Department of Health and Human Services v. Florida

[justicar5]

Anything to enhance the menu.

ok that got a lol.

[DimeBagHo]

Yes! Democrats are moderate conservatives by and large, and that is who Obama had to convince to pass health care reform, the most conservative of all Democrats. The Republican Party has become a party of extremist conservatives, so that's why he failed to get their votes. It's not "conservative" Democrats, with quotation marks, Democrats are a center-right party! The choice between Democrat and Republican in general is conservative and more conservative. Remember, the Democrats needed 60 votes to pass the bill in the Senate, giving extraordinarily tremendous power to one or two of the most conservative Democrats. It wasn't so much "insisting" on the individual mandate as much as favoring it over the public option. As for who killed the public option:

http://thinkprogress.org/health/2009...ion/?mobile=nc

Everything possible was done by Democrats to try and hide exactly who was to blame (they didn't want to hurt their own), but it was indeed the most conservative Democrats that killed it, leaving only the individual mandate for universal coverage.

All of this shows that lots of conservatives, Republican and Democrat, disliked the public option. But I don't see any sign here of conservatives who actually liked the individual mandate and insisted on it. At best it looks like they viewed it as the lesser of two evils.

That's what he says now, but he supported it at the federal level in numerous comments before running for President. Of course, how one wants to interpet the hobknobbling of a politician can be subjective I suppose, but IMHO Romney supported using the individual mandate at the federal level from looking at his past comments.

Romney does appear to have changed his mind out the individual mandate at the Federal level. That might just be politicking, or maybe the train wreck that is the AHA persuaded him that it was a bad idea. A good case could be made for either view.

And again, even for conservatives who take Romney at his word he never supported the idea of the individual mandate at the federal level, that's not good enough, because a state enforced individual mandate is no better to many of them.

I totally agree with this. Most conservatives have always thought that the individual mandate is a bad idea in any shape or form. But this doesn't exactly sit well with your claim that Obama got stuck with the Individual mandate because of all the conservatives who insisted on it. It would be more accurate to say that he got stuck with it because he insisted on universal coverage and a handful of conservatives hated the individual mandate a bit less than the public option.

No, you just didn't get the sarcasm then defined federalism in a narrow way, on probably its weakest point, a point that has been proven to be wrong in many ways.

How exactly does that have anything to do with federalism? It doesn't. Conservatives have pointed out how such an affront to freedom is just as bad whether at the state or federal level from a moral point of view. I was pointing this out. Federalism isn't even an issue, it doesn't address opinions about government programs. If I was talking about the Constitutionality of the individual mandate, it might have been an issue, but I wasn't.

I don't remember defining Federalism at all. I pointed out that there is a federalist argument for the claim that the Federal individual mandate is a serious infringement on liberty, while state individual mandates are not. The argument also strikes me as obviously sound. It is relatively easy for people to avoid a state individual mandate if they really don't like it, but nearly impossible to avoid the Federal version.

By saying that they can move places, yes yes. Many of the Founders were also slave owners, and only white male land owners (wealthy people generally) could vote then. Why, I believe that when slaves escaped to slave free states, many of these Founders wanted to make sure that they could be returned despite moving. Let's just say that this protection of liberty is a poor one indeed.

When there was Jim Crow in the South, you have to wonder why all blacks didn't move wholesale from all those bad states to relatively better ones? Many tried, and ended up in segregated ghettos for their effort (see, federalism works to protect individual liberty in this way!) But there are still a lot of black people in the South, which really makes me wonder about how effective this theory of federalism really is at protecting individual liberty.

And the funniest part is, the idea of federalism was used to keep Jim Crow around! That is until the ebil federal gubmint came in.

Federalism had nothing to do with slavery. In fact the law that required the return of slaves contradicted the principles of Federalism. Federalism did, however, provide significant relief from the evils of segregation. Millions of blacks escaped from the effects of Jim crow by moving north.

Basically, federalism can be a double edged sword when it comes to individual liberty.

I think it would be more accurate to say that Federalism can't be expected to solve every problem. Of course state governments can overstep their bounds just as easily as the Federal government, but as the founders recognised the later was a far more serious threat to liberty.

I don't know your circumstances, but if you were simply a traveller to the US, that seems like a strange analogy to make. Many people have lots of responsibilities and obligations that can make it hard to move. Kids and family especially. Many poor people depend on a network of family and friends from their birthplace to make it through, making moving a daunting task to be able to succeed in their new place. Not to mention that getting a new job in a different state is no easy task or guarantee. It can be a really risky proposition to move.

And I was talking about the truly wealthy, who could move if they wanted too quite easily. It might be inconvenient or expensive, but not that much, and they'd survive. For middle class people, the burden would be much higher. For the poor, it might not be possible. Then you are weighing job opportunity and salary against indivdual liberty. A choice federalism and the Founders surely wanted people to make...

I lived in the US for 12 years and had a wife and kids to cart around with me. This wasn't just my experience either. Most people in academia have to move around for work, so pretty much everyone we knew had moved state at least a few times. I think it would be more accurate to say that many people don't want to leave their local network of friends and family. Claiming that they can't leave is nonsense.

Well, you already called Romney a moderate conservative, when he has explicitly said he's "severly conservative", so it seems you are drawing your own conclusions and thinking critically about some matters. But honestly, anyone who just sticks to what candidates say are in for some real surprises.

Yes, the "severely conservative" line was funny.

[chilon]

Uh huh. So Obama had to include the Individual Mandate in order to appease "conservative" Democrats. But sadly this still failed to attract any votes from conservative Republicans? So can you name any of these "conservative" Democrats you are talking about, who insisted on the individual mandate?

The individual mandate was put in the bill to appease the HMOs (not individual conservative politicians or whatever Mathias is claiming erroneously). Without the individual mandate guaranteeing additional revenue from a group that would be paying more for insurance than it would take out in health services, the HMOs would have opposed the Affordable Care Act.

As a side note, the concept of the individual mandate originally came from the Heritage Foundation.

And another side, none of the actual issues with the problems with health care costs in America have been addressed by the Affordable Care Act...

[Astaroth]

I lived in the US for 12 years and had a wife and kids to cart around with me. This wasn't just my experience either. Most people in academia have to move around for work, so pretty much everyone we knew had moved state at least a few times. I think it would be more accurate to say that many people don't want to leave their local network of friends and family. Claiming that they can't leave is nonsense.

It isn't really easy to leave at all. Of course, when you are still studying or working towards some kind of degree it might be different. But once you are like 35 or 40, have a secure job, a house that isn't fully paid yet and several kids that go to nearby high schools, things are different.

Considering that everything - including your healthcare - is connected to your job, you can't just randomly call it quits and move to a different state, unless there is really no other option.

So in the end, a federal option is not much better at all. I bet that most people who have settled down would never leave their state just because they would otherwise have to pay a fine of a few hundred dollars a year. The risk just isn't worth it.

So while everyone can *technically* leave his state, everyone can also *technically* leave the whole country. The argument that giving states incredible amounts of power is no problem for liberty because you can just move away is simply terrible.

[DimeBagHo]

So while everyone can *technically* leave his state, everyone can also *technically* leave the whole country. The argument that giving states incredible amounts of power is no problem for liberty because you can just move away is simply terrible.

It's a good thing that no one ever made that argument then.

The argument that was made is that you can give more power to state governments (not "incredible amounts"; state governments still have to be republics with limited powers) because it is easier to leave a state than it is to leave the country.

I find these claims that moving state is impossible, or extremely difficult for most people, or just as difficult as moving country, to be frankly bizarre. Millions of people move state in the US every year. Lots of people could move state without changing job at all, and getting another job is usually not that difficult. Getting a job when you have no job is the hard bit, but then lots of people solve that problem by moving to a state with more jobs.

[Phier]

As I type this I have my first completely unneeded bureaucratic form on my desk to fill out for a patient thanks to Obamacare.

you so very much Obama, you.

Best part its so that people can spend their OWN money, its not even about coverage.

[Matthias]

As I type this I have my first completely unneeded bureaucratic form on my desk to fill out for a patient thanks to Obamacare.

I love Obama. Anything to get Phier in a tiz!

The individual mandate was put in the bill to appease the HMOs

Which give tons of money to Democrats, especially conservative Democrats. Last I checked, HMOs don't vote!

[mrmouth]

Thats funny. I was having a discussion with my brother in law (MD, GP) last weekend about how this health care law has affected his work load. He says it hasn't at all.

What form would that be, Phier?


I can say that my 63 yr old mother finally did lose her teaching job. She had been hanging on by a thread. At 63 she has really no chance of finding anything else, and her pension isnt enough to live on solely. She could retire, but that isnt enough, either. So she has to work, somehow. Problem is, she cannot work over a certain amount of hours a month without having her social security taxed heavily. So basically she is screwed. And so am I as I probably cannot move to Spain anymore. My wife can to take her job, but I'm likely stuck here, helping my mother. I'll see my wife on the major holidays and birthdays.

The best part (and the relevant part) is that now my chronically ill mother (COPD, AMD) has no health insurance for the nest two years. If she can survive without having her expensive inhaler until she is 65 and can get on Medicare, we are out of the woods. Somewhere along the line she can also collect on my fathers social security. So at that point, maybe I can move.

[Big War Bird]

Did your mother never buy disability insurance?

Also she may qualify for SSDI.

[Ciabhán]

Thats funny. I was having a discussion with my brother in law (MD, GP) last weekend about how this health care law has affected his work load. He says it hasn't at all.

What form would that be, Phier?


I can say that my 63 yr old mother finally did lose her teaching job. She had been hanging on by a thread. At 63 she has really no chance of finding anything else, and her pension isnt enough to live on solely. She could retire, but that isnt enough, either. So she has to work, somehow. Problem is, she cannot work over a certain amount of hours a month without having her social security taxed heavily. So basically she is screwed. And so am I as I probably cannot move to Spain anymore. My wife can to take her job, but I'm likely stuck here, helping my mother. I'll see my wife on the major holidays and birthdays.

The best part (and the relevant part) is that now my chronically ill mother (COPD, AMD) has no health insurance for the nest two years. If she can survive without having her expensive inhaler until she is 65 and can get on Medicare, we are out of the woods. Somewhere along the line she can also collect on my fathers social security. So at that point, maybe I can move.

The system is broken but this 'solution' won't fix it.

As to workload I don't think you'll see changes in that yet. However a good friend of mine who was a partner in a private surgical office has had to close up shop and take a contract with a local hospital as this new law makes it so Medicaid/Medicare won't reimburse physicians for services anymore. They will only pay out to hospitals. Because of that my friend and his partners, who mostly worked with older folks and others on Medicaid/Medicare had the choice of dropping those patients, eating the cost of treating them, or taking lage cuts in income to contract with that hospital. I believe there were seven docs at his office. Four I believe now work for the hospital, two retired early, one is still figuring things out because he isn't a fan of the local hospital so will have to uproot to go work at another or try to practice privately with no government aid patients.

I'm not a physician and I was told this story over drinks one night so I don't know if this is limited to his particular speciality or more widespread. If this is going to be something that applies to all practices at some point we're gonna lose docs and won't see as many new ones in the future. In that case as docs do become overworked everyone will have access to the same substandard care, long waits to be seen, and government interference.

[Phier]

Thats funny. I was having a discussion with my brother in law (MD, GP) last weekend about how this health care law has affected his work load. He says it hasn't at all.

Flex spend.

[MathiasOfAthens]

Just started thinking... the conundrum that resulted in the individual mandate stems from the Public option opposition but first from the 1986 law that requires hospitals to provide care to anyone who shows up.

Now this law has done a lot of good but unfortunately left no mechanism to pay for the care and has left hospitals flipping the bill. So the mandate comes in to provide the mechanism. If the SC decides to overturn the mandate law could they also overturn the 1986 law requiring hospitals to help anyone?

[HissingNewt]

^I think the main issue people have with this is that it locks you into a horribly inefficient and expensive system with the HMO's. If they wanted to actually address price, they'd let more companies compete with the insurance companies.