Now that the Decision is in

[huskrthill]

So as noted above, let 'em die in the streets.

The streets were littered with dead bodies in the 1980s.

[cm husker]

What disturbs me is the lack of defining the scope of coverage. Does every single American get the "cadillac" coverage to avoid "financial ruin"?

It's one thing to basically pay for everyone to have a check up/consult and maybe some prescription antibiotics.

It's quite another to pay for extremely expensive treatments indefinitely and in all cases.

Uh oh... nobody bring up death panels.

[cm husker]

The streets were littered with dead bodies in the 1980s.

In NYC, yes.

Were people turned away from hospitals in the 80s?

Regardless of the law, the doctors probably won't do it anyway... it's something about their professional ethics.

[Showman]

What does that mean ?

Does someone who say loses their house through gambling, bad investment deals any different than someone who loses their house through bad food,health choices ?

It means what it means. I suppose you can grab-bag any set of poor circumstances together and set them up against each other but I'm not sure what that in and of itself means, quite frankly.

[cm husker]

If people need care but can't afford it, then perhaps they should have to find a way to work off their debt to the hospital... or go to jail.

Now that is a radical approach to universal coverage.

Or will we stop treating jail inmates?

[huskrthill]

In NYC, yes.

Sounds like a NYC problem, not a huskrthill problem.

Were people turned away from hospitals in the 80s?

Regardless of the law, the doctors probably won't do it anyway... it's something about their professional ethics.

Right, so why should the government interject and mandate it?

[huskrthill]

Now that is a radical approach to universal coverage.

Or will we stop treating jail inmates?

Bare minimum coverage if in jail. Bare. Freaking. Minimum.

[huskernut]

What disturbs me is the lack of defining the scope of coverage. Does every single American get the "cadillac" coverage to avoid "financial ruin"?

It's one thing to basically pay for everyone to have a check up/consult and maybe some prescription antibiotics.

It's quite another to pay for extremely expensive treatments indefinitely and in all cases.

Uh oh... nobody bring up death panels.

It amazes me that the distinction you bring up above isn't more talked about. It is fantasy to believe we can afford to provide un-rationed technology-intensive care to everybody. If the electorate and then our elected officials were more mature about life, frankly, this "problem" would not be nearly so difficult to solve.

[huskheartguy]

This is a real question and not trying to just make some noise...does congress, the senate, and POTUS not have this coverage but has a much better one?

[Lakewood Husker]

Now regarding the political aspect of this ruling. If there is one thing the Republicans are real good at and have a long history of success is the framing of taxes. This ruling will be a boon to the Republicans.

Whereas the party sometimes gets lost and distracted on social issues this tax increase will resonate and is in the RNC wheelhouse. This will bring back the old tax and spend liberal moniker that has been hung over many a democrat carcass over the years.

[Huskermedic]

I still have never been able to get an anwser. If single payer systems are the best why have not the liberal states in this country all have them? Why because it will bankrupt them.

You let people buy medical insurance across state lines and drop all the silly mandates people will be able to afford HC insurance.

[ShuckIt]

I still have never been able to get an anwser. If single payer systems are the best why have not the liberal states in this country all have them? Why because it will bankrupt them.

You let people buy medical insurance across state lines and drop all the silly mandates people will be able to afford HC insurance.

This.

[ShuckIt]

I would like this to be put on my paycheck listed as: Charity Tax just so I know I'm helping those less fortunate than I. In reality I'm not sure yet how I feel about this ruling, well I know how I feel but I hope I'm wrong. I just don't have confidence in the government to do what is right for the people on this, all this is now is another revenue stream.

[ChitownHusker]

I think the basic framework of an individual mandate combined with certain concessions from insurance companies like coverage of pre-existing conditions is a good starting point. But that's all it is. The problem with the last health care debate is that alot of decent conservative ideas were ignored. There are a number of ways to increase the competitiveness of the health insurance market.

1. Portability across state lines. Insurers right now only have to compete against 6 or so other insurers authorized to do business in that state, which inhibits price competition. We need 30 or 40 insurers competing with each other not just a handful.

2. Medical Malpractice reform. So much med mal litigation is frivolous crap than amounts to nothing more than legalized extortion for a settlement. We need to penalize those suits while preserving the ability of people who have been legitimately injured to bring suit. We need stronger fee-shifting for frivolous litigation, caps on punitive damages and soft damages like pain and suffering and other measures that will reduce the incredibly high cost of malpractice insurance.

3. A better pricing system. Right now everything is based on a nebulous committee of doctors that sets pricing for Medicare and which often gets things wrong (for instance by charging for the use of a new device with every surgery when the device at issue is reusable). We need more than just doctors to participate in the pricing of reimbursement of health care services.

4. Elective vs. non-elective shouldn't be an either/or. It should be a sliding scale. Consumers should have to pay a higher percentage the more elective that the service is.

5. Transparency of pricing and greater consumer pricing. High deductible plans are a good start. We need consumers to know what they are paying for, and for consumers to have to pay something themselves, so they will only get what they really need.

Basically what we need is for the health care market to do a better job of allocating resources. People get a ton of unnecessary health care in this country because there is no incentive for them not to. That is what needs to change.

[Squatchsker]

HDHP with an HSA is the way to go. It truly gets you involved in your own healthcare. It is cheaper that PPO and has more long term benefits.

[cm husker]

Right, so why should the government interject and mandate it?

Probably because doctors (a) will quit being doctors if they aren't paid, (b) will pass the costs onto those who are treated by raising the price of services to those who actually pay, and (c) creating a larger risk pool means less individual costs for the participants in the pool.

Generally speaking, the mandate makes a lot of economic sense.

[cm husker]

It amazes me that the distinction you bring up above isn't more talked about. It is fantasy to believe we can afford to provide un-rationed technology-intensive care to everybody. If the electorate and then our elected officials were more mature about life, frankly, this "problem" would not be nearly so difficult to solve.

It was attempted, and both sides were accused of creating death panels.

For whatever reason, "rationed healthcare" is extremely taboo.... even though that's what insurance companies do today.

[cm husker]

This is a real question and not trying to just make some noise...does congress, the senate, and POTUS not have this coverage but has a much better one?

They have better coverage, and that makes good sense. Their better insurance is a financial/compensation incentive.

Minimum coverage is a completely separate thing.

[cm husker]

Now regarding the political aspect of this ruling. If there is one thing the Republicans are real good at and have a long history of success is the framing of taxes. This ruling will be a boon to the Republicans.

Whereas the party sometimes gets lost and distracted on social issues this tax increase will resonate and is in the RNC wheelhouse. This will bring back the old tax and spend liberal moniker that has been hung over many a democrat carcass over the years.

And that would be a nonsensical argument, similar to liberals arguing that republicans only care about people in the womb.

Anyone pull the numbers yet on who will be charged a penalty under the mandate? I'd say 90% or probably much more are probably already paying for insurance, so this mandate will not impact them at all, except that their premiums may go down.

[huskrthill]

Probably because doctors (a) will quit being doctors if they aren't paid, (b) will pass the costs onto those who are treated by raising the price of services to those who actually pay, and (c) creating a larger risk pool means less individual costs for the participants in the pool.

Generally speaking, the mandate makes a lot of economic sense.

How come these things have only recently become problems?