck off with that ignorant schtick. It is really getting tiresome.
Bush v. Gore, bad as it was, did NOT undo two centuries of jurisprudence and establish the Supreme Court, forever after and no matter what, as an institution of political hackery. That’s a lazy bullshit attitude worthy of a teatard.
@Violet: My brother’s girlfriend was very lucky to be able to go on her parents’ insurance when they got pregnant and had my niece. ACA is now covering my sister-out-law and my niece and I will be PISSED if these guys take that away.
If she ends up getting state aid, they’ll be happy to demonize her as single mom conning and stealing from the 1%.
If only we had the brilliant judicial minds of Alberto Gonzalez and Harriet Meiers arguing these cases, a loss would be more understandable.
If I could just get nominated to the USSC I’d be set for life. There is no need to know the law at all. Make up your mind, the clerks write the decisions anyway. Just tell your clerks how you want a case decided & they do the leg work of finding some bullshit reason that fits.
Its why we shouldn’t care that Uncle Thomas never asks a question or that Fat Tony is mean. They already know whatthey want & are killing time until they can get back on the golf course or logged into youporn or however they waste time IRL
And what miserable arguments do we have from the legal fraud reactionary side of the court? Why, that a complex intertemporal (with consequences lasting over decades) financial contract like health insurance is like the market for broccoli?
And from the silly putty moderate wing: this is unprecedented!
Yeah, well, a young country with free labor markets trying to ensure an adequate labor force for its vital maritime industry was unprecedented too. Hence the totalitarian founders era US mandated maritime accident and sickness insurance for all sailors in maritime industry.
And, gee, steamboats with boilers that blew up and killed people in different states as they chuffed up and down the rivers was unprecedented. So, the commie early eighteenth century Congress shoved its nose into how boilers should be regulated. Unbelievable.
The Mayan Apocalypse unfolds.
But, we have been here before with a the Supreme Court half full of incompetent and dishonest judges, with slavery and child labor, and other issues.
There’s the extra step of having states ratify them, but this is already half of the process.
In fact we do have some pretty fucking brilliant legal minds WITHIN THE COURT arguing on our side.
And contrary to what everybody seems to assume, the other justices are going to at least LISTEN to them.
SCOTUS will not strike down the ACA. I think people were shocked by listening to the audio of the arguments, but most did not know what to listen for. As of now I would say at least Kennedy and Roberts, and possibly Alito, sign on to an approval, with limiting language (i.e., don’t try this with broccoli).
@eemom: Shhh, don’t tell the poor ignorant soul that the process has been well on its way for a decade now.
Is that the best you’ve got?
I cut your freak’n leg off!
Pssh! Flesh wound.
The best argument I can see for the Court upholding ACA is the following: The conservatives on the Court dipped their toes into the water of radically limiting the reach of the Commerce Clause back in 1995, in Lopez v. US, when they found that Congress did not have the power to ban guns in a school zone under the Commerce Clause. While you could say that this was a special case, because the activity wasn’t directly commercial, there was some seemingly sweeping language and reasoning in the ruling. Many people at the time thought that was the beginning of something big (the folks at the Cato Institute practically wet themselves with glee, and liberals were very worried).
But conservatives, the argument goes, clearly thought better of it later, as they showed through rulings like Raich. Why would they walk back from the abyss, only to leap forward again?
But here’s why I don’t buy it, and why I think we’re going to lose, 5-4: ACA has become so politicized, it’s really on a footing with Bush v. Gore. And when the chips are really down, politically speaking, the five member Republican majority goes with its tribe.
I hope you are correct. I admit I have little experience decoding SCOTUS oral arguments.
I found the level of argument shockingly low, even if some of it was intentionally provocative to test both sides arguments.
This is total nonsense.
@Forum Transmitted Disease:
I keep seeing this opinion stated as fact, and for the life of me, I really don’t get the argument behind it. It’s not going to take fifty years for health insurance companies to go bankrupt and employers to stop routinely offering health benefits. None of the problems that precipitated this legislation are going anywhere anytime soon. Do you really think that Republican obstructionism can hold off the economic impact of an underinsured nation much longer? Do you think the money boys on Wall Street think that it’s in their best interests to keep a broken system in place as it cripples the economy?
I don’t know if dumping ACA speeds up or delays single-payer. But the “we’re dead in the water for fifty years” stuff is just facile and logically unsupportable.
@eemom: Well some optimism is a good thing, but yeah, single payer won’t happen until we get a generation that’s been raised with the idea that health care is a right and has had to live through the mess that is private insurance. And even then it’s going to be a tough fight. If the ACA is rolled back, taking health-care-as-basic-right with it, it only sets us back. I once let myself think that if the Court severed and overturned the mandate only, that the insurance companies would then go bankrupt and we’d have to implement single payer, but it’s far more likely that Congress will just repeal the whole thing if that happens.
@butler:But we know the founders never intended the Commerce Clause to allow the Federal Government to regulate everything on the planet…
What luck, since we aren’t trying to regulate everything on the planet!
Yeah. I don’t know, maybe the “anonymous conservative lawyer” Bernstein cites wanted to remain anonymous owing to the extreme half-assedness of his contention. It seems to me that unless the Founders actually did establish some quantitative guidelines as to what is and isn’t covered under the Commerce Clause, arguing what they “intended” is completely meaningless. But apparently lawyers do this kind of crap all the time.
@EconWatcher: Because what is getting it thrown out is the mandate, and that was always a half-measure that substitutes for single payer. It also benefits for-profit HC companies, so I’m wondering when the full effect of that is going to hit people. Maybe not for a while. But the consequences of taking away what has been offered are going to lead to better because more informed conversations about what programs would best, and most economically, deliver HC.
I sure hope so.
@eemom: If you will it, dude, it is no dream.
@Forum Transmitted Disease: Your comment contains no argument.
Constitutional scholars all agree it is constitutional. If the supreme court rules against it then their credibility will be severely damaged. That is why I am quite certain they won’t.
We have been inching towards a government funded insurance system, either by feds or combo state/fed programs at a pace of a half to a percentage point a year. That has been the trend for over a decade.
@ThatLeftTurnInABQ: Voting Rights Act?
Civil Rights legislation?
I agree it’s not going to happen easily, and may not happen at all, but Christ, overturning ACA HAS to have consequences. Even the fucking Village will see that. We’re at a watershed moment here, since we can’t keep the status quo forever.
Everyone is on the jock of Paul Clement, because he was so smooth and facile in the oral argument. But he was so glib he screwed himself. When he said SCOTUS should throw out the whole law and Congress can simply pass the other stuff again “easily, in a couple of days,” he was high-stepping into the end zone and fumbled at the one yard line. Everyone laughed, because we all know that Congress won’t pass jack on health care in the next couple of days – or decades – if ACA goes down. For the sake of a flippant joke, Clement pointed out the stark consequences of voiding ACA. SCOTUS won’t do it.
I agree that 50 years is too long to project out any sort of prediction. Who in 1962 could have predicted much about today. But 20 years seems like a more credible extrapolation based on the amount of time which passed between Clinton’s attempt at getting health care reform passed in the early 90s and where we are today. And the problem with saying: well of course Congress will adopt single payer because that will pass muster with SCOTUS, unlike Obamacare is that if the PPACA is struck down based on partisan hackery it is hard to see how any legislation passed by a Democratic Congress and signed by a Democratic President can be evaluated in terms of how likely it is to be struck down, beyond the simple equation: the more the Dems like it = the more likely SCOTUS will burn it down and salt the earth it was built on.
Forum Transmitted Disease
Wow, how polite.
@eemom: You are correct. The Supreme Court established themselves as an institution of political hackery long before Bush v. Gore. Bush v. Gore was just the latest in a long string of jurisprudence that can be shown to have been pulled not from precedence but straight out of a Justice’s ass, aided and abetted by four like-minded appointed-for-life brownshirts.
Umm, no. Because going down the same road is going to have an enormous impact on their bottom lines. Really enormous, like, a considerable number of folks unlucky enough to be hit with deductibles and copays on even routine surgery will find it hard to meet their mortgages, car payments and anything else that can’t be used to make “will work for food” signs.
Much of the modern U.S. nation-state was built around an elite consensus about the Commerce Clause. If you oppose the modern U.S. nation-state, such as a federal government empowered to do much of anything outside military affairs, and you prefer some sort of combo of late-19th century robber baronism but without, say, the nation-state capable of building the railroad system, then you have a clear target to go after: that aforementioned use of the Commerce Clause.
I have long feared that the conservative forces would one day realize the opportunity that attacking the modernist view of the Commerce Clause could yield.
@Culture of Truth: “Q: “what about the problem of ______ ?”
Q: What about the problem ____________ that the States have recoiled from in horror, or just made worse?
did the feds bring up that the Washington Administration had an insurance mandate for some industries? Because I’d like to know how the originalists would deal with the fact that the guys who were in the room when the constitution was written seemed to be ok with an insurance mandate in some cases.
kill da bill!
kill da bill!
kill da Bill!
Healing of America, by TR Reid, has a makes a good case for why US health care system in its current form will gradually become government funded program.
He also argues why, by some important measures, the US health insurance and care industry already has more government involvement and direct support than other commie developed countries with their commie totalitarian misery (and longer life expectancy at nearly all ages and for both sexes with higher public approval ratings) inducing health care systems.
Fundie icon Rick Warren says Morons aren’t christians and evangelical support for Black Jimmy Carter rising.
People are stupidly down on Verrilli because he didn’t seem as smooth, and he didn’t make some grand expansive argument in favor of ACA. His job was to give reasons that might persuade Kennedy, and stick to those come hell or high water. He did that, and he clearly had Kennedy – at least -leaning his way by the end of the argument. But nobody noticed because of this “optics” obsession everybody has.
@dr. bloor: And yet large businesses, which have faced spiraling healthcare costs for years, have been silent on the topic of real healthcare reform, when they’re not actively fighting against it.
It’s no secret that most corporations will take certain hits to their bottom line in order to preserve fealty to the party that protects profits over consumers in so many other ways. And you’re not wrong in saying this can’t go on forever. But I think you’re over-optimistic about how long the bleeding can be dragged out via things like drastic cuts in coverage, passage of legislation allowing insurance companies to congregate in antiregulation states, etc.
Judas Escargot, Your Postmodern Neighbor
In theory, yes. In practice, we’ll probably go bankrupt first, as the cost curve goes unbent for too long.
I am coming to understand that the GOP’s explicit purpose is to bankrupt the Republic, probably so they can raffle off the pieces to the highest bidder. Which ironically makes Mitt Romney their perfect President.
Sorry to be a Downer, but no other explanation fits the available data.
what makes you think they won’t find a reason to strike down single payer?
I can think of a fairly easy bullshit rationale to do it.
Yeah…. usually just a lurker, but I’m actually gonna have to agree with eemom here. I don’t think they’re willing to go as far as it requires to strike the ACA, despite the absurd questions at oral arguments. I’m no longer convinced about my original prediction of 7-2 upholding it, but I think eemom basically gets the analysis right.
So when is this decision due?
I don’t think they want to roll back the New Deal through Commerce Clause rulings. They had that chance after the Lopez ruling in 1995 and backed away from it.
But I do think they’ll view this case in particular as an us vs. them, political decision, and they’ll vote to smite the Obama Administration, using the narrowest reasoning possible, which will leave most of the New Deal intact. And they can do that with the argument that the Commerce Clause does not allow regulation of “inactivity” of the general public. You can call that arbitrary, but it is a workable limiting principle.
I say this with 51% certainty that I am right, so you can take it to the bank….
@Satanicpanic: ” Do you think the money boys on Wall Street think that it’s in their best interests to keep a broken system in place as it cripples the economy?”
Not just the money boys: GM
A nationalized healthcare system solves GM’s retiree healthcare and pension problems, as well as their CURRENT employee healthcare problems (by which Canada is cheaper).
They do not come out in favor of same.
On what do you base that? The Village doesn’t give a shit about us peasants — that’s what makes them The Village.
The status quo is rather profitable (for some people and industries) at the moment, it can continue for a good long time.
Cris (without an H)
okay, I’m listening
@Forum Transmitted Disease:
Please do elaborate on the “pre Bush v. Gore Justice’s Ass” doctrine, Dr. Legal Scholar. Include if you will, for each case cited, a diagram of the precise path from the judicial anus to the pages of the Supreme Court reporter that you say you can show us.
“Morons aren’t christians”
Not all of them, anyway.
@dr. bloor: So is climate change, you don’t see them exerting any pressure on government to deal with that. A lot of these people are just as nuts as the politicians they support. And I am highly skeptical that they spend any time wondering about what their actions today will mean in the future.
They’ll deal with it the same way they deal with it every other time it comes up: by utterly ignoring it, but in a very principled manner.
This really isn’t your actual thought process, is it?
@OzoneR: Once it’s in place and people know what it is and how it works, the Court can go fuck itself. They’ll help raise consciousness about public policy faster than us Liberal Professors ever could.
Yeah, that happens already and they STILL vote for them.
GOP can game the system; voter ID laws, gerrymandering, racial cat calling, so that no matter how many look at them with loathing and horror, they still win.
@elm: No, it can’t.
Enhanced Voting Techniques
So they strike it down and then what? The whole Health Insurance Industry was on the brink of collapse before ACA came in the effect. The whole game was increase premiums while denying more and more people converge. Insurance don’t work that way.
Why would they care? They have the power to overturn it, the people can’t vote them out.
Besides, it won’t take effect immediately, they’ll toss it out before it even is in place.
Yes…but how long is that going to take, since it will require a time when the Democrats have safe majorities in both house and senate, plus the presidency all at the same time. Given the gerrymandering the GOP success at statehouse levels enabled in redistricting, that means it’s going to be difficult for the dems to win more than fairly narrow majorities in congress until 2020 at least, if then. Meanwhile, the GOP will do its utmost to semi-permanently hobble the fiscal, practical, and legal ability to pursue any sort of progressive policy, and they’ll have their narrow 5-4 majority of henchmen at the Supreme Court as a backstop to undermine that which the GOP in congress cannot achieve by itself.
More ignorant bullshit.
The rationale for single payer — the government collecting the tax, and the government providing the benefit — rests on the exact same foundation as Social Security and Medicare. There is NO WAY to distinguish it.
The purported “distinction” with the ACA is that the mandate is to buy from private entities.
@BGinCHI: So how is it going to change? The U.S. has had the world’s most expensive health care system for quite a while. It’s been among the worst in the developed world for decades. Why can’t that continue?
Or are you taking some expansive view of history, like with Civil Rights legislation & Women’s Suffrage? Perhaps it can’t last literally forever, but only in the sense that no institution does.
It can easily last decades more, as did Jim Crow, child labor, and denying women the right to vote.
Culture of Truth
@elm: BG said they’ll see it, not that they will care. But even seeing it will be big step for them. :)
I’ve long thought that, if democracy does end in this country, it will largely be at the hands of a corrupt Supreme Court that decides that the Constitution says whatever the fuck they want it to say.
Single Payer will also eliminate an entire industry, and put corporations out of business. Aetna would no longer have a reason to exist.
Do you really think SCOTUS is going to sit idly by while the government tells a corporation, which its given special rights to already, that it will no longer exist?
it has nothing to do with taxes, it has to do with the rights of the insurance industry.
Enhanced Voting Techniques
@Judas Escargot, Your Postmodern Neighbor:
That’s because you are not understand how the Right thinks. As John Cole says they just hate and that’s it. A liberal proposed ACA, that means it’s communism and that’s as far as the Right thinks it threw.
@eemom: Yep, exactly.
I see why people are pessimistic about this, but holy christ, don’t the headlines after ACA is thrown out (if that happens) mean the panic is going to far overshadow the bliss from rightwing idiots?
The PRACTICAL consequences are going to far outweigh the glib satisfaction the tea partiers and GOP will have.
And I guarantee that HC will get people to the ballot box faster than seeing Obama take a political hit.
Any which way and every which way you look at it, Step 1 is liquidation of the Republican Party.
Could SCOTUS could strike down ACA because of the requirement to purchase from private insurance companies but preserve Social Security, Medicare, etc. ?
@EconWatcher: I’ve not been concerned about this just recently, I’ve been concerned about it ever since I saw how much of our modern nation depends upon the polite consensus around the Commerce Clause.
But there are plenty of conservatives — including major leaders — who don’t want just to roll back the New Deal: they want to roll back anything after Reconstruction.
And quite a few conservatives find that too timid, and just want to roll back the Civil War.
GM as a corporation may care. But the executives and stockholders do not. They want max profits in the shortest time, even if it complete destroys the economy to do so. That is someone else’s problem down the road.
@BGinCHI: The headlines after the ACA is thrown out? What do you think they’ll say, I’d love to hear it.
The media can’t report accurately on anything health-care or income-distribution related now. Why do you think they’ll do so if the SC throws out the ACA?
It hasn’t, but if they throw out the entire ACA suddenly lots of middle class kids age 22-26 will lose insurance, including my daughter. Middle class people don’t like to lose benefits. The outrage won’t be over the suffering, although there will be suffering and people will be outraged, it will be over the loss of coverage for people’s children.
If the Supreme Court goes whole hog, the way some people fear suddenly a lot of middle class, middle aged people will be scrambling to find a way to take care of grandma and grandpa, either by paying for a nursing home or having to take them in and care for them. THAT will cause a revolution.
If only the individual mandate gets thrown out, the insurance companies will start pulling out of the market. That is the worst case scenario, because it will take a while for the lack of coverage to become so pervasive that people will have fits. That is where there will be suffering and a slower move toward single payer, IMHO.
@elm: It’s too expensive. Jim Crow and sufferage were cheap, in terms of raw economic motivation. HC issues are going to really impact our economy, more so than they already are, very soon.
And honestly, how long can the GOP run on NO? For a good long time? Maybe, but I wouldn’t bet on it. If we still have a democracy, they are going to be fucked on the issues very soon.
Now, if our democracy becomes a “democracy,” then we’re talking about a different circumstance.
Belafon (formerly anonevent)
@eemom: Last time I checked, Republican politicians weren’t fond of those programs either. The only thing that saves SS and Medicare is they are entrenched, but Repbulicans are always looking for ways to end them. Since the ACA is not entrenched in the US psyche, it can be struck down independently, and then the Republicans can use it’s decision to end other programs.
I personally don’t think they will strike it down, but doing it would allow a lot of other things to be taken down.
@OzoneR: Have you heard of Medicare supplemental insurance? There will still be a thriving insurance industry in this country with or without single-payer. No one is proposing to make private insurance illegal.
Here’s the thing: It’s not a long-term issue ala global warming. “The future” is much closer than most people realize. Healthcare is going to kill the economy long before the Banksters lose their summer digs in East Hampton because the tide doesn’t go out anymore.
@Enhanced Voting Techniques:
I don’t really think they care. The health insurance industry is skimming 15-20% of 15% (heading to 20%) of the GDP of the world’s richest country. They are mostly MBA’s, greedheads and thieves in charge; none of which groups are notoriously farsighted or long-term-outcome oriented. They don’t give a fuck if they blow up the country, any more than Wall Street does.
@Enhanced Voting Techniques:
Well, Republicans move to “replace” which is a tax subsidy to buy a high deductible plan out of the least regulated state, with no federal regulation, “across state lines”.
I guess I don’t understand why we’re all assuming we keep what we have until there is an enormous crash.
I just assume they move us all over to high deductible, unregulated, with the rest out of pocket. Some will be able to pay for ordinary care out of pocket and others will not, but for high dollar care we’ll have insurance so providers will get paid.
Oh, and federal tort reform. Crisis “solved”!
@elm: I hear you. I’m not defending the goddamn Village.
But after they get finished jacking off about how Obama lost this fight (like it’s a tennis match or something), then they’ll have to think about what’s next.
And what’s that? The RYAN PLAN? Hmm. Maybe then they’ll look at what’s in it. If not, we’re all dead anyway.
I’m being brave and optimistic today, which may look like stupidity tomorrow. I get that. I hope the Dems are ready for this ruling when it comes down.
DougJ, Head of Infidelity
You doth protest too much.
Then you won’t have a good single payer system. It’ll be crap coverage.
Too expensive for whom? It certainly is for poor people who can’t afford treatment and suffer poor health, but due to shitty media coverage, they’re largely convinced that the U.S. system is really good.
While it’s too expensive for some people, it’s lucrative for others, like pharmaceutical companies, private insurers, private health care providers, and manufacturers of expensive diagnostic machines. They’re invested in the current inefficient system, they have lobbyists, and they have P.R. firms.
Other corporations benefit from it too, because the current fucked-up system makes employees more dependent on their employer. The current system makes it prohibitively risky to leave a job with benefits (without having another job with comparable benefits lined up).
If the ACA is thrown out, people will be generally ignorant about what that implies — just as they were before it passed.
@dr. bloor: These same people just did kill the economy, not 5 years ago. Most of them walked away unscathed. They’re in the process of selling off parts of what’s left of America, I just don’t see them pausing to consider the implications of what they’re doing.
Davis X. Machina
Indefinitely, or nearly so. The only thing limiting the size of the elephant you can make disappear stage left is the size of the puff of smoke and bang stage right.
“Wartime is no time to introduce another major social provision, especially one that has been so divisive in the recent past.”
The Washington Post editorials write themselves.
Eh, ultimately won’t matter what the MBA’s trying to keep their jobs think, it’s what the stockholders think. Profit margins are what, 3-4% in health insurance? With that current margin and an ACA-less future, only a crazy person would invest in them. Hell, even with ACA, only a crazy person would invest in them.
@Davis X. Machina:
Republicans can’t make anyone forget that they’re forking over $500/month toward their employer-provided health care for the privilege of dealing with 5-10K deductibles per year and copays of $25-50 per doctor visit plus much bigger hits for emergency care and hospitalization, depending on the specialty. And we’re pretty much there already.
@elm: OK, so your position is that if it’s thrown out, nothing will change in terms of people thinking about what we do next about HC.
I just don’t agree.
I do agree people need to know more and that the media sucks ass (in a bad way). I’m going to keep my frown turned upside down for a little while longer though, just because I sense that a lot of people in this country see the 27% as completely fucking crazy. And that’s going to mean they are afraid that the right is taking us off a cliff. And that means the right has no argument to make. And then things improve.
What worries me is that the MSM will spin this as “Blame the Dems, they are the ones who created this mess”. And not everybody in the target demographic has to believe that swill, just enough of them to swing a few elections in favor of the GOP so that Congressperson X loses their job in District Y because they voted for the PPACA and “look at what a mess that made, stupid Dems”. If more than a handful of Dems in swing districts lose their seats over something like this, it will be a long time before we can get Dems in swing districts to take a risky stance on this issue again. People underestimate to what degree votes in Congress are influenced by fear and risk avoidance, as in “don’t take a stance on that issue, remember what happened to Congressman X last time” as the default behavior.
@Enhanced Voting Techniques:
They could then sell supplemental policies for those who can afford them, assuring that the people who matter get the best ordinary care, while the rest of us have our catastrophic policy so we don’t get away with discharging our huge catastrophic medical debt in bankruptcy, and burden the system.
I think it could get substantially worse for most people.
Not necessarily. Even single-provider Britain has private insurers in their system.
Honestly, with the bizarre way our healthcare system has sprouted up, I really think it will be much easier for us to transition to a Swiss or Japanese style system where tightly regulated nonprofit insurers administer everyone’s plan than trying to destroy what we already have and switch to single payer.
It’s getting to that “tightly regulated nonprofit” system that’s going to require some more tooth-and-nail fighting.
And I will say what I’ve been saying all along: a 5-4 decision against ACA will require John Roberts to vote against huge corporations in favor of abstract ideology, and I don’t think I’ve seen any evidence that Roberts cares more about ideology than he does corporations.
The one thing that could save us here is Roberts’ fealty to corporations.
@ThatLeftTurnInABQ: That’s a damn good point and I sure as hell hope you’re wrong. Dems need to have a plan: let’s hope Obama is playing that dimensional chess shit again.
I don’t see this. There’s lots of ways for insurance companies to survive, and thrive.
They simply sell different policies. Catastrophic coverage is more in line with an ordinary insurance model anyway. They’ll sell policies that
cover only huge bills, and you’ll pay premiums until
you hit one.
That’s Britain, which has had a single payer system for over 60 years. This is the United Stats, where corporations are people.
Who doesn’t think this scenario won’t result in a situation where our single payer system will allow people to go to the doctor, but then purchase high-deductible, high-premium supplemental insurance to actually take care of their problems?
Judas Escargot, Your Postmodern Neighbor
@Enhanced Voting Techniques:
From where I sit, I can’t discern that the Right properly ‘thinks’ at all.
But when I look for intentions in their actions, I see only bad ones.
It’s not just the insurance companies, though. Our whole system is for-profit, top to bottom, and the kind of policies you’re talking about may be good for Cigna, but they’re not going to be great for Tenet. Plus, as others have said, those policies are going to put a nasty bite in the bottom line of a lot of major companies, not just ones with union obligations like GM. The Giant Evil Corporation I work for (you know, the rodent one) will NOT be pleased if they’re told by Cigna that all they can offer their employees is a major medical policy.
It could still go 5-4 against, but I really think it’s going to come down to what’s more important to John Roberts: corporations or ideology.
Actually, Britain does NOT have a single-payer system. They have a single-provider system where all basic healthcare is provided by government-employed doctors. The two systems are not synonymous. In Canada, the doctors and hospitals are private (ie not government employees), but they have a single payer, which is the government.
Sorry, I get very picky about terminology, because saying, “Well, every other industrialized nation has single payer!” simplifies the actual situation beyond recognition. You can’t look at Switzerland’s nonprofit insurance system and Britain’s government-run system and say, “See, everyone has single payer!”
Not sure who you’re referring to here. That certainly doesn’t describe my view.
You can believe whatever you choose to believe, but there’s no need to be a dick about it. Or to lie about what other people believe.
@DougJ, Head of Infidelity:
In what fucked-up parallel universe is “getting nervous” the same as “coming around to” a view that e has expressly disavowed?
If you want to play semantic Calvinball, find somebody else to play with.
Why would universal catastrophic policies put a nasty bite in GM?
They’d just start new employees with the same bare-bones coverage all other employers will have.
I think insurance companies can come up with a policy that makes money. Employers will be paying less than they are now. Providers won’t have insured payors for ordinary care, but people will pay out of pocket, and they won’t have to write off huge bills, because that’s what the catastrophic coverage is for.
I think the health care law was designed to shore up the system we have now. That doesn’t mean insurance companies can’t come up with a different approach that is less like a payment mechanism, but more like traditional insurance. It’s what they do.
As I said, I think it could get substantially worse for ordinary people before insurance companies go under. There’s just a world of options for insurance companies, once you break out of comprehensive policies, and gut regulation.
The only thing holding them back is state law. If ACA goes, and we’re “across state lines” race to the bottom on mandated benefits, it’s wide open.
I think it’s two different ways of looking at it. I am not confident that John Roberts has to ‘save” anything.
I am confident that large employers and insurance companies will save themselves, with or without this last-ditch effort to retain what most of us have, which is comprehensive employer-provided insurance.
There’s no rule that says we have to keep that, and we won’t.
That’s why I’m not persuaded by the pro-corporate argument.
Obama tried “first do no harm”.
But there’s plenty of harm that can be done.
I think you missed my point: major corporations are not going to want to offer bare-bones coverage to their employees. It is, quite frankly, a pain in their ass, especially if they have any employees who can be described as having a skill that’s difficult to replace. Sure, the CEO of Apple could probably pay out of pocket for everything short of a car accident, but what does he do when the project head of the next iteration of the operating system has cancer and is scrambling to get the money together for chemo because Cigna decides it doesn’t fit into the major medical policy they sold Apple?
Not to mention that, despite their protestations, the for-profit health insurance companies are happy to go along with PPACA if it means they get millions of new customers. They might prefer to go the major medical route, but it would require a fairly major retooling of their business model and if there’s one thing we know, it’s that large corporations really don’t like having to change their entire business model.
Note again, though, that I’m not speculating about what could maybe possibly happen if PPACA goes down. I’m stating my reasons for thinking that there’s a good possibility that John Roberts could come down on the side of PPACA.
If you think that Roberts is a pure ideologue who will vote down PPACA even though it hurts major corporations, then please explain why you think that.
Herbal Infusion Bagger
“Actually, Britain does NOT have a single-payer system. They have a single-provider system where all basic healthcare is provided by government-employed doctors. ”
Yeah, but the sole funding for the NHS* is from the Government. So it’s a single-payer and single provider.*
* Although there are supplementary private insurance policies given by some employers (most by a private healthcare insurance firm called BUPA).
@DougJ, Head of Infidelity: There is a non-zero chance of the law being overturned. The consequences of that happening would not be good. That could make a person nervous. It makes me nervous.
I’ve done some skydiving. There is a non-zero chance that, when I jump out of the plane, I will plummet headlong to my death. This makes me nervous. It doesn’t mean that I don’t have confidence that the the ‘chute will deploy properly, etc.
They could probably manage to come up with something if pushed, but do they want to? I think you’re underestimating how much of a pain in the ass it would be for large employers to have to do that.
Emperor of Ice Cream
I was having lunch today with my former boss who runs a DC advocacy organization that deals with the federal courts ( among other POLITICAL issues). We were talking about the political climate and this upcoming decision on HCR and we agreed that a) none of us are certain what the result will be, but we’re both worrie ( and she is a lawyer and close court watcher for nearly 50 years, so that she is worried has me even ore worried) and b) when you look at the GOP pattern across the country where they are in charge, one really does have the sense that this is the far right’s “go for it” moment. It’s the only way to understand their pushback against much of the electorate (and modernity); how can a viable political entity look at the demographic landscape and say lets go after unions, brown people, lgbt folks, and the topper, WOMEN? The cant unless they think that they will be able to control who can vote in the future (eg, the vote “fraud” protection movement) and/or they have the MBA mentality which doesnt care for any time period. I vote for a little bit of both, but think that it is mainly the third choice, which is being able to do all this – lower taxes, get rid of welfare, and keep health care private in order to control the serfs – is the point of there whole political movement. Sad to say, but I don’t think the SC five will let this moment pass and give Obama what will be spun as a huge political victory – ACA is overturned 5-4. They are GOING FOR IT.
I don’t think it’s hard for them at all. What’s holding it up? A tax advantage and competing for employees. They managed to transition us all out of pensions. They’ll just transition us all out of comprehensive insurance policies. I think they’d
Providers would take a hit, but they’d still have Medicare, and older people use the most healthcare anyway.
I just think starting from “everyone has to keep what they have now” is a false assumption.
No, they don’t. They could lose a lot, which was the point of the law in the first place, to retain insurance for those who have it and cover those who don’t.
I don’t know how it goes at the court, but, as usual, conservatives are behaving recklessley, while calling other people radicals.
We could end up with a radically WORSE system, and the only people who take a hit are ordinary people. That could happen.
Emperor of Ice Cream
And can I say the edit function su*ks for iPad. Forgive the typos.
I don’t come around here much since though I’ve never actually visited Firedoglake, I’m basically lumped in with the firebaggers, but I tell you. I was at law school all of 2 months in 2006 when this view of the court became my unshakable conviction. Nothing I ever encountered in school disabused me. If you were paying attention at all to Bush v. Gore you have no excuse at all.
@Emperor of Ice Cream: That’s OK, I can make out the meaning. And you should know know how the rollers of big cigars think, har har har.
Uh, I still get a pension through my employer. I think you’re seriously, seriously overgeneralizing if you really think that employers are chomping at the bit to get rid of health insurance to the point that John Roberts is going to decide that it’s in the best interest of all corporations to basically kill employer-provided insurance.
Maybe you need to get away from the internet and have a nice cup of tea for a few minutes.
ETA: Also, too, how would switching over to a major medical-only system affect the 300 pages of state regulations here in California? Won’t a lot of those laws about parity etc. have to be completely re-written for major corporations that are based here to get out of their lawful obligations? Trust me, Apple Computer and NBC/Universal are not going to pick up and move their corporate headquarters to Kentucky over health insurance regulations.
I think that because it doesn’t hurt major corporations to drop comprehensive health care coverage.
It hurts their employees. It helps major corporations to go to a tax credit and “across state lines” catastrophic policies, because then they’re out of the health care business.
The ACA may help major corporations retain our current model.
If the ACA goes, they’re free to throw out our current model, and find one they like better, because if the ACA goes, our current model won’t survive.
You still haven’t convinced me that major corporations think that the new model you’re proposing will be so much better for them that they’re throwing their weight behind the repeal of PPACA.
Insurance companies may be throwing their weight towards repeal, but I really don’t see the evidence that non-health insurance companies are demanding that PPACA be voided.
@kay: Exactly. That was what I was alluding to above.
@DougJ, Head of Infidelity: It does everything too much
@bogdan: Exactamundo! Remember when Constitutional scholars agreed that BushVGore was wack and the SCOTUS promptly evicted W and ushered Albert Gore into the W.house? Cause I don’t either…
If they accompany the decision throwing out ACA with a request for arguments on the constitutionality of Social Security and Medicare, what do we do then? There will come a point where this Court will have to be told to shove it.