Author Topic: What comes after the ACA?  (Read 1338914 times)

freya

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Re: What comes after the ACA?
« Reply #5950 on: March 07, 2020, 08:24:57 AM »
Doesn't make sense, but I suspect the ACA is history.  So far, the GOP & Trump are saying they will keep the part about not excluding pre-existing conditions - hopefully that will be the case.

I would not worry about this either way though.   There is a lot of baggage in the ACA law that has been driving medical and insurance costs up, and getting rid of that would frankly be a good thing.  Also, catastrophic policies would no longer be outlawed.   It would be interesting to price out one of those, with the highest deduction you can find, combined with a health sharing ministry subscription if you're not inclined to want to self-insure.

Also, there's an interesting trend developing: self-directed care replacing regular primary care visits.  Between direct to consumer labs, your ability to do your own checks at home for glucose, BP, even sleep disorders, and easy availability of online, on-demand telemedicine plus urgent care clinics popping up everywhere, you don't really need your health insurance for routine stuff.  All these except urgent care and preventative procedures (which don't require a referral) are cash-pay only and a lot cheaper than going the traditional route.  So you could opt for this for the routine stuff, and save insurance for those rare situations when you really need the backstop - i.e. what insurance is REALLY supposed to be for.   True, most people probably are better off relying on MD guidance, but those of us on this forum are smart enough to figure this out for themselves.  It's not rocket science.

John Galt incarnate!

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Re: What comes after the ACA?
« Reply #5951 on: March 07, 2020, 11:29:56 AM »

It doesn't make any sense on any number of levels. And yet we have Republican judges rubber-stamping it. This is what you get when Republicans have a stranglehold on the judiciary, law and order go out the window and they just do whatever they want to. And to think that *they* are the ones whining about "legislating from the bench"...


"An activist court is a court that makes a decision you don't like." Justice Kennedy



If legislation is not facially unconstitutional the Supreme Court's review of it  commences with a presumption of constitutionality.

Sometimes the high Court does "rewrite" legislation, or "legislates from the bench," to shape   legislation  so that it fits within the bounds of constitutionality.

The reason the Supreme Court does so is to observe the cardinal rule of statutory construction which is "to save and not to destroy," an observation that  effects the principle of judicial restraint.

waltworks

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Re: What comes after the ACA?
« Reply #5952 on: March 07, 2020, 12:41:32 PM »
Doesn't make sense, but I suspect the ACA is history.  So far, the GOP & Trump are saying they will keep the part about not excluding pre-existing conditions - hopefully that will be the case.

If the goal is short term chaos/the end of private insurance and long term single payer, then keeping the pre-existing condition protections and getting rid of the rest of the law is a great strategy. I can tell you exactly what I'd do in that situation - drop my health insurance, pay out of pocket for routine stuff, and buy insurance again if I get cancer.

-W

bacchi

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Re: What comes after the ACA?
« Reply #5953 on: March 07, 2020, 07:19:37 PM »
The reason the Supreme Court does so is to observe the cardinal rule of statutory construction which is "to save and not to destroy," an observation that  effects the principle of judicial restraint.

I think you're going to be surprised and saddened at the decisions this term and next. Some of the Justices don't believe in precedent as much as you think they do.

John Galt incarnate!

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Re: What comes after the ACA?
« Reply #5954 on: March 07, 2020, 08:14:37 PM »
The reason the Supreme Court does so is to observe the cardinal rule of statutory construction which is "to save and not to destroy," an observation that  effects the principle of judicial restraint.

I think you're going to be surprised and saddened at the decisions this term and next. Some of the Justices don't believe in precedent as much as you think they do.

Doubtless I've   consistently opined that the Supreme  Court will not overturn the A.C.A.

Time will tell if my prediction is correct.

I've been thinking about starting a thread that includes all of the Court's rationales that support  my opinion.

This thread already includes a sprinkling of them.

It's a lot of work  to write an opening post that includes all of them.

 Lately I'm feeling lazy due to the springlike weather.

Maybe next fall?

Maybe next winter?

For now, Justice Harlan's dissent in Plessy v. Ferguson (1896) provides a cogent  rationale in support of judicial restraint.


Is it meant that the determination of questions of legislative power depends upon the inquiry whether the statute whose validity is questioned is, in the judgment of the courts, a reasonable one, taking all the circumstances into consideration?

A statute may be unreasonable merely because a sound public policy forbade its enactment.

But I do not understand that the courts have anything to do with the policy or expediency of legislation.

A statute may be valid and yet, upon grounds of public policy, may well be characterized as unreasonable.

Mr. Sedgwick correctly states the rule when he says that, the legislative intention being clearly ascertained,


the courts have no other duty to perform than to execute the legislative will, without any regard to their views as to the wisdom or justice of the particular enactment.


There is a dangerous tendency in these latter days to enlarge the functions of the courts by means of judicial interference with the will of the people as expressed by the legislature.

 Our institutions have the distinguishing characteristic that the three departments of government are coordinate and separate.

Each must keep within the limits defined by the Constitution.

And the courts best discharge their duty by executing the will of the lawmaking power, constitutionally expressed, leaving the results of legislation to be dealt with by the people through their representatives.

Statutes must always have a reasonable construction. Sometimes they are to be construed strictly; sometimes liberally, in order to carry out the legislative will.

But however construed, the intent of the legislature is to be respected, if the particular statute in question is valid, although the courts, looking at the public interests, may conceive the statute to be both unreasonable and impolitic.

If the power exists to enact a statute, that ends the matter so far as the courts are concerned.

The adjudged cases in which statutes have been held to be void because unreasonable are those in which the means employed by the legislature were not at all germane to the end to which the legislature was competent.
 
« Last Edit: March 14, 2020, 10:45:51 AM by John Galt incarnate! »

American GenX

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Re: What comes after the ACA?
« Reply #5955 on: March 08, 2020, 08:25:45 AM »
Doesn't make sense, but I suspect the ACA is history.  So far, the GOP & Trump are saying they will keep the part about not excluding pre-existing conditions - hopefully that will be the case.

They don't want to keep pre-existing conditions or any other part of the ACA.  They've made that clear in the ACA lawsuit that they think the entire ACA should fall along with the mandate.  They are being dishonest about wanting to protect pre-existing conditions - they are trying to eliminate them.

Quote
There is a lot of baggage in the ACA law that has been driving medical and insurance costs up, and getting rid of that would frankly be a good thing.  Also, catastrophic policies would no longer be outlawed.   It would be interesting to price out one of those, with the highest deduction you can find, combined with a health sharing ministry subscription if you're not inclined to want to self-insure.

ACA helps keep healthcare costs down.  Those pre-ACA low cost "junk" policies and healthcare share ministries have left too many people holding the bill, not covering pre-existing conditions, getting dropped from their insurance, low coverage caps, having ridiculously high co-pays and deductibles, etc.  With subsidies, you can get some very affordable plans on the ACA marketplace that have required protections, and poor people can get FREE coverage through the ACA Medicaid expansion.

The ACA isn't perfect and can be improved on, but Trump/GOP are doing just the opposite, trying to dismantle it, removing funding, etc.  We're going to need a democrat in the White House as well as democratic majorities in Congress to see the improvements made.

freya

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Re: What comes after the ACA?
« Reply #5956 on: March 08, 2020, 09:31:34 AM »
ACA helps keep healthcare costs down.  Those pre-ACA low cost "junk" policies and healthcare share ministries have left too many people holding the bill, not covering pre-existing conditions, getting dropped from their insurance, low coverage caps, having ridiculously high co-pays and deductibles, etc.  With subsidies, you can get some very affordable plans on the ACA marketplace that have required protections, and poor people can get FREE coverage through the ACA Medicaid expansion.

The ACA may help keep YOUR healthcare costs down, but overall costs have increased.  Where do you think the subsidies come from?  It doesn't fall from the sky.

I think that a cash pay, private system will continue to develop alongside traditional insurance, which is limited to a fixed, severely over-regulated health-care delivery system that will become unable to cope with the healthcare needs of an increasingly sick population.  The analogy here is how commerce used to work in the Soviet Union:  there were mostly empty cheap, government-run stores, with long lines forming every time a store restocked.  Outside in the street, there was a thriving Wild-west of makeshift stalls where goods were sold at market prices with zero government oversight.  That's what happens when a centralized government tries to engineer a large segment of the economy.

Fortunately this is already happening -  the paleo/keto movement, DIY healthcare, online telemedicine etc.  If not for that, healthcare costs would be increasing even more.  I personally don't care whether the cost comes in the form of higher premiums/deductibles/copays, or increased taxes.  It'll come out the same either way.

Tyson

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Re: What comes after the ACA?
« Reply #5957 on: March 08, 2020, 10:02:05 AM »
ACA helps keep healthcare costs down.  Those pre-ACA low cost "junk" policies and healthcare share ministries have left too many people holding the bill, not covering pre-existing conditions, getting dropped from their insurance, low coverage caps, having ridiculously high co-pays and deductibles, etc.  With subsidies, you can get some very affordable plans on the ACA marketplace that have required protections, and poor people can get FREE coverage through the ACA Medicaid expansion.

The ACA may help keep YOUR healthcare costs down, but overall costs have increased.  Where do you think the subsidies come from?  It doesn't fall from the sky.

I think that a cash pay, private system will continue to develop alongside traditional insurance, which is limited to a fixed, severely over-regulated health-care delivery system that will become unable to cope with the healthcare needs of an increasingly sick population.  The analogy here is how commerce used to work in the Soviet Union:  there were mostly empty cheap, government-run stores, with long lines forming every time a store restocked.  Outside in the street, there was a thriving Wild-west of makeshift stalls where goods were sold at market prices with zero government oversight.  That's what happens when a centralized government tries to engineer a large segment of the economy.

Fortunately this is already happening -  the paleo/keto movement, DIY healthcare, online telemedicine etc.  If not for that, healthcare costs would be increasing even more.  I personally don't care whether the cost comes in the form of higher premiums/deductibles/copays, or increased taxes.  It'll come out the same either way.

[snark]Yes, I see what you mean!  Which is why we see such long lines outside of power stations.  Or the water plants.  [/snark]

Hell, we actually have a fully socialized system already set up - the military.  The military is certainly a model we could use to provide healthcare to all. 

Seriously, it's obviously possible for the government to do a fine job regulating and providing services on a large scale.  As someone who is concerned about the best outcomes for the highest number of people, that makes sense to me.  I should mention I'm a registered Democrat so that tells you where I am politically. 

But on the other hand, I realize there's a tradeoff.  With the free market approach to medicine, huge amounts of money get poured in to innovating medical solutions to things like cancer. 

My mom was just diagnosed with lung cancer, so this hits home for me.  Looking at the survival stats over the past few decades, her chances are a LOT better now than they would have been in the 60's or 70's.  Why?  Because there's been a ton of money poured into cancer research, including much better early detection tools.

With a socialized medicine approach, those types of innovations will slow down significantly and maybe stop completely in some areas.  That's the tradeoff.  Is it worth it?  Dunno.  But we should know what we are losing if we fully embrace socialized medicine.
« Last Edit: March 08, 2020, 10:03:36 AM by Tyson »

American GenX

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Re: What comes after the ACA?
« Reply #5958 on: March 08, 2020, 10:20:16 AM »
ACA helps keep healthcare costs down.  Those pre-ACA low cost "junk" policies and healthcare share ministries have left too many people holding the bill, not covering pre-existing conditions, getting dropped from their insurance, low coverage caps, having ridiculously high co-pays and deductibles, etc.  With subsidies, you can get some very affordable plans on the ACA marketplace that have required protections, and poor people can get FREE coverage through the ACA Medicaid expansion.

The ACA may help keep YOUR healthcare costs down, but overall costs have increased.  Where do you think the subsidies come from?  It doesn't fall from the sky.

Subsidies can help lower premiums and out of pocket costs, but I'm talking about total healthcare spending.  The increases in healthcare spending were reduced under the ACA, saving the country 2.3 trillions dollars.  Healtcare costs would have gone up a lot more without the ACA, and more people would be uninsured.  And the answer is not just preventative by going on a keto diet and getting exercise.  Healthcare is far more complex than that.

https://www.statnews.com/2019/03/22/affordable-care-act-controls-costs/

pecunia

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Re: What comes after the ACA?
« Reply #5959 on: March 08, 2020, 01:05:40 PM »

- SNIP -

[snark]Yes, I see what you mean!  Which is why we see such long lines outside of power stations.  Or the water plants.  [/snark]

Hell, we actually have a fully socialized system already set up - the military.  The military is certainly a model we could use to provide healthcare to all. 

Seriously, it's obviously possible for the government to do a fine job regulating and providing services on a large scale.  As someone who is concerned about the best outcomes for the highest number of people, that makes sense to me.  I should mention I'm a registered Democrat so that tells you where I am politically. 

But on the other hand, I realize there's a tradeoff.  With the free market approach to medicine, huge amounts of money get poured in to innovating medical solutions to things like cancer. 

My mom was just diagnosed with lung cancer, so this hits home for me.  Looking at the survival stats over the past few decades, her chances are a LOT better now than they would have been in the 60's or 70's.  Why?  Because there's been a ton of money poured into cancer research, including much better early detection tools.

With a socialized medicine approach, those types of innovations will slow down significantly and maybe stop completely in some areas.  That's the tradeoff.  Is it worth it?  Dunno.  But we should know what we are losing if we fully embrace socialized medicine.

There are things that are best left to private enterprise and there are things best done by a society working together as a whole.  Police, fire departments, public roads, libraries, schools and many other things are often better for the masses if done in peaceful cooperation.  Medicine is not currently done that way and many people die when they shouldn't be dying.  Many people go through their lives with illnesses that can be treated.

Thinking that a duplicate market will evolve is wishful thinking. 

Just think of the research money that could be allocated, if the cost of healthcare was halved to match the prices of other countries.  It seems reasonable that more innovations in medicine would occur.  What's more - these innovations could be of the type to benefit people rather than, for example, to hold a drug monopoly for a pharmaceutical company.

Davnasty

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Re: What comes after the ACA?
« Reply #5960 on: March 09, 2020, 08:41:44 AM »
ACA helps keep healthcare costs down.  Those pre-ACA low cost "junk" policies and healthcare share ministries have left too many people holding the bill, not covering pre-existing conditions, getting dropped from their insurance, low coverage caps, having ridiculously high co-pays and deductibles, etc.  With subsidies, you can get some very affordable plans on the ACA marketplace that have required protections, and poor people can get FREE coverage through the ACA Medicaid expansion.

The ACA may help keep YOUR healthcare costs down, but overall costs have increased.  Where do you think the subsidies come from?  It doesn't fall from the sky.

I think that a cash pay, private system will continue to develop alongside traditional insurance, which is limited to a fixed, severely over-regulated health-care delivery system that will become unable to cope with the healthcare needs of an increasingly sick population.  The analogy here is how commerce used to work in the Soviet Union:  there were mostly empty cheap, government-run stores, with long lines forming every time a store restocked.  Outside in the street, there was a thriving Wild-west of makeshift stalls where goods were sold at market prices with zero government oversight.  That's what happens when a centralized government tries to engineer a large segment of the economy.

Fortunately this is already happening -  the paleo/keto movement, DIY healthcare, online telemedicine etc.  If not for that, healthcare costs would be increasing even more.  I personally don't care whether the cost comes in the form of higher premiums/deductibles/copays, or increased taxes.  It'll come out the same either way.

Nearly every other developed country has some form of universal healthcare. Wouldn't any one of them be a closer analogy than the consumer goods market of the Soviet Union?

sherr

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Re: What comes after the ACA?
« Reply #5961 on: March 09, 2020, 09:35:07 AM »
Since it's directly relevant to this conversation and the recent questions that have arisen, I'll include a quote from Trump's Fox News townhall where he was specifically asked about pre-existing conditions:

Quote
Question: Because the issue of pre-existing conditions, you say you're going to protect them. But your administration is also fighting Obamacare in the courts. So how do you promise you're going to protect them based on that?

Quote
TRUMP: That's what I said.  We want to terminate Obamacare because it's bad.  Look, we're running it really well, but we know it's defective.  It's very defective.  We got rid of the worst part.  And that was a very important thing.  You know getting rid of the individual mandate was a very important thing.

But we want to get something if we can get the House, you'll have the best healthcare and health insurance anywhere on the planet.  But we have to get the House back.

Now, that means we have to hold the Senate.  We have to get the House.  We have to, obviously, keep the White House.  But, what we're doing is managing it really well.

Now, it's a case; it's called Texas vs. you understand it's Texas who is suing.  They want to terminate it.  But everybody there is also saying, and everybody we have our great senator from Pennsylvania.  Thank you very much, Pat, for being here.  (Applause.)  And Pat Toomey.

And but, very important and our by the way, our great congressmen, I have to say, they were warriors.  Right?   Real warriors, in terms of the fake impeachment.  I will tell you that.  (Applause.)

But, so Texas is trying and it's Texas and many states they're trying to terminate, but they want to put something that's much better.  They're terminating it to put much better.  And they've all pledged that preexisting conditions, 100 percent taken care of.

So still no actual answers to any of the questions, just a vague promise that if they win back the House (like he already had from 2017-2018) then everything will magically be better.

bacchi

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Re: What comes after the ACA?
« Reply #5962 on: March 09, 2020, 10:14:59 AM »
Since it's directly relevant to this conversation and the recent questions that have arisen, I'll include a quote from Trump's Fox News townhall where he was specifically asked about pre-existing conditions:

Quote
Question: Because the issue of pre-existing conditions, you say you're going to protect them. But your administration is also fighting Obamacare in the courts. So how do you promise you're going to protect them based on that?

Quote
TRUMP: That's what I said.  We want to terminate Obamacare because it's bad.  Look, we're running it really well, but we know it's defective.  It's very defective.  We got rid of the worst part.  And that was a very important thing.  You know getting rid of the individual mandate was a very important thing.

But we want to get something if we can get the House, you'll have the best healthcare and health insurance anywhere on the planet.  But we have to get the House back.

Now, that means we have to hold the Senate.  We have to get the House.  We have to, obviously, keep the White House.  But, what we're doing is managing it really well.

Now, it's a case; it's called Texas vs. you understand it's Texas who is suing.  They want to terminate it.  But everybody there is also saying, and everybody we have our great senator from Pennsylvania.  Thank you very much, Pat, for being here.  (Applause.)  And Pat Toomey.

And but, very important and our by the way, our great congressmen, I have to say, they were warriors.  Right?   Real warriors, in terms of the fake impeachment.  I will tell you that.  (Applause.)

But, so Texas is trying and it's Texas and many states they're trying to terminate, but they want to put something that's much better.  They're terminating it to put much better.  And they've all pledged that preexisting conditions, 100 percent taken care of.

So still no actual answers to any of the questions, just a vague promise that if they win back the House (like he already had from 2017-2018) then everything will magically be better.

Don't worry about it. This great plan -- the best, I'm told -- has been in the works for years. A few more details and it'll be ready.

American GenX

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Re: What comes after the ACA?
« Reply #5963 on: March 09, 2020, 07:50:19 PM »
Since it's directly relevant to this conversation and the recent questions that have arisen, I'll include a quote from Trump's Fox News townhall where he was specifically asked about pre-existing conditions:

Quote
Question: Because the issue of pre-existing conditions, you say you're going to protect them. But your administration is also fighting Obamacare in the courts. So how do you promise you're going to protect them based on that?

Quote
TRUMP: That's what I said.  We want to terminate Obamacare because it's bad.  Look, we're running it really well, but we know it's defective.  It's very defective.  We got rid of the worst part.  And that was a very important thing.  You know getting rid of the individual mandate was a very important thing.

But we want to get something if we can get the House, you'll have the best healthcare and health insurance anywhere on the planet.  But we have to get the House back.

Now, that means we have to hold the Senate.  We have to get the House.  We have to, obviously, keep the White House.  But, what we're doing is managing it really well.

Now, it's a case; it's called Texas vs. you understand it's Texas who is suing.  They want to terminate it.  But everybody there is also saying, and everybody we have our great senator from Pennsylvania.  Thank you very much, Pat, for being here.  (Applause.)  And Pat Toomey.

And but, very important and our by the way, our great congressmen, I have to say, they were warriors.  Right?   Real warriors, in terms of the fake impeachment.  I will tell you that.  (Applause.)

But, so Texas is trying and it's Texas and many states they're trying to terminate, but they want to put something that's much better.  They're terminating it to put much better.  And they've all pledged that preexisting conditions, 100 percent taken care of.

So still no actual answers to any of the questions, just a vague promise that if they win back the House (like he already had from 2017-2018) then everything will magically be better.

Trump has some very low level language skills and no understanding of what he is babbling about.  He says getting rid of the mandate was an important thing, yet the mandate is still in place and is why the GOP states filed the lawsuit on the grounds that the mandate is now unconstitutional due to the $0 penalty.  I think Trump really has no clue about any of it.  Worthless.

SugarMountain

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Re: What comes after the ACA?
« Reply #5964 on: March 11, 2020, 03:25:16 PM »

Trump has some very low level language skills and no understanding of what he is babbling about.  ...  I think Trump really has no clue about any of it.  Worthless.

You don't really need to know what the topic is for this to be true.

former player

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Re: What comes after the ACA?
« Reply #5965 on: March 11, 2020, 07:24:01 PM »

Trump has some very low level language skills and no understanding of what he is babbling about.  ...  I think Trump really has no clue about any of it.  Worthless.

You don't really need to know what the topic is for this to be true.
Quite.  He's just announced a month's travel ban from Europe, excluding the UK.  Does he not know that any EU citizen can come into the UK with minimal formalities?  Heathrow will be grateful for the business.

rantk81

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Re: What comes after the ACA?
« Reply #5966 on: March 12, 2020, 10:27:41 AM »
Some wide-spread infection (like COVID-19) exposes how fucked up things are in the United States is, and how it actually acts to continue the spread of disease.

- Deductibles (and all "cost sharing"), by definition, dis-incentivise people from seeking diagnostics or care early on with an infection.
- No national policy on paid-sick-leave.  So many low-paid employees (who frequently have jobs that interact directly with the public), are dissuaded from taking time off when they are ill.
- The Fed cutting rates to try to "stimulate" the economy more.  Don't you want to reduce economic activity (temporarily) to reduce the spread of a viral disease?

American GenX

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Re: What comes after the ACA?
« Reply #5967 on: March 12, 2020, 05:11:39 PM »
- No national policy on paid-sick-leave.  So many low-paid employees (who frequently have jobs that interact directly with the public), are dissuaded from taking time off when they are ill.

And then even if you have sick leave, a lot of times people feel guilty calling in sick, leaving the work to co-workers, people think they're just calling in for time off, or whatever.   And then, some people get PTO time, and they don't want to use their PTO time for sick days, so they will go to work sick so that they can save their PTO time for vacation days when they're feeling well.  And where I work, I get actual sick time in addition to other benefit days, but it still counts against us for using it, and you can face disciplinary action after just a few sick days over 6 months time.

bacchi

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Re: What comes after the ACA?
« Reply #5968 on: March 12, 2020, 05:24:28 PM »
How will Covid-19 affect the ACA decision?

The Justices are not 100% rational Constitutional automatons (regardless of what John Galt incarnate! believes :) and seeing the shitty health care system in the US, and how it makes pandemics worse, could tilt a pro-business Justice to vote for keeping it.

American GenX

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Re: What comes after the ACA?
« Reply #5969 on: March 12, 2020, 06:20:59 PM »
How will Covid-19 affect the ACA decision?

It tends to be more lethal to older people, so that will be be concern with these older justices.  That could change the balance of the court.  Wishing them the best along with everyone else.

Paul der Krake

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Re: What comes after the ACA?
« Reply #5970 on: March 12, 2020, 06:28:53 PM »
Courst have a long history of weighing in emergent threats when deciding cases. So that's probably a plus in the ACA's favor, ironically.

I'm more curious how that can impact premiums for 2021. I have no doubt hospitals will charge out the wazoo for those quarantine stays.

Exflyboy

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Re: What comes after the ACA?
« Reply #5971 on: March 12, 2020, 10:11:53 PM »
I can tell you I have no intention of going anywhere near a hospital unless I am at deaths door. As for testing,.. lets see $1000 each.. umm no thankyou!

Omy

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Re: What comes after the ACA?
« Reply #5972 on: March 13, 2020, 08:05:46 AM »
Don't mess around if you have shortness of breath. Better poor than dead!

Mr. Green

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Re: What comes after the ACA?
« Reply #5973 on: March 13, 2020, 12:06:56 PM »
Courst have a long history of weighing in emergent threats when deciding cases. So that's probably a plus in the ACA's favor, ironically.

I'm more curious how that can impact premiums for 2021. I have no doubt hospitals will charge out the wazoo for those quarantine stays.
Could you imagine if the effects of this pandemic ran into 2021 and SCOTUS killed the ACA with no replacement in sight? I don't even want to think about how ugly that would get. Wouldn't surprise me to see politicians getting shot at after that.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #5974 on: March 13, 2020, 03:39:51 PM »
I believe Justice Roberts has saved the ACA twice already, so it's likely he will save it a 3rd time.

American GenX

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Re: What comes after the ACA?
« Reply #5975 on: March 13, 2020, 04:01:34 PM »
I believe Justice Roberts has saved the ACA twice already, so it's likely he will save it a 3rd time.

Yes, assuming there are no other changes in the makeup of the court prior to any ruling.

John Galt incarnate!

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Re: What comes after the ACA?
« Reply #5976 on: March 13, 2020, 05:24:39 PM »
How will Covid-19 affect the ACA decision?

The Justices are not 100% rational Constitutional automatons (regardless of what John Galt incarnate! believes :) and seeing the shitty health care system in the US, and how it makes pandemics worse, could tilt a pro-business Justice to vote for keeping it.

Justice Stevens said that the longer he sat on the Supreme Court the more sensitive he was to the ramifications  of the Court's decisions, particularly their effect on the lives of the citizenry.

 As you correctly posted, the justices are not automatons.

"Reliance interest" is among the criteria the high Court weighs before it will overturn one of its  precedents.

The outbreak of COVID-19 underscores the body politic's  acute need for reliable medical services such as testing and treatment.

Their   need for these services  is a clear-cut demonstration of the "reliance interest" criterion so COVID-19 can only  have  the effect of  further  lowering  the virtually zero  probability  that the high Court will overturn the A.C.A.


 






« Last Edit: March 13, 2020, 05:41:31 PM by John Galt incarnate! »

pecunia

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Re: What comes after the ACA?
« Reply #5977 on: March 14, 2020, 07:09:53 AM »
Maybe, it's not just the supreme court people that see dire ramifications on what I would term a poor ruling for the ACA.

I figure the oligarchs who pull the strings and really run this country do not want to upset the apple cart.  They've probably already had a meeting in a dimly lit smoke filled room.  They've all had their toasts to each other's success and discussed future success.  They don't want a populace too uneasy.  It is bad for future profits.  It is bad to have problems with their labor force.  More will be talking unions and other alternatives they don't like.   Decisions have probably already been made.   Like the 1930s,  and other historic times, they will probably tell Congress to throw us a few bones after the election.  ACA should be slightly improved.  It will settle the masses.

John Galt incarnate!

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Re: What comes after the ACA?
« Reply #5978 on: March 14, 2020, 10:41:29 AM »
Maybe, it's not just the supreme court people that see dire ramifications on what I would term a poor ruling for the ACA.

I figure the oligarchs who pull the strings and really run this country do not want to upset the apple cart.  They've probably already had a meeting in a dimly lit smoke filled room.  They've all had their toasts to each other's success and discussed future success.  They don't want a populace too uneasy.  It is bad for future profits.  It is bad to have problems with their labor force.  More will be talking unions and other alternatives they don't like.   Decisions have probably already been made.   Like the 1930s,  and other historic times, they will probably tell Congress to throw us a few bones after the election.  ACA should be slightly improved.  It will settle the masses.


In another thread I posted briefly to you (IIRC) on the matter of unionists' opposition to single-payer or some sort of Medicare-for-all plan.

The unionists'  opposition doesn't make sense to me because union pension funds that  include  funding  for  health insurance can undergo sizable decreases  in value. 

 In the interest of unionists' retirement security I think it makes sense for them to support a single-payer plan or some kind of Medicare-for-all insurance.

As you suggest, overturning of the A.C.A. would convulse the polity, not a reaction the power elite, including Congress, would like.


DaMa

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Re: What comes after the ACA?
« Reply #5979 on: March 20, 2020, 07:55:47 AM »
The unions, especially the UAW, have some of the richest benefits still out there -- minimal if any deductibles and low copays.  ACA and Medicare have huge deductibles and coinsurance compared to their plans. 

pecunia

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Re: What comes after the ACA?
« Reply #5980 on: March 20, 2020, 04:23:01 PM »
People in unions are usually paid too well for ACA benefits.  As has been noted people in unions already have better health benefits than those given by the ACA.

Who would be the coalition that would work to save the ACA?  Poor people, maybe.  Early retirees almost certainly.  Not a whole lot of political clout from these groups.  It doesn't seem like the kind of thing that people band together to fight for.

Paul der Krake

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Re: What comes after the ACA?
« Reply #5981 on: March 20, 2020, 04:58:55 PM »
Fat chance mate, poor people don't vote and don't read the news.

pecunia

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Re: What comes after the ACA?
« Reply #5982 on: March 21, 2020, 11:19:16 AM »
Fat chance mate, poor people don't vote and don't read the news.

Sadly, I agree unless there is some serious event that leads them to action.    Hmmmmmm, maybe a global pandemic?  Probably, not even that.

It's kind of odd, actually that people are so willing to accept their lot in life.  This health care thing is so wrong and it looks like it will stay that way.

bilmar

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Re: What comes after the ACA?
« Reply #5983 on: March 21, 2020, 01:01:24 PM »
If we going to have close to 20% unemployment due to an ongoing  Pandemic, consider how many of those  newly unemployed people are going to be anxious to get their new ACA applications approved?

If Republicans succeed in killing it soon they better be ready for the backlash.....

American GenX

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Re: What comes after the ACA?
« Reply #5984 on: March 21, 2020, 01:07:16 PM »
If we going to have close to 20% unemployment due to an ongoing  Pandemic, consider how many of those  newly unemployed people are going to be anxious to get their new ACA applications approved?

If Republicans succeed in killing it soon they better be ready for the backlash.....

The Republicans can't kill it through legislation now - they don't have a majority in the house.  However, as mentioned in one of my previous posts, the Supreme Court will be taking up the existing ACA case next term, which could kill it.  But, we're probably going to have to wait for over a year to find out.

Omy

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Re: What comes after the ACA?
« Reply #5985 on: March 21, 2020, 03:02:39 PM »
This pandemic may wake people up after a few months. Would the Supreme Court dare to dismantle the ACA after this?

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Re: What comes after the ACA?
« Reply #5986 on: March 21, 2020, 04:00:19 PM »
This pandemic may wake people up after a few months. Would the Supreme Court dare to dismantle the ACA after this?

No.

Reliance interest is only one of the criteria that militates against the Court reversing the constitutionality of the A.C.A.



"Reliance interest" is among the criteria the high Court weighs before it will overturn one of its  precedents.

The outbreak of COVID-19 underscores the body politic's  acute need for reliable medical services such as testing and treatment.

Their   need for these services  is a clear-cut demonstration of the "reliance interest" criterion so COVID-19 can only  have  the effect of  further  lowering  the virtually zero  probability  that the high Court will overturn the A.C.A.
« Last Edit: March 21, 2020, 04:06:09 PM by John Galt incarnate! »

American GenX

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Re: What comes after the ACA?
« Reply #5987 on: March 21, 2020, 05:13:47 PM »
This pandemic may wake people up after a few months. Would the Supreme Court dare to dismantle the ACA after this?

No.

Reliance interest is only one of the criteria that militates against the Court reversing the constitutionality of the A.C.A.



"Reliance interest" is among the criteria the high Court weighs before it will overturn one of its  precedents.

The outbreak of COVID-19 underscores the body politic's  acute need for reliable medical services such as testing and treatment.

Their   need for these services  is a clear-cut demonstration of the "reliance interest" criterion so COVID-19 can only  have  the effect of  further  lowering  the virtually zero  probability  that the high Court will overturn the A.C.A.

That may be with the current makeup of the court.  But we have a good part of the year left, some older pro-ACA judges, and a virus pandemic for an illness which is worse for older people.

Crease

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Re: What comes after the ACA?
« Reply #5988 on: March 21, 2020, 05:41:38 PM »
This pandemic may wake people up after a few months. Would the Supreme Court dare to dismantle the ACA after this?

No.

Reliance interest is only one of the criteria that militates against the Court reversing the constitutionality of the A.C.A.



"Reliance interest" is among the criteria the high Court weighs before it will overturn one of its  precedents.

The outbreak of COVID-19 underscores the body politic's  acute need for reliable medical services such as testing and treatment.

Their   need for these services  is a clear-cut demonstration of the "reliance interest" criterion so COVID-19 can only  have  the effect of  further  lowering  the virtually zero  probability  that the high Court will overturn the A.C.A.

That may be with the current makeup of the court.  But we have a good part of the year left, some older pro-ACA judges, and a virus pandemic for an illness which is worse for older people.

Anyone know the Senate Majority Leader's current position on holding SCOTUS hearings in an election year?

American GenX

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Re: What comes after the ACA?
« Reply #5989 on: March 21, 2020, 05:50:12 PM »
This pandemic may wake people up after a few months. Would the Supreme Court dare to dismantle the ACA after this?

No.

Reliance interest is only one of the criteria that militates against the Court reversing the constitutionality of the A.C.A.



"Reliance interest" is among the criteria the high Court weighs before it will overturn one of its  precedents.

The outbreak of COVID-19 underscores the body politic's  acute need for reliable medical services such as testing and treatment.

Their   need for these services  is a clear-cut demonstration of the "reliance interest" criterion so COVID-19 can only  have  the effect of  further  lowering  the virtually zero  probability  that the high Court will overturn the A.C.A.

That may be with the current makeup of the court.  But we have a good part of the year left, some older pro-ACA judges, and a virus pandemic for an illness which is worse for older people.

Anyone know the Senate Majority Leader's current position on holding SCOTUS hearings in an election year?

Yes, I think it was mentioned earlier in the thread, but McConnell said he would confirm a Supreme Court justice in 2020.

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Re: What comes after the ACA?
« Reply #5990 on: March 25, 2020, 01:19:26 PM »
After the trauma of the Kavanaugh hearings, I really cannot see how we could handle a Supreme Court seat suddenly coming available right now.

I also cannot help but think it's likely given how all of the people in government seem to suddenly be catching the virus.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #5991 on: March 25, 2020, 08:27:52 PM »
For McConnell a power grab by any means necessary is the likely outcome.

pecunia

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Re: What comes after the ACA?
« Reply #5992 on: March 26, 2020, 05:20:03 PM »
Would the present times be an opportune time to press for a program to improve the medical system of the United States?  Seems like a system with better central planning would be an improvement.

dividendman

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Re: What comes after the ACA?
« Reply #5993 on: March 26, 2020, 07:05:42 PM »
Would the present times be an opportune time to press for a program to improve the medical system of the United States?  Seems like a system with better central planning would be an improvement.

You said central planning, therefore you are a communist and all of your ideas will be dismissed.

American GenX

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Re: What comes after the ACA?
« Reply #5994 on: March 26, 2020, 07:29:20 PM »
Would the present times be an opportune time to press for a program to improve the medical system of the United States?  Seems like a system with better central planning would be an improvement.
Trump is still president, so no, it's not the opportune time.

pecunia

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Re: What comes after the ACA?
« Reply #5995 on: March 28, 2020, 07:29:17 AM »
Would the present times be an opportune time to press for a program to improve the medical system of the United States?  Seems like a system with better central planning would be an improvement.

You said central planning, therefore you are a communist and all of your ideas will be dismissed.

I've been leaning that way.  I even think 5 year plans don't sound too bad. 

The way to get it done is to give Trump all the credit and say it is the act of our greatest most terrific president.

Mr. Green

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Re: What comes after the ACA?
« Reply #5996 on: April 04, 2020, 10:37:08 PM »
I can't help but wonder if the scope of this pandemic and the fallout from it by the time SCOTUS hears arguments on the case this Fall will make it nearly impossible to strike down the law.

pecunia

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Re: What comes after the ACA?
« Reply #5997 on: April 05, 2020, 07:22:13 AM »
As of today, this China Virus has caused 8,500 deaths in the US.  That's way more than the 2,977 deaths of 9/11.  And,......it ain't done yet.   

I'm thinking that when this is said and done there will be a clamor for better health care.  Since, the profit motive will not be enough to provide adequate preventive medicine, that there will be government programs to plan for this.  There could even be a new bureaucratic organization like the Department of Homeland Security spewed out of this mess.

Does anybody who reads this want a repeat?  History does repeat itself, in particular, for the ill prepared.

An ounce of prevention is worth a lb of cure.  Health Care for All may have helped provide some prevention.

The last time that Congress tried to stop the ACA, there was a hew and cry at various Town Meetings against some of the Conservatives who had the idea to get rid of it.  The attempt failed.  There should be an even more vocal reaction against whomever tries to dismantle it after this is over.

It's kind of obvious that pure free market medicine does not do the job for everyone because everyone does not have money.

What comes after the ACA?  Maybe, the country will have something better.

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Re: What comes after the ACA?
« Reply #5998 on: April 05, 2020, 08:20:40 AM »
An ounce of prevention is worth a lb of cure.  Health Care for All may have helped provide some prevention.

Health care coverage would not prevent the coronavirus at this point.  There's no vaccination or cure, and everyone will be covered for treating COVID-19 patients specifically.

Quote
There should be an even more vocal reaction against whomever tries to dismantle it after this is over.

There's already a lawsuit in progress mentioned above attempting to dismantle it completely, and we might not get a ruling for about a year, which could be under a different makeup of justices due to COVID-19 allowing Trump to get another choice confirmed.  It won't matter what the vocal reaction is - in that scenario it would likely be overturned.  So, hope for the best of health for the pro-ACA judges.

Mr. Green

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Re: What comes after the ACA?
« Reply #5999 on: April 05, 2020, 10:25:40 AM »
An ounce of prevention is worth a lb of cure.  Health Care for All may have helped provide some prevention.
Health care coverage would not prevent the coronavirus at this point.  There's no vaccination or cure, and everyone will be covered for treating COVID-19 patients specifically.
The problem is that solution doesn't address any of the collateral damage. What about people who develop physical ailments from being laid off and worrying about how they'll continue feeding their families? How about people who can't afford COBRA coverage after being fired, but are clueless that the ACA could provide them healthcare at a more reasonable cost because they've never needed it and this administration has done an excellent job at making sure it gets the least amount of public outreach possible? Maybe they end up without healthcare at all. Lots of people will inevitably require healthcare due to COVID-19, but not because they got the virus. And the fact that our system is set up to increase the number of people without healthcare at the time when it is needed most is simply a stupid system.
« Last Edit: April 05, 2020, 10:29:53 AM by Mr. Green »