And the ruling on the health care law is…

Today, the Supreme Court will announce its decision on the 2010 health care bill. According to the official schedule, the ruling won’t have occurred by the time this post goes live — and it certainly hasn’t happened as I actually write this post on Wednesday night — so I don’t have a lot to say about the decision right now. But presumably you all will, as events unfold.

If you’re reading this before the decision has been announced, you can read SCOTUSblog’s helpful summary of what exactly we’re waiting for. Law junkies can also follow SCOTUSblog’s live coverage of the event throughout the day – they’ve even created a backup site in case their main site gets flooded with viewers.

So, did the Supreme Court get it right?

  • Susan

    tODD,

    Another website that may be a helpful supplement is: The Volohk Conspiracy: http://www.volokh.com It is a large group of attorneys who analyze important law cases in the US. A number of these attorneys supplied work (briefs, amicus, and etc) in support of the challenge to the ACA.

  • Susan

    tODD,

    Another website that may be a helpful supplement is: The Volohk Conspiracy: http://www.volokh.com It is a large group of attorneys who analyze important law cases in the US. A number of these attorneys supplied work (briefs, amicus, and etc) in support of the challenge to the ACA.

  • Susan

    According to Ilya Somin at Volokh blog: If the Court ends up striking down the mandate, it will be because the federal government failed to come up with a good explanation of how the law can be upheld without giving Congress nearly unlimited power to impose other mandates.

    P.S. Somin is a high calibre attorney who has had his worked posted on SCOTUSblog in the past.

  • Susan

    According to Ilya Somin at Volokh blog: If the Court ends up striking down the mandate, it will be because the federal government failed to come up with a good explanation of how the law can be upheld without giving Congress nearly unlimited power to impose other mandates.

    P.S. Somin is a high calibre attorney who has had his worked posted on SCOTUSblog in the past.

  • http://enterthevein.wordpress.com J. Dean

    My prediction is that it will go the same way as the illegal immigration AZ case: it will be a halfway decision that will leave both sides saying “We didn’t get what we want!”

    I believe the mandate will be struck down, but not necessarily the rest of the measure.

  • http://enterthevein.wordpress.com J. Dean

    My prediction is that it will go the same way as the illegal immigration AZ case: it will be a halfway decision that will leave both sides saying “We didn’t get what we want!”

    I believe the mandate will be struck down, but not necessarily the rest of the measure.

  • fws

    J Dean @ 3

    How is the “mandate” any different in character than the requirement that we all pay into a retirement fund called social security and a medical fund called medicare?

    Isnt the mandate really just another tax?
    Isnt this just a another post modernist tussle over the meaning of a word determining the essence of what it describes?

  • fws

    J Dean @ 3

    How is the “mandate” any different in character than the requirement that we all pay into a retirement fund called social security and a medical fund called medicare?

    Isnt the mandate really just another tax?
    Isnt this just a another post modernist tussle over the meaning of a word determining the essence of what it describes?

  • fws

    so we can agree, or not, whether the mandate/tax is a good idea, or not. But do we really need to take this up as to the question of constitutionality?

  • fws

    so we can agree, or not, whether the mandate/tax is a good idea, or not. But do we really need to take this up as to the question of constitutionality?

  • Joe

    Frank — it can’t be a tax because if it is it is an illegal tax because of the way it is assessed. The federal gov’t’s taxing power can only be exercised in specific ways — the formula used in the AHCA does not operate in a way that brings it within the taxing power.

  • Joe

    Frank — it can’t be a tax because if it is it is an illegal tax because of the way it is assessed. The federal gov’t’s taxing power can only be exercised in specific ways — the formula used in the AHCA does not operate in a way that brings it within the taxing power.

  • Joe

    Frank — it looks like the S.Ct. disagrees with me. Initial reports are that the mandate survives as a tax …

  • Joe

    Frank — it looks like the S.Ct. disagrees with me. Initial reports are that the mandate survives as a tax …

  • Med Student

    @4/5
    I am certainly no expert on the matter by any means, but my understanding is that it’s not in fact a tax because the money is going to insurance companies, not to the government, and if you don’t buy the product, then you pay a fine. If Congress wanted to make it a tax, then we would all have to pay the government extra money for health insurance and then that money would be used by the government to pay for our healthcare. Which is exactly what happens with FICA taxes (which are not, in fact, mandatory in the same way, since you only pay them if you’re working). There’s a fairly substantial difference between the government telling you that you have to give them money and then using it for a specific purpose (tax) and the government telling you that you have to use your money to buy a specific product from a private company or you’ll be punished with fines/jail (ACA mandate).
    Of course, since my legal expertise (or rather, lack thereof) stems from a few classes in high school and college, I am open to correction from people who really know what they’re talking about. This is just based on various pieces I’ve read here and there.

  • Med Student

    @4/5
    I am certainly no expert on the matter by any means, but my understanding is that it’s not in fact a tax because the money is going to insurance companies, not to the government, and if you don’t buy the product, then you pay a fine. If Congress wanted to make it a tax, then we would all have to pay the government extra money for health insurance and then that money would be used by the government to pay for our healthcare. Which is exactly what happens with FICA taxes (which are not, in fact, mandatory in the same way, since you only pay them if you’re working). There’s a fairly substantial difference between the government telling you that you have to give them money and then using it for a specific purpose (tax) and the government telling you that you have to use your money to buy a specific product from a private company or you’ll be punished with fines/jail (ACA mandate).
    Of course, since my legal expertise (or rather, lack thereof) stems from a few classes in high school and college, I am open to correction from people who really know what they’re talking about. This is just based on various pieces I’ve read here and there.

  • Med Student

    @ Joe
    Is the fine for not buying health insurance what’s being labeled as a tax, or the buying of health insurance itself? (I should have refreshed while writing earlier – I missed your posts).

  • Med Student

    @ Joe
    Is the fine for not buying health insurance what’s being labeled as a tax, or the buying of health insurance itself? (I should have refreshed while writing earlier – I missed your posts).

  • WebMonk

    I haven’t been able to find the opinion itself, just lots of commentary on it as it is being read. I can’t watch the reading itself from here. :-P

    Looks like Roberts is the one who sided with the pro-HCA side, and he did so as long as the mandate is treated as a tax. According to the ruling, it would be unconstitutional if it were enforced using the Commerce Clause, but it is constitutional as a tax.

    I haven’t seen anywhere that has delved into why he feels it is a tax and not a Commerce Clause mandate.

    That was always one particular set of arguments, but I wouldn’t have thought he would have followed it. From the arguments, I thought the call-it-a-tax argument was extremely weak. I suspect he has used a different set of reasons from what was presented.

  • WebMonk

    I haven’t been able to find the opinion itself, just lots of commentary on it as it is being read. I can’t watch the reading itself from here. :-P

    Looks like Roberts is the one who sided with the pro-HCA side, and he did so as long as the mandate is treated as a tax. According to the ruling, it would be unconstitutional if it were enforced using the Commerce Clause, but it is constitutional as a tax.

    I haven’t seen anywhere that has delved into why he feels it is a tax and not a Commerce Clause mandate.

    That was always one particular set of arguments, but I wouldn’t have thought he would have followed it. From the arguments, I thought the call-it-a-tax argument was extremely weak. I suspect he has used a different set of reasons from what was presented.

  • Joe

    From the SCOTUS blog (the actual opinion is still not available):

    Amy Howe:
    In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

  • Joe

    From the SCOTUS blog (the actual opinion is still not available):

    Amy Howe:
    In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

  • Jon

    Told ya so.

  • Jon

    Told ya so.

  • Joe

    Also — note the breakdown of the Justices. Roberts is the 5th vote to uphold it and Kennedy voted to find the entire law unconstitutional. Also, Kennedy is on the bench reading from the dissent. Interesting that he seems to be taking a leading role in the dissent.

  • Joe

    Also — note the breakdown of the Justices. Roberts is the 5th vote to uphold it and Kennedy voted to find the entire law unconstitutional. Also, Kennedy is on the bench reading from the dissent. Interesting that he seems to be taking a leading role in the dissent.

  • WebMonk

    Here’s from the live-blogging:

    five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power.

    So, it is the penalty that would be considered a tax. People get a “tax break” if they have health care coverage. If they don’t have health care coverage, then they don’t get the tax break.

    That seems to be the rationale. I don’t think that was how the law was intended to go into effect, but that’s one way to look at it, I guess.

  • WebMonk

    Here’s from the live-blogging:

    five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power.

    So, it is the penalty that would be considered a tax. People get a “tax break” if they have health care coverage. If they don’t have health care coverage, then they don’t get the tax break.

    That seems to be the rationale. I don’t think that was how the law was intended to go into effect, but that’s one way to look at it, I guess.

  • WebMonk

    Whoops, Joe beat me to it.

  • WebMonk

    Whoops, Joe beat me to it.

  • WebMonk
  • WebMonk
  • WebMonk

    Ha! I got that one in first! :-D

  • WebMonk

    Ha! I got that one in first! :-D

  • Dr. Luther in the 21st Century

    I am kind of sad, but before supporters of the bill get all rah,rah. There is another challenge to the bill that is just getting started. The challengers were waiting on the outcome of this ruling. We have discussed it before on this blog. The Bishops of the Roman church and others will now begin a full court press that could strip the individual mandate of its power on First Amendment grounds. Plus, there will be even greater energy on the part of Republican party to claim both houses and the presidency. I myself may even bite the bullet and vote Romney just for the chance to repeal this monstrosity.

  • Dr. Luther in the 21st Century

    I am kind of sad, but before supporters of the bill get all rah,rah. There is another challenge to the bill that is just getting started. The challengers were waiting on the outcome of this ruling. We have discussed it before on this blog. The Bishops of the Roman church and others will now begin a full court press that could strip the individual mandate of its power on First Amendment grounds. Plus, there will be even greater energy on the part of Republican party to claim both houses and the presidency. I myself may even bite the bullet and vote Romney just for the chance to repeal this monstrosity.

  • formerly just steve

    WM #14, how is it a tax break?

  • formerly just steve

    WM #14, how is it a tax break?

  • mikeb

    I was shocked that Justice Kennedy didn’t vote with the majority. I figured 5-4 to strike or 6-3 to uphold. The preruling political chatter from the Left indicated a 5-4 ruling against the law would be a travesty. My guess is now that they’ll saw a 5-4 win is the greatest thing since sliced bread.

    It’s good news/bad news for Obama. The President can’t run against the obstructionist ultra-conservative Court now since they handed him victories, first against Arizona’s Immigration Law, and today with Obamacare. But at least his law stays for now. But I think this will energize the Tea Party types and the President is still on the hook for all the ACA taxes, spending, and individual mandate that poll after poll shows are highly unpopular.

    If the Republicans can use the ruling to energize their base and the vast majority of independents upset with the law’s specifics, they should find themselves in the majority in the Senate come January with Mitt Romney in the White House. If that happens, look for the entire law to be repealed using the same reconciliation tactics the Democrats used. So the ruling today is a tactical victory for Obama but probably a strategic victory for the Republicans.

  • mikeb

    I was shocked that Justice Kennedy didn’t vote with the majority. I figured 5-4 to strike or 6-3 to uphold. The preruling political chatter from the Left indicated a 5-4 ruling against the law would be a travesty. My guess is now that they’ll saw a 5-4 win is the greatest thing since sliced bread.

    It’s good news/bad news for Obama. The President can’t run against the obstructionist ultra-conservative Court now since they handed him victories, first against Arizona’s Immigration Law, and today with Obamacare. But at least his law stays for now. But I think this will energize the Tea Party types and the President is still on the hook for all the ACA taxes, spending, and individual mandate that poll after poll shows are highly unpopular.

    If the Republicans can use the ruling to energize their base and the vast majority of independents upset with the law’s specifics, they should find themselves in the majority in the Senate come January with Mitt Romney in the White House. If that happens, look for the entire law to be repealed using the same reconciliation tactics the Democrats used. So the ruling today is a tactical victory for Obama but probably a strategic victory for the Republicans.

  • scott

    @Dr Luther on 18: How do you think a Romney vote will help against this? The current GOP has not done anything to shrink the gov’t in several decades. Bush gave us “compassionate” conservatism which grew the gov’t. He also gave us “conservative” justices who just voted this thing through. And Romney gave us the blueprint for Obamacare. Why would anyone who wants less gov’t involvement vote for a GOP candidate? Supposedly the lesser of two evils? Good luck finding much wiggle room between Romney and Obama.

  • scott

    @Dr Luther on 18: How do you think a Romney vote will help against this? The current GOP has not done anything to shrink the gov’t in several decades. Bush gave us “compassionate” conservatism which grew the gov’t. He also gave us “conservative” justices who just voted this thing through. And Romney gave us the blueprint for Obamacare. Why would anyone who wants less gov’t involvement vote for a GOP candidate? Supposedly the lesser of two evils? Good luck finding much wiggle room between Romney and Obama.

  • Dr. Luther in the 21st Century

    @21 I realize this is an assumption, but as much as I don’t like Romney I don’t think he is an idiot. If a Republican congress hands him a repeal, I expect he is smart enough to sign it particularly if he wants a second term.

  • Dr. Luther in the 21st Century

    @21 I realize this is an assumption, but as much as I don’t like Romney I don’t think he is an idiot. If a Republican congress hands him a repeal, I expect he is smart enough to sign it particularly if he wants a second term.

  • scott

    @22 I guess we’ll have to see. The man has spent millions of his own dollars in a bid to be president. Is this an act of idiocy? Hmmm . . .

  • scott

    @22 I guess we’ll have to see. The man has spent millions of his own dollars in a bid to be president. Is this an act of idiocy? Hmmm . . .

  • Cincinnatus

    Hey, I though the SCOTUS was totally in the tank for the Republicans, man! This destroys my paradigm! [not really]

    This ruling, from my view, sets a disturbing precedent–not because it flouted my prediction (it did), and not simply because I am opposed to the concept of “Obamacare” in general (I am). It would have been bad enough had the Court upheld the mandate on Commerce Clause grounds–you all know how I feel about Commerce Clause jurisprudence–but at least such a ruling would have been predictable and fairly consistent with previous jurisprudence.

    But upholding the mandate as a tax? That seems dangerous, and it required some legal finagling. Apparently Roberts opposed the Commerce Clause notion that Congress can force citizens to buy private commodities. Fine. So do I. But isn’t the result here the same, just through a back door? Congress can’t force you to buy a private commodity, but it can penalize you if you don’t (to the tune of thousands of dollars)! Thus, SCOTUS actually a) confirmed not only that Congress can in fact compel citizens, albeit indirectly, to purchase private commodities and b) tremendously expanded the taxation powers of Congress! Now they can invent fees and penalties on whatever comes into their heads when revenue is short, and they can cite this case as clear precedent.

    Nice work, SCOTUS. On the bright side for Republicans, this ruling doesn’t help the Obama Administration as much as they might think: now they can argue legitimately that Obama raised taxes on the working and middle classes more drastically than any other President in recent history (when he specifically claimed that this bill wouldn’t raise anyone’s taxes). Obama might be happy with the conclusion, but probably not with the reasoning.

  • Cincinnatus

    Hey, I though the SCOTUS was totally in the tank for the Republicans, man! This destroys my paradigm! [not really]

    This ruling, from my view, sets a disturbing precedent–not because it flouted my prediction (it did), and not simply because I am opposed to the concept of “Obamacare” in general (I am). It would have been bad enough had the Court upheld the mandate on Commerce Clause grounds–you all know how I feel about Commerce Clause jurisprudence–but at least such a ruling would have been predictable and fairly consistent with previous jurisprudence.

    But upholding the mandate as a tax? That seems dangerous, and it required some legal finagling. Apparently Roberts opposed the Commerce Clause notion that Congress can force citizens to buy private commodities. Fine. So do I. But isn’t the result here the same, just through a back door? Congress can’t force you to buy a private commodity, but it can penalize you if you don’t (to the tune of thousands of dollars)! Thus, SCOTUS actually a) confirmed not only that Congress can in fact compel citizens, albeit indirectly, to purchase private commodities and b) tremendously expanded the taxation powers of Congress! Now they can invent fees and penalties on whatever comes into their heads when revenue is short, and they can cite this case as clear precedent.

    Nice work, SCOTUS. On the bright side for Republicans, this ruling doesn’t help the Obama Administration as much as they might think: now they can argue legitimately that Obama raised taxes on the working and middle classes more drastically than any other President in recent history (when he specifically claimed that this bill wouldn’t raise anyone’s taxes). Obama might be happy with the conclusion, but probably not with the reasoning.

  • Cincinnatus

    Sorry about the syntactical errors above.

    And I hope things aren’t as dire as my analysis claims, so I look forward to being corrected by more scholarly legal observers than I.

  • Cincinnatus

    Sorry about the syntactical errors above.

    And I hope things aren’t as dire as my analysis claims, so I look forward to being corrected by more scholarly legal observers than I.

  • Susan

    It looks like the SCOTUS decisions have effectively given Congress some monkey wrenches and ensured a rewrite/clarification by Congress that, at this point in time, will not have traction in a Republican House. And we have yet to address the lawsuits already in the pipeline challenging other Obamacare provisions (eg:the IPAB death panel, Medical Privacy Rights, etc.).

    Some of the interesting questions I’ve seen asked are:

    1) If it’s a tax, and all revenue-raising bills have to originate in the House, would this invalidate the law since it originated in the Senate? And since taxes can be repealed… what are the odds of it being repealed by Congress?

    2) Will the ruling against Medicaid Expansion as unconstitutional be a death knell for Obamacare since this was needed to expand coverage to include the uninsured. States have the constitutional right not have to expand their provisions and can’t be stripped of funds for not complying with expansion provisions.

    3) The mandate is not a mandate (regulated under commerce clause), but a tax (under constitutional power). The SC ruled that the taxpayer could refuse to pay the tax and not comply with the mandate. Does this mean it’s not a tax if it is not based on income or apportioned?

    Lastly: What does this mean for November?

    1) The Obama administration and Congressional Democrats wrote the legislation carefully defining it as not being a tax, sold this to the people as “not a tax” and yet that is the argument they made in front of the SC and the SC decides it is a tax. Ironically, the bill would never have passed if it was defined as a tax.

    2) Obama promised his plan would not raise taxes. So will this now be called the biggest tax in the history of America? Will Obama now be seen as the utlimate Tax and Spend Liberal?

    3) Since around 60-70% of Americans, depending upon the poll, oppose Obamacare, how will this effect Romney’s bid for the presidency? It will be easy to ask if Obama was knowingly lying to the American people when he claimed it wasn’t a tax since he defended it before the SC as a tax.

    Kinda makes Obama and the Democrats look like the Keystone Cops: http://www.youtube.com/watch?v=JVNSQ72wvlc&feature=endscreen&NR=1

  • Susan

    It looks like the SCOTUS decisions have effectively given Congress some monkey wrenches and ensured a rewrite/clarification by Congress that, at this point in time, will not have traction in a Republican House. And we have yet to address the lawsuits already in the pipeline challenging other Obamacare provisions (eg:the IPAB death panel, Medical Privacy Rights, etc.).

    Some of the interesting questions I’ve seen asked are:

    1) If it’s a tax, and all revenue-raising bills have to originate in the House, would this invalidate the law since it originated in the Senate? And since taxes can be repealed… what are the odds of it being repealed by Congress?

    2) Will the ruling against Medicaid Expansion as unconstitutional be a death knell for Obamacare since this was needed to expand coverage to include the uninsured. States have the constitutional right not have to expand their provisions and can’t be stripped of funds for not complying with expansion provisions.

    3) The mandate is not a mandate (regulated under commerce clause), but a tax (under constitutional power). The SC ruled that the taxpayer could refuse to pay the tax and not comply with the mandate. Does this mean it’s not a tax if it is not based on income or apportioned?

    Lastly: What does this mean for November?

    1) The Obama administration and Congressional Democrats wrote the legislation carefully defining it as not being a tax, sold this to the people as “not a tax” and yet that is the argument they made in front of the SC and the SC decides it is a tax. Ironically, the bill would never have passed if it was defined as a tax.

    2) Obama promised his plan would not raise taxes. So will this now be called the biggest tax in the history of America? Will Obama now be seen as the utlimate Tax and Spend Liberal?

    3) Since around 60-70% of Americans, depending upon the poll, oppose Obamacare, how will this effect Romney’s bid for the presidency? It will be easy to ask if Obama was knowingly lying to the American people when he claimed it wasn’t a tax since he defended it before the SC as a tax.

    Kinda makes Obama and the Democrats look like the Keystone Cops: http://www.youtube.com/watch?v=JVNSQ72wvlc&feature=endscreen&NR=1

  • SAL

    The varied provisions of the bill ought to accelerate increases in premiums.

    As the tax on not having insurance becomes much cheaper than insurance premiums, I’d not be surprised if we have more uninsured than today.

    The uninsured will just be hit with a double whammy of not having insurance and having to pay a tax for the privilege.

    Eventually the insurance bill will have to be revisited as the healthcare sector collapses from the command and control distortions in the bill.

  • SAL

    The varied provisions of the bill ought to accelerate increases in premiums.

    As the tax on not having insurance becomes much cheaper than insurance premiums, I’d not be surprised if we have more uninsured than today.

    The uninsured will just be hit with a double whammy of not having insurance and having to pay a tax for the privilege.

    Eventually the insurance bill will have to be revisited as the healthcare sector collapses from the command and control distortions in the bill.

  • WebMonk

    fjs – that is the way the SC ruling is treating the individual mandate portion of the ACA.

    What does the ACA do with the individual mandate? It states that everyone who doesn’t get health coverage has to pay money to the government.

    That functions like a “tax” that everyone has to pay, but there is a “tax break” for that amount for people who have health care.

    I got really busy at work, and haven’t been able to read the ruling yet beyond the first page and a half.

  • WebMonk

    fjs – that is the way the SC ruling is treating the individual mandate portion of the ACA.

    What does the ACA do with the individual mandate? It states that everyone who doesn’t get health coverage has to pay money to the government.

    That functions like a “tax” that everyone has to pay, but there is a “tax break” for that amount for people who have health care.

    I got really busy at work, and haven’t been able to read the ruling yet beyond the first page and a half.

  • http://jdueck.net Joel D.

    I’m actually glad it went forward in a way because I’m very curious about the outcome. I want to see what happens to insurance premiums with a larger insured pool that includes the nation’s healthy people: they may very well drop significantly, especially since under the ACA insurers are now required to spend a minimum of 80% of premiums on medical costs.

    So why not let it play out? If in 2015 we all have coverage for less, I’d say that’s a win for citizens. If premiums continue to skyrocket, conservatives will have all the political capital they need to do whatever they want with healthcare laws.

  • http://jdueck.net Joel D.

    I’m actually glad it went forward in a way because I’m very curious about the outcome. I want to see what happens to insurance premiums with a larger insured pool that includes the nation’s healthy people: they may very well drop significantly, especially since under the ACA insurers are now required to spend a minimum of 80% of premiums on medical costs.

    So why not let it play out? If in 2015 we all have coverage for less, I’d say that’s a win for citizens. If premiums continue to skyrocket, conservatives will have all the political capital they need to do whatever they want with healthcare laws.

  • WebMonk

    fjs – here you are, another statement about the court ruling it is a “tax”

    http://www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/

  • WebMonk

    fjs – here you are, another statement about the court ruling it is a “tax”

    http://www.scotusblog.com/2012/06/dont-call-it-a-mandate-its-a-tax/

  • Dr. Luther in the 21st Century

    @29 Required insurance and falling premiums, never happen. They have a captive audience, why would they even want to consider lowering prices, they were just guaranteed profits.

  • Dr. Luther in the 21st Century

    @29 Required insurance and falling premiums, never happen. They have a captive audience, why would they even want to consider lowering prices, they were just guaranteed profits.

  • DonS

    I have not yet read the opinion, so will be very cautious here. But, some initial thoughts:

    1) The broad taxing power of Congress has never been in doubt. That’s why administration lawyers switched to that argument as soon as they got into court, even though Obama and congressional sponsors of the legislation insisted all during the legislative process that the mandate was not a tax. I understand the Court’s longstanding precedent of straining to interpret statutes to be constitutional (though, of course, that doesn’t apply when liberal values are at stake, such as is the case for marriage laws that have been on the books for hundreds of years). However, I am surprised that they credited the administration with that argument when it had denied charges that it was a tax increase during enactment. It would have been easy for the Court to say, in response to the tax argument, that while it is true that Congress could have passed the legislation under its taxing power, it deliberately chose not to, and we will not presume to step in and legislate on behalf of Congress. I’ll bet that sort of argument rings through the dissents.

    2) Obama, through Obamacare, has now enacted the largest tax increase in history, and it falls squarely on the middle and lower classes. That is not something I would want to be running on if I were him. Republican messaging is already emphasizing this fact, as confirmed by the Court itself.

    3) As Susan mentions above, it appears that states can opt out of the expansion of Medicare without penalty. This may be a big deal, or it may not. More analysis is required. If they opt out, their taxpayers will still be subsidizing its expansion in other states, while also having to develop other means for covering their own citizens. That may not be politically tenable.

    4) Voters, who claim in polling to wish Obamacare to be repealed by a 2 to 1 margin, now know that if Obama is re-elected that repeal will never happen. Since either Romney or Obama will win this fall’s election, a vote for anyone but Romney is a vote for permanent Obamacare. I’m not saying that Romney will end up repealing it, but if Congress passes a repeal or substantial revision of health care legislation, he will likely sign it. Obama will not. After 2014, it will have been sufficiently put in place as to be substantially unrepealable. So the 2012 election is the last chance to have a chance to do so.

    That’s all for now.

  • DonS

    I have not yet read the opinion, so will be very cautious here. But, some initial thoughts:

    1) The broad taxing power of Congress has never been in doubt. That’s why administration lawyers switched to that argument as soon as they got into court, even though Obama and congressional sponsors of the legislation insisted all during the legislative process that the mandate was not a tax. I understand the Court’s longstanding precedent of straining to interpret statutes to be constitutional (though, of course, that doesn’t apply when liberal values are at stake, such as is the case for marriage laws that have been on the books for hundreds of years). However, I am surprised that they credited the administration with that argument when it had denied charges that it was a tax increase during enactment. It would have been easy for the Court to say, in response to the tax argument, that while it is true that Congress could have passed the legislation under its taxing power, it deliberately chose not to, and we will not presume to step in and legislate on behalf of Congress. I’ll bet that sort of argument rings through the dissents.

    2) Obama, through Obamacare, has now enacted the largest tax increase in history, and it falls squarely on the middle and lower classes. That is not something I would want to be running on if I were him. Republican messaging is already emphasizing this fact, as confirmed by the Court itself.

    3) As Susan mentions above, it appears that states can opt out of the expansion of Medicare without penalty. This may be a big deal, or it may not. More analysis is required. If they opt out, their taxpayers will still be subsidizing its expansion in other states, while also having to develop other means for covering their own citizens. That may not be politically tenable.

    4) Voters, who claim in polling to wish Obamacare to be repealed by a 2 to 1 margin, now know that if Obama is re-elected that repeal will never happen. Since either Romney or Obama will win this fall’s election, a vote for anyone but Romney is a vote for permanent Obamacare. I’m not saying that Romney will end up repealing it, but if Congress passes a repeal or substantial revision of health care legislation, he will likely sign it. Obama will not. After 2014, it will have been sufficiently put in place as to be substantially unrepealable. So the 2012 election is the last chance to have a chance to do so.

    That’s all for now.

  • http://jdueck.net Joel D.

    @31, my thought is that ACA requires insurers to spend 80% of our premiums on actual medical costs. They simply can’t jack up your premium to get whatever profit they want. If they end up taking in more money than they can spend on medical expenses, they are required to issue rebates to their policyholders.

  • http://jdueck.net Joel D.

    @31, my thought is that ACA requires insurers to spend 80% of our premiums on actual medical costs. They simply can’t jack up your premium to get whatever profit they want. If they end up taking in more money than they can spend on medical expenses, they are required to issue rebates to their policyholders.

  • DonS

    I was right @ 32 concerning what the dissent would say about the Court’s contortions in reading the mandate as a tax, after its supporters in Congress and Obama had been so vehement in denying that it was a tax:

    For all these reasons, to say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it. Judicial tax-writing is particularly troubling. Taxes have never been popular, see, e.g., Stamp Act of 1765, and in part for that reason, the Constitution requires tax increases to originate in the House of Representatives. See Art. I, §7, cl. 1. That is to say, they must originate in the legislative body most accountable to the people, where legislators must weigh the need for the tax against the terrible price they might pay at their next election, which is never more than two years off.

  • DonS

    I was right @ 32 concerning what the dissent would say about the Court’s contortions in reading the mandate as a tax, after its supporters in Congress and Obama had been so vehement in denying that it was a tax:

    For all these reasons, to say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it. Judicial tax-writing is particularly troubling. Taxes have never been popular, see, e.g., Stamp Act of 1765, and in part for that reason, the Constitution requires tax increases to originate in the House of Representatives. See Art. I, §7, cl. 1. That is to say, they must originate in the legislative body most accountable to the people, where legislators must weigh the need for the tax against the terrible price they might pay at their next election, which is never more than two years off.

  • DonS

    Joel D. there are at least two reasons why the thing you are hoping for will not happen.

    1) Obamacare mandates that insurance companies cover a lot of new benefits, many of them without copayments or deductibles. First dollar coverage is inordinately expensive, both because it drives utilization rates way up and because it means that these companies and health providers must administratively treat every health care transaction as a claim. Even if the insured pool marginally increases, there is no evidence that it will be sufficient to drive costs down. Our early experience with Obamacare is the opposite, premium costs are rising much more sharply as these new coverage mandates are enforced.

    2) The most stupid thing regulators do is enforce a silly requirement like mandating that 80% of premiums must be spent on care. Think about it for a second. If insurance companies have to pay all administrative costs and fund their profits from the remaining 20% of premiums, how do they provide an acceptable return for their shareholders? They have no option but to raise premiums, so that the 20% share is bigger. We see this same idiocy with public utilities regulation (where they typically earn, as guaranteed profits, a specified percentage of revenues), which is one reason why your friendly utility company is always asking for rate increases.

  • DonS

    Joel D. there are at least two reasons why the thing you are hoping for will not happen.

    1) Obamacare mandates that insurance companies cover a lot of new benefits, many of them without copayments or deductibles. First dollar coverage is inordinately expensive, both because it drives utilization rates way up and because it means that these companies and health providers must administratively treat every health care transaction as a claim. Even if the insured pool marginally increases, there is no evidence that it will be sufficient to drive costs down. Our early experience with Obamacare is the opposite, premium costs are rising much more sharply as these new coverage mandates are enforced.

    2) The most stupid thing regulators do is enforce a silly requirement like mandating that 80% of premiums must be spent on care. Think about it for a second. If insurance companies have to pay all administrative costs and fund their profits from the remaining 20% of premiums, how do they provide an acceptable return for their shareholders? They have no option but to raise premiums, so that the 20% share is bigger. We see this same idiocy with public utilities regulation (where they typically earn, as guaranteed profits, a specified percentage of revenues), which is one reason why your friendly utility company is always asking for rate increases.

  • Cincinnatus

    DonS and Susan:

    As I understand it, the otherwise legitimate concern about this “tax” originating unconstitutionally in the Senate was forestalled by the fact that the Senate essentially took a (tangentially related or unrelated?) bill written in the House, gutted it, and inserted their text containing the individual mandate. Voila: the bill actually originated in the House!

  • Cincinnatus

    DonS and Susan:

    As I understand it, the otherwise legitimate concern about this “tax” originating unconstitutionally in the Senate was forestalled by the fact that the Senate essentially took a (tangentially related or unrelated?) bill written in the House, gutted it, and inserted their text containing the individual mandate. Voila: the bill actually originated in the House!

  • DonS

    Someone up above, I think it was Susan, mentioned that the Obamacare legislation originated in the Senate, rather than the House, so cannot be regarded as tax legislation. The dissent mentions the constitutional requirement that tax legislation originate in the House in the portion I quoted @ 34. I don’t know how the majority opinion treats this, if it does. It seems as if it would have been another excellent opportunity to not strain to read the mandate as a tax. It’s an interesting issue, though.

  • DonS

    Someone up above, I think it was Susan, mentioned that the Obamacare legislation originated in the Senate, rather than the House, so cannot be regarded as tax legislation. The dissent mentions the constitutional requirement that tax legislation originate in the House in the portion I quoted @ 34. I don’t know how the majority opinion treats this, if it does. It seems as if it would have been another excellent opportunity to not strain to read the mandate as a tax. It’s an interesting issue, though.

  • DonS

    Cincinnatus @ 36: Our posts crossed. What you say may be the answer.

  • DonS

    Cincinnatus @ 36: Our posts crossed. What you say may be the answer.

  • rlewer

    Obamaspeak: Obama is praising the decision that is based on his bill being a tax and still claiming that his bill is not a tax.

  • rlewer

    Obamaspeak: Obama is praising the decision that is based on his bill being a tax and still claiming that his bill is not a tax.

  • Mary

    Let’s just say I am a part time worker. About 20 hours a week. I don’t have insurance. My employer doesn’t offer insurance. Will I be “taxed” if I don’t have insurance or will my employer? If I am “taxed” I still don’t have insurance, I am just out the (rumored) $2000 penalty because I still can’t afford the insurance premium. What is the next step? A steeper “tax”? Jail?
    The above is a fictional scenario, the following is true.

    My husband is a small business owner. We are in the middle of a recession so our profit is way down the last few years. We can’t raise prices enough to cover the cost of commodities at the risk of losing customers, so we just have to take a hit. If we now have to cover all of our employees insurance or even the penalty that throws them on the govt plan we will be out of business. We simply can not raise prices enough to cover tens of thousands to over one hundred thousand a year in insurance costs.

  • Mary

    Let’s just say I am a part time worker. About 20 hours a week. I don’t have insurance. My employer doesn’t offer insurance. Will I be “taxed” if I don’t have insurance or will my employer? If I am “taxed” I still don’t have insurance, I am just out the (rumored) $2000 penalty because I still can’t afford the insurance premium. What is the next step? A steeper “tax”? Jail?
    The above is a fictional scenario, the following is true.

    My husband is a small business owner. We are in the middle of a recession so our profit is way down the last few years. We can’t raise prices enough to cover the cost of commodities at the risk of losing customers, so we just have to take a hit. If we now have to cover all of our employees insurance or even the penalty that throws them on the govt plan we will be out of business. We simply can not raise prices enough to cover tens of thousands to over one hundred thousand a year in insurance costs.

  • DonS

    One more oddity about the decision is that a threshold issue for consideration was whether the Anti-Injunction Act applied. At least one lower court had ruled that it did, because the mandate was actually a tax and the AIA provides that tax legislation cannot be challenged until after the tax has been paid — taxpayers are forced to sue for a refund of the wrongful tax.

    So, the Court first found that the mandate was not a tax for the purposes of Anti-Injunction Act jurisdiction, but was a tax for purposes of upholding the law. This inconsistency was addressed in its opinion by a concession that this is not the most “straightforward” or “natural” reading of the law, but it is a “fairly possible one.” The dissent disagreed, unsurprisingly:

    Of course in many cases what was a regulatory mandate enforced by a penalty could have been imposed as a tax upon permissible action; or what was imposed as a tax upon permissible action could have been a regulatory mandate enforced by a penalty. But we know of no case, and the Government cites none, in which the imposition was, for constitutional purposes, both. The two are mutually exclusive.

    The dissent further stated:

    In a few cases, this Court has held that a ‘tax’ imposed upon private conduct was so onerous as to be in effect a penalty. But we have never held – never – that a penalty imposed for violation of the law was so trivial as to be in effect a tax.

    At first blush, it appears that the Court, in an effort to avoid appearances as an activist court, became one.

  • DonS

    One more oddity about the decision is that a threshold issue for consideration was whether the Anti-Injunction Act applied. At least one lower court had ruled that it did, because the mandate was actually a tax and the AIA provides that tax legislation cannot be challenged until after the tax has been paid — taxpayers are forced to sue for a refund of the wrongful tax.

    So, the Court first found that the mandate was not a tax for the purposes of Anti-Injunction Act jurisdiction, but was a tax for purposes of upholding the law. This inconsistency was addressed in its opinion by a concession that this is not the most “straightforward” or “natural” reading of the law, but it is a “fairly possible one.” The dissent disagreed, unsurprisingly:

    Of course in many cases what was a regulatory mandate enforced by a penalty could have been imposed as a tax upon permissible action; or what was imposed as a tax upon permissible action could have been a regulatory mandate enforced by a penalty. But we know of no case, and the Government cites none, in which the imposition was, for constitutional purposes, both. The two are mutually exclusive.

    The dissent further stated:

    In a few cases, this Court has held that a ‘tax’ imposed upon private conduct was so onerous as to be in effect a penalty. But we have never held – never – that a penalty imposed for violation of the law was so trivial as to be in effect a tax.

    At first blush, it appears that the Court, in an effort to avoid appearances as an activist court, became one.

  • Susan

    Oy vey! Here is a video of Obama testily arguing that his mandate is not a tax with George Stephanopoulos. This video is about to haunt him.

    Video Uploader’s comment:

    George wonders how mandates on the middle class is not a tax increase on the middle class … why he even went to the dictionary to see the definition of taxes. The One’s response … I don’t care what the dictionary says … it’s not a tax increase. Nuance!

  • Susan

    Oy vey! Here is a video of Obama testily arguing that his mandate is not a tax with George Stephanopoulos. This video is about to haunt him.

    Video Uploader’s comment:

    George wonders how mandates on the middle class is not a tax increase on the middle class … why he even went to the dictionary to see the definition of taxes. The One’s response … I don’t care what the dictionary says … it’s not a tax increase. Nuance!

  • Grace

    Obama: Mandate is Not a Tax

    By Jacqueline Klingebiel

    Sep 20, 2009 9:00am
    Obama: Mandate is Not a Tax
    STEPHANOPOULOS: You were against the individual mandate…

    OBAMA: Yes.

    STEPHANOPOULOS: …during the campaign. Under this mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?

    OBAMA: Well, hold on a second, George. Here — here’s what’s happening. You and I are both paying $900, on average — our families — in higher premiums because of uncompensated care. Now what I’ve said is that if you can’t afford health insurance, you certainly shouldn’t be punished for that. That’s just piling on. If, on the other hand, we’re giving tax credits, we’ve set up an exchange, you are now part of a big pool, we’ve driven down the costs, we’ve done everything we can and you actually can afford health insurance, but you’ve just decided, you know what, I want to take my chances. And then you get hit by a bus and you and I have to pay for the emergency room care, that’s…

    STEPHANOPOULOS: That may be, but it’s still a tax increase.

    OBAMA: “No. That’s not true, George. The — for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase. What it’s saying is, is that we’re not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that if you hit my car, that I’m not covering all the costs.”

    http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/

    Short VIDEO – interview – Obama and Stephhanopoulos

  • Grace

    Obama: Mandate is Not a Tax

    By Jacqueline Klingebiel

    Sep 20, 2009 9:00am
    Obama: Mandate is Not a Tax
    STEPHANOPOULOS: You were against the individual mandate…

    OBAMA: Yes.

    STEPHANOPOULOS: …during the campaign. Under this mandate, the government is forcing people to spend money, fining you if you don’t. How is that not a tax?

    OBAMA: Well, hold on a second, George. Here — here’s what’s happening. You and I are both paying $900, on average — our families — in higher premiums because of uncompensated care. Now what I’ve said is that if you can’t afford health insurance, you certainly shouldn’t be punished for that. That’s just piling on. If, on the other hand, we’re giving tax credits, we’ve set up an exchange, you are now part of a big pool, we’ve driven down the costs, we’ve done everything we can and you actually can afford health insurance, but you’ve just decided, you know what, I want to take my chances. And then you get hit by a bus and you and I have to pay for the emergency room care, that’s…

    STEPHANOPOULOS: That may be, but it’s still a tax increase.

    OBAMA: “No. That’s not true, George. The — for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase. What it’s saying is, is that we’re not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that if you hit my car, that I’m not covering all the costs.”

    http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/

    Short VIDEO – interview – Obama and Stephhanopoulos

  • Klasie Kraalogies

    DonS@35 – here in SK, when they make profits, and the commodity price goes down (in this case, natural gas), the actually ask for a decrease in rates – for example: http://saskenergy.com/About_SaskEnergy/News/news_releases/2012/Rates.pdf

    Note – they do not operate as a monopoly.

  • Klasie Kraalogies

    DonS@35 – here in SK, when they make profits, and the commodity price goes down (in this case, natural gas), the actually ask for a decrease in rates – for example: http://saskenergy.com/About_SaskEnergy/News/news_releases/2012/Rates.pdf

    Note – they do not operate as a monopoly.

  • http://jdueck.net Joel D.

    Dons @35, regarding your reason #1, I understand that there are still upward pressures on healthcare costs. I think that massive expansion of the insured pool combined with the 80% requirement could at least contribute a downward pressure. What I was saying is that I’m curious as to how the mix of pressures actually will play out. I think it’s likely (not certain) that once the mandate kicks post-2014 we will see coverage rise to 98 or 99% as it did in Massachusetts. It makes sense that under Obamacare costs are going up in the short term because insurers are having to pay for the extra benefits you mentioned without the increased insured pool that is supposed to come with the 2014 mandate.

    Regarding your #2, you still haven’t convinced me. In short, if you want to convince me that premiums will go nowhere but up up up as far as the eye can see, I need an explanation that factors in all of the following:

    * shareholder profit expectations
    * the 20% gross margin ceiling
    * competition between insurers
    * an increase in the national insured pool to 98% or so

    What I’m saying is that factors like these make the outcome a toss-up in terms of premium prices. Especially combined with unforeseen behaviours, incentives and loopholes, I don’t think anyone can *demonstrate* the inevitability of one outcome or the other.

    By the way, our local friendly utility company just filed for a *decrease* in rates due to reduced natural gas costs. Yes, those regulated profit margins can cut both ways but the end result is price stability without in any way constraining supply. The companies are still in business, and their shareholders accept these regulatory realities for the time being (at least until lobbyists can convince middle-class conservatives they’d be better off if their utilities didn’t have to answer to anyone but shareholders).

  • http://jdueck.net Joel D.

    Dons @35, regarding your reason #1, I understand that there are still upward pressures on healthcare costs. I think that massive expansion of the insured pool combined with the 80% requirement could at least contribute a downward pressure. What I was saying is that I’m curious as to how the mix of pressures actually will play out. I think it’s likely (not certain) that once the mandate kicks post-2014 we will see coverage rise to 98 or 99% as it did in Massachusetts. It makes sense that under Obamacare costs are going up in the short term because insurers are having to pay for the extra benefits you mentioned without the increased insured pool that is supposed to come with the 2014 mandate.

    Regarding your #2, you still haven’t convinced me. In short, if you want to convince me that premiums will go nowhere but up up up as far as the eye can see, I need an explanation that factors in all of the following:

    * shareholder profit expectations
    * the 20% gross margin ceiling
    * competition between insurers
    * an increase in the national insured pool to 98% or so

    What I’m saying is that factors like these make the outcome a toss-up in terms of premium prices. Especially combined with unforeseen behaviours, incentives and loopholes, I don’t think anyone can *demonstrate* the inevitability of one outcome or the other.

    By the way, our local friendly utility company just filed for a *decrease* in rates due to reduced natural gas costs. Yes, those regulated profit margins can cut both ways but the end result is price stability without in any way constraining supply. The companies are still in business, and their shareholders accept these regulatory realities for the time being (at least until lobbyists can convince middle-class conservatives they’d be better off if their utilities didn’t have to answer to anyone but shareholders).

  • Susan

    Here’s an interesting tidbit:

    According to Romney spokeswoman Andrea Saul, within an hour of the SCOTUS ruling, donations topping $300,000 for the morning had rolled in to the Romney campaign.

    Update (9:12 am Pacific): Romney has raised $375,000 and counting.

    Update (via Andrea tweet 31 minutes ago): 9,500+ donations to @MittRomney & Victory today for ‪#FullRepeal‬ $1.1 million & climbing

  • Susan

    Here’s an interesting tidbit:

    According to Romney spokeswoman Andrea Saul, within an hour of the SCOTUS ruling, donations topping $300,000 for the morning had rolled in to the Romney campaign.

    Update (9:12 am Pacific): Romney has raised $375,000 and counting.

    Update (via Andrea tweet 31 minutes ago): 9,500+ donations to @MittRomney & Victory today for ‪#FullRepeal‬ $1.1 million & climbing

  • Susan

    @ Joel and DonS

    It is my understanding that insurance companies are the most highly regulated businesses in the US. My cousin was an insurance underwriter for around 35 years and if I remember correctly, even how much profit they can keep is regulated with an average of around 2-3% being reported by the companies.

  • Susan

    @ Joel and DonS

    It is my understanding that insurance companies are the most highly regulated businesses in the US. My cousin was an insurance underwriter for around 35 years and if I remember correctly, even how much profit they can keep is regulated with an average of around 2-3% being reported by the companies.

  • Klasie Kraalogies

    A really interesting observation is made over at The Atlantic, playing on the “It is a tax” thing:

    http://www.theatlantic.com/national/archive/2012/06/in-health-care-ruling-roberts-steals-a-move-from-john-marshalls-playbook/259121/

  • Klasie Kraalogies

    A really interesting observation is made over at The Atlantic, playing on the “It is a tax” thing:

    http://www.theatlantic.com/national/archive/2012/06/in-health-care-ruling-roberts-steals-a-move-from-john-marshalls-playbook/259121/

  • http://www.toddstadler.com/ tODD

    Remember, as many a conservative holding his nose will tell you, the main reason to vote for Romney is to ensure that you get conservative-minded justices in the Supreme Court.

    Wasn’t that also the reason to vote for George W. Bush? Who appointed Roberts?

    Ahem.

  • http://www.toddstadler.com/ tODD

    Remember, as many a conservative holding his nose will tell you, the main reason to vote for Romney is to ensure that you get conservative-minded justices in the Supreme Court.

    Wasn’t that also the reason to vote for George W. Bush? Who appointed Roberts?

    Ahem.

  • Grace

    I believe that the Supreme Court has outlived it’s usefulness.

    The “Abortion Bill” of 1973 is a glaring reminder.

    “Taxation without representation” was one of the prime reasons, the Revolutionary War was fought.

    More than 50 percent of the people do not want this “Health Care Bill” to be law. WE the PEOPLE should be allowed to vote upon this Bill.

    In this case they are IGNORING the voice of the peoples of the United States -

  • Grace

    I believe that the Supreme Court has outlived it’s usefulness.

    The “Abortion Bill” of 1973 is a glaring reminder.

    “Taxation without representation” was one of the prime reasons, the Revolutionary War was fought.

    More than 50 percent of the people do not want this “Health Care Bill” to be law. WE the PEOPLE should be allowed to vote upon this Bill.

    In this case they are IGNORING the voice of the peoples of the United States -

  • Grace

    I don’t believe ANYONE truly knows a potential Supreme Justice, UNTIL they become one of the nine.

    We have a Congress and the Senate – looking back at many decisions of the Supreme Court, are not the will of the people of the United States – Either we as a people are governing ourselves, or we are leaving it up to, AT THE END OF THE DAY, nine (9) people to decide our fate. In the case of over 50 million unborn infants, that is a TRAVESTY, an imitation of goodness, mercy and love towards smallest and most helpess creations of God ALMIGHTY!

  • Grace

    I don’t believe ANYONE truly knows a potential Supreme Justice, UNTIL they become one of the nine.

    We have a Congress and the Senate – looking back at many decisions of the Supreme Court, are not the will of the people of the United States – Either we as a people are governing ourselves, or we are leaving it up to, AT THE END OF THE DAY, nine (9) people to decide our fate. In the case of over 50 million unborn infants, that is a TRAVESTY, an imitation of goodness, mercy and love towards smallest and most helpess creations of God ALMIGHTY!

  • Fws

    I am increasingly pleased with both roberts and obama. It will be up the congress to resolve anying we dont like about this. That is where it belongs.

  • Fws

    I am increasingly pleased with both roberts and obama. It will be up the congress to resolve anying we dont like about this. That is where it belongs.

  • larry

    The biggest thing I wonder in all this, whether one is pro or con for the health care, is do words actually mean anything any more whereby any conversation can be conducted. It seems in our day and age the one constant is that words are increasingly less constant. So if I tell you I’m bringing you a pet dog, on the day of delivery I bring a cat and you ask, “But you said a ‘dog’”, I can then say, “No, I said cat. Even if my lips enunciated ‘duh-ohg’, you should have heard ‘kah-at’, so here’s your cat.”

  • larry

    The biggest thing I wonder in all this, whether one is pro or con for the health care, is do words actually mean anything any more whereby any conversation can be conducted. It seems in our day and age the one constant is that words are increasingly less constant. So if I tell you I’m bringing you a pet dog, on the day of delivery I bring a cat and you ask, “But you said a ‘dog’”, I can then say, “No, I said cat. Even if my lips enunciated ‘duh-ohg’, you should have heard ‘kah-at’, so here’s your cat.”

  • Grace

    larry @ 53

    “It seems in our day and age the one constant is that words are increasingly less constant. So if I tell you I’m bringing you a pet dog, on the day of delivery I bring a cat and you ask, “But you said a ‘dog’”, I can then say, “No, I said cat. Even if my lips enunciated ‘duh-ohg’, you should have heard ‘kah-at’, so here’s your cat.”

    PRECISELY

  • Grace

    larry @ 53

    “It seems in our day and age the one constant is that words are increasingly less constant. So if I tell you I’m bringing you a pet dog, on the day of delivery I bring a cat and you ask, “But you said a ‘dog’”, I can then say, “No, I said cat. Even if my lips enunciated ‘duh-ohg’, you should have heard ‘kah-at’, so here’s your cat.”

    PRECISELY

  • Grace

    Something right happened today:

    This just in from CNN:

    The House of Representatives voted to hold Attorney General Eric Holder in criminal contempt for refusing to turn over documents tied to the Fast and Furious gun-running sting.

    The 255-67 vote marked the first time in American history that the head of the Justice Department has been held in contempt by Congress. Almost every House Republican backed the measure, along with nearly 20 Democrats.

    House members are also expected to pass a civil contempt measure later in the day.”

  • Grace

    Something right happened today:

    This just in from CNN:

    The House of Representatives voted to hold Attorney General Eric Holder in criminal contempt for refusing to turn over documents tied to the Fast and Furious gun-running sting.

    The 255-67 vote marked the first time in American history that the head of the Justice Department has been held in contempt by Congress. Almost every House Republican backed the measure, along with nearly 20 Democrats.

    House members are also expected to pass a civil contempt measure later in the day.”

  • Susan

    Another oy! From Justice Ginsberg of all people and a clue to how the HHS mandate may fall when it has it’s turn before the SC:

    My friend Mark Barrett, a lawyer with an apparently amazing capacity to read and absorb legal decisions, writes with this interesting quote from Justice Ginsberg’s concurring opinion (page 29):

    A mandate to purchase a particular product would be unconstitutional if, for example, the edict impermissibly abridged the freedom of speech, inter­fered with the free exercise of religion, or infringed on a liberty interest protected by the Due Process Clause.

    Source: http://www.firstthings.com/blogs/firstthoughts/2012/06/28/ginsberg-on-the-mandate-and-or-versus-the-free-exercise-of-religion/

  • Susan

    Another oy! From Justice Ginsberg of all people and a clue to how the HHS mandate may fall when it has it’s turn before the SC:

    My friend Mark Barrett, a lawyer with an apparently amazing capacity to read and absorb legal decisions, writes with this interesting quote from Justice Ginsberg’s concurring opinion (page 29):

    A mandate to purchase a particular product would be unconstitutional if, for example, the edict impermissibly abridged the freedom of speech, inter­fered with the free exercise of religion, or infringed on a liberty interest protected by the Due Process Clause.

    Source: http://www.firstthings.com/blogs/firstthoughts/2012/06/28/ginsberg-on-the-mandate-and-or-versus-the-free-exercise-of-religion/

  • Grace

    Speaker Boehner Statement on the Supreme Court’s Health Care Ruling

    Posted by Speaker Boehner Press Office

    June 28, 2012
    Press Release

    WASHINGTON, DC – House Speaker John Boehner (R-OH) released the following statement after the Supreme Court announced its ruling on the president’s health care law:

    The president’s health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today’s ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans’ access to the care they need, from the doctor they choose, at a lower cost. Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare.

    http://www.speaker.gov/press-release/speaker-boehner-statement-supreme-court-s-health-care-ruling

  • Grace

    Speaker Boehner Statement on the Supreme Court’s Health Care Ruling

    Posted by Speaker Boehner Press Office

    June 28, 2012
    Press Release

    WASHINGTON, DC – House Speaker John Boehner (R-OH) released the following statement after the Supreme Court announced its ruling on the president’s health care law:

    The president’s health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today’s ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans’ access to the care they need, from the doctor they choose, at a lower cost. Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare.

    http://www.speaker.gov/press-release/speaker-boehner-statement-supreme-court-s-health-care-ruling

  • Dust

    well, even if the law stands and is not repealed, the potus, whomever, can just tell the various agencies not to enforce any or all of the provisions, such as the fines for not having health coverage, and/or anything else the find objectionable? and they can do that with any other federal law passed by the “other” party against their objections?

    per Larry….yes, that is how is it now days, but it did not happen overnite….and by overnite I really mean the time between the sun going down and coming back up :)

    cheers!

  • Dust

    well, even if the law stands and is not repealed, the potus, whomever, can just tell the various agencies not to enforce any or all of the provisions, such as the fines for not having health coverage, and/or anything else the find objectionable? and they can do that with any other federal law passed by the “other” party against their objections?

    per Larry….yes, that is how is it now days, but it did not happen overnite….and by overnite I really mean the time between the sun going down and coming back up :)

    cheers!

  • Susan

    For those who are gluttons for legalese, please don’t miss:

    SCOTUSBlog has begun posting contributions to its post-decision symposium on NFIB v. Sebelius. Among those with contributions thus far are Laurence Tribe, Alan Morrison Ricahrd Epstein, and Randy Barnett.

    Source: http://www.volokh.com/2012/06/28/scotusblog-post-decision-symposium/

  • Susan

    For those who are gluttons for legalese, please don’t miss:

    SCOTUSBlog has begun posting contributions to its post-decision symposium on NFIB v. Sebelius. Among those with contributions thus far are Laurence Tribe, Alan Morrison Ricahrd Epstein, and Randy Barnett.

    Source: http://www.volokh.com/2012/06/28/scotusblog-post-decision-symposium/

  • http://steadfastlutherans.org/ SAL

    Republican Governors are ignoring the requirements of Obamacare until after the election. Hopefully this thing gets repealed. Otherwise we just speed up the bankruptcy of the nation.

    The Supreme Court did rule that the states wouldn’t have to expand Medicaid eligibility. Almost no states will given the massive costs.

    So Obamacare will fine people for not having insurance but the states won’t give Medicaid to those who can’t afford insurance. So the uninsured will now lack insurance and have to pay thousands in “taxes”.

  • http://steadfastlutherans.org/ SAL

    Republican Governors are ignoring the requirements of Obamacare until after the election. Hopefully this thing gets repealed. Otherwise we just speed up the bankruptcy of the nation.

    The Supreme Court did rule that the states wouldn’t have to expand Medicaid eligibility. Almost no states will given the massive costs.

    So Obamacare will fine people for not having insurance but the states won’t give Medicaid to those who can’t afford insurance. So the uninsured will now lack insurance and have to pay thousands in “taxes”.

  • kerner

    Dust @58:
    “well, even if the law stands and is not repealed, the potus, whomever, can just tell the various agencies not to enforce any or all of the provisions”

    SAL @60:
    “Republican Governors are ignoring the requirements of Obamacare until after the election”

    Well, “Rule of Law” alert! Arizona and all the other states better pass laws forcing their local Police and Sheriffs to enforce ObamaCare because it would be terrible if politicians failed to enforce federal law…oh wait…they can’t…just found that out a couple days ago. ;)

  • kerner

    Dust @58:
    “well, even if the law stands and is not repealed, the potus, whomever, can just tell the various agencies not to enforce any or all of the provisions”

    SAL @60:
    “Republican Governors are ignoring the requirements of Obamacare until after the election”

    Well, “Rule of Law” alert! Arizona and all the other states better pass laws forcing their local Police and Sheriffs to enforce ObamaCare because it would be terrible if politicians failed to enforce federal law…oh wait…they can’t…just found that out a couple days ago. ;)

  • Grace

    Does this mean illegal aliens will still get free care when they go to a hospital emergency room?

    If so, who pays for the millions of illegals?

    Or is this just the first step before giving them a FREE PASS for citizenship?

    OR, is this a question that has a hidden answer, which we as tax payers will find out L A T E R ?

    What does today’s health care ruling mean to you?
    By Connie Cass The Associated PressAssociated Press
    Posted: 06/28/2012 08:13:31 AM PDT
    June 28, 2012 5:34 PM GMTUpdated: 06/28/2012 10:34:57 AM PDT

    EXCERPT from article:

    STILL, NOT EVERYONE WILL BE COVERED

    “An estimated 26 million people will remain without coverage once the law is fully implemented, including illegal immigrants, people who don’t sign up and choose to face the fines instead, and those who can’t afford it even with the subsidies. That number could be higher, depending on whether any states refuse the Medicaid expansion.”

    http://www.contracostatimes.com/california/ci_20962548/look-at-ruling-upholding-obamacare

  • Grace

    Does this mean illegal aliens will still get free care when they go to a hospital emergency room?

    If so, who pays for the millions of illegals?

    Or is this just the first step before giving them a FREE PASS for citizenship?

    OR, is this a question that has a hidden answer, which we as tax payers will find out L A T E R ?

    What does today’s health care ruling mean to you?
    By Connie Cass The Associated PressAssociated Press
    Posted: 06/28/2012 08:13:31 AM PDT
    June 28, 2012 5:34 PM GMTUpdated: 06/28/2012 10:34:57 AM PDT

    EXCERPT from article:

    STILL, NOT EVERYONE WILL BE COVERED

    “An estimated 26 million people will remain without coverage once the law is fully implemented, including illegal immigrants, people who don’t sign up and choose to face the fines instead, and those who can’t afford it even with the subsidies. That number could be higher, depending on whether any states refuse the Medicaid expansion.”

    http://www.contracostatimes.com/california/ci_20962548/look-at-ruling-upholding-obamacare

  • Grace

    Did Justice Roberts change his Obamacare vote at the last minute?

    By Liz Goodwin
    June 28, 2012

    “Did Chief Justice John Roberts decide to join the court’s liberal wing and uphold the individual mandate at the very last minute?

    That’s the theory floated by Paul Campos, a law professor at the University of Boulder, and Brad DeLong, a Berkeley economics professor and former Treasury Department official under President Clinton. Campos wrote Thursday in Salon that the dissent had a triumphant tone, as if it were written as a majority opinion, and that the four conservative justices incorrectly refer to Justice Ruth Bader Ginsburg’s concurring opinion as a “dissent.”

    EXCERPT – LAST PARAGRAPH of ARTICLE:

    “My own sense, from reading the Roberts opinion, is that it was written as a majority opinion in all of its drafts, and that various Justices joined or dropped off,” Denniston told Yahoo News. “I think he was determined to try to uphold some key parts of the law, if he could find a way, partly because…he has grown concerned about the public perception that his Court is a partisan-driven Court.”

    READ the whole article:
    http://abcnews.go.com/Politics/OTUS/justice-roberts-change-obamacare-vote-minute/story?id=16673072#.T-zefLjDVoY

  • Grace

    Did Justice Roberts change his Obamacare vote at the last minute?

    By Liz Goodwin
    June 28, 2012

    “Did Chief Justice John Roberts decide to join the court’s liberal wing and uphold the individual mandate at the very last minute?

    That’s the theory floated by Paul Campos, a law professor at the University of Boulder, and Brad DeLong, a Berkeley economics professor and former Treasury Department official under President Clinton. Campos wrote Thursday in Salon that the dissent had a triumphant tone, as if it were written as a majority opinion, and that the four conservative justices incorrectly refer to Justice Ruth Bader Ginsburg’s concurring opinion as a “dissent.”

    EXCERPT – LAST PARAGRAPH of ARTICLE:

    “My own sense, from reading the Roberts opinion, is that it was written as a majority opinion in all of its drafts, and that various Justices joined or dropped off,” Denniston told Yahoo News. “I think he was determined to try to uphold some key parts of the law, if he could find a way, partly because…he has grown concerned about the public perception that his Court is a partisan-driven Court.”

    READ the whole article:
    http://abcnews.go.com/Politics/OTUS/justice-roberts-change-obamacare-vote-minute/story?id=16673072#.T-zefLjDVoY

  • Susan

    @ Grace

    I think we’ll find out later. Sebelius, who has no medical training, has been given 1000+ (fill-in-the-blank) regulations to concoct (congress was too busy to create them) for Obamacare. If the HHS mandate for “free” contraceptives, and abortifacients, and sterilizations masquerading as women’s reproductive health care is only the beginning of her misguided reign… well, I still want that time machine for Christmas.

  • Susan

    @ Grace

    I think we’ll find out later. Sebelius, who has no medical training, has been given 1000+ (fill-in-the-blank) regulations to concoct (congress was too busy to create them) for Obamacare. If the HHS mandate for “free” contraceptives, and abortifacients, and sterilizations masquerading as women’s reproductive health care is only the beginning of her misguided reign… well, I still want that time machine for Christmas.

  • Susan

    I have a dumb question for the attorneys and wanna-be attorneys.

    Some of the governors have chosen to wait until after the election to do anything about Obamacare. That seems wise because there is no sense wasting money if it is repealed. It also seems to be wise to wait until Congress has re-written Obamacare. Again, no sense wasting money until you are sure what you are dealing with.

    BUT, here’s my question: what is stop the states from dropping their Medicaid programs and putting them into the insurance exchanges that go into effect in 2014?

    It would be in the states best interests to let the Federal government pay for all of their expenses and spend state resources on other things. This would break Obamacare and necessarily skyrocket costs because of the sheer numbers of unanticipated persons. Kinda reminds me of Obama saying our utility costs would necessarily skyrocket under his energy program and rescinding 287g broke Arizona’s border’s open…. yeah, the old Adam lives.

  • Susan

    I have a dumb question for the attorneys and wanna-be attorneys.

    Some of the governors have chosen to wait until after the election to do anything about Obamacare. That seems wise because there is no sense wasting money if it is repealed. It also seems to be wise to wait until Congress has re-written Obamacare. Again, no sense wasting money until you are sure what you are dealing with.

    BUT, here’s my question: what is stop the states from dropping their Medicaid programs and putting them into the insurance exchanges that go into effect in 2014?

    It would be in the states best interests to let the Federal government pay for all of their expenses and spend state resources on other things. This would break Obamacare and necessarily skyrocket costs because of the sheer numbers of unanticipated persons. Kinda reminds me of Obama saying our utility costs would necessarily skyrocket under his energy program and rescinding 287g broke Arizona’s border’s open…. yeah, the old Adam lives.

  • Grace

    Roberts Facing Medical Option on 2nd Seizure

    By DENISE GRADY and LAWRENCE K. ALTMAN
    Published: August 1, 2007
    “Despite his quick recovery from the seizure he suffered on Monday, Chief Justice John G. Roberts Jr. faces a complex diagnosis and a difficult decision.

    Because the seizure was his second — he had a similar one in 1993 — he meets the criteria for epilepsy, and he and his doctors will have to decide whether he should take medication to prevent further seizures, said neurologists not involved in his care. (Neither the chief justice nor his doctors would comment yesterday.)

    The decision will involve weighing the risk of more seizures against the risk of side effects from the drugs. Major seizures can be a frightening and traumatic experience for patients and family members. Patients are advised to avoid heights and not to swim alone, and many states bar them from driving until they can provide evidence that the disease is under control.

    But the drugs can have troubling side effects, including drowsiness or insomnia, weight loss or weight gain, rashes, irritability, mental slowing and forgetfulness. Many patients can be treated with minimal side effects, doctors say, but it may take trial and error to find the right drug.

    http://www.nytimes.com/2007/08/01/health/01seizure.html?_r=1

    I read a lot of news, however, I never read anything about Roberts suffering from “Seizures” -

  • Grace

    Roberts Facing Medical Option on 2nd Seizure

    By DENISE GRADY and LAWRENCE K. ALTMAN
    Published: August 1, 2007
    “Despite his quick recovery from the seizure he suffered on Monday, Chief Justice John G. Roberts Jr. faces a complex diagnosis and a difficult decision.

    Because the seizure was his second — he had a similar one in 1993 — he meets the criteria for epilepsy, and he and his doctors will have to decide whether he should take medication to prevent further seizures, said neurologists not involved in his care. (Neither the chief justice nor his doctors would comment yesterday.)

    The decision will involve weighing the risk of more seizures against the risk of side effects from the drugs. Major seizures can be a frightening and traumatic experience for patients and family members. Patients are advised to avoid heights and not to swim alone, and many states bar them from driving until they can provide evidence that the disease is under control.

    But the drugs can have troubling side effects, including drowsiness or insomnia, weight loss or weight gain, rashes, irritability, mental slowing and forgetfulness. Many patients can be treated with minimal side effects, doctors say, but it may take trial and error to find the right drug.

    http://www.nytimes.com/2007/08/01/health/01seizure.html?_r=1

    I read a lot of news, however, I never read anything about Roberts suffering from “Seizures” -

  • reg

    Grace,
    I have a question. What is the determining factor as to which font, type size, case and font attribute you use for any particular word. Do you select it randomly or is there a hidden algorithm to the process which escapes me. Just curious.

  • reg

    Grace,
    I have a question. What is the determining factor as to which font, type size, case and font attribute you use for any particular word. Do you select it randomly or is there a hidden algorithm to the process which escapes me. Just curious.

  • Susan

    P.S. I’d really appreciate your input. I’m scratching my head wondering if the states could end their Medicaid programs and put all of the people who would qualify for Medicaid under Obamacare into the exchanges… dumb idea? It would solve the problem of uninsured poor and give the problem back to the people who created the problem: Congress. Other ideas?

  • Susan

    P.S. I’d really appreciate your input. I’m scratching my head wondering if the states could end their Medicaid programs and put all of the people who would qualify for Medicaid under Obamacare into the exchanges… dumb idea? It would solve the problem of uninsured poor and give the problem back to the people who created the problem: Congress. Other ideas?

  • Grace

    Susan – at this point, just finding out about Roberts medical condition (as I stated earlier, I read a lot of news) I am stunned – The only reason I can possibly imagine, for my not knowing is that it happened late July, most likely when we were on vacation.

    I am surprised that more wasn’t made of this, back in August of 2007. Medication, and their side-effects are no small matter.

  • Grace

    Susan – at this point, just finding out about Roberts medical condition (as I stated earlier, I read a lot of news) I am stunned – The only reason I can possibly imagine, for my not knowing is that it happened late July, most likely when we were on vacation.

    I am surprised that more wasn’t made of this, back in August of 2007. Medication, and their side-effects are no small matter.

  • Susan

    @ Grace,

    I’ve read some of the speculation about Roberts, but if there is no evidence that it affected his decision, I’m guessing it won’t go anywhere. I’m having fun speculating and wondering if the states could turn the tables on the Feds. Seems only “fair” and “the right thing to do”… ;)

  • Susan

    @ Grace,

    I’ve read some of the speculation about Roberts, but if there is no evidence that it affected his decision, I’m guessing it won’t go anywhere. I’m having fun speculating and wondering if the states could turn the tables on the Feds. Seems only “fair” and “the right thing to do”… ;)

  • Grace

    Susan, the side effects of such drugs are no small matter. Nothing will probably come of this, but it certainly should be given far more attention if it happens again, OR if there are other people in high positions who take such medication.

    As for the rest of our comments @ 70 – who knows, this is going to be a very interesting summer, and fall, VERY INTERESTING ;)

  • Grace

    Susan, the side effects of such drugs are no small matter. Nothing will probably come of this, but it certainly should be given far more attention if it happens again, OR if there are other people in high positions who take such medication.

    As for the rest of our comments @ 70 – who knows, this is going to be a very interesting summer, and fall, VERY INTERESTING ;)

  • Susan

    @ Grace,

    You might want to look at some of the other speculations besides Robert’s health. Here is an interesting post that covers a number of speculations. Here is a sampling:

    1) “Glenn Reynolds at Instapundit was among the first to recognize that Roberts might be playing an elaborate game. He compared the decision to Marbury v. Madison, where Chief Justice John Marshall surrendered in the case before the court while firmly and eloquently reasserting the Court’s right and responsibility to engage in judicial review; and Reynolds pointed to one crucial fact: Senate rules do not allow a filibuster when the bill under consideration has to do with imposing or repealing a tax. If the Republicans take the Senate and the Presidency, they can now repeal the individual mandate. They will not need sixty votes.”

    2) Here and there a few commentators have begun to recognize what Roberts did. In a piece entitled Obama Wins the Battle, Roberts Wins the War, Tom Scocca rightly marvels at Roberts’ genius. But perhaps the best discussion is to be found in Ezra Klein’s The Political Genius of John Roberts. “He made it a point to affirm the once-radical arguments that animated the conservative challenge to the legislation,” Klein writes. “But then he upheld it on a technicality.”

    Read the rest here – Roberts may be as cunning as a fox:
    http://ricochet.com/main-feed/An-Act-of-Great-Cunning

  • Susan

    @ Grace,

    You might want to look at some of the other speculations besides Robert’s health. Here is an interesting post that covers a number of speculations. Here is a sampling:

    1) “Glenn Reynolds at Instapundit was among the first to recognize that Roberts might be playing an elaborate game. He compared the decision to Marbury v. Madison, where Chief Justice John Marshall surrendered in the case before the court while firmly and eloquently reasserting the Court’s right and responsibility to engage in judicial review; and Reynolds pointed to one crucial fact: Senate rules do not allow a filibuster when the bill under consideration has to do with imposing or repealing a tax. If the Republicans take the Senate and the Presidency, they can now repeal the individual mandate. They will not need sixty votes.”

    2) Here and there a few commentators have begun to recognize what Roberts did. In a piece entitled Obama Wins the Battle, Roberts Wins the War, Tom Scocca rightly marvels at Roberts’ genius. But perhaps the best discussion is to be found in Ezra Klein’s The Political Genius of John Roberts. “He made it a point to affirm the once-radical arguments that animated the conservative challenge to the legislation,” Klein writes. “But then he upheld it on a technicality.”

    Read the rest here – Roberts may be as cunning as a fox:
    http://ricochet.com/main-feed/An-Act-of-Great-Cunning

  • Grace

    Roberts may indeed believe he is “cunning as a fox” and so might others, but his lack of forthrightness, if that is the case is appalling.

    If in fact, this is true, it is one of the most outrageous, dangerous stunts to have pulled. Anything could happen before the election, OR, there could be things, unforseen, that would preclude this wrong, ever being made right.

  • Grace

    Roberts may indeed believe he is “cunning as a fox” and so might others, but his lack of forthrightness, if that is the case is appalling.

    If in fact, this is true, it is one of the most outrageous, dangerous stunts to have pulled. Anything could happen before the election, OR, there could be things, unforseen, that would preclude this wrong, ever being made right.

  • Dust

    yes, roberts handed the admin a judicial victory, albeit temporary, and the rnc a political victory, with much more long lasting potential…..a great mind even if under the influence, will still checkmate second stringers :)

    cheers!

  • Dust

    yes, roberts handed the admin a judicial victory, albeit temporary, and the rnc a political victory, with much more long lasting potential…..a great mind even if under the influence, will still checkmate second stringers :)

    cheers!

  • Grace

    Susan, I believe there is something behind this vote, and outcome on the Health Care issue – what it is, I don’t know. Some of what I’ve thought of, all day, I’m not willing to share. And that is just before I found out about Roberts illness, I certainly had not included that in the equation, or what I might suspect.

  • Grace

    Susan, I believe there is something behind this vote, and outcome on the Health Care issue – what it is, I don’t know. Some of what I’ve thought of, all day, I’m not willing to share. And that is just before I found out about Roberts illness, I certainly had not included that in the equation, or what I might suspect.

  • reg

    Grace and Susan,
    So its either the meds talking or it was a double reverse swicheroo ploy on Roberts’ part. It can’t be that he simply holds a different view from you.
    I think we have achieved escape velocity here.

  • reg

    Grace and Susan,
    So its either the meds talking or it was a double reverse swicheroo ploy on Roberts’ part. It can’t be that he simply holds a different view from you.
    I think we have achieved escape velocity here.

  • Grace

    Whatever you’re bouncing about this time, have fun – I’m not interested! :razz:

  • Grace

    Whatever you’re bouncing about this time, have fun – I’m not interested! :razz:

  • Cincinnatus

    Grace, you have a wonderful ability to send discussions off into the realm of foil-wearing, bona fide crazy.

  • Cincinnatus

    Grace, you have a wonderful ability to send discussions off into the realm of foil-wearing, bona fide crazy.

  • Grace

    Cincinnatus @ 78

    Is that so?

    Did you know that only the kids have kept the “foil-wearing” phrase for their fav expressions? :lol: I’m not surprised that you use it!

  • Grace

    Cincinnatus @ 78

    Is that so?

    Did you know that only the kids have kept the “foil-wearing” phrase for their fav expressions? :lol: I’m not surprised that you use it!

  • Cincinnatus

    Actually, Grace, I hang out with college kids all day and have never heard a single one mention the term “foil-wearing” even once. But ok, fine. I’m a child because I used that phrase.

    Fortunately, someday I’ll grow up. You’ll probably always be crazy, though.

  • Cincinnatus

    Actually, Grace, I hang out with college kids all day and have never heard a single one mention the term “foil-wearing” even once. But ok, fine. I’m a child because I used that phrase.

    Fortunately, someday I’ll grow up. You’ll probably always be crazy, though.

  • Susan

    Aw, reg,

    You must have missed the news pieces containing speculations about Roberts’ political leanings and point of view. That’s being discussed in the news milieu too. Surely, you should try to get out more often.

  • Susan

    Aw, reg,

    You must have missed the news pieces containing speculations about Roberts’ political leanings and point of view. That’s being discussed in the news milieu too. Surely, you should try to get out more often.

  • Grace
  • Grace
  • Grace

    Cincinnatus

    College kids are older, maybe that’s why _______ . :lol:

  • Grace

    Cincinnatus

    College kids are older, maybe that’s why _______ . :lol:

  • Jon

    Anybody think the SCOTUS ruling is an indication that the Whitehorse Prophecy is coming true?

    You know, with the Constitution hanging, as it were, by a thread and all that?

    Is it a sign? Was Joseph right? We’ll see come November!

  • Jon

    Anybody think the SCOTUS ruling is an indication that the Whitehorse Prophecy is coming true?

    You know, with the Constitution hanging, as it were, by a thread and all that?

    Is it a sign? Was Joseph right? We’ll see come November!

  • Susan

    @ reg & cincinnatus & Jon

    The tin foil hats come in your sizes too, ya know?

    http://gwally.com/news/000778.php

    Can we lighten up and stop picking at each other, now?

  • Susan

    @ reg & cincinnatus & Jon

    The tin foil hats come in your sizes too, ya know?

    http://gwally.com/news/000778.php

    Can we lighten up and stop picking at each other, now?

  • Grace

    POOR Jon,

    Joseph Smith (LDS/Mormon) made a great many propbecies, or didn’t you know that? :lol: – some of which, are so silly, even a child would laugh!

  • Grace

    POOR Jon,

    Joseph Smith (LDS/Mormon) made a great many propbecies, or didn’t you know that? :lol: – some of which, are so silly, even a child would laugh!

  • Dust

    Well no matter how you interpret it…the roberts decision was perhaps the last thing anyone expected…so it’s only natural that folks would be scratching their heads and bringing out the foil hats. Hey, maybe roberts was wearing his when he wrote the dissent :)

    cheers!

  • Dust

    Well no matter how you interpret it…the roberts decision was perhaps the last thing anyone expected…so it’s only natural that folks would be scratching their heads and bringing out the foil hats. Hey, maybe roberts was wearing his when he wrote the dissent :)

    cheers!

  • Grace

    Susan – maybe the whole idea is to make a joke of this thread – it’s happened before ;)

  • Grace

    Susan – maybe the whole idea is to make a joke of this thread – it’s happened before ;)

  • Susan

    @Grace

    Sounds good to me.

  • Susan

    @Grace

    Sounds good to me.

  • Cincinnatus

    Dust@87 (and others speculating on this question):

    Actually, constitutional scholar friends of mine argue (or claim, at least) that there is nothing terribly surprising about Roberts’s decision: he’s (apparently) typically measured and “conservative” in cases like these in the sense that he tends to uphold “established” governmental powers. The Obama lawyers (hypocritically) argued that the mandate constituted a tax. Congress’s power to tax in situations like these is well-established under the taxation code. In that sense, it’s not really an activist ruling.

    In fact, the true activists in this case were, as usual, the “liberal” justices. Word on the street is that the liberal judges were opposed to upholding the mandate under the taxation power–they wanted to expand the Commerce Clause to accommodate the mandate–but were so desperate to uphold the ACA at all costs that they sided with Roberts. Hence the large number of concurrences from the liberal justices essentially saying “Yes, but…”

    Roberts’s decision is only shocking to those who stereotype him as a cookie-cutter Republican operative. He’s not, so it seems.

  • Cincinnatus

    Dust@87 (and others speculating on this question):

    Actually, constitutional scholar friends of mine argue (or claim, at least) that there is nothing terribly surprising about Roberts’s decision: he’s (apparently) typically measured and “conservative” in cases like these in the sense that he tends to uphold “established” governmental powers. The Obama lawyers (hypocritically) argued that the mandate constituted a tax. Congress’s power to tax in situations like these is well-established under the taxation code. In that sense, it’s not really an activist ruling.

    In fact, the true activists in this case were, as usual, the “liberal” justices. Word on the street is that the liberal judges were opposed to upholding the mandate under the taxation power–they wanted to expand the Commerce Clause to accommodate the mandate–but were so desperate to uphold the ACA at all costs that they sided with Roberts. Hence the large number of concurrences from the liberal justices essentially saying “Yes, but…”

    Roberts’s decision is only shocking to those who stereotype him as a cookie-cutter Republican operative. He’s not, so it seems.

  • Cincinnatus

    Grace@89: Why are you blaming others for the fact that you are the one who makes a regular habit of turning this blog into a freak show? If C-Carol “ALL CAPS ALL THE TIME” Christian Soldier were here, we’d have a real party!

    As it is, you’re almost singularly the reason I don’t comment on this blog much anymore. Not that that matters to you, but I don’t know why you feel the need to “contribute” as you do to what are otherwise intelligent discussions.

    …aaaand now I’ll just wait for you to corrupt the thread even further as you “respond” to this comment.

  • Cincinnatus

    Grace@89: Why are you blaming others for the fact that you are the one who makes a regular habit of turning this blog into a freak show? If C-Carol “ALL CAPS ALL THE TIME” Christian Soldier were here, we’d have a real party!

    As it is, you’re almost singularly the reason I don’t comment on this blog much anymore. Not that that matters to you, but I don’t know why you feel the need to “contribute” as you do to what are otherwise intelligent discussions.

    …aaaand now I’ll just wait for you to corrupt the thread even further as you “respond” to this comment.

  • Grace

    Cincinnatus @91

    You have a short memory – you post here all the time.

    Why not post what you believe, regarding what happened today, and LEAVE OUT the PERSONAL ATTACKS?

    The Health Care Bill is very important news. It will have far reaching effects. Let’s stay on subject OK?

  • Grace

    Cincinnatus @91

    You have a short memory – you post here all the time.

    Why not post what you believe, regarding what happened today, and LEAVE OUT the PERSONAL ATTACKS?

    The Health Care Bill is very important news. It will have far reaching effects. Let’s stay on subject OK?

  • Dust

    my opinion doesn’t matter to most, but Susan and Grace are right….grown ups should stop the underhanded insults, etc.

    cheers!

  • Dust

    my opinion doesn’t matter to most, but Susan and Grace are right….grown ups should stop the underhanded insults, etc.

    cheers!

  • Jon

    OK but you gotta wonder if Mormon apologists aren’t thinking White Horse about right now.

  • Jon

    OK but you gotta wonder if Mormon apologists aren’t thinking White Horse about right now.

  • Dust

    Jon…interesting…what is White Horse? thanks!

  • Dust

    Jon…interesting…what is White Horse? thanks!

  • Grace

    ONE VOTE, but who’s VOTE?

    55,175,368.5 – that’s over FIFTY FIVE MILLION LITTLE INFANTS, have been killed, by the abortionists tools. Infants in the womb have been slaughtered since 1973 just minutes before I made this post. http://www.numberofabortions.com/

    The Supreme Court of the United States made their pronouncement, and therefore, ABORTION – women’s right to choose, became law.

    Why should nine (9) people, have the ability to nay or yeah, such a vote? – OR, more importantly ONE individual, as in the case of todays vote, on Health Care, be the DECIDING VOTE for an entire country? A country of over THREE HUNDRED MILLION PEOPLE.

    Do we not vote?

    Do our votes become invalid, because one individual decides for an entire nation, we the citizens of the United States of America? There are 313,837,700 million people in the U.S.

    Today is no different. The majority do not want Obama’s Health Bill, however, after all is said, ONE PERSON DECIDES the FATE of the Health Bill.

  • Grace

    ONE VOTE, but who’s VOTE?

    55,175,368.5 – that’s over FIFTY FIVE MILLION LITTLE INFANTS, have been killed, by the abortionists tools. Infants in the womb have been slaughtered since 1973 just minutes before I made this post. http://www.numberofabortions.com/

    The Supreme Court of the United States made their pronouncement, and therefore, ABORTION – women’s right to choose, became law.

    Why should nine (9) people, have the ability to nay or yeah, such a vote? – OR, more importantly ONE individual, as in the case of todays vote, on Health Care, be the DECIDING VOTE for an entire country? A country of over THREE HUNDRED MILLION PEOPLE.

    Do we not vote?

    Do our votes become invalid, because one individual decides for an entire nation, we the citizens of the United States of America? There are 313,837,700 million people in the U.S.

    Today is no different. The majority do not want Obama’s Health Bill, however, after all is said, ONE PERSON DECIDES the FATE of the Health Bill.

  • http://www.toddstadler.com/ tODD

    Yeah, Cincinnatus (@91)! Can you LEAVE OUT the PERSONAL ATTACKS, and focus on the matter at hand: suggesting that the Chief Justice of the United States decided this issue incorrectly because he was high on goofballs! Which news has flown under everyone’s radar because Grace was on vacation in July 2007.

  • http://www.toddstadler.com/ tODD

    Yeah, Cincinnatus (@91)! Can you LEAVE OUT the PERSONAL ATTACKS, and focus on the matter at hand: suggesting that the Chief Justice of the United States decided this issue incorrectly because he was high on goofballs! Which news has flown under everyone’s radar because Grace was on vacation in July 2007.

  • DonS

    Joel @45: Thanks for your reply.

    I’m not sure where you get your 98 or 99% coverage rate in MA, or why you think that would apply to Obamacare to create a “massive” increase in the insured pool. I tried to find an at least ostensibly non-partisan or perhaps liberal-leaning source for this — the best I came up with is: http://www.princeton.edu/~kuziemko/gallup_19june2011.pdf

    This year-old study found that, using best case pricing strategies (about $2,000 annual premium), perhaps 33 million uninsured would voluntarily obtain coverage through the exchanges rather than pay the Obamacare tax. This is hardly a “massive” expansion of the insured pool, in a country having a population 10 times that size, even if one discounts those covered by government health insurance such as Medicare or Medicaid. It would definitely have an impact on risk distribution, if it came to pass, but it would hardly be earth shattering, or account for the increases we have seen already because of mandated coverages such as free preventive care, coverage under parents’ policies until age 26, and, most significantly, guaranteed issue. I also don’t see how a policy premium will cost anywhere near only $2,000 annually by 2014, even if you take into account subsidies. With guaranteed issue, a healthy young person will be far better off paying the tax, which begins at only 1% of income (maybe $400 annually for an average earner), and increases ultimately to 2 1/2 % of income. With guaranteed issue, this is a low-risk strategy, as they can obtain insurance when they get sick or injured. Because Obamacare also limits premium disparities due to age, it requires heavy subsidies of older insured by younger insured, which will further discourage young healthy people from entering the pool until they need healthcare.

    As for the issue of the 80% mandate on insurance companies, I’m not sure what you don’t understand. Why would you think that such a mandate would work to reduce health care costs or premiums? Ideally, you want to incentivize health care providers and insurance companies to reduce patient care costs, and thus, insurance premiums. This sort of mandate does not do that, and in fact does the opposite. If the insurance company succeeds in negotiating lower provider rates, then its 20% administrative share must also decrease proportionally, thus reducing insurance company profits. You mention that your utility company occasionally lowers rates because energy costs are lower. Of course that’s true. I’m not saying that other factors in play will never operate to reduce costs. Competition for customers, a greater policyholder base, and the like may work to improve efficiencies or justify a lower administrative overhead, for example. But in no way can this 80% mandate incentivize those decreases. They will occur despite the mandate, not because of it.

  • DonS

    Joel @45: Thanks for your reply.

    I’m not sure where you get your 98 or 99% coverage rate in MA, or why you think that would apply to Obamacare to create a “massive” increase in the insured pool. I tried to find an at least ostensibly non-partisan or perhaps liberal-leaning source for this — the best I came up with is: http://www.princeton.edu/~kuziemko/gallup_19june2011.pdf

    This year-old study found that, using best case pricing strategies (about $2,000 annual premium), perhaps 33 million uninsured would voluntarily obtain coverage through the exchanges rather than pay the Obamacare tax. This is hardly a “massive” expansion of the insured pool, in a country having a population 10 times that size, even if one discounts those covered by government health insurance such as Medicare or Medicaid. It would definitely have an impact on risk distribution, if it came to pass, but it would hardly be earth shattering, or account for the increases we have seen already because of mandated coverages such as free preventive care, coverage under parents’ policies until age 26, and, most significantly, guaranteed issue. I also don’t see how a policy premium will cost anywhere near only $2,000 annually by 2014, even if you take into account subsidies. With guaranteed issue, a healthy young person will be far better off paying the tax, which begins at only 1% of income (maybe $400 annually for an average earner), and increases ultimately to 2 1/2 % of income. With guaranteed issue, this is a low-risk strategy, as they can obtain insurance when they get sick or injured. Because Obamacare also limits premium disparities due to age, it requires heavy subsidies of older insured by younger insured, which will further discourage young healthy people from entering the pool until they need healthcare.

    As for the issue of the 80% mandate on insurance companies, I’m not sure what you don’t understand. Why would you think that such a mandate would work to reduce health care costs or premiums? Ideally, you want to incentivize health care providers and insurance companies to reduce patient care costs, and thus, insurance premiums. This sort of mandate does not do that, and in fact does the opposite. If the insurance company succeeds in negotiating lower provider rates, then its 20% administrative share must also decrease proportionally, thus reducing insurance company profits. You mention that your utility company occasionally lowers rates because energy costs are lower. Of course that’s true. I’m not saying that other factors in play will never operate to reduce costs. Competition for customers, a greater policyholder base, and the like may work to improve efficiencies or justify a lower administrative overhead, for example. But in no way can this 80% mandate incentivize those decreases. They will occur despite the mandate, not because of it.

  • DonS

    tODD @ 49:

    Remember, as many a conservative holding his nose will tell you, the main reason to vote for Romney is to ensure that you get conservative-minded justices in the Supreme Court.
    Wasn’t that also the reason to vote for George W. Bush? Who appointed Roberts?
    Ahem.

    What Roberts did today in his ruling was disappointing to most conservatives, although it may in the long run prove to be politically advantageous. But it was not liberal. He merely declined to overturn congressional legislation that many of us would have like to have seen overturned.

    The reason why we want conservative justices on the courts is not to do our political work for us. That is what separates us from liberals, who often seek to have the courts do by fiat what they cannot convince their fellow voters to enact. The reason for conservative justices is to thwart that kind of liberal mischief.

    I’m not worried about Roberts going rogue activist on us. What I am concerned about is that the four liberal justices on the Court were fully ready today to entirely eviscerate the Commerce Clause without a second thought, thereby handing Congress essentially unlimited power.

    The next election is important for two reasons. One is so that Obamacare can be overturned or sharply revised through the political process. The second is so that Obama does not have the opportunity to pack the courts with more Sotomayor’s or Kagen’s.

  • DonS

    tODD @ 49:

    Remember, as many a conservative holding his nose will tell you, the main reason to vote for Romney is to ensure that you get conservative-minded justices in the Supreme Court.
    Wasn’t that also the reason to vote for George W. Bush? Who appointed Roberts?
    Ahem.

    What Roberts did today in his ruling was disappointing to most conservatives, although it may in the long run prove to be politically advantageous. But it was not liberal. He merely declined to overturn congressional legislation that many of us would have like to have seen overturned.

    The reason why we want conservative justices on the courts is not to do our political work for us. That is what separates us from liberals, who often seek to have the courts do by fiat what they cannot convince their fellow voters to enact. The reason for conservative justices is to thwart that kind of liberal mischief.

    I’m not worried about Roberts going rogue activist on us. What I am concerned about is that the four liberal justices on the Court were fully ready today to entirely eviscerate the Commerce Clause without a second thought, thereby handing Congress essentially unlimited power.

    The next election is important for two reasons. One is so that Obamacare can be overturned or sharply revised through the political process. The second is so that Obama does not have the opportunity to pack the courts with more Sotomayor’s or Kagen’s.

  • James Sarver

    My biggest concern is the explicit approval of taxation of inactivity, previously referred to as a penalty. It seems that previously taxation has been applied to some sort of activity and that this is an innovation rather than a confirmation of something that Congress has always had the right to do.

    It appears to be a tax on existence. Once in effect every child born in the U.S. will spring forth from the womb bearing a tax liability that may only be avoided if and when that child obtains or has provided for it government approved health insurance. There are no other options or outcomes.

    Can somebody refute this logically?

  • James Sarver

    My biggest concern is the explicit approval of taxation of inactivity, previously referred to as a penalty. It seems that previously taxation has been applied to some sort of activity and that this is an innovation rather than a confirmation of something that Congress has always had the right to do.

    It appears to be a tax on existence. Once in effect every child born in the U.S. will spring forth from the womb bearing a tax liability that may only be avoided if and when that child obtains or has provided for it government approved health insurance. There are no other options or outcomes.

    Can somebody refute this logically?

  • http://enterthevein.wordpress.com J. Dean

    Well, on the other hand, let’s remember that God is sovereign on this, and that He is still ultimately in control, regardless of what happens in D.C.

    In the words of Job, “Shall we indeed accept good from God and not accept adversity?”

  • http://enterthevein.wordpress.com J. Dean

    Well, on the other hand, let’s remember that God is sovereign on this, and that He is still ultimately in control, regardless of what happens in D.C.

    In the words of Job, “Shall we indeed accept good from God and not accept adversity?”

  • Cincinnatus

    I’d just like to take a moment to mention that the anti-federalists were right. About everything.

  • Cincinnatus

    I’d just like to take a moment to mention that the anti-federalists were right. About everything.

  • Susan

    @ James Sarver

    Re: Can somebody refute this logically?

    No, because you are right. The Supreme Court’s ruling is an example of shoddy jurisprudence.

    Here is a list of some others:

    The Supreme Court has done a fair number of truly awful things in its history, falsely blaming them on the Constitution: creating a constitutional property right to slavery and extending it into new territories (Dred Scott, 1857); gutting the Fourteenth Amendment’s guarantee of equal protection of the laws by warmly embracing state racial segregation (Plessy v. Ferguson, 1896); discrimination against women (Bradwell v. Illinois, 1873), and eugenic sterilization of the disabled (Buck v. Bell, 1927); declining to disturb a state-wide scheme to deprive blacks of the right to vote (Giles v. Harris, 1903); ratifying Franklin Roosevelt’s military internment of innocent Japanese-American civilians during World War II (Korematsu v. United States, 1944); ordering a religious college to cease teaching blacks and whites together (Berea College v. Kentucky, 1908); upholding the expulsion from school of children whose religious beliefs forbade them to salute the flag (Minersville School District v.Gobitis, 1940); and affirming the criminal conviction and incarceration of a prominent former presidential candidate for making an anti-war speech (Debs v. United States, 1919), to name just a few of the most infamous.

    Source: http://www.thepublicdiscourse.com/2012/06/5774

  • Susan

    @ James Sarver

    Re: Can somebody refute this logically?

    No, because you are right. The Supreme Court’s ruling is an example of shoddy jurisprudence.

    Here is a list of some others:

    The Supreme Court has done a fair number of truly awful things in its history, falsely blaming them on the Constitution: creating a constitutional property right to slavery and extending it into new territories (Dred Scott, 1857); gutting the Fourteenth Amendment’s guarantee of equal protection of the laws by warmly embracing state racial segregation (Plessy v. Ferguson, 1896); discrimination against women (Bradwell v. Illinois, 1873), and eugenic sterilization of the disabled (Buck v. Bell, 1927); declining to disturb a state-wide scheme to deprive blacks of the right to vote (Giles v. Harris, 1903); ratifying Franklin Roosevelt’s military internment of innocent Japanese-American civilians during World War II (Korematsu v. United States, 1944); ordering a religious college to cease teaching blacks and whites together (Berea College v. Kentucky, 1908); upholding the expulsion from school of children whose religious beliefs forbade them to salute the flag (Minersville School District v.Gobitis, 1940); and affirming the criminal conviction and incarceration of a prominent former presidential candidate for making an anti-war speech (Debs v. United States, 1919), to name just a few of the most infamous.

    Source: http://www.thepublicdiscourse.com/2012/06/5774

  • Susan

    Three quotes offered without comment:

    1) Justice Roberts in Thurday’s SC decision:

    “The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” wrote Chief Justice John Roberts, in his majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

    2) Joseph Knippenberg at First Thoughts:

    “It’s worth remembering that the real limitation on government is not the Supreme Court’s interpretation of the Constitution. The Justices are perfectly capable of getting it wrong. The real limit on government, the real mechanism for upholding the Constitution, is an electorate vigilant about its rights and responsible about its duties. We have long relied too heavily on the Supreme Court and have forgotten the wisdom of The Federalist Papers, which remind us that, by itself, the Constitution is merely a parchment barrier that will be maintained only so long as the citizens insist that their representatives respect it. The ball is in our court. If we want a limited government, we have to vote that way.”

    3) Excerpts from Justice Kennedy’s dissent:

    Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority. Congress already possesses expansive power to regulate what people do. Upholding the Affordable Care Act under the Commerce Clause would give Congress the same license to regulate what people do not do. The Framers knew the difference between doing something and doing nothing.

    The Constitution, though it dates from the founding of the Republic, has powerful meaning and vital relevance to our own times. The constitutional protections that this case involves are protections of structure. Structural protections—notably, the restraints imposed by federalism and separation of powers—are less romantic and have less obvious a connection to personal freedom than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach otherwise, to remind our people that the Framers considered structural protections of freedom the most important ones, for which reason they alone were embodied in the original Constitution and not left to later amendment. The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s decision should have vindicated, should have taught, this truth; instead, our judgment today has disregarded it.

  • Susan

    Three quotes offered without comment:

    1) Justice Roberts in Thurday’s SC decision:

    “The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” wrote Chief Justice John Roberts, in his majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

    2) Joseph Knippenberg at First Thoughts:

    “It’s worth remembering that the real limitation on government is not the Supreme Court’s interpretation of the Constitution. The Justices are perfectly capable of getting it wrong. The real limit on government, the real mechanism for upholding the Constitution, is an electorate vigilant about its rights and responsible about its duties. We have long relied too heavily on the Supreme Court and have forgotten the wisdom of The Federalist Papers, which remind us that, by itself, the Constitution is merely a parchment barrier that will be maintained only so long as the citizens insist that their representatives respect it. The ball is in our court. If we want a limited government, we have to vote that way.”

    3) Excerpts from Justice Kennedy’s dissent:

    Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority. Congress already possesses expansive power to regulate what people do. Upholding the Affordable Care Act under the Commerce Clause would give Congress the same license to regulate what people do not do. The Framers knew the difference between doing something and doing nothing.

    The Constitution, though it dates from the founding of the Republic, has powerful meaning and vital relevance to our own times. The constitutional protections that this case involves are protections of structure. Structural protections—notably, the restraints imposed by federalism and separation of powers—are less romantic and have less obvious a connection to personal freedom than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach otherwise, to remind our people that the Framers considered structural protections of freedom the most important ones, for which reason they alone were embodied in the original Constitution and not left to later amendment. The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s decision should have vindicated, should have taught, this truth; instead, our judgment today has disregarded it.

  • Joe

    There has been a lot of speculation that Roberts switched his vote late in the game in order to save the integrity of the court. Had there been a 5-4 decision striking the law, we could be assured that a large part of the president’s campaign would have focused on the conservative court run wild. Unfortunately, it appears that all this speculation about why Roberts “switched” may very well harm the integrity of the court Roberts was (allegedly) seeking to protect. I was fairly dismissive about this speculation, but there is some decent evidence that the joint dissent was originally the majority opinion:

    1. Structurally it reads like a majority opinion. 2. It is a joint dissent, rather than a dissent authored by a particular justice and joined by others. In other words, this was going to be a per curium decision by the court. I have not been able to think of another joint dissent. 3. The joint dissent refers to Justice Ginsburg’s “dissent’ 15 times. Ginsburg did not dissent — she concurred. However, had Roberts voted with the dissenters, her concurrence would have been a dissent. 4. Justice Thomas’ individual dissent refers to the joint dissent as the “joint opinion.”

    Number 3 is really interesting.

  • Joe

    There has been a lot of speculation that Roberts switched his vote late in the game in order to save the integrity of the court. Had there been a 5-4 decision striking the law, we could be assured that a large part of the president’s campaign would have focused on the conservative court run wild. Unfortunately, it appears that all this speculation about why Roberts “switched” may very well harm the integrity of the court Roberts was (allegedly) seeking to protect. I was fairly dismissive about this speculation, but there is some decent evidence that the joint dissent was originally the majority opinion:

    1. Structurally it reads like a majority opinion. 2. It is a joint dissent, rather than a dissent authored by a particular justice and joined by others. In other words, this was going to be a per curium decision by the court. I have not been able to think of another joint dissent. 3. The joint dissent refers to Justice Ginsburg’s “dissent’ 15 times. Ginsburg did not dissent — she concurred. However, had Roberts voted with the dissenters, her concurrence would have been a dissent. 4. Justice Thomas’ individual dissent refers to the joint dissent as the “joint opinion.”

    Number 3 is really interesting.

  • Susan

    @Joe

    I’m not trying to initiate an argument and I’m happy to be corrected where I’m wrong, so please bear with me. I would like to ask: If Roberts changed his vote at the last moment, would that explain why the some of Roberts’ decisions are clearly convoluted/illogical? Eg: Ruling what is clearly a penalty a tax? Upholding limits on the government’s use of commerce clause and then seemingly giving congress the same power through their taxing authority? And the lack of distinguishing the difference between activity and inactivity with regard to his rulings impact on individual liberties? I hope those questions make sense.

  • Susan

    @Joe

    I’m not trying to initiate an argument and I’m happy to be corrected where I’m wrong, so please bear with me. I would like to ask: If Roberts changed his vote at the last moment, would that explain why the some of Roberts’ decisions are clearly convoluted/illogical? Eg: Ruling what is clearly a penalty a tax? Upholding limits on the government’s use of commerce clause and then seemingly giving congress the same power through their taxing authority? And the lack of distinguishing the difference between activity and inactivity with regard to his rulings impact on individual liberties? I hope those questions make sense.

  • Joe

    Susan

    The switch theory would completely explain the “it’s a tax” holding. It is the only possible way to uphold the law and remain consistent with what everyone currently understands Robert’s philosophy on the commerce clause. The it’s a tax holding was the way to uphold the law with doing the least damage to the constitution. Whether something is a tax or a penalty is driven largely by unique aspects of the law at issue, so future courts will be able to limit the reach of the holding in this case by finding differences in the future laws that attempt to use the taxing power. This also explains why Roberts did not spend a ton of time setting out any new law with regard to the operation of the taxing power but tried so hard to fit this square peg into a round hole.

  • Joe

    Susan

    The switch theory would completely explain the “it’s a tax” holding. It is the only possible way to uphold the law and remain consistent with what everyone currently understands Robert’s philosophy on the commerce clause. The it’s a tax holding was the way to uphold the law with doing the least damage to the constitution. Whether something is a tax or a penalty is driven largely by unique aspects of the law at issue, so future courts will be able to limit the reach of the holding in this case by finding differences in the future laws that attempt to use the taxing power. This also explains why Roberts did not spend a ton of time setting out any new law with regard to the operation of the taxing power but tried so hard to fit this square peg into a round hole.

  • Bass

    http://www.newyorker.com/online/blogs/comment/2012/06/something-wicked-this-way-comes.html

    Think about the those who don’t have health care because they either can’t afford it or are denied it due to a pre-existing condition. Think about them, pray for them, and work hard to ensure they get the aid that most of us take for granted. The free market god isn’t helping these folks.

  • Bass

    http://www.newyorker.com/online/blogs/comment/2012/06/something-wicked-this-way-comes.html

    Think about the those who don’t have health care because they either can’t afford it or are denied it due to a pre-existing condition. Think about them, pray for them, and work hard to ensure they get the aid that most of us take for granted. The free market god isn’t helping these folks.

  • Joe

    Bass you are conflating the ideas of health care and health insurance. Not having health insurance is not the same thing as not having access to health care. And, can we all please stop and think about this pre-existing condition issue for a second. If you are already sick you are not buying insurance. Insurance is why you buy to protect yourself against the POSSIBILITY that something bad might happen. If the bad has already happened its not insurance. You simply are asking someone else to pay your bills in exchange for a premium that is necessarily less than the bills. Would you accept the notion that I should be able to buy car insurance after I get in an accident?

    But of course we should pray for those who are in need, including those who can’t afford the medical care they need. And we can even look for policy solutions to attempt to help them. But we have to do it within the confines of the system of gov’t we have.

  • Joe

    Bass you are conflating the ideas of health care and health insurance. Not having health insurance is not the same thing as not having access to health care. And, can we all please stop and think about this pre-existing condition issue for a second. If you are already sick you are not buying insurance. Insurance is why you buy to protect yourself against the POSSIBILITY that something bad might happen. If the bad has already happened its not insurance. You simply are asking someone else to pay your bills in exchange for a premium that is necessarily less than the bills. Would you accept the notion that I should be able to buy car insurance after I get in an accident?

    But of course we should pray for those who are in need, including those who can’t afford the medical care they need. And we can even look for policy solutions to attempt to help them. But we have to do it within the confines of the system of gov’t we have.

  • DonS

    James @ 100: Good observation. I read this “birth tax” argument a number of times yesterday, and, obviously, this kind of expansion of the taxing authority of the government bothers me. I don’t like the decision, and the observations Joe is sharing this morning about a possible late switch by Justice Roberts are rampant on the legal blogs — it appears likely to be the case in view of the circumstantial evidence available from the opinions. However, if I understand the whole penalty, or as we now know, tax provision of the Obamacare law, it doesn’t apply to everyone. It’s based on income, and the poor are exempt. So it is really, at its root, an income tax surcharge.

  • DonS

    James @ 100: Good observation. I read this “birth tax” argument a number of times yesterday, and, obviously, this kind of expansion of the taxing authority of the government bothers me. I don’t like the decision, and the observations Joe is sharing this morning about a possible late switch by Justice Roberts are rampant on the legal blogs — it appears likely to be the case in view of the circumstantial evidence available from the opinions. However, if I understand the whole penalty, or as we now know, tax provision of the Obamacare law, it doesn’t apply to everyone. It’s based on income, and the poor are exempt. So it is really, at its root, an income tax surcharge.

  • Stephen

    “But of course we should pray for those who are in need, including those who can’t afford the medical care they need. And we can even look for policy solutions to attempt to help them. But we have to do it within the confines of the system of gov’t we have.”

    Um, this is an answer to the prayers of many who are financially excluded. The resources to pay for medical care do not fall out of the sky. God uses means. And in this case, as the court decided, the means seem to be legislation which falls within the “confines of the system of gov’t we have.”

    Moving on . . .

  • Stephen

    “But of course we should pray for those who are in need, including those who can’t afford the medical care they need. And we can even look for policy solutions to attempt to help them. But we have to do it within the confines of the system of gov’t we have.”

    Um, this is an answer to the prayers of many who are financially excluded. The resources to pay for medical care do not fall out of the sky. God uses means. And in this case, as the court decided, the means seem to be legislation which falls within the “confines of the system of gov’t we have.”

    Moving on . . .

  • Susan

    @ Joe,

    Thanks for your reply. If I’m on the right track, I would still differ with you.

    First, if the court was supposed to determine the constitutionality of the mandate on it’s merits as written, then it should have been found unconstitutional and rejected the entire bill. Upholding the bill requires the SC rewrite the mandate and substitute the word tax for penalty in order to uphold it. If the SC is not supposed to rewrite legislation, but judge it as written, then upholding a rewritten/redefined version is outside the boundaries of the court.

    Second, even if it was within their scope of duties to rewrite or redefine the word penalty, it flunks the smell test. Even an ordinary person like myself can understand the difference between being offered a discount to purchase something (an incentive) and be charged for not purchasing something (a penalty). Ilya Somin convinced me my common sense was on solid ground and he does well explaining why the penalty cannot be a variety of different taxes (that square peg in a round hole you mentioned).

    I may be wrong, but you might want to read Ilya’s argument. I also do not understand how anyone can consider it an income tax (hi DonS!) if it is a flat $2000 fine and numerous organizations/unions/businesses have been exempted on different grounds after the law was passed (plus see Ilya’s argument). Can you see my dilemma?: http://www.volokh.com/2012/06/28/the-tax-issue-is-not-just-a-technicality

    Excerpt:

    As recently as 1996, the Supreme Court reiterated the crucial distinction between a penalty and a tax. It ruled that “[a] tax is a pecuniary burden laid upon individuals or property for the purpose of supporting the Government,” while a penalty is “an exaction imposed by statute as punishment for an unlawful act” or – as in the case of the individual mandate – an unlawful omission. The individual mandate is a clear example of a penalty, where Congress requires people to purchase health insurance, and then punishes them with a fine if they fail to comply.

    In September 2009, President Obama himself noted that “for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase.” He was right….

    Even if the individual mandate does somehow qualify as a tax, it is not one of the types of taxes that Congress is authorized to impose. The Constitution gives Congress the power to enact several types of taxes: Excise taxes, duties and imposts, income taxes, and “direct taxes” that must be apportioned among the states in proportion to population.

    No one, including the federal government, claims that the individual mandate is a duty or an impost. The individual mandate is not an income tax because an income tax must target some “accession to wealth,” in the words of Commissioner of Internal Revenue v. Glenshaw Glass Co., the leading Supreme Court case on the subject. The fine imposed by the mandate does not target any accession to wealth or flow of income. It simply forces individuals to pay a penalty if they disobey the federal government’s regulatory requirement. The fact that low-income individuals are exempted does not change this analysis. A fine for jaywalking would not become an income tax if low-income individuals were exempted from it….

    It is even more implausible to suggest that the mandate is an excise tax. Excise taxes apply to economic transactions or the use of property of some kind. For example, a tax on the sale of alcoholic beverages qualifies as an excise. The individual mandate does not tax any kind of activity, use of property or economic transaction….

    If the mandate is not a tariff, impost, income tax, or excise tax, it is either a direct tax or no tax at all. And if it is a direct tax, it would be an unconstitutional one, because it is not apportioned among the states in proportion to population as the Constitution requires.

  • Susan

    @ Joe,

    Thanks for your reply. If I’m on the right track, I would still differ with you.

    First, if the court was supposed to determine the constitutionality of the mandate on it’s merits as written, then it should have been found unconstitutional and rejected the entire bill. Upholding the bill requires the SC rewrite the mandate and substitute the word tax for penalty in order to uphold it. If the SC is not supposed to rewrite legislation, but judge it as written, then upholding a rewritten/redefined version is outside the boundaries of the court.

    Second, even if it was within their scope of duties to rewrite or redefine the word penalty, it flunks the smell test. Even an ordinary person like myself can understand the difference between being offered a discount to purchase something (an incentive) and be charged for not purchasing something (a penalty). Ilya Somin convinced me my common sense was on solid ground and he does well explaining why the penalty cannot be a variety of different taxes (that square peg in a round hole you mentioned).

    I may be wrong, but you might want to read Ilya’s argument. I also do not understand how anyone can consider it an income tax (hi DonS!) if it is a flat $2000 fine and numerous organizations/unions/businesses have been exempted on different grounds after the law was passed (plus see Ilya’s argument). Can you see my dilemma?: http://www.volokh.com/2012/06/28/the-tax-issue-is-not-just-a-technicality

    Excerpt:

    As recently as 1996, the Supreme Court reiterated the crucial distinction between a penalty and a tax. It ruled that “[a] tax is a pecuniary burden laid upon individuals or property for the purpose of supporting the Government,” while a penalty is “an exaction imposed by statute as punishment for an unlawful act” or – as in the case of the individual mandate – an unlawful omission. The individual mandate is a clear example of a penalty, where Congress requires people to purchase health insurance, and then punishes them with a fine if they fail to comply.

    In September 2009, President Obama himself noted that “for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase.” He was right….

    Even if the individual mandate does somehow qualify as a tax, it is not one of the types of taxes that Congress is authorized to impose. The Constitution gives Congress the power to enact several types of taxes: Excise taxes, duties and imposts, income taxes, and “direct taxes” that must be apportioned among the states in proportion to population.

    No one, including the federal government, claims that the individual mandate is a duty or an impost. The individual mandate is not an income tax because an income tax must target some “accession to wealth,” in the words of Commissioner of Internal Revenue v. Glenshaw Glass Co., the leading Supreme Court case on the subject. The fine imposed by the mandate does not target any accession to wealth or flow of income. It simply forces individuals to pay a penalty if they disobey the federal government’s regulatory requirement. The fact that low-income individuals are exempted does not change this analysis. A fine for jaywalking would not become an income tax if low-income individuals were exempted from it….

    It is even more implausible to suggest that the mandate is an excise tax. Excise taxes apply to economic transactions or the use of property of some kind. For example, a tax on the sale of alcoholic beverages qualifies as an excise. The individual mandate does not tax any kind of activity, use of property or economic transaction….

    If the mandate is not a tariff, impost, income tax, or excise tax, it is either a direct tax or no tax at all. And if it is a direct tax, it would be an unconstitutional one, because it is not apportioned among the states in proportion to population as the Constitution requires.

  • Joe

    Stephen — I disagree with the Court on whether this law is constitutional. But if we want to discuss the actual substance of the law — it will not make healthcare more affordable for anyone. The very design of the bill precludes it. The main cost reduction mechanism is the individual mandate, force healthy people to buy in so that the risk pool is more favorable and then prices would come down. But the fatal flaw is that per the very words of the law the penalty, er tax, cannot exceed the cost of the premium. So it will be cheaper to not comply with the mandate. Which means that all of those young healthy people who don’t have insurance now, will still have an economic incentive to forgo insurance. Couple that with the fact that you can now buy insurance after your already sick and the risk of choosing to go without insurance is really minimal. Heck, I’m thinking of dropping my coverage in 2014.

  • Joe

    Stephen — I disagree with the Court on whether this law is constitutional. But if we want to discuss the actual substance of the law — it will not make healthcare more affordable for anyone. The very design of the bill precludes it. The main cost reduction mechanism is the individual mandate, force healthy people to buy in so that the risk pool is more favorable and then prices would come down. But the fatal flaw is that per the very words of the law the penalty, er tax, cannot exceed the cost of the premium. So it will be cheaper to not comply with the mandate. Which means that all of those young healthy people who don’t have insurance now, will still have an economic incentive to forgo insurance. Couple that with the fact that you can now buy insurance after your already sick and the risk of choosing to go without insurance is really minimal. Heck, I’m thinking of dropping my coverage in 2014.

  • Grace

    Joe @ 105

    There has been a lot of speculation that Roberts switched his vote late in the game in order to save the integrity of the court. Had there been a 5-4 decision striking the law, we could be assured that a large part of the president’s campaign would have focused on the conservative court run wild. Unfortunately, it appears that all this speculation about why Roberts “switched” may very well harm the integrity of the court Roberts was (allegedly) seeking to protect.


    This from my post @63 yesterday:

    Did Justice Roberts change his Obamacare vote at the last minute?

    By Liz Goodwin
    June 28, 2012

    “Did Chief Justice John Roberts decide to join the court’s liberal wing and uphold the individual mandate at the very last minute?

    That’s the theory floated by Paul Campos, a law professor at the University of Boulder, and Brad DeLong, a Berkeley economics professor and former Treasury Department official under President Clinton. Campos wrote Thursday in Salon that the dissent had a triumphant tone, as if it were written as a majority opinion, and that the four conservative justices incorrectly refer to Justice Ruth Bader Ginsburg’s concurring opinion as a “dissent.”

    EXCERPT – LAST PARAGRAPH of ARTICLE:

    “My own sense, from reading the Roberts opinion, is that it was written as a majority opinion in all of its drafts, and that various Justices joined or dropped off,” Denniston told Yahoo News. “I think he was determined to try to uphold some key parts of the law, if he could find a way, partly because…he has grown concerned about the public perception that his Court is a partisan-driven Court.”

    READ the whole article:
    http://abcnews.go.com/Politics/OTUS/justice-roberts-change-obamacare-vote-minute/story?id=16673072#.T-zefLjDVoY

    This just might be true. IF it is, it’s more than troubling, regarding the Supreme Court of the United States.

  • Grace

    Joe @ 105

    There has been a lot of speculation that Roberts switched his vote late in the game in order to save the integrity of the court. Had there been a 5-4 decision striking the law, we could be assured that a large part of the president’s campaign would have focused on the conservative court run wild. Unfortunately, it appears that all this speculation about why Roberts “switched” may very well harm the integrity of the court Roberts was (allegedly) seeking to protect.


    This from my post @63 yesterday:

    Did Justice Roberts change his Obamacare vote at the last minute?

    By Liz Goodwin
    June 28, 2012

    “Did Chief Justice John Roberts decide to join the court’s liberal wing and uphold the individual mandate at the very last minute?

    That’s the theory floated by Paul Campos, a law professor at the University of Boulder, and Brad DeLong, a Berkeley economics professor and former Treasury Department official under President Clinton. Campos wrote Thursday in Salon that the dissent had a triumphant tone, as if it were written as a majority opinion, and that the four conservative justices incorrectly refer to Justice Ruth Bader Ginsburg’s concurring opinion as a “dissent.”

    EXCERPT – LAST PARAGRAPH of ARTICLE:

    “My own sense, from reading the Roberts opinion, is that it was written as a majority opinion in all of its drafts, and that various Justices joined or dropped off,” Denniston told Yahoo News. “I think he was determined to try to uphold some key parts of the law, if he could find a way, partly because…he has grown concerned about the public perception that his Court is a partisan-driven Court.”

    READ the whole article:
    http://abcnews.go.com/Politics/OTUS/justice-roberts-change-obamacare-vote-minute/story?id=16673072#.T-zefLjDVoY

    This just might be true. IF it is, it’s more than troubling, regarding the Supreme Court of the United States.

  • DonS

    Susan @ 112: Please understand that I disagree with the Supreme Court decision. I am with you — this law should have been found to be unconstitutional. Particularly since the supporters of the law denied that the penalty was a tax, it was wrong for the Court to find it to be one.

    That said, it is what it is. You say that you cannot see how the tax is an income tax. I think that is perhaps because you don’t understand its provisions — understandable since everything about this law is utter confusion. First, we need to keep straight that it is the individual mandate that is at issue, not the tax on employers if they fail to provide health care to their employees. That tax is flat, but there is no constitutional basis for challenging it. The individual mandate tax, on the other hand, provides for exemptions for hardship (i.e. low income). Above a certain income, it is the greater of a flat amount or a percentage of income. See here: http://www.thegatewaypundit.com/2012/06/get-ready-america-for-your-obamacare-tax-penalty-over-2085-a-year/ where this provision is explained. Since the amount you pay is based on your income, it is essentially an income tax.

  • DonS

    Susan @ 112: Please understand that I disagree with the Supreme Court decision. I am with you — this law should have been found to be unconstitutional. Particularly since the supporters of the law denied that the penalty was a tax, it was wrong for the Court to find it to be one.

    That said, it is what it is. You say that you cannot see how the tax is an income tax. I think that is perhaps because you don’t understand its provisions — understandable since everything about this law is utter confusion. First, we need to keep straight that it is the individual mandate that is at issue, not the tax on employers if they fail to provide health care to their employees. That tax is flat, but there is no constitutional basis for challenging it. The individual mandate tax, on the other hand, provides for exemptions for hardship (i.e. low income). Above a certain income, it is the greater of a flat amount or a percentage of income. See here: http://www.thegatewaypundit.com/2012/06/get-ready-america-for-your-obamacare-tax-penalty-over-2085-a-year/ where this provision is explained. Since the amount you pay is based on your income, it is essentially an income tax.

  • Grace

    York: Roberts’ dodge at heart of Obamacare decision
    June 28, 2012

    Byron York

    No one knew it at the time, but the key moment in the Supreme Court Obamacare case came on March 26, the first day of oral arguments, when few people were paying close attention.

    Before getting to the heart of the case, the justices first wanted to deal with what seemed to be a side issue: Was the penalty imposed by the individual mandate in Obamacare a tax? If it was, the case would run afoul of a 19th century-law known as the Anti-Injunction Act, which said a tax cannot be challenged in court until someone has actually been forced to pay it. Since the Obamacare mandate wouldn’t go into effect until 2014, that would mean there could be no court case until then.

    No one had challenged Obamacare on that basis; the challengers wanted the case to go forward now. The White House, having argued strenuously during the Obamacare debate that the penalty wasn’t a tax, wanted to go ahead as well. So the court, on its own, tapped a Washington attorney to make the argument that the penalty was a tax and therefore the case should not go ahead.

    READ THE REST:

    http://washingtonexaminer.com/york-roberts-dodge-at-heart-of-obamacare-decision/article/2500925

  • Grace

    York: Roberts’ dodge at heart of Obamacare decision
    June 28, 2012

    Byron York

    No one knew it at the time, but the key moment in the Supreme Court Obamacare case came on March 26, the first day of oral arguments, when few people were paying close attention.

    Before getting to the heart of the case, the justices first wanted to deal with what seemed to be a side issue: Was the penalty imposed by the individual mandate in Obamacare a tax? If it was, the case would run afoul of a 19th century-law known as the Anti-Injunction Act, which said a tax cannot be challenged in court until someone has actually been forced to pay it. Since the Obamacare mandate wouldn’t go into effect until 2014, that would mean there could be no court case until then.

    No one had challenged Obamacare on that basis; the challengers wanted the case to go forward now. The White House, having argued strenuously during the Obamacare debate that the penalty wasn’t a tax, wanted to go ahead as well. So the court, on its own, tapped a Washington attorney to make the argument that the penalty was a tax and therefore the case should not go ahead.

    READ THE REST:

    http://washingtonexaminer.com/york-roberts-dodge-at-heart-of-obamacare-decision/article/2500925

  • James Sarver

    DonS @ 110,

    “However, if I understand the whole penalty, or as we now know, tax provision of the Obamacare law, it doesn’t apply to everyone.”

    Thanks for making me reread that section of the law. As read it, exceptions may be applied for specifically in the case of membership in a protected sect or division, membership in a ‘health care sharing ministry’ (whatever that is!), membership in an Indian tribe or having an eligible financial hardship.

    My point would be that it in fact does apply to everyone unless relief is specifically granted at the discretion of the government on an individual basis. So my logical fallacy was that there were no other possible options or outcomes. That was incorrect. One has a “snowball’s chance” it seems, of having an exception granted.

  • James Sarver

    DonS @ 110,

    “However, if I understand the whole penalty, or as we now know, tax provision of the Obamacare law, it doesn’t apply to everyone.”

    Thanks for making me reread that section of the law. As read it, exceptions may be applied for specifically in the case of membership in a protected sect or division, membership in a ‘health care sharing ministry’ (whatever that is!), membership in an Indian tribe or having an eligible financial hardship.

    My point would be that it in fact does apply to everyone unless relief is specifically granted at the discretion of the government on an individual basis. So my logical fallacy was that there were no other possible options or outcomes. That was incorrect. One has a “snowball’s chance” it seems, of having an exception granted.

  • Susan

    @ Bass,

    Thanks for the link. There are a few things you might want to consider after you digest Joe’s input.

    1) Prior to Obamacare, there were 35 states that had high-risk pools for those who could not get insurance because of pre-existing conditions and offered state subsidized insurance with a price scale based upon the buyer’s income.

    2) The kind of insurance you have affects which doctors will accept you and the level of care you will receive. Medicaid is the program Obamcare uses to cover the poor and was going to expand to cover to poor who do not currently qualify for Medicaid and/or are uninsured. There are few things it is helpful to know about Medicaid. It reimburses the doctors the least for their costs and because they lose money serving these patients, it is considered charity work. For a long time, it has been difficult for Medicaid holders to find a doctor to accept them. It is even more difficult for them to find a dentist. It will get worse if Medicaid has been allowed to be expanded. And because the Medicaid holders cannot find doctors or are covered for services through Medicaid, they end up in the ER to receive medical care. Not all hospitals will accept walk-ins for the ER – it must be life-threatening and they are sent to hospitals that will serve the poor. I’ve read too often that the waits can be up to 72 hours.

    3) There will be an even worse doctor shortage if Obamacare is allowed to go into effect in 2014. A large number of doctors have said they will retire if it goes through. About 1/3 of the doctors in my state of Texas have already dropped all acceptance of government insurance including all new Medicare holders which is different than Medicaid. Previous to this change many doctors would not accept Medicare unless one had the supplemental Medicaid Advantage program along with their Medicare. We also have a large number of doctors who have dropped all acceptance of any insurance and it is up to the patient to deal with their insurer.

    4) Obamacare was supposed to end the Medicare Advantage supplement this year, but put it off until after the election. It’s part of what has been called the Senior Swindle and you can read more about it here: http://www.weeklystandard.com/articles/obama-s-senior-swindle_642177.html

    As you can see, Obamacare has a dark underbelly that does not help the poor, aged, or disabled. Too many of the Obamacare promotions are deceptive advertising.

  • Susan

    @ Bass,

    Thanks for the link. There are a few things you might want to consider after you digest Joe’s input.

    1) Prior to Obamacare, there were 35 states that had high-risk pools for those who could not get insurance because of pre-existing conditions and offered state subsidized insurance with a price scale based upon the buyer’s income.

    2) The kind of insurance you have affects which doctors will accept you and the level of care you will receive. Medicaid is the program Obamcare uses to cover the poor and was going to expand to cover to poor who do not currently qualify for Medicaid and/or are uninsured. There are few things it is helpful to know about Medicaid. It reimburses the doctors the least for their costs and because they lose money serving these patients, it is considered charity work. For a long time, it has been difficult for Medicaid holders to find a doctor to accept them. It is even more difficult for them to find a dentist. It will get worse if Medicaid has been allowed to be expanded. And because the Medicaid holders cannot find doctors or are covered for services through Medicaid, they end up in the ER to receive medical care. Not all hospitals will accept walk-ins for the ER – it must be life-threatening and they are sent to hospitals that will serve the poor. I’ve read too often that the waits can be up to 72 hours.

    3) There will be an even worse doctor shortage if Obamacare is allowed to go into effect in 2014. A large number of doctors have said they will retire if it goes through. About 1/3 of the doctors in my state of Texas have already dropped all acceptance of government insurance including all new Medicare holders which is different than Medicaid. Previous to this change many doctors would not accept Medicare unless one had the supplemental Medicaid Advantage program along with their Medicare. We also have a large number of doctors who have dropped all acceptance of any insurance and it is up to the patient to deal with their insurer.

    4) Obamacare was supposed to end the Medicare Advantage supplement this year, but put it off until after the election. It’s part of what has been called the Senior Swindle and you can read more about it here: http://www.weeklystandard.com/articles/obama-s-senior-swindle_642177.html

    As you can see, Obamacare has a dark underbelly that does not help the poor, aged, or disabled. Too many of the Obamacare promotions are deceptive advertising.

  • DonS

    James @ 117: Not exactly. The hardship exemption is to be automatically granted based on low income, among other factors (see http://www.healthreformgps.org/resources/maintenance-of-minimum-essential-coverage/):

    Furthermore, individuals (and their dependents) are exempt from the penalty for the months in which the following circumstances apply:

    Coverage is unaffordable, meaning that the individual’s required contribution[20] is over 8% of household income that month.[21] If an individual is eligible for employer- sponsored insurance (ESI) by relation to the employee (i.e., by virtue of being a spouse or dependent), affordability is determined based on the employee’s contribution.[22] If the cost of self-only coverage is affordable under the standard, but family coverage would not be considered affordable, the employee is subject to the penalty if he or she fails to purchase coverage, but his or her dependents would not be subject to the penalty.[23]
    The individual’s household income is under the tax filing threshold,[24] (approximately $9,500 for an individual and $19,000 for a family in 2011).
    The individual is a member of an Indian tribe.[25]
    The individual experiences a short lapse (i.e., less than three consecutive months), in which case the exemption is available one time during a tax year. All subsequent lapses during the same tax year are subject to the penalty.[26]
    The individual experiences hardship with respect to the ability to obtain coverage under a qualified health plan through an Exchange or through the individual’s employer as determined by the Secretary of HHS.[27]

  • DonS

    James @ 117: Not exactly. The hardship exemption is to be automatically granted based on low income, among other factors (see http://www.healthreformgps.org/resources/maintenance-of-minimum-essential-coverage/):

    Furthermore, individuals (and their dependents) are exempt from the penalty for the months in which the following circumstances apply:

    Coverage is unaffordable, meaning that the individual’s required contribution[20] is over 8% of household income that month.[21] If an individual is eligible for employer- sponsored insurance (ESI) by relation to the employee (i.e., by virtue of being a spouse or dependent), affordability is determined based on the employee’s contribution.[22] If the cost of self-only coverage is affordable under the standard, but family coverage would not be considered affordable, the employee is subject to the penalty if he or she fails to purchase coverage, but his or her dependents would not be subject to the penalty.[23]
    The individual’s household income is under the tax filing threshold,[24] (approximately $9,500 for an individual and $19,000 for a family in 2011).
    The individual is a member of an Indian tribe.[25]
    The individual experiences a short lapse (i.e., less than three consecutive months), in which case the exemption is available one time during a tax year. All subsequent lapses during the same tax year are subject to the penalty.[26]
    The individual experiences hardship with respect to the ability to obtain coverage under a qualified health plan through an Exchange or through the individual’s employer as determined by the Secretary of HHS.[27]

  • Grace

    A great majority of physicians here, use what is called the “Concierge Program” which costs between one hundred and two hundred dollars per month, per person. The program became very popular about seven years ago, maybe longer. Patients under this program receive preferential care, and attention.

    Many doctors will only accept those patients who agree to join the “Concierge Program” – no matter what insurance they have.

  • Grace

    A great majority of physicians here, use what is called the “Concierge Program” which costs between one hundred and two hundred dollars per month, per person. The program became very popular about seven years ago, maybe longer. Patients under this program receive preferential care, and attention.

    Many doctors will only accept those patients who agree to join the “Concierge Program” – no matter what insurance they have.

  • Grace

    Just to clarify:

    It is Internists (primary care physicians) who use the “Concierge Program” -

  • Grace

    Just to clarify:

    It is Internists (primary care physicians) who use the “Concierge Program” -

  • http://www.toddstadler.com/ tODD

    Grace said (@120),

    A great majority of physicians here, use what is called the “Concierge Program” which costs between one hundred and two hundred dollars per month, per person.

    That’s probably a bit of an insight into the bubble you’re living in there, Grace.

    According to the U-T, there were 17 concierge physicians in San Diego a year ago.

    That would be a great minority of physicians — ones that only the wealthiest have access to.

  • http://www.toddstadler.com/ tODD

    Grace said (@120),

    A great majority of physicians here, use what is called the “Concierge Program” which costs between one hundred and two hundred dollars per month, per person.

    That’s probably a bit of an insight into the bubble you’re living in there, Grace.

    According to the U-T, there were 17 concierge physicians in San Diego a year ago.

    That would be a great minority of physicians — ones that only the wealthiest have access to.

  • Cincinnatus

    Grace in a bubble? UNPOSSIBLE.

    Meanwhile, Wisconsin Governor Scott Walker, perhaps unsurprisingly, has claimed that his administration will refuse to implement the aspects of ACA under his control–notably, the expansion of Medicaid and the establishment of insurance exchanges. Other governors are making similar claims. This could be interesting.

  • Cincinnatus

    Grace in a bubble? UNPOSSIBLE.

    Meanwhile, Wisconsin Governor Scott Walker, perhaps unsurprisingly, has claimed that his administration will refuse to implement the aspects of ACA under his control–notably, the expansion of Medicaid and the establishment of insurance exchanges. Other governors are making similar claims. This could be interesting.

  • Grace

    tODD,

    “That’s probably a bit of an insight into the bubble you’re living in there, Grace.

    there were 17 concierge physicians in San Diego a year ago.

    That would be a great minority of physicians — ones that only the wealthiest have access to.”

    California is a BIG state tODD. San Diego County covers more than just the city of San Diego, that is just one part of the county near the border. Those who live in LaJolla, Carlsbad and a host of other cities and communities are a different story.

    People spend money on different things – some would rather have the best health care – that isn’t a “bubble” it’s a reality.

  • Grace

    tODD,

    “That’s probably a bit of an insight into the bubble you’re living in there, Grace.

    there were 17 concierge physicians in San Diego a year ago.

    That would be a great minority of physicians — ones that only the wealthiest have access to.”

    California is a BIG state tODD. San Diego County covers more than just the city of San Diego, that is just one part of the county near the border. Those who live in LaJolla, Carlsbad and a host of other cities and communities are a different story.

    People spend money on different things – some would rather have the best health care – that isn’t a “bubble” it’s a reality.

  • Joe

    tODD — I would not necessarily conclude that the concierge physicians are only working with the wealthiest among us. I have a friend who has a concierge practice and his client base is pretty varied. I do think it fair to say that genuinely poor individuals do not use his service.

    Also, there have been a few companies here in Milwaukee that replaced their health insurance programs with a system where the company contracts with the concierge doc.

    The real advantage is that because the primary care doc is not dealing with insurance companies he can get better deals from the local hospitals and labs. You as the patient are still free to submit your bills to your ins. company if you have one.

  • Joe

    tODD — I would not necessarily conclude that the concierge physicians are only working with the wealthiest among us. I have a friend who has a concierge practice and his client base is pretty varied. I do think it fair to say that genuinely poor individuals do not use his service.

    Also, there have been a few companies here in Milwaukee that replaced their health insurance programs with a system where the company contracts with the concierge doc.

    The real advantage is that because the primary care doc is not dealing with insurance companies he can get better deals from the local hospitals and labs. You as the patient are still free to submit your bills to your ins. company if you have one.

  • Cincinnatus

    Joe@125:

    I think tODD’s point was that Grace was committing a rather grotesque logical fallacy in extrapolating her experience with concierge doctors to a “majority” of healthcare providers, as if “most” doctors employed this practice and that it’s therefore something “most” people should get used to.

    In reality, only 17 doctors (apparently) in the San Diego area, out of probably hundreds, use the practice.

    In short, the point was that Grace is the one living in a bubble. Which is entirely unsurprising. It would be like me claiming that there’s no such thing as concierge doctors because there are none in my area (true story, at least to my knowledge).

  • Cincinnatus

    Joe@125:

    I think tODD’s point was that Grace was committing a rather grotesque logical fallacy in extrapolating her experience with concierge doctors to a “majority” of healthcare providers, as if “most” doctors employed this practice and that it’s therefore something “most” people should get used to.

    In reality, only 17 doctors (apparently) in the San Diego area, out of probably hundreds, use the practice.

    In short, the point was that Grace is the one living in a bubble. Which is entirely unsurprising. It would be like me claiming that there’s no such thing as concierge doctors because there are none in my area (true story, at least to my knowledge).

  • Joe

    Cincy — I got that, but in the context of making his point, tODD incorrectly limited concierge practices to the wealthiest among us. I just wanted to provide some additional insight on that point.

    As for Grace’s bubble. I have no desire to participate in that conversation.

  • Joe

    Cincy — I got that, but in the context of making his point, tODD incorrectly limited concierge practices to the wealthiest among us. I just wanted to provide some additional insight on that point.

    As for Grace’s bubble. I have no desire to participate in that conversation.

  • Susan
  • Susan
  • Grace

    tODD @ 97

    YOU STATED:

    “Can you LEAVE OUT the PERSONAL ATTACKS, and focus on the matter at hand: suggesting that the Chief Justice of the United States decided this issue incorrectly because he was high on goofballs! Which news has flown under everyone’s radar because Grace was on vacation in July 2007.

    GOOFBALLS? You refer to medication for “seizures” as “goofballs” ? That’s just brilliant!

    For future use:
    definition for “goofballs” is:

    “A barbiturate or tranquilizer pill, especially when taken for nonmedical purposes.

    I pointed in my comments @66, regarding the New York Times article, written, August 1, 2007 “Roberts Facing Medical Option on 2nd Seizure” – which made mention of Roberts “seizure” and medication that ‘might have side effects.

    This is a good time for you to focus on what actually is posted, rather than manipulating what is written, to serve your purpose.

    Yes, people do take vacations, at which time they “focus” on enjoying themselves. It’s a good thing!

  • Grace

    tODD @ 97

    YOU STATED:

    “Can you LEAVE OUT the PERSONAL ATTACKS, and focus on the matter at hand: suggesting that the Chief Justice of the United States decided this issue incorrectly because he was high on goofballs! Which news has flown under everyone’s radar because Grace was on vacation in July 2007.

    GOOFBALLS? You refer to medication for “seizures” as “goofballs” ? That’s just brilliant!

    For future use:
    definition for “goofballs” is:

    “A barbiturate or tranquilizer pill, especially when taken for nonmedical purposes.

    I pointed in my comments @66, regarding the New York Times article, written, August 1, 2007 “Roberts Facing Medical Option on 2nd Seizure” – which made mention of Roberts “seizure” and medication that ‘might have side effects.

    This is a good time for you to focus on what actually is posted, rather than manipulating what is written, to serve your purpose.

    Yes, people do take vacations, at which time they “focus” on enjoying themselves. It’s a good thing!

  • Susan

    @DonS

    Thanks for the link. I stand corrected on tax rates based on income. It’s probably grasping for straws, but it would be nice to hear from some Tax Attorneys.

    Obamacare is nasty stuff. It looks like they are importing all the chaos/complexity of the IRS rules into healthcare and we haven’t even looked at the insurance plans yet. It also stinks to have to pay additional taxes for good insurance rather than what looks like will be pretty basic coverage. If I’m understanding this correctly, we are expanding the number of people covered and will be reducing the amount of services that will be covered by the insurance plans. I’m afraid Medicare (sans the Advantage Plan) and Medicaid will most likely end up being less than worthless in actual practice. It’s already a fight for every penny of coverage for a large number with disabilities. The government has a long history of denying claims at over 2x the rate of private insurers.

  • Susan

    @DonS

    Thanks for the link. I stand corrected on tax rates based on income. It’s probably grasping for straws, but it would be nice to hear from some Tax Attorneys.

    Obamacare is nasty stuff. It looks like they are importing all the chaos/complexity of the IRS rules into healthcare and we haven’t even looked at the insurance plans yet. It also stinks to have to pay additional taxes for good insurance rather than what looks like will be pretty basic coverage. If I’m understanding this correctly, we are expanding the number of people covered and will be reducing the amount of services that will be covered by the insurance plans. I’m afraid Medicare (sans the Advantage Plan) and Medicaid will most likely end up being less than worthless in actual practice. It’s already a fight for every penny of coverage for a large number with disabilities. The government has a long history of denying claims at over 2x the rate of private insurers.

  • Joe

    Susan — from your article: “To be sure, the number of primary-care doctors who operate under the direct pay model remains relatively small.” I don’t see how this supports the assertion that a great majority of physicians are using the concierge model. Given that your article is from San Antonio and Grace is in California (I think?) I really don’t see how it has anything to do with anything.

    Oh man — I guess I am now part of the conversation I was purposefully avoiding …

  • Joe

    Susan — from your article: “To be sure, the number of primary-care doctors who operate under the direct pay model remains relatively small.” I don’t see how this supports the assertion that a great majority of physicians are using the concierge model. Given that your article is from San Antonio and Grace is in California (I think?) I really don’t see how it has anything to do with anything.

    Oh man — I guess I am now part of the conversation I was purposefully avoiding …

  • http://www.toddstadler.com/ tODD

    Joe (@125, 127), fair enough, I over-reached with “only the wealthiest” (@122).

    That said, as more and more employees are being asked to pay out-of-pocket for (a small or large portion of) their employer’s health insurance plan, I’d be surprised to find that many who are not well-to-do would pay an additional four-figure annual fee to get preferential treatment from a doctor.

    Susan (@128), the article you link to backs up my point:

    Norris and Rodriguez are part of a small but expanding segment of primary-care physicians who have ditched health insurance for a “direct pay” model…

    Now contrast that with Grace’s statement (@120):

    A great majority of physicians here, use what is called the “Concierge Program”…

    Never mind that your article was about San Antonio, while the one I linked to was about San Diego, which is where Grace’s “here” is, more or less.

  • http://www.toddstadler.com/ tODD

    Joe (@125, 127), fair enough, I over-reached with “only the wealthiest” (@122).

    That said, as more and more employees are being asked to pay out-of-pocket for (a small or large portion of) their employer’s health insurance plan, I’d be surprised to find that many who are not well-to-do would pay an additional four-figure annual fee to get preferential treatment from a doctor.

    Susan (@128), the article you link to backs up my point:

    Norris and Rodriguez are part of a small but expanding segment of primary-care physicians who have ditched health insurance for a “direct pay” model…

    Now contrast that with Grace’s statement (@120):

    A great majority of physicians here, use what is called the “Concierge Program”…

    Never mind that your article was about San Antonio, while the one I linked to was about San Diego, which is where Grace’s “here” is, more or less.

  • Grace

    Thank you Susan.

    Sometimes the “Concierge Program” is used in conjuction with the patients insurance. There are many different options.

    I believe, after observing and talking to many people in all walks of life. People choose how and what they will spend their money on. There are those who gamble, that they will not become ill, and therefore feel no need to invest in health insurance – EVEN THOUGH, they could afford it, IF, they didn’t squander their money on other things which are not necessities.

    I have talked to those who don’t have health insurance. They could pay for it, but feel the government should pay for their health insurance. They see no reason why they shouldn’t CASH IN, and make those who have more, pay their way.

  • Grace

    Thank you Susan.

    Sometimes the “Concierge Program” is used in conjuction with the patients insurance. There are many different options.

    I believe, after observing and talking to many people in all walks of life. People choose how and what they will spend their money on. There are those who gamble, that they will not become ill, and therefore feel no need to invest in health insurance – EVEN THOUGH, they could afford it, IF, they didn’t squander their money on other things which are not necessities.

    I have talked to those who don’t have health insurance. They could pay for it, but feel the government should pay for their health insurance. They see no reason why they shouldn’t CASH IN, and make those who have more, pay their way.

  • Grace

    tODD @ 132

    YOU WROTE: “Never mind that your article was about San Antonio, while the one I linked to was about San Diego, which is where Grace’s “here” is, more or less.”

    No tODD, I’ve never lived in the city of San Diego.

  • Grace

    tODD @ 132

    YOU WROTE: “Never mind that your article was about San Antonio, while the one I linked to was about San Diego, which is where Grace’s “here” is, more or less.”

    No tODD, I’ve never lived in the city of San Diego.

  • http://www.toddstadler.com/ tODD

    Grace (@134), I said “more or less”. It’s clear you live in an affluent part of Southern California, whatever the actual city you happen to reside in is.

  • http://www.toddstadler.com/ tODD

    Grace (@134), I said “more or less”. It’s clear you live in an affluent part of Southern California, whatever the actual city you happen to reside in is.

  • Klasie Kraalogies

    Concierge Doctors which are members of the AAPP:

    Alabama: none
    Alaska: none
    Arizona: 8
    ….
    Minnesota: 3
    ….
    Texas: 12
    ….
    Wisconsin: 1

    Note, the AAPP provdes the highest estimates of the number of Concierge doctors in the US – 5000. Other estimates go as low as 800.

    According to the AMA, there is 814000 registered physicians in the US. So, the percentage doctors that are concierge doctors, ranges from 0.0098% to 0.006%. Precisely what you’d expect with a unregulated, rare phenomenon (ultra low percentages, widely scattered estimates).

    Thus:

    Grace lives in a bubble. QED.

  • Klasie Kraalogies

    Concierge Doctors which are members of the AAPP:

    Alabama: none
    Alaska: none
    Arizona: 8
    ….
    Minnesota: 3
    ….
    Texas: 12
    ….
    Wisconsin: 1

    Note, the AAPP provdes the highest estimates of the number of Concierge doctors in the US – 5000. Other estimates go as low as 800.

    According to the AMA, there is 814000 registered physicians in the US. So, the percentage doctors that are concierge doctors, ranges from 0.0098% to 0.006%. Precisely what you’d expect with a unregulated, rare phenomenon (ultra low percentages, widely scattered estimates).

    Thus:

    Grace lives in a bubble. QED.

  • Grace

    tODD,

    I’m not interested in your assumptions.

  • Grace

    tODD,

    I’m not interested in your assumptions.

  • Klasie Kraalogies

    Sorry, that last number should be o.6%.

  • Klasie Kraalogies

    Sorry, that last number should be o.6%.

  • Grace

    KK

    You have no idea how unlearned you are, concerning the AMA, or the way medicine works here in the United States.

    Your GOOGLE routine, is sophomoric.

  • Grace

    KK

    You have no idea how unlearned you are, concerning the AMA, or the way medicine works here in the United States.

    Your GOOGLE routine, is sophomoric.

  • Grace

    Can we get back on SUBJECT, or are all the kiddies, bound and determined to play their “bubble game” ? :razz:

  • Grace

    Can we get back on SUBJECT, or are all the kiddies, bound and determined to play their “bubble game” ? :razz:

  • Cincinnatus

    Grace@139:

    Hahahahaha. Ok, you’re allowed to stay if you’re always this hilarious.

    But seriously, I’m inclined to believe KK because he actually provided data. I’ll believe you if you can demonstrate that’s he’s wrong. Meanwhile, it seems that “concierge doctors” represent an extreme minority of the medical profession, and aren’t really a relevant phenomenon when discussing Obamacare.

  • Cincinnatus

    Grace@139:

    Hahahahaha. Ok, you’re allowed to stay if you’re always this hilarious.

    But seriously, I’m inclined to believe KK because he actually provided data. I’ll believe you if you can demonstrate that’s he’s wrong. Meanwhile, it seems that “concierge doctors” represent an extreme minority of the medical profession, and aren’t really a relevant phenomenon when discussing Obamacare.

  • Klasie Kraalogies

    This coming from the “grab quotes”, is really funny.

    Can you disprove the data though? Merely saying something is off, is not the same as proving it is wrong.

  • Klasie Kraalogies

    This coming from the “grab quotes”, is really funny.

    Can you disprove the data though? Merely saying something is off, is not the same as proving it is wrong.

  • http://www.toddstadler.com/ tODD

    Grace (@137), it’s not an assumption. You’ve admitted to living in Southern California. That you live in an affluent area certainly isn’t hard to deduce, either, as this thread demonstrates.

    But the point wasn’t to sniff out your current physical location. It was to demonstrate that your claims here have little bearing on most people’s reality. As others have also shown.

  • http://www.toddstadler.com/ tODD

    Grace (@137), it’s not an assumption. You’ve admitted to living in Southern California. That you live in an affluent area certainly isn’t hard to deduce, either, as this thread demonstrates.

    But the point wasn’t to sniff out your current physical location. It was to demonstrate that your claims here have little bearing on most people’s reality. As others have also shown.

  • Klasie Kraalogies

    My editing is horrible today. Meant to say”the Queen of grab quotes”…

  • Klasie Kraalogies

    My editing is horrible today. Meant to say”the Queen of grab quotes”…

  • Grace

    KK,

    I find going down bunnie trails, just to prove you wrong is boring. There are times when it serves a purpose, but this isn’t one of them.

  • Grace

    KK,

    I find going down bunnie trails, just to prove you wrong is boring. There are times when it serves a purpose, but this isn’t one of them.

  • http://www.toddstadler.com/ tODD

    Klasie (@144), and that is as close to an admission of error as you will ever get from Grace! Enjoy it!

  • http://www.toddstadler.com/ tODD

    Klasie (@144), and that is as close to an admission of error as you will ever get from Grace! Enjoy it!

  • Cincinnatus

    Grace@145: According to studies/surveys conducted by Georgetown University and the University of Chicago, there are only 500 concierge doctors in the United States (out of over 800,000 doctors total).

    Unless you can find data that refutes this study, it seems that concierge doctors are basically an irrelevant consideration, both as regards this discussion, as regards the future of American medicine, and as regards the lives of most ordinary citizens.

    Concierge doctors are an interesting idea, but it would seem that the ACA renders them even more irrelevant, since very few people are going to elect to pay the mandate penalty and whatever fees a concierge doctor prefers. It would be more cost effective just to purchase insurance. (This is on top of the fact that concierge doctors are usually consulted as a supplement to full insurance plans, not as a free-standing option to full insurance.)

  • Cincinnatus

    Grace@145: According to studies/surveys conducted by Georgetown University and the University of Chicago, there are only 500 concierge doctors in the United States (out of over 800,000 doctors total).

    Unless you can find data that refutes this study, it seems that concierge doctors are basically an irrelevant consideration, both as regards this discussion, as regards the future of American medicine, and as regards the lives of most ordinary citizens.

    Concierge doctors are an interesting idea, but it would seem that the ACA renders them even more irrelevant, since very few people are going to elect to pay the mandate penalty and whatever fees a concierge doctor prefers. It would be more cost effective just to purchase insurance. (This is on top of the fact that concierge doctors are usually consulted as a supplement to full insurance plans, not as a free-standing option to full insurance.)

  • DonS

    Concierge medicine is an interesting, though tiny, part of medical practice. There’s even a cable TV show about a concierge practice on the USA Network — Royal Pains.

    I don’t see concierge practices becoming a significant part of medicine any time soon, but I bet they will grow substantially as Obamacare continues to kick in. Wealthier people are not going to be satisfied with rationed managed care. We see this in the UK, with its private health care system for the wealthier population and NHS for everyone else.

    Short of concierge practices, which take only a very limited number of patients to ensure access, are cash-only, and require retainers, we will see an explosion of medical practices which are cash-only. Physicians are fed up with the paperwork, long wait times for payments, and very low reimbursement schedules attendant to managed care. A friend of mine is in a local emergency room practice, and tells me that they are only reimbursed about $8-10 per patient for routine ER visits by patients covered under Medi-Cal, California’s version of Medicaid. That’s obviously absurd, and these kinds of very low schedules are a large reason why so few practices contract with Medicaid and Medicare in our area.

    By the way, I believe that Grace has said in the past that she lives on the West Side in Los Angeles.

  • DonS

    Concierge medicine is an interesting, though tiny, part of medical practice. There’s even a cable TV show about a concierge practice on the USA Network — Royal Pains.

    I don’t see concierge practices becoming a significant part of medicine any time soon, but I bet they will grow substantially as Obamacare continues to kick in. Wealthier people are not going to be satisfied with rationed managed care. We see this in the UK, with its private health care system for the wealthier population and NHS for everyone else.

    Short of concierge practices, which take only a very limited number of patients to ensure access, are cash-only, and require retainers, we will see an explosion of medical practices which are cash-only. Physicians are fed up with the paperwork, long wait times for payments, and very low reimbursement schedules attendant to managed care. A friend of mine is in a local emergency room practice, and tells me that they are only reimbursed about $8-10 per patient for routine ER visits by patients covered under Medi-Cal, California’s version of Medicaid. That’s obviously absurd, and these kinds of very low schedules are a large reason why so few practices contract with Medicaid and Medicare in our area.

    By the way, I believe that Grace has said in the past that she lives on the West Side in Los Angeles.

  • http://www.toddstadler.com/ tODD

    Anyhow, Joe (@105), your suggestion is quite troubling, even if it were true (and yes, you did allude to this yourself).

    Basically, what you’re suggesting is that Roberts abnegated his responsibility to rule on the specifics of the law in question (vis-a-vis the Constitution), and instead played pure politics with complete disregard for the actual texts involved — the very thing “conservative” justices are, you know, not supposed to do.

    Also, there’s this (@107):

    The it’s a tax holding was the way to uphold the law with doing the least damage to the constitution. Whether something is a tax or a penalty is driven largely by unique aspects of the law at issue, so future courts will be able to limit the reach of the holding in this case by finding differences in the future laws that attempt to use the taxing power.

    That reasoning would make more sense … if we didn’t have the bizarre example that is the ACA. If the ACA’s obvious non-tax penalty can, somehow, be found to be a tax in spite of all the facts (and thereby avoid questions about the Commerce Clause), then any monetary demand from the government could be found to be a tax (not a penalty).

    So how does that limit the damage to the Constitution?

  • http://www.toddstadler.com/ tODD

    Anyhow, Joe (@105), your suggestion is quite troubling, even if it were true (and yes, you did allude to this yourself).

    Basically, what you’re suggesting is that Roberts abnegated his responsibility to rule on the specifics of the law in question (vis-a-vis the Constitution), and instead played pure politics with complete disregard for the actual texts involved — the very thing “conservative” justices are, you know, not supposed to do.

    Also, there’s this (@107):

    The it’s a tax holding was the way to uphold the law with doing the least damage to the constitution. Whether something is a tax or a penalty is driven largely by unique aspects of the law at issue, so future courts will be able to limit the reach of the holding in this case by finding differences in the future laws that attempt to use the taxing power.

    That reasoning would make more sense … if we didn’t have the bizarre example that is the ACA. If the ACA’s obvious non-tax penalty can, somehow, be found to be a tax in spite of all the facts (and thereby avoid questions about the Commerce Clause), then any monetary demand from the government could be found to be a tax (not a penalty).

    So how does that limit the damage to the Constitution?

  • Susan

    @Joe

    I feel for ya – I have found myself stepping into things too. I posted that link fairly quickly because it rebuts the ‘only the wealthy’ charge and I get tired of the childish gotcha behavior towards Grace. Anecdotally, I can tell you I have been hearing a lot about retainer medicine the last few years (both from doctors and others) and I have several doctors who are cash only (time of appointment not retainer) and who no longer accept new patients insured by the government. According to what I’ve read, around 20% of doctors are expected to retire within the next 10 years.

  • Susan

    @Joe

    I feel for ya – I have found myself stepping into things too. I posted that link fairly quickly because it rebuts the ‘only the wealthy’ charge and I get tired of the childish gotcha behavior towards Grace. Anecdotally, I can tell you I have been hearing a lot about retainer medicine the last few years (both from doctors and others) and I have several doctors who are cash only (time of appointment not retainer) and who no longer accept new patients insured by the government. According to what I’ve read, around 20% of doctors are expected to retire within the next 10 years.

  • Susan

    @ tODD

    You seem to have missed: “Rodriguez is trying to build a new business model where patients pay $25 per month plus a $10 co-pay per visit, which includes an annual physical exam.” This supports the affordability claims and “New patient Natalie Grubb, a hairstylist with no insurance who “jumped at the chance” to sign up for care when she heard how the new plan works,” That support the claims that it can be used by uninsured persons. Lastly, you have missed the fact that this is national trend not one confined to a specific region. And, one that is growing with Obamacare looming.

  • Susan

    @ tODD

    You seem to have missed: “Rodriguez is trying to build a new business model where patients pay $25 per month plus a $10 co-pay per visit, which includes an annual physical exam.” This supports the affordability claims and “New patient Natalie Grubb, a hairstylist with no insurance who “jumped at the chance” to sign up for care when she heard how the new plan works,” That support the claims that it can be used by uninsured persons. Lastly, you have missed the fact that this is national trend not one confined to a specific region. And, one that is growing with Obamacare looming.

  • DonS

    tODD @ 149: The only speculation that has any support is that Roberts may have changed his position late during the consideration period, between the oral arguments and the issuance of the decision. There are indicia in the opinions, as Joe points out, that support this speculation to some extent. But, it is still speculation.

    There is not a shred of evidence to support the speculation that Roberts changed his position to “save the Court”. If he did change his mind after the initial drafts were written, there are a host of legitimate reasons, such as his being convinced by a particular argument, or something he read in an old case, that caused him to think about things in a different way than he did initially. No one will ever know, for sure, given the Court’s historic tradition of blanket secrecy concerning its deliberations.

    The tax argument didn’t come out of the blue. It was the argument the Obama Administration made right away, as an alternative to the Commerce Clause. The penalty is administered by the IRS and is income-dependent. It was called a tax by Republicans on the floor of Congress. Several lower court judges rendered decisions on the basis of it being a tax, including one who ruled, on the basis of the Anti-Injunction Act, that the lawsuit was premature because the tax had not yet come into effect. The only odd thing was that the Court allowed supporters of the law to get away with duping the people when the law was passed, claiming the penalty was not a tax, and then doing a 180 when defending the law in court and asserting that it was a tax after all. But Roberts’ view was that a tax is a tax, no matter how it was labeled.

  • DonS

    tODD @ 149: The only speculation that has any support is that Roberts may have changed his position late during the consideration period, between the oral arguments and the issuance of the decision. There are indicia in the opinions, as Joe points out, that support this speculation to some extent. But, it is still speculation.

    There is not a shred of evidence to support the speculation that Roberts changed his position to “save the Court”. If he did change his mind after the initial drafts were written, there are a host of legitimate reasons, such as his being convinced by a particular argument, or something he read in an old case, that caused him to think about things in a different way than he did initially. No one will ever know, for sure, given the Court’s historic tradition of blanket secrecy concerning its deliberations.

    The tax argument didn’t come out of the blue. It was the argument the Obama Administration made right away, as an alternative to the Commerce Clause. The penalty is administered by the IRS and is income-dependent. It was called a tax by Republicans on the floor of Congress. Several lower court judges rendered decisions on the basis of it being a tax, including one who ruled, on the basis of the Anti-Injunction Act, that the lawsuit was premature because the tax had not yet come into effect. The only odd thing was that the Court allowed supporters of the law to get away with duping the people when the law was passed, claiming the penalty was not a tax, and then doing a 180 when defending the law in court and asserting that it was a tax after all. But Roberts’ view was that a tax is a tax, no matter how it was labeled.

  • Susan

    For those who can’t resist the childish gotcha games:

    The AAPP (American Academy of Private Physicians) is but one of a large number of medical organizations and limiting the survey to one organization is not adequate even though it is a specialty group targeting the concierge market. A few of the primary care provider categories that would need to be looked into: family physicians, internists, pediatricians, general practitioners, and the growing number of D.O.s (Doctor of Osteopathic Medicine). The alternative/complementary medicine physicians should also be included. A search of all the various organizations would need to be surveyed in order to start compiling some better estimates in retainer medicine. But one example would be: the AAFP (American Academy of Family Physicians) not to be confused with the AAPP.

    The 2010 study by Georgetown and Chicago, was drawn from a literature review as well as 28 interviews with experts in the field, beneficiary advocates, and individual physicians. The conservative estimate was 756 retainer‐based physicians (not 500), and the number of 756 was seen as a lower limit for the number of physicians practicing in this model of care. Two studies that the report relied on heavily are outdated (2004/2005). Some of the problems with the validity in the report numbers are clearly presented: “We compiled this list through lists available on the websites of the Society for Innovative Medical Practice Design, MDVIP, Concierge Choice, an online directory at http://conciergemds.com/, and news stories about retainer‐based care. Through these methods, we were able to identify 756 physicians listed as having a retainer‐based practice. It is important to note that this list represents a minimum number of physicians in this type of practice. It is likely that there are physicians who are practicing this model of care without being listed in any of these sources.” It should be noted that their survey was limited to 3 groups that self-identify, did not check for double entries of the same doctors within these groups, did not ask the organizations for updates, and did not attempt to survey any the other resources for primary care physicians to investigate whether the retainer medicine model was employed. Finally, it failed to look for growth and trends in the retainer model.

    Another correction for you: In 2010, there were approximately 209,000 practicing primary care physicians in the U.S. The number of 800,000 would most likely include the specialities in medicine.

  • Susan

    For those who can’t resist the childish gotcha games:

    The AAPP (American Academy of Private Physicians) is but one of a large number of medical organizations and limiting the survey to one organization is not adequate even though it is a specialty group targeting the concierge market. A few of the primary care provider categories that would need to be looked into: family physicians, internists, pediatricians, general practitioners, and the growing number of D.O.s (Doctor of Osteopathic Medicine). The alternative/complementary medicine physicians should also be included. A search of all the various organizations would need to be surveyed in order to start compiling some better estimates in retainer medicine. But one example would be: the AAFP (American Academy of Family Physicians) not to be confused with the AAPP.

    The 2010 study by Georgetown and Chicago, was drawn from a literature review as well as 28 interviews with experts in the field, beneficiary advocates, and individual physicians. The conservative estimate was 756 retainer‐based physicians (not 500), and the number of 756 was seen as a lower limit for the number of physicians practicing in this model of care. Two studies that the report relied on heavily are outdated (2004/2005). Some of the problems with the validity in the report numbers are clearly presented: “We compiled this list through lists available on the websites of the Society for Innovative Medical Practice Design, MDVIP, Concierge Choice, an online directory at http://conciergemds.com/, and news stories about retainer‐based care. Through these methods, we were able to identify 756 physicians listed as having a retainer‐based practice. It is important to note that this list represents a minimum number of physicians in this type of practice. It is likely that there are physicians who are practicing this model of care without being listed in any of these sources.” It should be noted that their survey was limited to 3 groups that self-identify, did not check for double entries of the same doctors within these groups, did not ask the organizations for updates, and did not attempt to survey any the other resources for primary care physicians to investigate whether the retainer medicine model was employed. Finally, it failed to look for growth and trends in the retainer model.

    Another correction for you: In 2010, there were approximately 209,000 practicing primary care physicians in the U.S. The number of 800,000 would most likely include the specialities in medicine.

  • Cincinnatus

    Two unrelated points:

    First, a new healthcare crisis is, in fact, approaching, and ACA only exacerbates/hastens it. Namely, many doctors cannot afford to treat Medicare and Medicaid patients, and some are switching to cash-only models. This will be an interesting and potentially disturbing phenomenon to observe over the next 5-10 years. Note, however, that cash-only models are distinct from concierge models.

    As for concierge medicine, I don’t see it catching on except for the wealthy. Sure, paying $25/month + a copay works for routine care and preventative medicine. But such fees will absolutely not cover the cost of, say, open-heart surgery, organ transplants, or cancer treatments. Which is why only the rich will be able to participate in a-la-carte schemes like this. Again, concierge medicine will work for minor tests and treatments; for example (and this is why our current model is unsustainble), my insurance recently billed us $720 for a routine ultrasound of our (soon-to-be)-child. Meanwhile, I could go to a boutique clinic in the city that only provides fetal ultrasounds for the affordable rate of $50. The outrageous cost of the insurance ultrasound is a result of a combination of price gouging (we charge this much because we can), an attempt to make up for Medicaid/care patients who don’t actually pay enough for the services they use, and the fact that insurance does and must cover every single medical procedure imaginable, leading to “overuse” of such services by insured patients (e.g., no need to go to a doctor and prescribed antibiotics for a cold–but I’m insured, so why not!).

    This is why, again, one of my proposed solutions is to abolish insurance coverage for routine and preventative care. Instead, most folks should pay out-of-pocket for things like doctor visits, routine blood tests, most non-chronic prescriptions, etc. Insurance should be restricted, as it once was, to major medical issues. This is why car insurance is relatively affordable: if I scratch my car, I pay for it. If I am in a serious accident, I have catastrophic insurance. Catastrophic accidents, like heart surgery, are comparatively rare, so insurance agencies aren’t on the hook for every accident (i.e., medical procedure) that ever occurs anywhere in America.

    Anyway, this is a bit far afield from ACA…

  • Cincinnatus

    Two unrelated points:

    First, a new healthcare crisis is, in fact, approaching, and ACA only exacerbates/hastens it. Namely, many doctors cannot afford to treat Medicare and Medicaid patients, and some are switching to cash-only models. This will be an interesting and potentially disturbing phenomenon to observe over the next 5-10 years. Note, however, that cash-only models are distinct from concierge models.

    As for concierge medicine, I don’t see it catching on except for the wealthy. Sure, paying $25/month + a copay works for routine care and preventative medicine. But such fees will absolutely not cover the cost of, say, open-heart surgery, organ transplants, or cancer treatments. Which is why only the rich will be able to participate in a-la-carte schemes like this. Again, concierge medicine will work for minor tests and treatments; for example (and this is why our current model is unsustainble), my insurance recently billed us $720 for a routine ultrasound of our (soon-to-be)-child. Meanwhile, I could go to a boutique clinic in the city that only provides fetal ultrasounds for the affordable rate of $50. The outrageous cost of the insurance ultrasound is a result of a combination of price gouging (we charge this much because we can), an attempt to make up for Medicaid/care patients who don’t actually pay enough for the services they use, and the fact that insurance does and must cover every single medical procedure imaginable, leading to “overuse” of such services by insured patients (e.g., no need to go to a doctor and prescribed antibiotics for a cold–but I’m insured, so why not!).

    This is why, again, one of my proposed solutions is to abolish insurance coverage for routine and preventative care. Instead, most folks should pay out-of-pocket for things like doctor visits, routine blood tests, most non-chronic prescriptions, etc. Insurance should be restricted, as it once was, to major medical issues. This is why car insurance is relatively affordable: if I scratch my car, I pay for it. If I am in a serious accident, I have catastrophic insurance. Catastrophic accidents, like heart surgery, are comparatively rare, so insurance agencies aren’t on the hook for every accident (i.e., medical procedure) that ever occurs anywhere in America.

    Anyway, this is a bit far afield from ACA…

  • DonS

    Amen, Cincinnatus @ 154. I’ve been making that same point for years. The cost of first dollar coverage of routine medical procedures is immense, in processing/administrative costs, as well as the resulting extreme burdens on practitioners, as they spend so much time managing paperwork and waiting for the much-reduced payments insurance companies offer them.

    Congratulations on your (soon-to-be) child!!

  • DonS

    Amen, Cincinnatus @ 154. I’ve been making that same point for years. The cost of first dollar coverage of routine medical procedures is immense, in processing/administrative costs, as well as the resulting extreme burdens on practitioners, as they spend so much time managing paperwork and waiting for the much-reduced payments insurance companies offer them.

    Congratulations on your (soon-to-be) child!!

  • Cincinnatus

    Oh, and my second point is this:

    Supreme Court justices, for better or worse, fairly regularly make and even change their decisions on important cases in the last moments. This is probably for the worse, but it happens nonetheless. The memos and letters, often sternly-worded, often embarrassing, passed between Justices in the course of formulating majority opinions–pressuring other Justices to support the majority, castigating dissenters for their errors, which errors are often not even legal or philosophical but ideological–is a rather disturbing study in political calculus. All this to say that social scientists have long recognized and acknowledged that Supreme Court Justices are no less “political” than their counterparts in the other branches of government. They are certainly not the impartial demigods imagined by their admirers.

    And Susan, are you a slightly smarter/much more articulate version of Grace or something? Did she hire you? I don’t understand your motives for “defending” Grace. If you’ve been here a while, you know–and should know even from this thread alone–that she has a habit of derailing threads with a combination of idiosyncratic speculation (Roberts ruled as he did because he was on some kind of medication), monomaniacal obsessions (ROMNEY IS A MORMON CONSPIRATOR), oddly formatted and irrelevant quotations (cf. the innumerable examples earlier in the thread), ad hominem attacks (“only kids use the term ‘foil-wearing’”), obviously fallacious claims (a “large majority” of doctors are using the concierge model), and general silliness. I wouldn’t bother if I were you.

    Besides, Grace claimed, as I noted, that a “large majority” of doctors are concierge doctors. This claim is facially absurd; tODD and I provided evidence just as a courtesy. Are you really attempting to prove Grace right?

  • Cincinnatus

    Oh, and my second point is this:

    Supreme Court justices, for better or worse, fairly regularly make and even change their decisions on important cases in the last moments. This is probably for the worse, but it happens nonetheless. The memos and letters, often sternly-worded, often embarrassing, passed between Justices in the course of formulating majority opinions–pressuring other Justices to support the majority, castigating dissenters for their errors, which errors are often not even legal or philosophical but ideological–is a rather disturbing study in political calculus. All this to say that social scientists have long recognized and acknowledged that Supreme Court Justices are no less “political” than their counterparts in the other branches of government. They are certainly not the impartial demigods imagined by their admirers.

    And Susan, are you a slightly smarter/much more articulate version of Grace or something? Did she hire you? I don’t understand your motives for “defending” Grace. If you’ve been here a while, you know–and should know even from this thread alone–that she has a habit of derailing threads with a combination of idiosyncratic speculation (Roberts ruled as he did because he was on some kind of medication), monomaniacal obsessions (ROMNEY IS A MORMON CONSPIRATOR), oddly formatted and irrelevant quotations (cf. the innumerable examples earlier in the thread), ad hominem attacks (“only kids use the term ‘foil-wearing’”), obviously fallacious claims (a “large majority” of doctors are using the concierge model), and general silliness. I wouldn’t bother if I were you.

    Besides, Grace claimed, as I noted, that a “large majority” of doctors are concierge doctors. This claim is facially absurd; tODD and I provided evidence just as a courtesy. Are you really attempting to prove Grace right?

  • Klasie Kraalogies

    Susan @153 – and if you browsed through the list of concierge doctors at the AAPP, you’ll find that it also includes specialists. Thus my % calculation earlier stands.

    Grace @ 145: You are an unmitigated, arrogant, know nothing whatsisname: When facts prove you wrong, you say it is boring to investigate. When your statements are proven wrong, you attack the person. When your logic is proven wrong, you again attack the individual proving it. Now, whereas these kinds of tactics are common on the internet, they are not common here. You are essentially loud wallpaper here. Or a nice target for comic sport (and it is really funny that you have never realized that it is the main reason a lot of us interact with you).

    Don’t you have any self respect??

  • Klasie Kraalogies

    Susan @153 – and if you browsed through the list of concierge doctors at the AAPP, you’ll find that it also includes specialists. Thus my % calculation earlier stands.

    Grace @ 145: You are an unmitigated, arrogant, know nothing whatsisname: When facts prove you wrong, you say it is boring to investigate. When your statements are proven wrong, you attack the person. When your logic is proven wrong, you again attack the individual proving it. Now, whereas these kinds of tactics are common on the internet, they are not common here. You are essentially loud wallpaper here. Or a nice target for comic sport (and it is really funny that you have never realized that it is the main reason a lot of us interact with you).

    Don’t you have any self respect??

  • Cincinnatus

    DonS: Thanks for the endorsement, and I see that you had already made my point earlier in the thread. In any case, our current health insurance model is like an auto insurance policy that covers gasoline fill-ups and oil changes. Except with layers and layers and layers of bureaucracy and government fiat piled on top. It’s absurd and unsustainable.

  • Cincinnatus

    DonS: Thanks for the endorsement, and I see that you had already made my point earlier in the thread. In any case, our current health insurance model is like an auto insurance policy that covers gasoline fill-ups and oil changes. Except with layers and layers and layers of bureaucracy and government fiat piled on top. It’s absurd and unsustainable.

  • Grace

    Susan @ 150

    “According to what I’ve read, around 20% of doctors are expected to retire within the next 10 years.”

    They aren’t necessarily going to “retire” (many are well below the age, most physicians retire) – what they are doing is, using their medical backgrounds, and going into business, with other doctors. This would include care facilities, either full nursing, assisted care facilities, and other venues, within their profession. The doctors are well acquainted with the surrounding hospitals, and know most all the doctors – this gives them all the contacts for a successful transition from their practice into another area.

  • Grace

    Susan @ 150

    “According to what I’ve read, around 20% of doctors are expected to retire within the next 10 years.”

    They aren’t necessarily going to “retire” (many are well below the age, most physicians retire) – what they are doing is, using their medical backgrounds, and going into business, with other doctors. This would include care facilities, either full nursing, assisted care facilities, and other venues, within their profession. The doctors are well acquainted with the surrounding hospitals, and know most all the doctors – this gives them all the contacts for a successful transition from their practice into another area.

  • Grace

    KK @ 157

    You have no first hand knowledge of the medical profession in Southern California. This is a common practice, or attitude from those who live, either in another country, (as you do) or they try and guess or google their way down the road. It’s far more complicated.

    Because we have very good friends in the medical community, we know what the situation is. I talked with one of my friends (female speciality doctor) just this afternoon, regarding the Health Bill – the doctors are not going to go along with it. There are ways to circumvent the problem.

  • Grace

    KK @ 157

    You have no first hand knowledge of the medical profession in Southern California. This is a common practice, or attitude from those who live, either in another country, (as you do) or they try and guess or google their way down the road. It’s far more complicated.

    Because we have very good friends in the medical community, we know what the situation is. I talked with one of my friends (female speciality doctor) just this afternoon, regarding the Health Bill – the doctors are not going to go along with it. There are ways to circumvent the problem.

  • Grace

    The “Concierge program” is mainly something Internists and primary care physicians institute within their practice. Some of these doctors share offices with other physicians, who have specialties, such as OB/GYN, Dermatologie, Gastroenterology, Urology, and a host of other specialties.

    Those who are specialists don’t have a “Concierge program” to my knowledge – if they do, I am not aware of it.

  • Grace

    The “Concierge program” is mainly something Internists and primary care physicians institute within their practice. Some of these doctors share offices with other physicians, who have specialties, such as OB/GYN, Dermatologie, Gastroenterology, Urology, and a host of other specialties.

    Those who are specialists don’t have a “Concierge program” to my knowledge – if they do, I am not aware of it.

  • Grace

    This is what I believe will be the next step:

    The older idea of “The Clinic” – where people can go, be seen, evaluated, examined, and receive care. This will eliminate what is known as “private physicians” for people under a much less expensive medical plan – this will enable those who do not have insurance, but are subsidized by the government to receive medical care.

  • Grace

    This is what I believe will be the next step:

    The older idea of “The Clinic” – where people can go, be seen, evaluated, examined, and receive care. This will eliminate what is known as “private physicians” for people under a much less expensive medical plan – this will enable those who do not have insurance, but are subsidized by the government to receive medical care.

  • Klasie Kraalogies

    Grace – remember those words next time we discuss RussiaCanadaUKItalyFranceSouthAfricaIranIsraelJapanChinaNigeriaMexicoGuatemalaAustraliaIndiaEgyptSyriaNorthKoreaSpainGreeceDenmarkSwedenIrelandZimbabweNamibiaDRCRwandaKenyaArgentinaBrazilVaticanAustriaNepal………………………………….

    Or ScieceEvolutionGeologyStatisticsLutheranismCatholicsimSpaceStarsRomanEmpireZoologyCalvinismBuddhismEngineeringArchitecture…….

    Or
    PoliticsEconomicsSocialismKeneysianismMaoismMonarchy…..

    If you don’t live there, or have a qualification in it, we would appreciate YOUR silence, Grace.

  • Klasie Kraalogies

    Grace – remember those words next time we discuss RussiaCanadaUKItalyFranceSouthAfricaIranIsraelJapanChinaNigeriaMexicoGuatemalaAustraliaIndiaEgyptSyriaNorthKoreaSpainGreeceDenmarkSwedenIrelandZimbabweNamibiaDRCRwandaKenyaArgentinaBrazilVaticanAustriaNepal………………………………….

    Or ScieceEvolutionGeologyStatisticsLutheranismCatholicsimSpaceStarsRomanEmpireZoologyCalvinismBuddhismEngineeringArchitecture…….

    Or
    PoliticsEconomicsSocialismKeneysianismMaoismMonarchy…..

    If you don’t live there, or have a qualification in it, we would appreciate YOUR silence, Grace.

  • Grace

    KK

    I sure hope you’re OK – take it easy. :razz:

  • Grace

    KK

    I sure hope you’re OK – take it easy. :razz:

  • Grace

    Doctors spend far more time going to school then most other people, in other fields. For this reason, they should receive more compensation for their services, and dedication, but alas the majority of people are angered by this.

    You cannot expect men and women to run up high education bills, go to university, medical school. Then intern, staying up 20 hours straight, on a regular basis, and then choose a specialty which again, puts them into an internship, with long hours for several years. When they begin practicing they have to repay many of their education loans, even if much of it was scholarship, that doesn’t cover all the rest.

    The vast majority of our population have no idea what all this entails – what they see, is the financial results of an individual’s lifestyle, after they’ve spent years and years in university, and hospital internships. Then there is the constant interruption of sleep, especially for Internists, OB/GYN and those who are Cardiologist, and other specialties, whose patients OR emergency referrals, require immediate attention, often resulting in a unexpected surgery, long before dawn breaks that morning.

    After all this, one can see, doctors are not anxious to make every accommodation for the NEW health care Bill – they are getting the shaft for all their hard work, and all the animosity that’s thrown their way.

  • Grace

    Doctors spend far more time going to school then most other people, in other fields. For this reason, they should receive more compensation for their services, and dedication, but alas the majority of people are angered by this.

    You cannot expect men and women to run up high education bills, go to university, medical school. Then intern, staying up 20 hours straight, on a regular basis, and then choose a specialty which again, puts them into an internship, with long hours for several years. When they begin practicing they have to repay many of their education loans, even if much of it was scholarship, that doesn’t cover all the rest.

    The vast majority of our population have no idea what all this entails – what they see, is the financial results of an individual’s lifestyle, after they’ve spent years and years in university, and hospital internships. Then there is the constant interruption of sleep, especially for Internists, OB/GYN and those who are Cardiologist, and other specialties, whose patients OR emergency referrals, require immediate attention, often resulting in a unexpected surgery, long before dawn breaks that morning.

    After all this, one can see, doctors are not anxious to make every accommodation for the NEW health care Bill – they are getting the shaft for all their hard work, and all the animosity that’s thrown their way.

  • Dust

    KK above…re: WE would blah, blah, blah….please make that “we” minus ME, thank very much :)

    cheers!

  • Dust

    KK above…re: WE would blah, blah, blah….please make that “we” minus ME, thank very much :)

    cheers!

  • Susan

    @Grace

    Byron York’s article was interesting. There are so many parts and pieces in the Obamacare story. I would hate to be the person trying to document it and write an historical account from start to finish.

    You are right about the variety situation people are in who use a concierge physician. From what I’ve read, it sounds like it is a good arrangement for both doctor and patient. As the San Antonio article reported, uninsured or insured, rich or not. And right about the gambling. No insurance is a gamble we won’t need it. The insurance companies look at our records and do a risk analysis to set our premium rates gambling they will make money on us and not lose money.

    What I have found interesting is how many options there are if you choose to not use health insurance. There are a wealth of non-traditional doctors in my area that have helped a few of the people I know with chronic illness that could not seem to regain their health through traditional medicine. I can see the concierge medicine being a blessing for those with chronic illness.

    tODD’s link to you was interesting. The AAPP estimated that about 3,500 physicians are using some form of the concierge model. They also estimate: there has been a 50 percent annual growth in the number of concierge physicians across the country. I would hazard the guess that the numbers may be growing even more quickly now that medicine has become politicized.

  • SKPeterson

    So, after perusing the posts, I have one question: Can I secede now?

  • Susan

    @Grace

    Byron York’s article was interesting. There are so many parts and pieces in the Obamacare story. I would hate to be the person trying to document it and write an historical account from start to finish.

    You are right about the variety situation people are in who use a concierge physician. From what I’ve read, it sounds like it is a good arrangement for both doctor and patient. As the San Antonio article reported, uninsured or insured, rich or not. And right about the gambling. No insurance is a gamble we won’t need it. The insurance companies look at our records and do a risk analysis to set our premium rates gambling they will make money on us and not lose money.

    What I have found interesting is how many options there are if you choose to not use health insurance. There are a wealth of non-traditional doctors in my area that have helped a few of the people I know with chronic illness that could not seem to regain their health through traditional medicine. I can see the concierge medicine being a blessing for those with chronic illness.

    tODD’s link to you was interesting. The AAPP estimated that about 3,500 physicians are using some form of the concierge model. They also estimate: there has been a 50 percent annual growth in the number of concierge physicians across the country. I would hazard the guess that the numbers may be growing even more quickly now that medicine has become politicized.

  • SKPeterson

    So, after perusing the posts, I have one question: Can I secede now?

  • Susan

    @ Cincinnatus

    Considering how you try to bait Grace, perhaps she deserves more credit than you give her. And considering the boorish behavior you display towards her, she seems quite mild and goodnatured in her replies. Apparently, you seem to think you own the blog and should judge who is worthy to comment and lack any tolerance for those you deem your inferiors. Quite the attitude. I don’t see your use of facts or ability to be coherent as necessarily superior. You don’t seem to consider the errors you have posted or that you were proved wrong on a few things. I don’t see that as a problem since any of us can be prone to skimming instead of reading and make ordinary mistakes. The problem is the snotty “gotcha game” and the inability to restrain yourself and let go of things. It certainly makes you look petty, vain, and gauche. You have a choice what you type on your keyboard and have a delete key.

    In the past, my commenting on this blog has been semi-rare. The last few weeks have been unusual for me. I’ve been commenting more mainly because of the topics related to the SC cases. I may be tempted to stay so I can remind you to behave yourself.

  • Susan

    @ Cincinnatus

    Considering how you try to bait Grace, perhaps she deserves more credit than you give her. And considering the boorish behavior you display towards her, she seems quite mild and goodnatured in her replies. Apparently, you seem to think you own the blog and should judge who is worthy to comment and lack any tolerance for those you deem your inferiors. Quite the attitude. I don’t see your use of facts or ability to be coherent as necessarily superior. You don’t seem to consider the errors you have posted or that you were proved wrong on a few things. I don’t see that as a problem since any of us can be prone to skimming instead of reading and make ordinary mistakes. The problem is the snotty “gotcha game” and the inability to restrain yourself and let go of things. It certainly makes you look petty, vain, and gauche. You have a choice what you type on your keyboard and have a delete key.

    In the past, my commenting on this blog has been semi-rare. The last few weeks have been unusual for me. I’ve been commenting more mainly because of the topics related to the SC cases. I may be tempted to stay so I can remind you to behave yourself.

  • Susan

    @ Klassie,

    Please reread what I wrote. AAPP is only one organization of several organization with doctors who are using the retainer model. The other organizations’ numbers would need to be included in the total not to mention the need to survey other physician’s groups. The Georgetown/Chicago report used 3 other concierge groups and all 4 groups would need to be cross checked for duplicates. So, yes, the numbers you are relying on are off. And, no, your calculation doesn’t stand. You will need to refigure the numbers to come up with numbers that acknowledge the differences in the specialties and break them down otherwise the numbers are pretty vague/useless. There is a difference if 2000 of 200,000 primary care physicians employ retainer models and 3,500 out of 800,000 total doctors use retainer models. If you read the link tODD gave to Grace, you will see some more interesting information there. In that article the estimate from AAPP is that 3500 doctors are using some form of the retainer model. I’m guessing you understand why statistics don’t mean much/anything if the methodology stinks.

    It might be best to learn to love the wallpaper and appreciate the good qualities. Until then, let it go. The behavior you men are displaying is worthy of the woodshed.

  • Susan

    @ Klassie,

    Please reread what I wrote. AAPP is only one organization of several organization with doctors who are using the retainer model. The other organizations’ numbers would need to be included in the total not to mention the need to survey other physician’s groups. The Georgetown/Chicago report used 3 other concierge groups and all 4 groups would need to be cross checked for duplicates. So, yes, the numbers you are relying on are off. And, no, your calculation doesn’t stand. You will need to refigure the numbers to come up with numbers that acknowledge the differences in the specialties and break them down otherwise the numbers are pretty vague/useless. There is a difference if 2000 of 200,000 primary care physicians employ retainer models and 3,500 out of 800,000 total doctors use retainer models. If you read the link tODD gave to Grace, you will see some more interesting information there. In that article the estimate from AAPP is that 3500 doctors are using some form of the retainer model. I’m guessing you understand why statistics don’t mean much/anything if the methodology stinks.

    It might be best to learn to love the wallpaper and appreciate the good qualities. Until then, let it go. The behavior you men are displaying is worthy of the woodshed.

  • Michael B.

    I wish I had been the person who would have been allowed to post new stories to the blog. I would post a story about what happens to people who aren’t healthy and don’t have health insurance. And while I’m doing some wishful thinking, wouldn’t it’d be great to see people on here have the same kind of outrage towards their plight as they do toward 2 queers getting married or a tax increase? “How outrageous!”, they would say — “We live in one of the richest countries in the world, and yet many of our citizens lack proper medical care!”. One day we could even expand the conversation world-wide. For every one story we have about queers or birth control, we’d hear another about how some American Christians are building multi-million dollar new churches while Christians in other countries live in filth.

  • Michael B.

    I wish I had been the person who would have been allowed to post new stories to the blog. I would post a story about what happens to people who aren’t healthy and don’t have health insurance. And while I’m doing some wishful thinking, wouldn’t it’d be great to see people on here have the same kind of outrage towards their plight as they do toward 2 queers getting married or a tax increase? “How outrageous!”, they would say — “We live in one of the richest countries in the world, and yet many of our citizens lack proper medical care!”. One day we could even expand the conversation world-wide. For every one story we have about queers or birth control, we’d hear another about how some American Christians are building multi-million dollar new churches while Christians in other countries live in filth.

  • Cincinnatus

    Susan,

    1) I baited Grace? I–along with tODD, kk, and others who are generally tired of her “participation” on this blog–am the enemy of thoughtful discourse here? Ok, sure. mea culpa. I give in. Apologies all around. Once again, Grace fulfills the dictates of her nomenclature in brilliant fashion, and we, we scoffers have been humiliated.

    2) I’m proven wrong quite regularly on this blog and elsewhere, and I’m always willing to admit it. But where in this thread have I been guilty of “errors” and been “proven wrong”? Do tell. So far, most commenters have generally agreed with my analysis, and those who haven’t have done so on theoretical or political, not factual, grounds (i.e., on grounds where “correctness” doesn’t pertain). At most, you’ve tried to show that there are slightly more concierge doctors than I claimed (and my claim, by the way, was a direct citation from a scholarly article). So what? What does that have to do with anything? Fine, there are possibly several more than 500 concierge doctors–3500, by your (rather tortuous) estimate. Potato, potahto. They still represent a miniscule portion of the healthcare market, and they have literally nothing to do with the ACA. Let’s move on to a more relevant topic. Like, say, the Supreme Court decision, in which you claim to be deeply interested.

    You’re investing all this effort defending an hilariously dramatic and completely irrelevant overstatement by Grace (that a “great majority” of doctors use the concierge model)–along with, apparently, her risible “response” to its critics–and yet I’m the villain for calling her claim into question (actually tODD did it first). All while ignoring her ridiculous intimations that Roberts was under the influence of medication and that none of this would have happened if Grace hadn’t been on vacation at the time! I mean, really? Grace has actually implied in this thread that she is the reason that Obamacare was not overturned, and that if she had only been around, Roberts wouldn’t have been taking medication which confused him and caused him to write an opinion that he couldn’t possibly agree with. This is what you’re defending?

    I look forward to your returning and defending Grace when she insists–nay, spams a thread by repeating ad nauseam–that Luther was a vicious anti-Semite, Romney is a wicked Mormon conspirator-overlord, and all who disagree with her illegible quotations are ignorant children of some kind. And then insults anyone who challenges her often incoherent claims while refusing to engage any counterarguments. Oh, and while peppering her comments with insane formatting, syntax, and punctuation that would receive a generous “F” in any middle school composition class. Her last comment in this thread is one of the most coherent, measured things she’s ever said–the bit about doctor salaries–but it has literally nothing to do with anything that’s been discussed in this thread heretofore! And it’s almost impossible to read to boot.

    Still, nonetheless, I am the hate-baiting enemy of thoughtful discussion.

    Why am I bothering to defend myself here?

  • Cincinnatus

    Susan,

    1) I baited Grace? I–along with tODD, kk, and others who are generally tired of her “participation” on this blog–am the enemy of thoughtful discourse here? Ok, sure. mea culpa. I give in. Apologies all around. Once again, Grace fulfills the dictates of her nomenclature in brilliant fashion, and we, we scoffers have been humiliated.

    2) I’m proven wrong quite regularly on this blog and elsewhere, and I’m always willing to admit it. But where in this thread have I been guilty of “errors” and been “proven wrong”? Do tell. So far, most commenters have generally agreed with my analysis, and those who haven’t have done so on theoretical or political, not factual, grounds (i.e., on grounds where “correctness” doesn’t pertain). At most, you’ve tried to show that there are slightly more concierge doctors than I claimed (and my claim, by the way, was a direct citation from a scholarly article). So what? What does that have to do with anything? Fine, there are possibly several more than 500 concierge doctors–3500, by your (rather tortuous) estimate. Potato, potahto. They still represent a miniscule portion of the healthcare market, and they have literally nothing to do with the ACA. Let’s move on to a more relevant topic. Like, say, the Supreme Court decision, in which you claim to be deeply interested.

    You’re investing all this effort defending an hilariously dramatic and completely irrelevant overstatement by Grace (that a “great majority” of doctors use the concierge model)–along with, apparently, her risible “response” to its critics–and yet I’m the villain for calling her claim into question (actually tODD did it first). All while ignoring her ridiculous intimations that Roberts was under the influence of medication and that none of this would have happened if Grace hadn’t been on vacation at the time! I mean, really? Grace has actually implied in this thread that she is the reason that Obamacare was not overturned, and that if she had only been around, Roberts wouldn’t have been taking medication which confused him and caused him to write an opinion that he couldn’t possibly agree with. This is what you’re defending?

    I look forward to your returning and defending Grace when she insists–nay, spams a thread by repeating ad nauseam–that Luther was a vicious anti-Semite, Romney is a wicked Mormon conspirator-overlord, and all who disagree with her illegible quotations are ignorant children of some kind. And then insults anyone who challenges her often incoherent claims while refusing to engage any counterarguments. Oh, and while peppering her comments with insane formatting, syntax, and punctuation that would receive a generous “F” in any middle school composition class. Her last comment in this thread is one of the most coherent, measured things she’s ever said–the bit about doctor salaries–but it has literally nothing to do with anything that’s been discussed in this thread heretofore! And it’s almost impossible to read to boot.

    Still, nonetheless, I am the hate-baiting enemy of thoughtful discussion.

    Why am I bothering to defend myself here?

  • Grace

    Forbes

    Doctors And AMA Split Over Contentious Issue Of ObamaCare

    9/26/2011
    Sally Pipes Contributor

    “For more than 160 years, the American Medical Association has served as the self-appointed chief lobbying group for doctors. But the AMA’s lofty status has been under threat over the last several years — and is under attack today. In fact, the AMA now only counts about 17% of doctors as members.
    According to a new survey, the majority of doctors do not believe that the AMA represents their views and interests. Much of that dissatisfaction stems from the organization’s support for President Obama’s contentious health care reform package.

    That shouldn’t be surprising. The AMA declares that its core mission is to “help doctors help patients.” But ObamaCare undermines that pursuit by making life harder for physicians and driving down the quality of care available to patients.

    The survey — conducted by physician recruitment firm Jackson & Coker — is a brutal indictment of both the AMA and ObamaCare. Just 13% of doctors agree with their trade association’s support of the health reform law.

    Some doctors are even dissociating themselves from the AMA. Of those who have terminated their membership, 47% cited the organization’s continued backing of the health care law as the primary reason. Increasingly doctors are turning to associations like Docs4PatientCare and the Association of American Physicians and Surgeons that actually do represent their interests.”

    http://www.forbes.com/sites/sallypipes/2011/09/26/doctor-and-ama-split-over-contentious-issue-of-obamacare/

  • Grace

    Forbes

    Doctors And AMA Split Over Contentious Issue Of ObamaCare

    9/26/2011
    Sally Pipes Contributor

    “For more than 160 years, the American Medical Association has served as the self-appointed chief lobbying group for doctors. But the AMA’s lofty status has been under threat over the last several years — and is under attack today. In fact, the AMA now only counts about 17% of doctors as members.
    According to a new survey, the majority of doctors do not believe that the AMA represents their views and interests. Much of that dissatisfaction stems from the organization’s support for President Obama’s contentious health care reform package.

    That shouldn’t be surprising. The AMA declares that its core mission is to “help doctors help patients.” But ObamaCare undermines that pursuit by making life harder for physicians and driving down the quality of care available to patients.

    The survey — conducted by physician recruitment firm Jackson & Coker — is a brutal indictment of both the AMA and ObamaCare. Just 13% of doctors agree with their trade association’s support of the health reform law.

    Some doctors are even dissociating themselves from the AMA. Of those who have terminated their membership, 47% cited the organization’s continued backing of the health care law as the primary reason. Increasingly doctors are turning to associations like Docs4PatientCare and the Association of American Physicians and Surgeons that actually do represent their interests.”

    http://www.forbes.com/sites/sallypipes/2011/09/26/doctor-and-ama-split-over-contentious-issue-of-obamacare/

  • Cincinnatus

    Oh, and while I’m in such a good mood, thanks for your flame-baiting, ideologically monotone, utterly stereotypical and predictable contribution, Michael B.@171!

  • Cincinnatus

    Oh, and while I’m in such a good mood, thanks for your flame-baiting, ideologically monotone, utterly stereotypical and predictable contribution, Michael B.@171!

  • Grace

    I wanted to post much earlier on this thread, regarding the AMA, and then decided to see how many of you would respond, with what little you know, regarding physicians. I doubted most of you realized how doctors view the AMA, I was right! You don’t know.

    As you can read for yourself the AMA now only counts about 17% of doctors as members.

    Interesting information. Read the rest of the article from Forbes.

  • Grace

    I wanted to post much earlier on this thread, regarding the AMA, and then decided to see how many of you would respond, with what little you know, regarding physicians. I doubted most of you realized how doctors view the AMA, I was right! You don’t know.

    As you can read for yourself the AMA now only counts about 17% of doctors as members.

    Interesting information. Read the rest of the article from Forbes.

  • Cincinnatus

    Grace@175, perhaps you could descend the throne you have assumed to lord over us our ignorance of the medical profession–you’re a doctor, right? Because, given your responses to KK, only doctors are qualified to comment about doctors–and tell us what doctors think about the ACA? Not the AMA. The AMA is completely irrelevant.

    In addition, tell us why it matters what doctors think about ACA? How does the opinion of various doctors pertain to the law’s constitutionality?

    And for God’s sake, cite something other than Forbes, the Washington Examiner, and other opinion pieces. And for God’s sake, whatever you cite, paraphrase it, preferably without over-indulging in bold font, italics, random punctuation, and, in general, crazy formatting.

  • Cincinnatus

    Grace@175, perhaps you could descend the throne you have assumed to lord over us our ignorance of the medical profession–you’re a doctor, right? Because, given your responses to KK, only doctors are qualified to comment about doctors–and tell us what doctors think about the ACA? Not the AMA. The AMA is completely irrelevant.

    In addition, tell us why it matters what doctors think about ACA? How does the opinion of various doctors pertain to the law’s constitutionality?

    And for God’s sake, cite something other than Forbes, the Washington Examiner, and other opinion pieces. And for God’s sake, whatever you cite, paraphrase it, preferably without over-indulging in bold font, italics, random punctuation, and, in general, crazy formatting.

  • Grace

    Cincinnatus

    Leaping after Susan as you did in post 172, is to your shame. She is obviously very learned in law.

    As for your garbled comment in 172, in part below, making it up as you type:

    “All while ignoring her ridiculous intimations that Roberts was under the influence of medication and that none of this would have happened if Grace hadn’t been on vacation at the time! I mean, really? Grace has actually implied in this thread that she is the reason that Obamacare was not overturned, and that if she had only been around, Roberts wouldn’t have been taking medication which confused him and caused him to write an opinion that he couldn’t possibly agree with. This is what you’re defending?

    You have a wild imagination.

  • Grace

    Cincinnatus

    Leaping after Susan as you did in post 172, is to your shame. She is obviously very learned in law.

    As for your garbled comment in 172, in part below, making it up as you type:

    “All while ignoring her ridiculous intimations that Roberts was under the influence of medication and that none of this would have happened if Grace hadn’t been on vacation at the time! I mean, really? Grace has actually implied in this thread that she is the reason that Obamacare was not overturned, and that if she had only been around, Roberts wouldn’t have been taking medication which confused him and caused him to write an opinion that he couldn’t possibly agree with. This is what you’re defending?

    You have a wild imagination.

  • Grace

    Cincinnatus @176

    And for God’s sake, whatever you cite, paraphrase it, preferably without over-indulging in bold font, italics, random punctuation, and, in general, crazy formatting.

    No Cincinnatus, I will NOT PARAPHRASE, and will NOT stop using quotes. You might do the same – in this way, what you post will be ACCURATE instead of your IMAGINED ideas, that are INCORRECT.

    Italics are used when quoting, if this bothers you, or if you were not instructed in your educational processs, that’s too bad.

  • Grace

    Cincinnatus @176

    And for God’s sake, whatever you cite, paraphrase it, preferably without over-indulging in bold font, italics, random punctuation, and, in general, crazy formatting.

    No Cincinnatus, I will NOT PARAPHRASE, and will NOT stop using quotes. You might do the same – in this way, what you post will be ACCURATE instead of your IMAGINED ideas, that are INCORRECT.

    Italics are used when quoting, if this bothers you, or if you were not instructed in your educational processs, that’s too bad.

  • Med Student

    This isn’t really a response to anything previously written, just a thought on health insurance in general. A common theme I have noticed among the doctors I ran across during my first year of school is that health insurance incentives are skewed toward procedures and away from the doctor/patient visit, and this both causes a lot of unnecessary procedures to be done and hurts the doctor/patient relationship, which in turn affects the quality of medical care. Does anyone really think 15 minutes of their doctor’s time is sufficient to address all their problems and concerns? And yet doctors cram so many appointments into one day in order to cover expenses and make a decent living because the reimbursements for office visits are relatively low (unless, of course, a procedure is done). Not to mention all the time spent answering emails and phone calls from patients, which is important and beneficial, but generally not reimbursed.
    The theory has even been floated that a lot of end-of-life spending could be curbed if doctors were reimbursed for having an appointment with their patients to discuss things like DNR’s and the like (most people are woefully ignorant about how often CPR is actually successful, especially since its rates of success on TV shows are much higher than in real life). Anyway, not really related to the ACA in particular, but something doctors wish would change about health insurance. Patients might appreciate having a little more time to really discuss things thoroughly with their docs, too.

  • Med Student

    This isn’t really a response to anything previously written, just a thought on health insurance in general. A common theme I have noticed among the doctors I ran across during my first year of school is that health insurance incentives are skewed toward procedures and away from the doctor/patient visit, and this both causes a lot of unnecessary procedures to be done and hurts the doctor/patient relationship, which in turn affects the quality of medical care. Does anyone really think 15 minutes of their doctor’s time is sufficient to address all their problems and concerns? And yet doctors cram so many appointments into one day in order to cover expenses and make a decent living because the reimbursements for office visits are relatively low (unless, of course, a procedure is done). Not to mention all the time spent answering emails and phone calls from patients, which is important and beneficial, but generally not reimbursed.
    The theory has even been floated that a lot of end-of-life spending could be curbed if doctors were reimbursed for having an appointment with their patients to discuss things like DNR’s and the like (most people are woefully ignorant about how often CPR is actually successful, especially since its rates of success on TV shows are much higher than in real life). Anyway, not really related to the ACA in particular, but something doctors wish would change about health insurance. Patients might appreciate having a little more time to really discuss things thoroughly with their docs, too.

  • Susan

    @ Cincinnatus

    Please reread your comments to Grace and consider your comments. Boorish vs. Grace’s inoffensive comments. Your complaints about being sidetracked and wanting to control the conversation sounds quite strange on an open blog. There is room for all and you have choices in how you handle yourself. I do believe you will learn to handle distractions, begin to understand how little control you have, and much more after your child arrives.

    Re: “I’m proven wrong quite regularly on this blog and elsewhere, and I’m always willing to admit it. But where in this thread have I been guilty of “errors” and been “proven wrong”?”

    I made my comment hoping you would recognize the good you have been given by others in response to your failings and remember you get to respond to others who exasperate you in that way too.

    Re: “So far, most commenters have generally agreed with my analysis, and those who haven’t have done so on theoretical or political, not factual, grounds (i.e., on grounds where “correctness” doesn’t pertain). At most, you’ve tried to show that there are slightly more concierge doctors than I claimed (and my claim, by the way, was a direct citation from a scholarly article). So what? What does that have to do with anything?

    Please reread your comments to Grace and look at what boor you were to her over trivia. And, you expect the kid glove treatment? And you think if enough people agree with you, you must be right? Hogwash. Your “scholarly” report is flawed. And yes, statistics are important when the methodology is flawed and you are trying to use it to beat Grace with it and daring her to prove you wrong. Who are you? The narcissistic thin-skinned Obama who is a thug to others? I would hope your behavior is a glitch and not a pattern.

    Re: “You’re investing all this effort defending an hilariously dramatic and completely irrelevant overstatement by Grace (that a “great majority” of doctors use the concierge model)” ———

    No, I didn’t defend her claim, I corrected your errors because of your behavior. And, in answer to the rest of your paragraph… Pitching a fit and blaming Grace for your bad behavior will get you nowhere with me. You can see through her comments extravagances and see they are innocuous. You can learn to get over yourself and ignore it. Make sense?

    Re: “Why am I bothering to defend myself here?”

    I would hazard because you have yet to see yourself clearly and have yet to give a real apology to Grace. I suspect you know that’s no way to talk to people like Grace no matter how inane her comments may strike you. That’s why I’m giving you a tough time.

  • Susan

    @ Cincinnatus

    Please reread your comments to Grace and consider your comments. Boorish vs. Grace’s inoffensive comments. Your complaints about being sidetracked and wanting to control the conversation sounds quite strange on an open blog. There is room for all and you have choices in how you handle yourself. I do believe you will learn to handle distractions, begin to understand how little control you have, and much more after your child arrives.

    Re: “I’m proven wrong quite regularly on this blog and elsewhere, and I’m always willing to admit it. But where in this thread have I been guilty of “errors” and been “proven wrong”?”

    I made my comment hoping you would recognize the good you have been given by others in response to your failings and remember you get to respond to others who exasperate you in that way too.

    Re: “So far, most commenters have generally agreed with my analysis, and those who haven’t have done so on theoretical or political, not factual, grounds (i.e., on grounds where “correctness” doesn’t pertain). At most, you’ve tried to show that there are slightly more concierge doctors than I claimed (and my claim, by the way, was a direct citation from a scholarly article). So what? What does that have to do with anything?

    Please reread your comments to Grace and look at what boor you were to her over trivia. And, you expect the kid glove treatment? And you think if enough people agree with you, you must be right? Hogwash. Your “scholarly” report is flawed. And yes, statistics are important when the methodology is flawed and you are trying to use it to beat Grace with it and daring her to prove you wrong. Who are you? The narcissistic thin-skinned Obama who is a thug to others? I would hope your behavior is a glitch and not a pattern.

    Re: “You’re investing all this effort defending an hilariously dramatic and completely irrelevant overstatement by Grace (that a “great majority” of doctors use the concierge model)” ———

    No, I didn’t defend her claim, I corrected your errors because of your behavior. And, in answer to the rest of your paragraph… Pitching a fit and blaming Grace for your bad behavior will get you nowhere with me. You can see through her comments extravagances and see they are innocuous. You can learn to get over yourself and ignore it. Make sense?

    Re: “Why am I bothering to defend myself here?”

    I would hazard because you have yet to see yourself clearly and have yet to give a real apology to Grace. I suspect you know that’s no way to talk to people like Grace no matter how inane her comments may strike you. That’s why I’m giving you a tough time.

  • Grace

    Medical Student

    YOU WROTE: “The theory has even been floated that a lot of end-of-life spending could be curbed if doctors were reimbursed for having an appointment with their patients to discuss things like DNR’s and the like (most people are woefully ignorant about how often CPR is actually successful, especially since its rates of success on TV shows are much higher than in real life).”

    CPR is successful in many cases, to say it isn’t, gives the reader the wrong information. How many people have suffered a heart attack or stroke, an ambulance called. All necessary procedures were given, the patient went staight to hospital, receiving a pacemaker, or any number of lifesaving heart procedures. The same goes for stroke victims. Perhaps these people are in their late 60′s, 70′s or even 80′s – You don’t think they should have that chance?

    DNR – Do not resuscitate.

    Letting someone die, doing nothing isn’t reasonable. It’s something that is suggested by those who don’t want insurance dollars spent on anyone over a certain age. Euthanasia is disguised in that scheme!

  • Grace

    Medical Student

    YOU WROTE: “The theory has even been floated that a lot of end-of-life spending could be curbed if doctors were reimbursed for having an appointment with their patients to discuss things like DNR’s and the like (most people are woefully ignorant about how often CPR is actually successful, especially since its rates of success on TV shows are much higher than in real life).”

    CPR is successful in many cases, to say it isn’t, gives the reader the wrong information. How many people have suffered a heart attack or stroke, an ambulance called. All necessary procedures were given, the patient went staight to hospital, receiving a pacemaker, or any number of lifesaving heart procedures. The same goes for stroke victims. Perhaps these people are in their late 60′s, 70′s or even 80′s – You don’t think they should have that chance?

    DNR – Do not resuscitate.

    Letting someone die, doing nothing isn’t reasonable. It’s something that is suggested by those who don’t want insurance dollars spent on anyone over a certain age. Euthanasia is disguised in that scheme!

  • Cincinnatus

    I absolutely love that Grace is now instructing a medical student on the success rates of CPR and the meaning of the acronym “DNR.”

    This says everything one needs to know about Grace, really. Oops, how boorish of me to point this out!

  • Cincinnatus

    I absolutely love that Grace is now instructing a medical student on the success rates of CPR and the meaning of the acronym “DNR.”

    This says everything one needs to know about Grace, really. Oops, how boorish of me to point this out!

  • fws

    Grace, did you change your screen name here to susan? the posts under those two usernames seem to be written by the same person. They both look like your style of writing Grace.

  • fws

    Grace, did you change your screen name here to susan? the posts under those two usernames seem to be written by the same person. They both look like your style of writing Grace.

  • Grace

    Cincinnatus

    Medical students are not doctors. Many of them just like the one posting here, actually believe ‘thinking well educated people, receive their information from, of all thing TV. It just isn’t so.

    End of life discussions normally take place when a son or daughter is present, and has requested such a conversation.

    DNR – Do not resuscitate, is often discussed when there is a terminal illness, or when someone is very old and fragile.

    All too many young men and women are being instructed within medical schools regarding DNR’s – it doesn’t apply to all patients of a certain age. People do survive heart attacks, and strokes, even into their 80′s with the proper care, medication and surgeries.

    Euthanasia comes up all to often now. DNR’s all rolled into one!

  • Grace

    Cincinnatus

    Medical students are not doctors. Many of them just like the one posting here, actually believe ‘thinking well educated people, receive their information from, of all thing TV. It just isn’t so.

    End of life discussions normally take place when a son or daughter is present, and has requested such a conversation.

    DNR – Do not resuscitate, is often discussed when there is a terminal illness, or when someone is very old and fragile.

    All too many young men and women are being instructed within medical schools regarding DNR’s – it doesn’t apply to all patients of a certain age. People do survive heart attacks, and strokes, even into their 80′s with the proper care, medication and surgeries.

    Euthanasia comes up all to often now. DNR’s all rolled into one!

  • Grace

    There certainly are a number of regular posters, who have chosen to disrupt this thread. Is the topic to hard to handle, are those who are participating in this way, unable to carry on a discussion without insults?

    ANSWER: No I don’t use another name.

  • Grace

    There certainly are a number of regular posters, who have chosen to disrupt this thread. Is the topic to hard to handle, are those who are participating in this way, unable to carry on a discussion without insults?

    ANSWER: No I don’t use another name.

  • Med Student

    Forgive me for the massive copy and paste and my inability to format well, but here goes – several paragraphs from the text “Resolving Ethical Dilemmas” on the efficacy of CPR in various situations:

    “To make informed decisions about CPR, patients (or their surrogates) need to understand the limited effectiveness of CPR in many clinical situations. When CPR is attempted on general wards of an acute care hospital, circulation and breathing are restored in about 40% of cases (1). Of those initially resuscitated, about one third survive to discharge from the hospital. Thus, about 14% of patients on whom CPR is attempted are discharged alive from the hospital (1,2). In other words, even when CPR is attempted, about 86% of patients die. CPR is more effective when patients suffer cardiopulmonary arrests in the operating room, the cardiac catheterization laboratory, and intensive care units (ICUs).
    In certain patient groups CPR is even less beneficial. Survival to discharge is significantly lower in patients with metastatic cancer, sepsis, and elevated serum creatinine (1). For patients with metastatic cancer, several older series reported zero survival after CPR (3), although two more recent series report about 10% survival rates in such patients (4,5). In the most recent series, there were no survivors if the arrest was anticipated and occurred after the patient gradually deteriorated, but 22% of patients with unexpected cardiopulmonary arrest were successfully resuscitated and survived to discharge (6).
    For patients with sepsis, survival is also highly unlikely. In one series only 1 of 73 patients survived, whereas in another study 0 of 42 patients survived (7,8). CPR is usually ineffective in the elderly, but it is not clear whether this is due to age per se or comorbid diseases in the elderly (1,7,9). Outcomes for nursing home residents who receive CPR are also poor. In two series, 0% and 1.7% of nursing home residents on whom paramedics attempted CPR survived (10,11).
    Complications might occur in patients who are revived by CPR. A dreaded outcome of CPR is severe neurological impairment. Even though circulation is restored, the brain might suffer severe anoxic damage. In one series only 1 patient survived to discharge among 52 patients who remained unconscious 24 hours after successful initial resuscitation (12). Other medical complications might also occur during CPR. For example, fractured ribs or sternum or flail chest occur in 30% of cases (13).”

    All the citations refer to articles in various medical journals, such as JAMA, the Annals of Internal Medicine, and NEJM. I am not advocating anything approaching euthanasia. I am saying that patients need to be well-informed in order to make good choices, and often doctors don’t take the time to inform their patients fully about all their options because they’re not reimbursed for it. I certainly nowhere said that patients shouldn’t be given a chance or left to die; I said that patients deserve to know that they would only have about a 1 in 7 chance of surviving to discharge with CPR. More information is always better. It doesn’t help to have this knee-jerk reaction of EUTHANASIA! LEAVING PEOPLE TO DIE! every time someone says it would be a good idea to at least have a discussion with patients to make sure they’re making informed decisions instead of basing them on anecdotes or TV shows.

  • Med Student

    Forgive me for the massive copy and paste and my inability to format well, but here goes – several paragraphs from the text “Resolving Ethical Dilemmas” on the efficacy of CPR in various situations:

    “To make informed decisions about CPR, patients (or their surrogates) need to understand the limited effectiveness of CPR in many clinical situations. When CPR is attempted on general wards of an acute care hospital, circulation and breathing are restored in about 40% of cases (1). Of those initially resuscitated, about one third survive to discharge from the hospital. Thus, about 14% of patients on whom CPR is attempted are discharged alive from the hospital (1,2). In other words, even when CPR is attempted, about 86% of patients die. CPR is more effective when patients suffer cardiopulmonary arrests in the operating room, the cardiac catheterization laboratory, and intensive care units (ICUs).
    In certain patient groups CPR is even less beneficial. Survival to discharge is significantly lower in patients with metastatic cancer, sepsis, and elevated serum creatinine (1). For patients with metastatic cancer, several older series reported zero survival after CPR (3), although two more recent series report about 10% survival rates in such patients (4,5). In the most recent series, there were no survivors if the arrest was anticipated and occurred after the patient gradually deteriorated, but 22% of patients with unexpected cardiopulmonary arrest were successfully resuscitated and survived to discharge (6).
    For patients with sepsis, survival is also highly unlikely. In one series only 1 of 73 patients survived, whereas in another study 0 of 42 patients survived (7,8). CPR is usually ineffective in the elderly, but it is not clear whether this is due to age per se or comorbid diseases in the elderly (1,7,9). Outcomes for nursing home residents who receive CPR are also poor. In two series, 0% and 1.7% of nursing home residents on whom paramedics attempted CPR survived (10,11).
    Complications might occur in patients who are revived by CPR. A dreaded outcome of CPR is severe neurological impairment. Even though circulation is restored, the brain might suffer severe anoxic damage. In one series only 1 patient survived to discharge among 52 patients who remained unconscious 24 hours after successful initial resuscitation (12). Other medical complications might also occur during CPR. For example, fractured ribs or sternum or flail chest occur in 30% of cases (13).”

    All the citations refer to articles in various medical journals, such as JAMA, the Annals of Internal Medicine, and NEJM. I am not advocating anything approaching euthanasia. I am saying that patients need to be well-informed in order to make good choices, and often doctors don’t take the time to inform their patients fully about all their options because they’re not reimbursed for it. I certainly nowhere said that patients shouldn’t be given a chance or left to die; I said that patients deserve to know that they would only have about a 1 in 7 chance of surviving to discharge with CPR. More information is always better. It doesn’t help to have this knee-jerk reaction of EUTHANASIA! LEAVING PEOPLE TO DIE! every time someone says it would be a good idea to at least have a discussion with patients to make sure they’re making informed decisions instead of basing them on anecdotes or TV shows.

  • Grace

    Med Student,

    YOU WROTE: “All the citations refer to articles in various medical journals, such as JAMA, the Annals of Internal Medicine, and NEJM.”

    Thank you for your information, however you have not given any LINKS for your material.

    Most of your material came from:
    Resolving Ethical Dilemmas 4E: Full text – iPublishCentral
    Why is that?

    Unless patients, or their loved ones ASK for information of that kind, it isn’t always the best thing to give unsolicited information regarding DNR’s.

    I see this from another perspective, that of my own family members. In many cases they did survive, they did recieve medical treatment for heart attacks well into their 80′s. and 90′s. That includes strokes as well.

  • Grace

    Med Student,

    YOU WROTE: “All the citations refer to articles in various medical journals, such as JAMA, the Annals of Internal Medicine, and NEJM.”

    Thank you for your information, however you have not given any LINKS for your material.

    Most of your material came from:
    Resolving Ethical Dilemmas 4E: Full text – iPublishCentral
    Why is that?

    Unless patients, or their loved ones ASK for information of that kind, it isn’t always the best thing to give unsolicited information regarding DNR’s.

    I see this from another perspective, that of my own family members. In many cases they did survive, they did recieve medical treatment for heart attacks well into their 80′s. and 90′s. That includes strokes as well.

  • Grace

    Med Student,

    Unless one has the code, they are unable to fully check out your statistics, or where they actually come from. I found the LINK, but one must have a code, etc.

    All the information you gave cannot be verified as to where and when, and who gathered the material, and when the material was gathered. All of these facts are important when offering proof of what you’re advocating as factual.

  • Grace

    Med Student,

    Unless one has the code, they are unable to fully check out your statistics, or where they actually come from. I found the LINK, but one must have a code, etc.

    All the information you gave cannot be verified as to where and when, and who gathered the material, and when the material was gathered. All of these facts are important when offering proof of what you’re advocating as factual.

  • Dust

    fws….all you have to do is have tODD look up the isp addresses that are attached to everyone’s comments to see if there is some likelihood that Grace and Susan are one and the same…he has done it in the past and knows the routine, as am sure you am aware too my friend :)

    cheers!

  • Dust

    fws….all you have to do is have tODD look up the isp addresses that are attached to everyone’s comments to see if there is some likelihood that Grace and Susan are one and the same…he has done it in the past and knows the routine, as am sure you am aware too my friend :)

    cheers!

  • http://www.toddstadler.com/ tODD

    Susan, the only reason anyone here is discussing “concierge” physicians is due to Grace’s claim (@120) that:

    A great majority of physicians here, use what is called the “Concierge Program”…

    Of course, this claim has yet to be anywhere close to substantiated by anyone — even her would-be defenders!

    In fact, if we take the numbers that you offered up as part of your own contribution to “the childish gotcha games” — “the conservative estimate was 756 retainer-based physicians” and “in 2010, there were approximately 209,000 practicing primary care physicians in the U.S.” — you will see that, well, the math doesn’t exactly pencil out.

    Heck, if I grant that there were three times as many “concierge” physicians as that one suggested minimum (that’d be over 2200), that would still constitute a very mere 1% of the physician population. Which, and I guess this bears pointing out, falls a wee bit short, of Grace’s claim that such physicians constitute “a great majority”.

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.

    At least, that’s all I’ve seen from you so far. And hey, have at it. But let’s not pretend you’re acting here in the defense of well-informed discourse, or reasonable claims, or anything like that. Because you seem perfectly willing to overlook what Grace is actually claiming here, while jumping on those who point that out to her.

  • http://www.toddstadler.com/ tODD

    Susan, the only reason anyone here is discussing “concierge” physicians is due to Grace’s claim (@120) that:

    A great majority of physicians here, use what is called the “Concierge Program”…

    Of course, this claim has yet to be anywhere close to substantiated by anyone — even her would-be defenders!

    In fact, if we take the numbers that you offered up as part of your own contribution to “the childish gotcha games” — “the conservative estimate was 756 retainer-based physicians” and “in 2010, there were approximately 209,000 practicing primary care physicians in the U.S.” — you will see that, well, the math doesn’t exactly pencil out.

    Heck, if I grant that there were three times as many “concierge” physicians as that one suggested minimum (that’d be over 2200), that would still constitute a very mere 1% of the physician population. Which, and I guess this bears pointing out, falls a wee bit short, of Grace’s claim that such physicians constitute “a great majority”.

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.

    At least, that’s all I’ve seen from you so far. And hey, have at it. But let’s not pretend you’re acting here in the defense of well-informed discourse, or reasonable claims, or anything like that. Because you seem perfectly willing to overlook what Grace is actually claiming here, while jumping on those who point that out to her.

  • Grace

    tODD @ 190

    WOW!

    You wrote:

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.”

    You make a statement, as though I stated what you’ve written. What a JOKE. I never stated what you wrote above. :lol:

    What I NOTICE, is your desire to re-write, rather than use QUOTES.

  • Grace

    tODD @ 190

    WOW!

    You wrote:

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.”

    You make a statement, as though I stated what you’ve written. What a JOKE. I never stated what you wrote above. :lol:

    What I NOTICE, is your desire to re-write, rather than use QUOTES.

  • http://www.toddstadler.com/ tODD

    Grace, you continue to be an endless source of entertainment here. You clearly want us all to be impressed with your would-be superior medical knowledge.

    I wanted to post much earlier on this thread, regarding the AMA, and then decided to see how many of you would respond, with what little you know, regarding physicians. I doubted most of you realized how doctors view the AMA, I was right! You don’t know.

    What’s funny is that how doctors “view the AMA” is completely irrelevant to anything that had been said up until you wedged it into this conversation! But I guess you just had to point out how much more informed you are than us … on topics that no one’s even discussing!

    Of course, then we see you employ one of your favorite bullying tactics, the old “you have no first hand knowledge”, and therefore your opinion doesn’t count tactic (@160). You use that one on Klasie a lot, because you’re irrationally biased against the entire nation of Canada based on, what, a business trip you once took there? Anyhow, you use that tactic a lot whenever immigration comes up, to try to shut up anyone who doesn’t live in a southern border state.

    What’s funny is seeing you then attempt (@181) to educate someone (@179) who obviously has first-hand knowledge of the medical profession (evidently more than you do, based on her conversance with common medical abbreviations), and then defending yourself by noting that “Medical students are not doctors”. Hey, you wanna know who else isn’t a doctor, or even a student studying to become a doctor? It’s you, Grace!

    Oh, but wait, there’s more! You then complain (@187) to Med Student that she has “not given any LINKS for your material”, even though she explicitly mentioned (@186) that she was quoting “several paragraphs from the text ‘Resolving Ethical Dilemmas’”. Which is, you know, a book.

    But I guess you missed that, and instead you concluded that “Most of your material came from: Resolving Ethical Dilemmas 4E: Full text – iPublishCentral Why is that?” Which is just hilarious. Yes, the woman who said that someone else’s “GOOGLE routine, is sophomoric” (@139), and who decried those who “try and guess or google their way down the road”, couldn’t even be bothered to look up something found in a book, so she searched the Web for a quotation and ended up who-knows-where. Well done.

    Here, I looked up the relevant chapter of the book for you, Grace.

    I particularly enjoyed the irony of this bit from you, as well:

    All the information you gave cannot be verified as to where and when, and who gathered the material, and when the material was gathered. All of these facts are important when offering proof of what you’re advocating as factual.

    …Said the woman who, and I wish I was making this up, cited a Michael Savage video as factual evidence for your claim that Roberts was not in his right mind when he made this ruling. Yeah, real high standard for facts there, Grace!

  • http://www.toddstadler.com/ tODD

    Grace, you continue to be an endless source of entertainment here. You clearly want us all to be impressed with your would-be superior medical knowledge.

    I wanted to post much earlier on this thread, regarding the AMA, and then decided to see how many of you would respond, with what little you know, regarding physicians. I doubted most of you realized how doctors view the AMA, I was right! You don’t know.

    What’s funny is that how doctors “view the AMA” is completely irrelevant to anything that had been said up until you wedged it into this conversation! But I guess you just had to point out how much more informed you are than us … on topics that no one’s even discussing!

    Of course, then we see you employ one of your favorite bullying tactics, the old “you have no first hand knowledge”, and therefore your opinion doesn’t count tactic (@160). You use that one on Klasie a lot, because you’re irrationally biased against the entire nation of Canada based on, what, a business trip you once took there? Anyhow, you use that tactic a lot whenever immigration comes up, to try to shut up anyone who doesn’t live in a southern border state.

    What’s funny is seeing you then attempt (@181) to educate someone (@179) who obviously has first-hand knowledge of the medical profession (evidently more than you do, based on her conversance with common medical abbreviations), and then defending yourself by noting that “Medical students are not doctors”. Hey, you wanna know who else isn’t a doctor, or even a student studying to become a doctor? It’s you, Grace!

    Oh, but wait, there’s more! You then complain (@187) to Med Student that she has “not given any LINKS for your material”, even though she explicitly mentioned (@186) that she was quoting “several paragraphs from the text ‘Resolving Ethical Dilemmas’”. Which is, you know, a book.

    But I guess you missed that, and instead you concluded that “Most of your material came from: Resolving Ethical Dilemmas 4E: Full text – iPublishCentral Why is that?” Which is just hilarious. Yes, the woman who said that someone else’s “GOOGLE routine, is sophomoric” (@139), and who decried those who “try and guess or google their way down the road”, couldn’t even be bothered to look up something found in a book, so she searched the Web for a quotation and ended up who-knows-where. Well done.

    Here, I looked up the relevant chapter of the book for you, Grace.

    I particularly enjoyed the irony of this bit from you, as well:

    All the information you gave cannot be verified as to where and when, and who gathered the material, and when the material was gathered. All of these facts are important when offering proof of what you’re advocating as factual.

    …Said the woman who, and I wish I was making this up, cited a Michael Savage video as factual evidence for your claim that Roberts was not in his right mind when he made this ruling. Yeah, real high standard for facts there, Grace!

  • Grace

    tODD @ 190

    YOUR POST to Susan:

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.”

    OFF you go, trying to make a QUOTE, that I never posted, or “claimed” - instead you ask Susan to comment on a “claim” that was never made by me. → → “But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that” ……..

    On it goes!

  • Grace

    tODD @ 190

    YOUR POST to Susan:

    But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that the Chief Justice was mentally incapacitated due to his medical treatments, but nobody seemed to notice, and he decided to sit on the bench in spite of being out of his right mind; whoops)? You’re just here to defend Grace, no matter what ludicrous claims she makes.”

    OFF you go, trying to make a QUOTE, that I never posted, or “claimed” - instead you ask Susan to comment on a “claim” that was never made by me. → → “But then, you haven’t exactly shown any interest in the facts behind Grace’s claim, have you (or her other whopper, that” ……..

    On it goes!

  • http://www.toddstadler.com/ tODD

    Grace (@191), don’t be fatuous.

    You know as well as I do what you posted (@82). I don’t need to quote your execrable sources (i.e., Michael Savage) to allude to their patently ridiculous assertions.

    But while you’re here, I thought I’d let you know that you apparently know as much about copy-editing (@178) as you do medicine:

    Italics are used when quoting, if this bothers you, or if you were not instructed in your educational processs, that’s too bad.

    One style manual. Just quote from one style manual that says that “italics are used when quoting”. Just one. LA, MLA, Chicago, doesn’t matter. Just one.

  • http://www.toddstadler.com/ tODD

    Grace (@191), don’t be fatuous.

    You know as well as I do what you posted (@82). I don’t need to quote your execrable sources (i.e., Michael Savage) to allude to their patently ridiculous assertions.

    But while you’re here, I thought I’d let you know that you apparently know as much about copy-editing (@178) as you do medicine:

    Italics are used when quoting, if this bothers you, or if you were not instructed in your educational processs, that’s too bad.

    One style manual. Just quote from one style manual that says that “italics are used when quoting”. Just one. LA, MLA, Chicago, doesn’t matter. Just one.

  • Susan

    @tODD

    In earlier comments, I tried to make it clear why I was defending Grace. I plainly said I was not trying to defend her claim about how many physicians were using the retainer model, but making the point that ya’ll were using erroneous facts/numbers to bash and make fun of Grace for her erroneous facts. Pot meet kettle – you are hypocrites. Being nasty to her is not excusable under the guise of “defense of well-informed discourse.” There is no justification for ganging up on her and acting like bullies. If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her. If you pay attention to her comments, you will see she marches to the beat of a different drummer. Cut her some slack and act like men instead of juveniles and stop using her comments as an excuse for boorish behavior. It’s not the end of the world if she goes off-track, doesn’t get her facts straight, or uses fonts in way you do not appreciate. You have a choice whether you allow yourselves to be distracted by them and whether you choose to respond to them.

  • Susan

    @tODD

    In earlier comments, I tried to make it clear why I was defending Grace. I plainly said I was not trying to defend her claim about how many physicians were using the retainer model, but making the point that ya’ll were using erroneous facts/numbers to bash and make fun of Grace for her erroneous facts. Pot meet kettle – you are hypocrites. Being nasty to her is not excusable under the guise of “defense of well-informed discourse.” There is no justification for ganging up on her and acting like bullies. If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her. If you pay attention to her comments, you will see she marches to the beat of a different drummer. Cut her some slack and act like men instead of juveniles and stop using her comments as an excuse for boorish behavior. It’s not the end of the world if she goes off-track, doesn’t get her facts straight, or uses fonts in way you do not appreciate. You have a choice whether you allow yourselves to be distracted by them and whether you choose to respond to them.

  • Med Student

    Grace, I know I didn’t include a link; that was intentional since the access to the book I was using was through my school’s library system and requires a password. I told you what book it was, however, and tODD did find it on Google books (I guess he’s not as lazy as I am). As to why I used that book – it’s the book we use in our ethics class, and it’s the one with all the statistics I remembered reading. I wasn’t trying to hide anything. You didn’t really think I just made all that up, did you?
    I’ll give you a bit more about whether patients in general want to at least discuss DNR’s with their physicians, and how accurate most patients’ knowledge really is before such discussions:

    “In fact, most ambulatory patients—between 67% and 85%—want to discuss life-sustaining treatment with physicians (24,25). Among hospitalized patients, between 42% and 81% want to discuss end-of-life decisions with their physicians (26,27).”
    And
    “Many patients misunderstand basic information about the nature of CPR. Few patients understand that mechanical ventilation is usually required after CPR and that patients on a ventilator are usually conscious but cannot talk (30). Patients substantially overestimate favorable outcomes after CPR (31). Many patients who initially accept CPR change their minds after they are informed about the nature and outcomes of CPR (31,32).”

    Again, my point is that patients have the right to make well-informed decisions about all aspects of their medical care, and it would help physicians and patients to have better discussions if there were better reimbursement for doctor visits. DNR’s was just one example, because a lot of sick people change their minds when they’re informed about it (and a lot don’t, which is their right). I’m glad many of your relatives survived with CPR; that’s a great blessing but it’s clearly not the norm.

  • Med Student

    Grace, I know I didn’t include a link; that was intentional since the access to the book I was using was through my school’s library system and requires a password. I told you what book it was, however, and tODD did find it on Google books (I guess he’s not as lazy as I am). As to why I used that book – it’s the book we use in our ethics class, and it’s the one with all the statistics I remembered reading. I wasn’t trying to hide anything. You didn’t really think I just made all that up, did you?
    I’ll give you a bit more about whether patients in general want to at least discuss DNR’s with their physicians, and how accurate most patients’ knowledge really is before such discussions:

    “In fact, most ambulatory patients—between 67% and 85%—want to discuss life-sustaining treatment with physicians (24,25). Among hospitalized patients, between 42% and 81% want to discuss end-of-life decisions with their physicians (26,27).”
    And
    “Many patients misunderstand basic information about the nature of CPR. Few patients understand that mechanical ventilation is usually required after CPR and that patients on a ventilator are usually conscious but cannot talk (30). Patients substantially overestimate favorable outcomes after CPR (31). Many patients who initially accept CPR change their minds after they are informed about the nature and outcomes of CPR (31,32).”

    Again, my point is that patients have the right to make well-informed decisions about all aspects of their medical care, and it would help physicians and patients to have better discussions if there were better reimbursement for doctor visits. DNR’s was just one example, because a lot of sick people change their minds when they’re informed about it (and a lot don’t, which is their right). I’m glad many of your relatives survived with CPR; that’s a great blessing but it’s clearly not the norm.

  • Mary

    May I change the focus a bit? Okay I take that as an affirmative response. Check out this post at Get Religion

    http://www.getreligion.org/2012/06/health-care-justice-ruth-ginsberg-said-what/#comm

    The HHS mandate on abortion, sterilization, etc could be in constitutional trouble as a result of this ruling?

  • Mary

    May I change the focus a bit? Okay I take that as an affirmative response. Check out this post at Get Religion

    http://www.getreligion.org/2012/06/health-care-justice-ruth-ginsberg-said-what/#comm

    The HHS mandate on abortion, sterilization, etc could be in constitutional trouble as a result of this ruling?

  • Mary

    I agree with Cincinnatus way up at 154. I think I remember that insurance coverage went off the tracks when employers started providing it and unions saw it as a way to get even more and more out of them. I would be happy to stand corrected on that though. Before that time insurance was mostly catastrophic coverage only. Sometimes called 80/20. They pay 80% you pay 20%. Once the insurance companies became responsible for every conceivable procedure and visit the cost sky rocketed. And why would the patient care? They had no skin in the game.
    I have a basic 80/20 policy. You can bet I question every test my doctor wants me to have. I do not have coverage for any tests unless I am already in the hospital. It does cover one screening mammogram a year. If I need an MRI or CT scan I call around to get the cheapest rate and most places will give me a greatly reduced rate when I explain my situation to them and agree to come with check in hand. My primary care doctor even has a special rate if I agree to pay at time of service-that way they don’t have to mess with all the paper work .

  • Mary

    I agree with Cincinnatus way up at 154. I think I remember that insurance coverage went off the tracks when employers started providing it and unions saw it as a way to get even more and more out of them. I would be happy to stand corrected on that though. Before that time insurance was mostly catastrophic coverage only. Sometimes called 80/20. They pay 80% you pay 20%. Once the insurance companies became responsible for every conceivable procedure and visit the cost sky rocketed. And why would the patient care? They had no skin in the game.
    I have a basic 80/20 policy. You can bet I question every test my doctor wants me to have. I do not have coverage for any tests unless I am already in the hospital. It does cover one screening mammogram a year. If I need an MRI or CT scan I call around to get the cheapest rate and most places will give me a greatly reduced rate when I explain my situation to them and agree to come with check in hand. My primary care doctor even has a special rate if I agree to pay at time of service-that way they don’t have to mess with all the paper work .

  • fws

    Mary @ 197

    “The HHS mandate on abortion, sterilization, etc”

    I am aware that the “HHS mandate (requirement by force of Law) ” mandates (forces) that those charities, which receive government funds and contracts, must make available contraceptives in their health insurance to their employees.

    And even then there is no “mandate” beyond that. meaning that employees will not have a federal gun pointed at their head “mandating (forcing)” them to use contraceptives.

    so for those who do not use contraceptives for moral reasons, the result of the HHS Mandate is……. nothing at all .

    Where, other than conservative sources, do you see that the HHS is “mandating” ie forcing catholic charities or individuals to abort or sterilize?!! If that is the Law, then whoever is mandated/forced to do this must accept jail time or whatever consequence but they must resist. This would be new news for me.

    Show me where this is the HHS mandate please! And dont point me to some roman catholic site or fox news etc to do this.

  • fws

    Mary @ 197

    “The HHS mandate on abortion, sterilization, etc”

    I am aware that the “HHS mandate (requirement by force of Law) ” mandates (forces) that those charities, which receive government funds and contracts, must make available contraceptives in their health insurance to their employees.

    And even then there is no “mandate” beyond that. meaning that employees will not have a federal gun pointed at their head “mandating (forcing)” them to use contraceptives.

    so for those who do not use contraceptives for moral reasons, the result of the HHS Mandate is……. nothing at all .

    Where, other than conservative sources, do you see that the HHS is “mandating” ie forcing catholic charities or individuals to abort or sterilize?!! If that is the Law, then whoever is mandated/forced to do this must accept jail time or whatever consequence but they must resist. This would be new news for me.

    Show me where this is the HHS mandate please! And dont point me to some roman catholic site or fox news etc to do this.

  • Tom Hering

    Yeah guys. Act like men. Treat Grace the way a woman should be treated by being a bit more chivalrous, and a bit more condescending, instead of assuming she can take punches just like everyone else here (just because she’s taken the punches for a couple of years now and always come back for more). Have the goodness to treat her like the weaker sex when it’s convenient for her.

  • Tom Hering

    Yeah guys. Act like men. Treat Grace the way a woman should be treated by being a bit more chivalrous, and a bit more condescending, instead of assuming she can take punches just like everyone else here (just because she’s taken the punches for a couple of years now and always come back for more). Have the goodness to treat her like the weaker sex when it’s convenient for her.

  • Mary

    fws:

    heading to work so I can’t really respond at the moment.

    You have to be kidding. I do believe we have gone down this road before. Did you read the link? I know you have followed all of the ins and outs of this, up to and including the head of my (LCMS) church body testifying before congress on this issue. I suggest you take it up with him. Perhaps by going to LCMS.org.

    And now I am late for work!

  • Mary

    fws:

    heading to work so I can’t really respond at the moment.

    You have to be kidding. I do believe we have gone down this road before. Did you read the link? I know you have followed all of the ins and outs of this, up to and including the head of my (LCMS) church body testifying before congress on this issue. I suggest you take it up with him. Perhaps by going to LCMS.org.

    And now I am late for work!

  • Mary

    and I don’t believe I said that any one is “forcing” some one to abort. But if I am paying for them to do so, even if only by paying for their insurance am I not complicit in the act? I know your answer to that already don’t I?

  • Mary

    and I don’t believe I said that any one is “forcing” some one to abort. But if I am paying for them to do so, even if only by paying for their insurance am I not complicit in the act? I know your answer to that already don’t I?

  • Cincinnatus

    Mary@197 raises a good point–one that I can’t remember being raised in the avalanche of comments in this thread (maybe it was, but my attention span is short, I guess). There are numerous challenges to the ACA moving through the system. The Commerce Clause challenge, which morphed into a taxation challenge, apparently, was only one of them.

    Just as the Court has recently maintained an excessively expansive conception of the Commerce Clause, it has also constructed an expansive understanding of the First Amendment. I wouldn’t be surprised if one of the First Amendment challenges is heard by SCOTUS and upheld. But I’m not familiar yet with the details of any of these cases, so I won’t offer a concrete prediction.

    Worth discussing, though.

  • Cincinnatus

    Mary@197 raises a good point–one that I can’t remember being raised in the avalanche of comments in this thread (maybe it was, but my attention span is short, I guess). There are numerous challenges to the ACA moving through the system. The Commerce Clause challenge, which morphed into a taxation challenge, apparently, was only one of them.

    Just as the Court has recently maintained an excessively expansive conception of the Commerce Clause, it has also constructed an expansive understanding of the First Amendment. I wouldn’t be surprised if one of the First Amendment challenges is heard by SCOTUS and upheld. But I’m not familiar yet with the details of any of these cases, so I won’t offer a concrete prediction.

    Worth discussing, though.

  • fws

    mary @ 197

    “youre kidding” “take it up with [president harrison]” “we’ve gone down this road before”

    Dismissive.

    “mandate” definition:
    Definition: 1. an order or charge; 2. a document giving an official command. Synonyms: order, command, ruling, decree, requirement, sanction

    You said “abortion sterilization mandate”. An order to abort or sterilize. That is different than to say and order to make such proceedures available to those who want them. This nuance is not a trivial one. It is manipulative bending of words.

    Then you follow with a purely rhetorical question.
    They you presume to know my response to that rhetorical .

    Ok. I just KNOW that your um… conversations… are similarly dismissive and purely rhetorical.

    This is a tax. By whatever name.
    You can read. Therefore you can quickly know that your government taxes you to use that money to support things that you are very opposed to. Buddhism, mormonism, scientology? Subsidized by your taxes providing free police and fire dept etc to them. Subsidized by priviledged tax exempt status. So are you “complicit in the act” of mormons raising their kids to spend eternity in hell?

    And this is the response you just KNEW would be my response right?

    Such is your small closed world Mary.

    Do you really need to be so patronizing and condescending in your response?

  • fws

    mary @ 197

    “youre kidding” “take it up with [president harrison]” “we’ve gone down this road before”

    Dismissive.

    “mandate” definition:
    Definition: 1. an order or charge; 2. a document giving an official command. Synonyms: order, command, ruling, decree, requirement, sanction

    You said “abortion sterilization mandate”. An order to abort or sterilize. That is different than to say and order to make such proceedures available to those who want them. This nuance is not a trivial one. It is manipulative bending of words.

    Then you follow with a purely rhetorical question.
    They you presume to know my response to that rhetorical .

    Ok. I just KNOW that your um… conversations… are similarly dismissive and purely rhetorical.

    This is a tax. By whatever name.
    You can read. Therefore you can quickly know that your government taxes you to use that money to support things that you are very opposed to. Buddhism, mormonism, scientology? Subsidized by your taxes providing free police and fire dept etc to them. Subsidized by priviledged tax exempt status. So are you “complicit in the act” of mormons raising their kids to spend eternity in hell?

    And this is the response you just KNEW would be my response right?

    Such is your small closed world Mary.

    Do you really need to be so patronizing and condescending in your response?

  • Susan

    @Tom Hering

    You appear to have some gender confusion. If you were female, I would have addressed you as women not men. That you describe how you treat her as “punches” underscores the point about boorish behavior.

  • Susan

    @Tom Hering

    You appear to have some gender confusion. If you were female, I would have addressed you as women not men. That you describe how you treat her as “punches” underscores the point about boorish behavior.

  • Cincinnatus

    fws:

    Chillax, bro.

    Mary is, at the very least, somewhat right. The HHS mandate question is still unsettled. At the moment, it appears that the government will be forcing healthcare providers–including Lutheran and Catholic facilities–to fund and provide what they perceive to be morally objectionable medical procedures such as abortion (and gender reassignment is only a matter of time, right?). This is a fact, and there’s a compelling First Amendment challenge to be raised here.

    But you mention something intriguing: the fact that this bill has been redefined as a tax could hamper the First Amendment case here. After all, our taxes fund all sorts of objectionable activities and we have no say in it: bombing Middle Eastern children, abortions in Mexico, food stamps for meth addicts, etc. Back when it appeared the ACA and its tentacles were an ad hoc program forcing religious institutions to violate their moral principles, the First Amendment claim was clear. Now?

    Help me out, constitutional scholars!

  • Cincinnatus

    fws:

    Chillax, bro.

    Mary is, at the very least, somewhat right. The HHS mandate question is still unsettled. At the moment, it appears that the government will be forcing healthcare providers–including Lutheran and Catholic facilities–to fund and provide what they perceive to be morally objectionable medical procedures such as abortion (and gender reassignment is only a matter of time, right?). This is a fact, and there’s a compelling First Amendment challenge to be raised here.

    But you mention something intriguing: the fact that this bill has been redefined as a tax could hamper the First Amendment case here. After all, our taxes fund all sorts of objectionable activities and we have no say in it: bombing Middle Eastern children, abortions in Mexico, food stamps for meth addicts, etc. Back when it appeared the ACA and its tentacles were an ad hoc program forcing religious institutions to violate their moral principles, the First Amendment claim was clear. Now?

    Help me out, constitutional scholars!

  • fws

    cinn @ 203

    Roberts handed down a truly conservative ruling. How? It respects the roles off the legislative and executive branches. His ruling basically gave an act of congress a constitutional presumption of innocence. His ruling basically said that a law would be overturned by the same body that issued the ruling.
    it is not a stretch to call this a tax. notice my prediction in post @ 3 or so. I am no constitutional lawyer, but this is not so unobvious.

    What you suggest by all those lawsuits is that end justifies means. We just KNOW the legal result we want, so we will throw as much against the wall as we can find until we find something that sticks and gives us the result we want.

    The more conservative approach is to let represented officials to the small r republican role that has been assigned to them by the rule of Law (ie the constitution) and not try to overpower that by democracy in the form of a swarm of lawsuits.

    I suggest that the proper conservative response is to elect different representatives to congress, and repeal the law if that can be done. Lawsuits suck up lots of resources that could be more prudently invested.

  • fws

    cinn @ 203

    Roberts handed down a truly conservative ruling. How? It respects the roles off the legislative and executive branches. His ruling basically gave an act of congress a constitutional presumption of innocence. His ruling basically said that a law would be overturned by the same body that issued the ruling.
    it is not a stretch to call this a tax. notice my prediction in post @ 3 or so. I am no constitutional lawyer, but this is not so unobvious.

    What you suggest by all those lawsuits is that end justifies means. We just KNOW the legal result we want, so we will throw as much against the wall as we can find until we find something that sticks and gives us the result we want.

    The more conservative approach is to let represented officials to the small r republican role that has been assigned to them by the rule of Law (ie the constitution) and not try to overpower that by democracy in the form of a swarm of lawsuits.

    I suggest that the proper conservative response is to elect different representatives to congress, and repeal the law if that can be done. Lawsuits suck up lots of resources that could be more prudently invested.

  • fws

    cinn @ 206

    I am totally chill dear friend. But Mary’s approach seems similar to graces in her most recent responses. dismissive. she just knows what my response would be right? Why even post then?

    saying HHS mandate…abort… sterilization.. in the same sentence is shrill and manipulative. It says HHS demanded abortion and sterilization. Nuance is required. I know that we americans love an echo box where we can speak in such shorthand with likeminded individuals, but it does a disservice to public discourse in that it is a lie.

    Cinn. When the government imposes a regulation that costs something, it is a tax. Forcing you to pay HR block to do your tax return and pay them to do it is a tax.

    Why not just look at it as that. IF the government were to force an individual to abort (eg what China does), then a that fatal line as been crossed.

    Governments will do such things. Eventually ours will too. But not yet. And it moves us to that point more rapidly by conservatives engaging in the same kind of postmodernist manipulation through phrases. Fighting fire with fire by using language less than honestly, only will burn down everything that is true and good.

  • fws

    cinn @ 206

    I am totally chill dear friend. But Mary’s approach seems similar to graces in her most recent responses. dismissive. she just knows what my response would be right? Why even post then?

    saying HHS mandate…abort… sterilization.. in the same sentence is shrill and manipulative. It says HHS demanded abortion and sterilization. Nuance is required. I know that we americans love an echo box where we can speak in such shorthand with likeminded individuals, but it does a disservice to public discourse in that it is a lie.

    Cinn. When the government imposes a regulation that costs something, it is a tax. Forcing you to pay HR block to do your tax return and pay them to do it is a tax.

    Why not just look at it as that. IF the government were to force an individual to abort (eg what China does), then a that fatal line as been crossed.

    Governments will do such things. Eventually ours will too. But not yet. And it moves us to that point more rapidly by conservatives engaging in the same kind of postmodernist manipulation through phrases. Fighting fire with fire by using language less than honestly, only will burn down everything that is true and good.

  • Stephen

    Joe @ 113

    Well, dropping your coverage is your choice, but it seems foolish to me. It also seems foolish to pay a penalty and get nothing in return when for just a little more one could buy coverage. I think the vast majority are likely to shop for coverage rather than pay the penalty. So, I don’t think the premise you are operating under holds water. It sounds to me like a rhetorical scare tactic that is being played rather than something that will actually happen.

    I also think insurance companies will have to become more competitive and not less as the market expands. And as the number of those covered expands significantly so will the pool of risk, eventually creating savings and bringing the overall price down, maybe even substantially.

    As for “pre-exisitng conditions” – speaking from experience, insurance companies will refuse anyone who has ANY prior health problems, such as ones that are one-off situation, so it is not the case that everyone who will now be able to buy insurance will drain the system. I guess it remains to be seen for those, like yourself, who drop their coverage and opt for the penalty go running to get insurance that can no longer be denied them under this law because they discover they’ve got an illness or accident that drains their savings and threatens their future and their family’s future.

    This isn’t flawless, and it will develop over time, but I think it is a step in the right direction. Like I said, moving on . . .

  • Stephen

    Joe @ 113

    Well, dropping your coverage is your choice, but it seems foolish to me. It also seems foolish to pay a penalty and get nothing in return when for just a little more one could buy coverage. I think the vast majority are likely to shop for coverage rather than pay the penalty. So, I don’t think the premise you are operating under holds water. It sounds to me like a rhetorical scare tactic that is being played rather than something that will actually happen.

    I also think insurance companies will have to become more competitive and not less as the market expands. And as the number of those covered expands significantly so will the pool of risk, eventually creating savings and bringing the overall price down, maybe even substantially.

    As for “pre-exisitng conditions” – speaking from experience, insurance companies will refuse anyone who has ANY prior health problems, such as ones that are one-off situation, so it is not the case that everyone who will now be able to buy insurance will drain the system. I guess it remains to be seen for those, like yourself, who drop their coverage and opt for the penalty go running to get insurance that can no longer be denied them under this law because they discover they’ve got an illness or accident that drains their savings and threatens their future and their family’s future.

    This isn’t flawless, and it will develop over time, but I think it is a step in the right direction. Like I said, moving on . . .

  • Klasie Kraalogies

    Which Western country that has some kind of Universal Healthcare system, forces abortions? This Monday it would be 50 years since Saskatchewan introduced universal Healtcare. No forced abortions, no prohibitive taxes, actually we have one of the few balanced budgets in, well, anywhere.

    Sure the system isn’t perfect. No perfect system exists. I actually think that a sizeable part of the troubles in the system is due to the Unions, bybut that is another debate.

    A good friend of mine just had an emergency apendicitomy, followed by 8/9 days in the hospital. That episode cost more than double what getting his Masters at a reputable University cost him. He lives in the West coast of the US.

    Obama is proposing a solution – and as far as I can ascertain, not a very good one. But in all the opposition shown here to that, much of it merely ideological, and because it wasn’t “your guy”, haven’t anybody thought to stop and ask why the hell the circumstances are what they are, and why the devil did the right not attemp to do something about it, the last couple of decades?

  • Klasie Kraalogies

    Which Western country that has some kind of Universal Healthcare system, forces abortions? This Monday it would be 50 years since Saskatchewan introduced universal Healtcare. No forced abortions, no prohibitive taxes, actually we have one of the few balanced budgets in, well, anywhere.

    Sure the system isn’t perfect. No perfect system exists. I actually think that a sizeable part of the troubles in the system is due to the Unions, bybut that is another debate.

    A good friend of mine just had an emergency apendicitomy, followed by 8/9 days in the hospital. That episode cost more than double what getting his Masters at a reputable University cost him. He lives in the West coast of the US.

    Obama is proposing a solution – and as far as I can ascertain, not a very good one. But in all the opposition shown here to that, much of it merely ideological, and because it wasn’t “your guy”, haven’t anybody thought to stop and ask why the hell the circumstances are what they are, and why the devil did the right not attemp to do something about it, the last couple of decades?

  • Cincinnatus

    KK@210:

    I think some language has been garbled here. The ACA and the HHS mandate don’t “force” anyone to have abortions, obviously. Rather, they force employers and healthcare institutions to fund and provide abortions (among other potentially objectionable practices). This does in fact raise a clear First Amendment grievance–though whether the Court would validate such a grievance is yet to be determined.

    How does this differ from single-payer in Canada? Well, for one thing, the government is forcing private institutions to fund the care (including abortions) directly, rather than via the general tax system. So, while it’s been deemed acceptable by the Court for the government to use your taxes for things you don’t like–wars, abortions, etc.–it’s not generally acceptable for the government to make you pay directly for something that violates your religious principles. Hence, the Amish, for example, are entirely exempted from Social Security, Medicare, public education, the draft, and other programs.

    Such an argument may win the day in the case of ACA, too. But Roberts’ decision to label the mandate a tax may throw a wrench in any such case.

  • Cincinnatus

    KK@210:

    I think some language has been garbled here. The ACA and the HHS mandate don’t “force” anyone to have abortions, obviously. Rather, they force employers and healthcare institutions to fund and provide abortions (among other potentially objectionable practices). This does in fact raise a clear First Amendment grievance–though whether the Court would validate such a grievance is yet to be determined.

    How does this differ from single-payer in Canada? Well, for one thing, the government is forcing private institutions to fund the care (including abortions) directly, rather than via the general tax system. So, while it’s been deemed acceptable by the Court for the government to use your taxes for things you don’t like–wars, abortions, etc.–it’s not generally acceptable for the government to make you pay directly for something that violates your religious principles. Hence, the Amish, for example, are entirely exempted from Social Security, Medicare, public education, the draft, and other programs.

    Such an argument may win the day in the case of ACA, too. But Roberts’ decision to label the mandate a tax may throw a wrench in any such case.

  • Tom Hering

    Susan @ 205, get off yuur high horse. If you’d been around here long enough, you’d know we’ve all had this conversation before, and that the conversation included Grace, and that Grace doesn’t want to be treated any more genteely than anyone else. I actually kind of admire here for that, if little else.

    Oh, and boxing metaphors are pretty common in describing arguments. So fold up your definition of “boorishness,” put it away in your lavender pantsuit, and invite me over for Mah-Jongg sometime. I promise I’ll come. :-D

  • Tom Hering

    Susan @ 205, get off yuur high horse. If you’d been around here long enough, you’d know we’ve all had this conversation before, and that the conversation included Grace, and that Grace doesn’t want to be treated any more genteely than anyone else. I actually kind of admire here for that, if little else.

    Oh, and boxing metaphors are pretty common in describing arguments. So fold up your definition of “boorishness,” put it away in your lavender pantsuit, and invite me over for Mah-Jongg sometime. I promise I’ll come. :-D

  • fws

    cinn @ 211
    “I think some language has been garbled here. The ACA and the HHS mandate don’t “force” anyone to have abortions, obviously.”

    That would not be obvious from what lots of conservatives say. I suggest this is an intentional, and dishonorable, manipulative use of language to inflame and issue.

    So now we are asking for the same exemption as the Amish? No cinn. I know you. You dont mean that. So why bring up the Amish then?

    I suggest you made a distinction that is not really a distinction. 1) Obama said that catholic charities must offer the services, but the government will foot the cost. It’s true.
    And the HHS mandate is about offering contraceptives.
    Where is there anything in it about abortion or sterilization (as mary asserts)?

    You need to be clear here that you are using the slippery slope argument. The argument NOW is about contraceptives, but you assert that LATER it COULD become the same deal for abortion and , as mary throws in, sterilization.

    This is far far far from clear in the “conservative’ rhetoric.

    Finally, this HHS mandate that insists that ALL insurance carriers make contraceptives available looks exactly like any other tax . Why? there are NO exceptions to the rule for anyone. The roman catholics make this into targeting them and singling them out.

    The real picture is that they should seek an exemption similar to the ones the Amish have. their situation looks more like that. And if they sought such an exemption, then perhaps they would prevail.

    So why dont they? What is different from what the amish situation is? a) it is not about what the roman catholics just do among themselves. b) the amish receive no federal funding or state grants. 90% of the budget of catholic charities is government money.

    So catholic charities could refuse all government funds. End of story. Problem resolved. What? the feds would prevent a roman catholic charity from giving a loaf of bread to a starving person because they refuse to provide condoms to their no roman catholic staff? Get real. That is not what this looks like or is about.

    Of COURSE they wont do that. But by omitting such facts, and making the issue soley a “religious freedom ” issue, they are not being honest about the entire situation are they?

  • fws

    cinn @ 211
    “I think some language has been garbled here. The ACA and the HHS mandate don’t “force” anyone to have abortions, obviously.”

    That would not be obvious from what lots of conservatives say. I suggest this is an intentional, and dishonorable, manipulative use of language to inflame and issue.

    So now we are asking for the same exemption as the Amish? No cinn. I know you. You dont mean that. So why bring up the Amish then?

    I suggest you made a distinction that is not really a distinction. 1) Obama said that catholic charities must offer the services, but the government will foot the cost. It’s true.
    And the HHS mandate is about offering contraceptives.
    Where is there anything in it about abortion or sterilization (as mary asserts)?

    You need to be clear here that you are using the slippery slope argument. The argument NOW is about contraceptives, but you assert that LATER it COULD become the same deal for abortion and , as mary throws in, sterilization.

    This is far far far from clear in the “conservative’ rhetoric.

    Finally, this HHS mandate that insists that ALL insurance carriers make contraceptives available looks exactly like any other tax . Why? there are NO exceptions to the rule for anyone. The roman catholics make this into targeting them and singling them out.

    The real picture is that they should seek an exemption similar to the ones the Amish have. their situation looks more like that. And if they sought such an exemption, then perhaps they would prevail.

    So why dont they? What is different from what the amish situation is? a) it is not about what the roman catholics just do among themselves. b) the amish receive no federal funding or state grants. 90% of the budget of catholic charities is government money.

    So catholic charities could refuse all government funds. End of story. Problem resolved. What? the feds would prevent a roman catholic charity from giving a loaf of bread to a starving person because they refuse to provide condoms to their no roman catholic staff? Get real. That is not what this looks like or is about.

    Of COURSE they wont do that. But by omitting such facts, and making the issue soley a “religious freedom ” issue, they are not being honest about the entire situation are they?

  • Cincinnatus

    fws:

    This thread is really getting out of hand, and I’m not inclined–though others might be–to reopen the vast debate about the HHS mandate, etc.

    But I will say a couple of things. First, I don’t understand your animus against the Amish. I just used them as a fairly random example to demonstrate that First Amendment claims have been used to exempt all kinds of groups from otherwise legitimate programs–and that’s if such programs aren’t entirely overturned in the first place.

    Second, factually speaking, the ACA actually does require that federal funds be used to provide elective abortions, though it’s unclear at the moment whether these funds will have to be spent (if you know what I mean) by institutions that object. Meanwhile, the HHS mandate, as you note, is about providing contraception–my mistake in confusing the issues in my comment. But, yeah, the government is going to force Catholic institutions to provide contraception. I’m not interested in arguing the nuances of that issue at the moment, except to say that Catholic institutions do have a very strong First Amendment case here, and they very well could win their case if/when the case makes it to the Supreme Court. I’ll also note that a) the HHS mandate does not resemble a typical tax (since when does a tax require me to disburse, say, abortions or cruise missiles to people with my own hands?) and b) the fact that Catholic institutions receive federal funds is mostly irrelevant; the government can’t force you to do whatever it wants about anything just because you accept funds from them, says the Court (the reality is a bit more nuanced than this, but in general I’m correct).

    And if they don’t, (elective) contraception shouldn’t be covered by health insurance anyway, nor should elective abortions.

    Also, I haven’t made any slippery slope arguments. I never implied that if Obama requires x, then it’s only a matter of time before y happens. You may be thinking of someone else. But just because an argument claims “x therefore y” doesn’t necessarily mean that it’s spurious or a fallacious slippery slope. That is to say, some slippery slopes are actually real. Remember when gay activists said conservatives were crazy for fearing that the institution of gay marriage would energize polyamory movements? Or when scientists insisted that biotechnology advancements couldn’t possibly lead to the mass production of fetal cells for commercial use? Or when Democrats insisted that healthcare reform wouldn’t possibly lead to a government that dictates minute healthcare decisions to institutions and persons? Etc.

  • Cincinnatus

    fws:

    This thread is really getting out of hand, and I’m not inclined–though others might be–to reopen the vast debate about the HHS mandate, etc.

    But I will say a couple of things. First, I don’t understand your animus against the Amish. I just used them as a fairly random example to demonstrate that First Amendment claims have been used to exempt all kinds of groups from otherwise legitimate programs–and that’s if such programs aren’t entirely overturned in the first place.

    Second, factually speaking, the ACA actually does require that federal funds be used to provide elective abortions, though it’s unclear at the moment whether these funds will have to be spent (if you know what I mean) by institutions that object. Meanwhile, the HHS mandate, as you note, is about providing contraception–my mistake in confusing the issues in my comment. But, yeah, the government is going to force Catholic institutions to provide contraception. I’m not interested in arguing the nuances of that issue at the moment, except to say that Catholic institutions do have a very strong First Amendment case here, and they very well could win their case if/when the case makes it to the Supreme Court. I’ll also note that a) the HHS mandate does not resemble a typical tax (since when does a tax require me to disburse, say, abortions or cruise missiles to people with my own hands?) and b) the fact that Catholic institutions receive federal funds is mostly irrelevant; the government can’t force you to do whatever it wants about anything just because you accept funds from them, says the Court (the reality is a bit more nuanced than this, but in general I’m correct).

    And if they don’t, (elective) contraception shouldn’t be covered by health insurance anyway, nor should elective abortions.

    Also, I haven’t made any slippery slope arguments. I never implied that if Obama requires x, then it’s only a matter of time before y happens. You may be thinking of someone else. But just because an argument claims “x therefore y” doesn’t necessarily mean that it’s spurious or a fallacious slippery slope. That is to say, some slippery slopes are actually real. Remember when gay activists said conservatives were crazy for fearing that the institution of gay marriage would energize polyamory movements? Or when scientists insisted that biotechnology advancements couldn’t possibly lead to the mass production of fetal cells for commercial use? Or when Democrats insisted that healthcare reform wouldn’t possibly lead to a government that dictates minute healthcare decisions to institutions and persons? Etc.

  • http://www.toddstadler.com/ tODD

    Susan said (@195):

    There is no justification for ganging up on her and acting like bullies. If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her.

    I think it’s pretty humorous that you think it’s “proper” to run whining to the authorities, behind the offending person’s back, rather than directly addressing one’s criticisms to that person.

    I mean, if you don’t like what I’m doing here, shouldn’t you follow your own example, leave me alone, and complain to Dr. Veith that I’m doing it wrong?

    I also see from your example that you’re not terribly bothered by people “ganging up” … when it serves your purpose.

  • http://www.toddstadler.com/ tODD

    Susan said (@195):

    There is no justification for ganging up on her and acting like bullies. If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her.

    I think it’s pretty humorous that you think it’s “proper” to run whining to the authorities, behind the offending person’s back, rather than directly addressing one’s criticisms to that person.

    I mean, if you don’t like what I’m doing here, shouldn’t you follow your own example, leave me alone, and complain to Dr. Veith that I’m doing it wrong?

    I also see from your example that you’re not terribly bothered by people “ganging up” … when it serves your purpose.

  • fws

    cinn @ 214
    My point is not aimed at you. It is that catholic charities is deliberately exagerating and enflaming the issue.

    Fact: even if the government mandated that condoms be provided, Catholic charities would STILL object. The issue is making catholic charities provide services etc that they find religiously objectionable.

    No animus against the amish. Only a dilineation of how the catholic charities situation is not the same situtation a)not about just what catholics do amongst themselves and b) amish arent 90% budgeted by the govt.

    The bottom line is this Cinn:
    when the govt forces an individual to abort, sterilize or contracept, then that individual must follow his conscience.

    That is not currently the case. Catholic charities omits two important facts.

    to listen to catholic charities , none of what I stated, which are the facts, would be obvious. No.. “catholic charities is fighting against HHS ‘mandated (!!!)” abortions and sterilizations! not. true.

    Catholic charities omits the fact that 90% of their budget is from the government. Clear and prominent identification of that fact would constitute honest disclosure. They dont disclose this fact.

    Fact: if Catholic charities refused all government funding then the issue would disappear. Poof. The issue is receipt of govt funds then. One would not know this from the rhetoric .

  • fws

    cinn @ 214
    My point is not aimed at you. It is that catholic charities is deliberately exagerating and enflaming the issue.

    Fact: even if the government mandated that condoms be provided, Catholic charities would STILL object. The issue is making catholic charities provide services etc that they find religiously objectionable.

    No animus against the amish. Only a dilineation of how the catholic charities situation is not the same situtation a)not about just what catholics do amongst themselves and b) amish arent 90% budgeted by the govt.

    The bottom line is this Cinn:
    when the govt forces an individual to abort, sterilize or contracept, then that individual must follow his conscience.

    That is not currently the case. Catholic charities omits two important facts.

    to listen to catholic charities , none of what I stated, which are the facts, would be obvious. No.. “catholic charities is fighting against HHS ‘mandated (!!!)” abortions and sterilizations! not. true.

    Catholic charities omits the fact that 90% of their budget is from the government. Clear and prominent identification of that fact would constitute honest disclosure. They dont disclose this fact.

    Fact: if Catholic charities refused all government funding then the issue would disappear. Poof. The issue is receipt of govt funds then. One would not know this from the rhetoric .

  • Cincinnatus

    fws:

    First, I’m not sure why it matters that an institution rather than an individual is being forced to hand out contraception. Wouldn’t you object, for example, if local churches were required to provide contraception? Oh wait: they are! You do know that the monstrosity known as Catholic Charities isn’t the only group affected by the HHS mandate, right? This is bigger than just a few Catholics complaining about a “trivial” government policy.

    Second, I already addressed the question of funding. While the government can constitutionally attach conditions to the receipt of funding if the requirements are germane to the purpose of the grant, the fact that a group or person receives money from the government doesn’t mean the group is therefore beholden to the government in all matters, or that the government can therefore make the institution do whatever it wants. The Court has repeatedly rejected this idea.

    Would Catholic Charities “look” better in this case if they didn’t receive substantial federal funding? Sure, but it’s substantively irrelevant. And would the issue “disappear,” as you claim, if they didn’t receive funding? No, it wouldn’t. That’s why the HHS mandate is a big problem for a lot of people.

    Anyway, Catholic Charities isn’t going to lose or give up its funding. It won’t give up the funding because it can’t function without it. It won’t have the funding taken away because a substantial proportion of America’s healthcare is provided by Catholic and other religious health institutions. So that wouldn’t make for a very good Obama campaign slogan: “Obama: The Candidate who shut down all our hospitals in a political pissing match while assaulting the First Amendment.” Good luck with that.

    Anyway, as I said, this is a bit of a distraction from the broader question of the ACA. And you’ve also got a bit of a straw man going there. Who, exactly, has claimed that the HHS mandate “FORCES” people to have abortions and sterilizations? I certainly haven’t heard Catholic Charities make that argument. I haven’t made it. President Harrison hasn’t made it. I don’t know where you’re getting this, or why it’s relevant to the question at hand. On the other hand, the HHS mandate is certainly far more problematic than you’re depicting it to be.

  • Cincinnatus

    fws:

    First, I’m not sure why it matters that an institution rather than an individual is being forced to hand out contraception. Wouldn’t you object, for example, if local churches were required to provide contraception? Oh wait: they are! You do know that the monstrosity known as Catholic Charities isn’t the only group affected by the HHS mandate, right? This is bigger than just a few Catholics complaining about a “trivial” government policy.

    Second, I already addressed the question of funding. While the government can constitutionally attach conditions to the receipt of funding if the requirements are germane to the purpose of the grant, the fact that a group or person receives money from the government doesn’t mean the group is therefore beholden to the government in all matters, or that the government can therefore make the institution do whatever it wants. The Court has repeatedly rejected this idea.

    Would Catholic Charities “look” better in this case if they didn’t receive substantial federal funding? Sure, but it’s substantively irrelevant. And would the issue “disappear,” as you claim, if they didn’t receive funding? No, it wouldn’t. That’s why the HHS mandate is a big problem for a lot of people.

    Anyway, Catholic Charities isn’t going to lose or give up its funding. It won’t give up the funding because it can’t function without it. It won’t have the funding taken away because a substantial proportion of America’s healthcare is provided by Catholic and other religious health institutions. So that wouldn’t make for a very good Obama campaign slogan: “Obama: The Candidate who shut down all our hospitals in a political pissing match while assaulting the First Amendment.” Good luck with that.

    Anyway, as I said, this is a bit of a distraction from the broader question of the ACA. And you’ve also got a bit of a straw man going there. Who, exactly, has claimed that the HHS mandate “FORCES” people to have abortions and sterilizations? I certainly haven’t heard Catholic Charities make that argument. I haven’t made it. President Harrison hasn’t made it. I don’t know where you’re getting this, or why it’s relevant to the question at hand. On the other hand, the HHS mandate is certainly far more problematic than you’re depicting it to be.

  • fws

    cinn @214

    I am saying you are conflating lots of stuff.
    Catholic charities is doing the same to intentionally obsfuscate .
    I am not saying you are doing that too.

    1) Fact: if tommorrow you founded a charity to provide medical care to the poor, the government would not make you stop if you failed to also provide abortions, contraceptives and sterilizations and condoms. Why not. You are not receiving any government funding. I know you at least that well. If you DID receive government funding or contracts, those would be cut off if you refused to provide such services. So?
    Stop taking the money and continue to follow your conscience. But dont build it into a case of being singled out for your religious convictions!

    2) What if you were now required to provide health insurance to all your staff? ALL insurance plans are now required to make abortions and contraceptives and sterilizations available.
    Does this constitute a violation of religious freedom?
    If you are Amish then yes, but not for the same reasons you would suggest.
    if you are roman catholic? No. it is a tax. they are also against capital punishment. Guess what? their tax dollars are used for that too.
    Ah but insurance money is earmarked specifically for medical stuff? Opt to pay the penalty rather than get the government aca mandated insurance then! That penalty would go into a general fund, which is the same reality as SS and medicare. there is no segregated fund for any govt programs any longer. not even the highway trust fund. Those are all reserved “funds”now in name only. Horns of moral dilema resolved!

    Cinn, this is a very cynical attempt by catholic charities to preserve their government funding on THEIR terms. it is dishonest and manipulative.

  • fws

    cinn @214

    I am saying you are conflating lots of stuff.
    Catholic charities is doing the same to intentionally obsfuscate .
    I am not saying you are doing that too.

    1) Fact: if tommorrow you founded a charity to provide medical care to the poor, the government would not make you stop if you failed to also provide abortions, contraceptives and sterilizations and condoms. Why not. You are not receiving any government funding. I know you at least that well. If you DID receive government funding or contracts, those would be cut off if you refused to provide such services. So?
    Stop taking the money and continue to follow your conscience. But dont build it into a case of being singled out for your religious convictions!

    2) What if you were now required to provide health insurance to all your staff? ALL insurance plans are now required to make abortions and contraceptives and sterilizations available.
    Does this constitute a violation of religious freedom?
    If you are Amish then yes, but not for the same reasons you would suggest.
    if you are roman catholic? No. it is a tax. they are also against capital punishment. Guess what? their tax dollars are used for that too.
    Ah but insurance money is earmarked specifically for medical stuff? Opt to pay the penalty rather than get the government aca mandated insurance then! That penalty would go into a general fund, which is the same reality as SS and medicare. there is no segregated fund for any govt programs any longer. not even the highway trust fund. Those are all reserved “funds”now in name only. Horns of moral dilema resolved!

    Cinn, this is a very cynical attempt by catholic charities to preserve their government funding on THEIR terms. it is dishonest and manipulative.

  • Cincinnatus

    fws@218:

    No. Wrong, wrong, and more wrong.

    1) How many times do I have to say it? The HHS mandate is not contingent on the receipt of federal funding. If I open a charity that employees people, I will be required to provide (i.e., pay for, out of my own pocket) insurance that covers (i.e., pays for) abortions, sterilizations, and contraception. It doesn’t matter whether I receive a single dime of federal money. Why are you not getting this? ANY employer who provides insurance to its employees–private, public, non-profit, charity, churches, hospitals, whatever–is subject to the requirements of the HHS mandate.

    2) Perhaps I’m dense, but I fail to understand why the HHS mandate (hypothetically) violates the religious freedoms of the Amish, but not those of the Catholics. The Catholic Church is strongly opposed to contraception on moral, religious grounds. Forcing them to pay for contraception, even on an institutional basis to non-Catholics, is thus a violation of their free exercise rights (cf. many Supreme Court cases)–or it is at least plausible that Catholics would see it that way.

    If there is an essential difference between Catholics and the Amish on this question, it has absolutely nothing to do with the fact that Catholic Charities receives federal funding. Nothing. Please understand this. The question of funding sources is not an issue relevant to the HHS mandate. Again, even if Catholic Charities could refuse all federal funding and it would still be forced to provide contraception to its employees. So would Lutheran Churches. So would any group anywhere that offers insurance to its employees. Again, this issue is not “just” a “cynical ploy” by Catholic Charities to manipulate the disbursement of federal funds.

    You’re usually smarter than this, fws! I’m not asking you to agree with me on whether the HHS mandate is legitimate. But at least get the facts and issues right!

  • Cincinnatus

    fws@218:

    No. Wrong, wrong, and more wrong.

    1) How many times do I have to say it? The HHS mandate is not contingent on the receipt of federal funding. If I open a charity that employees people, I will be required to provide (i.e., pay for, out of my own pocket) insurance that covers (i.e., pays for) abortions, sterilizations, and contraception. It doesn’t matter whether I receive a single dime of federal money. Why are you not getting this? ANY employer who provides insurance to its employees–private, public, non-profit, charity, churches, hospitals, whatever–is subject to the requirements of the HHS mandate.

    2) Perhaps I’m dense, but I fail to understand why the HHS mandate (hypothetically) violates the religious freedoms of the Amish, but not those of the Catholics. The Catholic Church is strongly opposed to contraception on moral, religious grounds. Forcing them to pay for contraception, even on an institutional basis to non-Catholics, is thus a violation of their free exercise rights (cf. many Supreme Court cases)–or it is at least plausible that Catholics would see it that way.

    If there is an essential difference between Catholics and the Amish on this question, it has absolutely nothing to do with the fact that Catholic Charities receives federal funding. Nothing. Please understand this. The question of funding sources is not an issue relevant to the HHS mandate. Again, even if Catholic Charities could refuse all federal funding and it would still be forced to provide contraception to its employees. So would Lutheran Churches. So would any group anywhere that offers insurance to its employees. Again, this issue is not “just” a “cynical ploy” by Catholic Charities to manipulate the disbursement of federal funds.

    You’re usually smarter than this, fws! I’m not asking you to agree with me on whether the HHS mandate is legitimate. But at least get the facts and issues right!

  • Cincinnatus

    And the HHS mandate is not, I repeat not a tax! Even the “updated” version is a cynical ploy to make it look like a tax, but–I doubt it will hold up on those grounds.

    What you’re pretending is the case–that the HHS mandate simply raises generic taxes on an organization, which taxes go into a general fund, which funds are disbursed as they always are to wars, roads, and now contraception–is not actually the case. I don’t know where you’re getting this. I’m tempted to pull a Grace: is it because you’re in Brazil or something?

  • Cincinnatus

    And the HHS mandate is not, I repeat not a tax! Even the “updated” version is a cynical ploy to make it look like a tax, but–I doubt it will hold up on those grounds.

    What you’re pretending is the case–that the HHS mandate simply raises generic taxes on an organization, which taxes go into a general fund, which funds are disbursed as they always are to wars, roads, and now contraception–is not actually the case. I don’t know where you’re getting this. I’m tempted to pull a Grace: is it because you’re in Brazil or something?

  • fws

    cincinatus @ 217

    CINN “Wouldn’t you object, for example, if local churches were required to provide contraception? Oh wait: they are!”

    No. This is not true. My local church is not required to hand out contraceptives.

    CINN”Who is saying that the HHS mandate is about abortions and sterilizations?” Your last paragraph

    “mary @ 197 The HHS mandate on abortion, sterilization, etc could be in constitutional trouble as a result of this ruling?”
    This is not an uncommon casual implied factoid. Why . It is the meme that catholic charities is pushing. It is dishonest. This sorta talk IS making the rounds!

    So great. you agree it is all about the money. Cath0lic charities doesnt want to give it up. And your argument is “why should they?! why cant they be granted , along with the LCMS and others, the same kind of exemption as the amish. ”

    Because it is not the same situation as the Amish for one.

    Your secondly.. “I already addressed this…” so. you didnt address it correctly. the govt includes the availability of abortion contraception and sterilization as part of the definition of “health services” in their contracts. They get to do that. Why not? and catholic charities gets to refuse to do provision of health services contracts with the government as well! THAT is the Issue. You would not know that from reading the RC hype.

    To then conflate the separate issue, and it IS a separate issue, of whether or not catholic charities needs to provide insurance that also provides for these things is also a disservice to public discourse. These are two separate issues.

    I discussed this earlier didnt I? So I wont repeat myself.

  • fws

    cincinatus @ 217

    CINN “Wouldn’t you object, for example, if local churches were required to provide contraception? Oh wait: they are!”

    No. This is not true. My local church is not required to hand out contraceptives.

    CINN”Who is saying that the HHS mandate is about abortions and sterilizations?” Your last paragraph

    “mary @ 197 The HHS mandate on abortion, sterilization, etc could be in constitutional trouble as a result of this ruling?”
    This is not an uncommon casual implied factoid. Why . It is the meme that catholic charities is pushing. It is dishonest. This sorta talk IS making the rounds!

    So great. you agree it is all about the money. Cath0lic charities doesnt want to give it up. And your argument is “why should they?! why cant they be granted , along with the LCMS and others, the same kind of exemption as the amish. ”

    Because it is not the same situation as the Amish for one.

    Your secondly.. “I already addressed this…” so. you didnt address it correctly. the govt includes the availability of abortion contraception and sterilization as part of the definition of “health services” in their contracts. They get to do that. Why not? and catholic charities gets to refuse to do provision of health services contracts with the government as well! THAT is the Issue. You would not know that from reading the RC hype.

    To then conflate the separate issue, and it IS a separate issue, of whether or not catholic charities needs to provide insurance that also provides for these things is also a disservice to public discourse. These are two separate issues.

    I discussed this earlier didnt I? So I wont repeat myself.

  • Cincinnatus

    fws:

    I’m not going to proceed with this discussion until you demonstrate that you actually understand what the HHS mandate is and does. It’s clear at the moment that you distinctly don’t. (Oh, and the HHS mandate does mandate funding for sterilizations. And the ACA does mandate funding for elective abortions. What am I missing here?)

  • Cincinnatus

    fws:

    I’m not going to proceed with this discussion until you demonstrate that you actually understand what the HHS mandate is and does. It’s clear at the moment that you distinctly don’t. (Oh, and the HHS mandate does mandate funding for sterilizations. And the ACA does mandate funding for elective abortions. What am I missing here?)

  • fws

    cinn @ 219

    How many times do I need to say this. You are conflating two issues that need to be addresses separately.

    1) CINN “even if Catholic Charities could refuse all federal funding and it would still be forced to provide contraception to its employees. So would Lutheran Churches. So would any group anywhere that offers insurance to its employees”

    Any group. Anywhere. This is like a tax. Taxes are used in ways we morally do not approve of. How is this different. Exemption on moral grounds? How so? The Amish argument? No.

    2) The Govt gets to define “availability and delivery of health services” to include abortions, contraceptives, and sterilizations in contracts with private agencies.
    Catholic charities gets to refuse such contracts.
    How does this constitute religious persecution or a singling out of the religious ? that is how this is being presented. Not true!

  • fws

    cinn @ 219

    How many times do I need to say this. You are conflating two issues that need to be addresses separately.

    1) CINN “even if Catholic Charities could refuse all federal funding and it would still be forced to provide contraception to its employees. So would Lutheran Churches. So would any group anywhere that offers insurance to its employees”

    Any group. Anywhere. This is like a tax. Taxes are used in ways we morally do not approve of. How is this different. Exemption on moral grounds? How so? The Amish argument? No.

    2) The Govt gets to define “availability and delivery of health services” to include abortions, contraceptives, and sterilizations in contracts with private agencies.
    Catholic charities gets to refuse such contracts.
    How does this constitute religious persecution or a singling out of the religious ? that is how this is being presented. Not true!

  • fws

    cinn @ 222

    My understanding is that the HHS mandate/binding requirement/law is that ALL insurance offered to employees by anyone must make available contraceptives. Obama has said that, for religious institutions, the government would foot the cost of those contraceptives, in an attempt to answer a religious exemption.

    I am not aware that the HHS mandate also requires sterilizations to be made available. Where would I find the footnote for that? Why would that fact make a difference in outcomes as to what we are discussing?

    The ACA is regulation for all insurers anywhere just as you say. It mandates that all insurers make available abortions , sterilizations and contraceptives. Whether one choses to call it a tax or not, it functions exactly as a tax. the words “all” and “anywhere” make that so.

    Again where is the moral issue: if anyone is personally FORCED , to abort, contracept, sterilize, blood transfuse, etc, then we have an issue. This would include individual doctors nurses and patients of course.

    Otherwise I say we dont have a moral issue Cinn!

  • fws

    cinn @ 222

    My understanding is that the HHS mandate/binding requirement/law is that ALL insurance offered to employees by anyone must make available contraceptives. Obama has said that, for religious institutions, the government would foot the cost of those contraceptives, in an attempt to answer a religious exemption.

    I am not aware that the HHS mandate also requires sterilizations to be made available. Where would I find the footnote for that? Why would that fact make a difference in outcomes as to what we are discussing?

    The ACA is regulation for all insurers anywhere just as you say. It mandates that all insurers make available abortions , sterilizations and contraceptives. Whether one choses to call it a tax or not, it functions exactly as a tax. the words “all” and “anywhere” make that so.

    Again where is the moral issue: if anyone is personally FORCED , to abort, contracept, sterilize, blood transfuse, etc, then we have an issue. This would include individual doctors nurses and patients of course.

    Otherwise I say we dont have a moral issue Cinn!

  • fws

    cinn

    the catholics inflame the issue making it into what it is not.
    even if they were “mandated ” to make a jar of condoms available they would still object. And that would be their right.

    But most would find that objection less than a threat to religious liberty, freedom and the constitution as we know it.

    So they bring up abortifacents, and sterilizations etc.

    The issue isnt that. It is religious liberty.
    And there are two issues at play:

    1) Insurance regulations. All. Anywhere. Maybe not a tax technically but sure smells like a universal tax. So then the govt funds executions. Catholics object to that too.

    2)Government contracts to private religious charities awarding public funds. Abortions are define as “health care” whether we like or not. So are contraceptives and sterilizations. I sympathize with many , but not all, RC arguments here. But that is the way it is legally right now. So the government includes such things and mandates their inclusion in the term “delivery of health services”

    Refuse the contracts! or…. make it obvious to the watching world that what is really being sought is an exception to the rule. This is so not the religious persecution that roman catholics are making it out to be. This is very dishonest to paint it that way.

  • fws

    cinn

    the catholics inflame the issue making it into what it is not.
    even if they were “mandated ” to make a jar of condoms available they would still object. And that would be their right.

    But most would find that objection less than a threat to religious liberty, freedom and the constitution as we know it.

    So they bring up abortifacents, and sterilizations etc.

    The issue isnt that. It is religious liberty.
    And there are two issues at play:

    1) Insurance regulations. All. Anywhere. Maybe not a tax technically but sure smells like a universal tax. So then the govt funds executions. Catholics object to that too.

    2)Government contracts to private religious charities awarding public funds. Abortions are define as “health care” whether we like or not. So are contraceptives and sterilizations. I sympathize with many , but not all, RC arguments here. But that is the way it is legally right now. So the government includes such things and mandates their inclusion in the term “delivery of health services”

    Refuse the contracts! or…. make it obvious to the watching world that what is really being sought is an exception to the rule. This is so not the religious persecution that roman catholics are making it out to be. This is very dishonest to paint it that way.

  • Cincinnatus

    fws: I’m heading out–out of my home, that is–for the afternoon, so I don’t have time to respond to most your critiques. For the record, you still absolutely fail to understand what the HHS mandate is.

    Before I go, though, at a more macroscopic level, it’s very interesting to me–disturbing, in fact–that you’re identifying a religious, non-profit charity as the villain here, when it’s really the near-omnipotent State that created this problem in the first place by launching a manipulative power-grab in order to continue its recreation of society in the image of the “liberated” sexual revolution (while forcing religious institutions to conform inescapably). I mean, say what you want about the HHS mandate, but Catholics are hardly the aggressors here, and the end results of a Catholic victory are hardly as problematic as those from a State victory in this case. Just a thought.

  • Cincinnatus

    fws: I’m heading out–out of my home, that is–for the afternoon, so I don’t have time to respond to most your critiques. For the record, you still absolutely fail to understand what the HHS mandate is.

    Before I go, though, at a more macroscopic level, it’s very interesting to me–disturbing, in fact–that you’re identifying a religious, non-profit charity as the villain here, when it’s really the near-omnipotent State that created this problem in the first place by launching a manipulative power-grab in order to continue its recreation of society in the image of the “liberated” sexual revolution (while forcing religious institutions to conform inescapably). I mean, say what you want about the HHS mandate, but Catholics are hardly the aggressors here, and the end results of a Catholic victory are hardly as problematic as those from a State victory in this case. Just a thought.

  • fws

    Cinn

    I am not addressing whether or not abortion, contraceptives or sterilizations or even condoms or executions are right or wrong of course.

    And I am not saying that the HHS ruling or the ACA is a tax or not.

    I am saying neither of those matter.

    If ALL are EVERYWHERE required to pay out money for insurance then that functions exactly as a tax does whether one calls it a tax or not. It is the moral equivalent in that case of a RC paying income taxes and state sale taxes that are used for executions.

    I am not getting how this is the same as the amish situation. You are making that comparison not me Cinn.
    Why isnt it the same? If it WERE the same, roman catholics could pay NO taxes. Why not? taxes are used to provide services like executions and to subsidize services to other religions.

    Then we would be back to the 1600 when catholics said that “error has no rights”. that means that lutherans and anglicans have no rights to practice other than the roman catholic faith.

    The amish argument is different. But that is not what you are aiming at.

    You are making a too general argument that if the Amish are granted any religious exceptions at all, for whatever reason, then their exceptions are the SAME exceptions for the same reasons ERGO Roman Catholics should be granted whatever exceptions they want as well. you need to get more granular here.

  • fws

    Cinn

    I am not addressing whether or not abortion, contraceptives or sterilizations or even condoms or executions are right or wrong of course.

    And I am not saying that the HHS ruling or the ACA is a tax or not.

    I am saying neither of those matter.

    If ALL are EVERYWHERE required to pay out money for insurance then that functions exactly as a tax does whether one calls it a tax or not. It is the moral equivalent in that case of a RC paying income taxes and state sale taxes that are used for executions.

    I am not getting how this is the same as the amish situation. You are making that comparison not me Cinn.
    Why isnt it the same? If it WERE the same, roman catholics could pay NO taxes. Why not? taxes are used to provide services like executions and to subsidize services to other religions.

    Then we would be back to the 1600 when catholics said that “error has no rights”. that means that lutherans and anglicans have no rights to practice other than the roman catholic faith.

    The amish argument is different. But that is not what you are aiming at.

    You are making a too general argument that if the Amish are granted any religious exceptions at all, for whatever reason, then their exceptions are the SAME exceptions for the same reasons ERGO Roman Catholics should be granted whatever exceptions they want as well. you need to get more granular here.

  • fws

    cinn @ 226

    my response was @ 224

    Thanks for the nonresponse.

  • fws

    cinn @ 226

    my response was @ 224

    Thanks for the nonresponse.

  • Klasie Kraalogies

    Cinn, I know the systems are different – that is why I said Obama’s approach is not the best. Rather I have been responding to the over-heated contra-rhetoric, which seems to refuse ask the fundamental questions, as I highlighted.

  • Klasie Kraalogies

    Cinn, I know the systems are different – that is why I said Obama’s approach is not the best. Rather I have been responding to the over-heated contra-rhetoric, which seems to refuse ask the fundamental questions, as I highlighted.

  • Grace

    Todd @192

    “What’s funny is that how doctors “view the AMA” is completely irrelevant to anything that had been said up until you wedged it into this conversation! But I guess you just had to point out how much more informed you are than us … on topics that no one’s even discussing!

    REALLY?

    The so called “wedged” response –

    Check out Klasie Kraalogies comments @ 136 regarding the AMA.

    According to the AMA, there is 814000 registered physicians in the US. So, the percentage doctors that are concierge doctors, ranges from 0.0098% to 0.006%. Precisely what you’d expect with a unregulated, rare phenomenon (ultra low percentages, widely scattered estimates).

    Thus:

    Grace lives in a bubble. QED.

    That’s the so called “bubble” – From the article @173 In fact, the AMA now only counts about 17% of doctors as members. The AMA is not recognized by the majority of doctors, but alas, KK who does not live in the U.S. uses the AMA as a source. LOL

  • Grace

    Todd @192

    “What’s funny is that how doctors “view the AMA” is completely irrelevant to anything that had been said up until you wedged it into this conversation! But I guess you just had to point out how much more informed you are than us … on topics that no one’s even discussing!

    REALLY?

    The so called “wedged” response –

    Check out Klasie Kraalogies comments @ 136 regarding the AMA.

    According to the AMA, there is 814000 registered physicians in the US. So, the percentage doctors that are concierge doctors, ranges from 0.0098% to 0.006%. Precisely what you’d expect with a unregulated, rare phenomenon (ultra low percentages, widely scattered estimates).

    Thus:

    Grace lives in a bubble. QED.

    That’s the so called “bubble” – From the article @173 In fact, the AMA now only counts about 17% of doctors as members. The AMA is not recognized by the majority of doctors, but alas, KK who does not live in the U.S. uses the AMA as a source. LOL

  • Grace

    Susan @ 195

    “If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her. If you pay attention to her comments, you will see she marches to the beat of a different drummer.”

    Why would you suggest that those who disagree with me go to Dr. Veith and “let him decide” ? No one has humiliated me Susan, if anything they’ve humiliated themselves by twisting what I’ve written, and then paraphrasing it, just as children do, to change the meaning of what was said to suit there arguments.

    The post I made @171 regarding the AMA, in regards to KK’s so called knowledge @136 – followed by typical comments, the AMA becme irrelevant.

    Please explain what “If you pay attention to her comments, you will see she marches to the beat of a different drummer. What drum might that be Susan?

  • Grace

    Susan @ 195

    “If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her. If you pay attention to her comments, you will see she marches to the beat of a different drummer.”

    Why would you suggest that those who disagree with me go to Dr. Veith and “let him decide” ? No one has humiliated me Susan, if anything they’ve humiliated themselves by twisting what I’ve written, and then paraphrasing it, just as children do, to change the meaning of what was said to suit there arguments.

    The post I made @171 regarding the AMA, in regards to KK’s so called knowledge @136 – followed by typical comments, the AMA becme irrelevant.

    Please explain what “If you pay attention to her comments, you will see she marches to the beat of a different drummer. What drum might that be Susan?

  • Susan

    @Grace

    I apologize for trying to intervene and will explain the two statements.

    1) Re: “If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her.” A couple of comments blatantly told you to stop commenting and gave the impression they were trying to make participation unbearable for you so that you would stop participating. I was hoping they would recognize their behavior and understand it wasn’t their place to decide who should comment – I would hazard they know Dr. Veith would politely correct them and would be too embarrassed to presume such entitlement.

    2) Re: “If you pay attention to her comments, you will see she marches to the beat of a different drummer.” I was trying to address a few of the commenters’ insults/complaints about you and hoping they would recognize there is no need for clones and to respect differences. It is a positive statement that tells others to back off and respect differences. It often refers to individuals who are not cowed into conformity by peer pressure and follow their own course. These people often end up successful (eg: entrepreneurs, artists, etc.). It is from a quote: “If a man does not keep pace with his companions, perhaps it is because he hears a different drummer. Let him step to the music which he hears, however measured or far away.”- Henry David Thoreau 1854

    You are right that they humiliate themselves. Since I made the comment, it has become plain that some prefer a form of discourse where insults, ad hominems, gotcha games, and so forth rule supreme. As one wag put it: you can’t fix stupid.

  • Susan

    @Grace

    I apologize for trying to intervene and will explain the two statements.

    1) Re: “If you think she should be off the blog, then act like men and make formal complaint to Dr. Veith and let him decide. Use the proper means and stop trying to humiliate her.” A couple of comments blatantly told you to stop commenting and gave the impression they were trying to make participation unbearable for you so that you would stop participating. I was hoping they would recognize their behavior and understand it wasn’t their place to decide who should comment – I would hazard they know Dr. Veith would politely correct them and would be too embarrassed to presume such entitlement.

    2) Re: “If you pay attention to her comments, you will see she marches to the beat of a different drummer.” I was trying to address a few of the commenters’ insults/complaints about you and hoping they would recognize there is no need for clones and to respect differences. It is a positive statement that tells others to back off and respect differences. It often refers to individuals who are not cowed into conformity by peer pressure and follow their own course. These people often end up successful (eg: entrepreneurs, artists, etc.). It is from a quote: “If a man does not keep pace with his companions, perhaps it is because he hears a different drummer. Let him step to the music which he hears, however measured or far away.”- Henry David Thoreau 1854

    You are right that they humiliate themselves. Since I made the comment, it has become plain that some prefer a form of discourse where insults, ad hominems, gotcha games, and so forth rule supreme. As one wag put it: you can’t fix stupid.

  • Grace

    Susan

    Thank you for addressing my questions, I appreciate your candor.

    Behavior such as is exhibted on this blog, by a group of commenters is expected. It never fails, and most always never surprises me.

    The sophomoric way in which “paraphrasing” is used, instead of quotes, is one of the most obvious way in which some distort what others say. It becomes a game, rather then staying on topic. I believe most people see through it. I also believe it’s done when they don’t understand the subject, or have any background or education in the given topic at hand.

    I could be wrong, but your background appears to be within the legal field – mine is in medicine. DonS is an attorney, I read his posts with interest. There are others who appear not to have any sort of professional career – but are quick to give their interpretation, on any given subject, no matter how little they understand .. there is always google ;) more often then not, it shows.

    Thank you for your kind words.

  • Grace

    Susan

    Thank you for addressing my questions, I appreciate your candor.

    Behavior such as is exhibted on this blog, by a group of commenters is expected. It never fails, and most always never surprises me.

    The sophomoric way in which “paraphrasing” is used, instead of quotes, is one of the most obvious way in which some distort what others say. It becomes a game, rather then staying on topic. I believe most people see through it. I also believe it’s done when they don’t understand the subject, or have any background or education in the given topic at hand.

    I could be wrong, but your background appears to be within the legal field – mine is in medicine. DonS is an attorney, I read his posts with interest. There are others who appear not to have any sort of professional career – but are quick to give their interpretation, on any given subject, no matter how little they understand .. there is always google ;) more often then not, it shows.

    Thank you for your kind words.

  • helen

    I haven’t been able to keep up with most of this but, Cincinnatus, it’s not because fws is in Brazil.
    It’s because, if he were in the US, he’ d be in the ELCA, which already provides abortions for its employees, including its female “clergy”. They are conspicuous by their silence because they, and the liberal churches they are in fellowship with, have no problem with abortion (next day, next month or day before delivery).

    No use arguing with that mindset, they haven’t got a religious conviction to be endangered.

  • helen

    I haven’t been able to keep up with most of this but, Cincinnatus, it’s not because fws is in Brazil.
    It’s because, if he were in the US, he’ d be in the ELCA, which already provides abortions for its employees, including its female “clergy”. They are conspicuous by their silence because they, and the liberal churches they are in fellowship with, have no problem with abortion (next day, next month or day before delivery).

    No use arguing with that mindset, they haven’t got a religious conviction to be endangered.

  • Cincinnatus

    fws:

    1) The HHS mandate is not a tax, nor does it function even remotely as a tax. Taking into account the revisions made by the Administration after Catholics (rightly) protested, the mandate says this: you have to provide insurance to your employees. That insurance must cover elective contraception and sterilization. The logistics of how this works are mostly irrelevant; when the chips are on the table, the government is requiring private entities, including religious organizations, to pay for contraceptives, even if it violates their ethico-religious beliefs.

    2) Please explain to me why the Amish and Catholics are fundamentally different when they raise religious objections. How many times do I have to say this? I’ll put it in bold: Whether a group receives federal funds has nothing intrinsically to do with whether that group’s religious rights are being violated by a requirement that is morally objectionable.

    Here’s what the Supreme Court has said about this question: If the federal government gives you a grant for a specific purpose, it can require you to do certain things if and only if they are directly related to the purpose for which the funds were disbursed. So, for example, if the government gave Catholic Charities a grant to help it fund insurance for its employees, it could conceivably require those insurance policies to cover “x” procedures. However, if it gave CC a grant to, say, defray the cost of an MRI machine, the government could not simply demand that CC fund contraceptives simply because they’re “beholden” to the government for an unrelated grant. See how that works? The mere fact that you receive federal funding doesn’t mean that the government can violate your constitutional rights willy-nilly.

    Even if the HHS mandate were equivalent to a general tax (like, say, Medicare or FICA), CC could and should still be considered for a religious exemption precisely because said tax could violate–actually, does violate–their fundamental moral beliefs.

    That’s why your distinction between Catholics and the Amish is spurious. The Amish don’t receive exemptions to federal programs because they also refuse to take federal funding (which isn’t true: they benefit from all kinds of federal programs). They receive exemptions because their religious rights would be violated otherwise. The Catholic Church and Catholic Charities (the latter still being consider a religious organization by the government) are entitled to the same exemptions as the Amish when appropriate–when, that is, their fundamental beliefs are being violated. (There are complications, of course: Employment Division v. Smith is sometimes used to modify this logic, but the general logic nonetheless holds).

    Moreover, the Amish are exempt from all kinds of programs that are “general” and that apply to “ALL” citizens and groups. Almost all federal programs that apply to everyone are supposed to contain latitude for religious exemptions. If Medicare violates your religion’s conscience, your religion can refuse to pay those taxes. Etc.

    Frank, it’s not that I don’t understand your logic. It’s that your logic is just wrong on a simple, factual basis. The HHS mandate isn’t a tax. The federal government can’t make CC do whatever it wants simply because it receives federal funds. Both Catholics and Amish are entitled to the exact same rights of conscience, regardless of whether they participate in federal programs. Again, you’re entirely free to disagree with me regarding whether the HHS mandate (and ACA in general!) is a good or bad idea, but you’re not free to invent the facts.

  • Cincinnatus

    fws:

    1) The HHS mandate is not a tax, nor does it function even remotely as a tax. Taking into account the revisions made by the Administration after Catholics (rightly) protested, the mandate says this: you have to provide insurance to your employees. That insurance must cover elective contraception and sterilization. The logistics of how this works are mostly irrelevant; when the chips are on the table, the government is requiring private entities, including religious organizations, to pay for contraceptives, even if it violates their ethico-religious beliefs.

    2) Please explain to me why the Amish and Catholics are fundamentally different when they raise religious objections. How many times do I have to say this? I’ll put it in bold: Whether a group receives federal funds has nothing intrinsically to do with whether that group’s religious rights are being violated by a requirement that is morally objectionable.

    Here’s what the Supreme Court has said about this question: If the federal government gives you a grant for a specific purpose, it can require you to do certain things if and only if they are directly related to the purpose for which the funds were disbursed. So, for example, if the government gave Catholic Charities a grant to help it fund insurance for its employees, it could conceivably require those insurance policies to cover “x” procedures. However, if it gave CC a grant to, say, defray the cost of an MRI machine, the government could not simply demand that CC fund contraceptives simply because they’re “beholden” to the government for an unrelated grant. See how that works? The mere fact that you receive federal funding doesn’t mean that the government can violate your constitutional rights willy-nilly.

    Even if the HHS mandate were equivalent to a general tax (like, say, Medicare or FICA), CC could and should still be considered for a religious exemption precisely because said tax could violate–actually, does violate–their fundamental moral beliefs.

    That’s why your distinction between Catholics and the Amish is spurious. The Amish don’t receive exemptions to federal programs because they also refuse to take federal funding (which isn’t true: they benefit from all kinds of federal programs). They receive exemptions because their religious rights would be violated otherwise. The Catholic Church and Catholic Charities (the latter still being consider a religious organization by the government) are entitled to the same exemptions as the Amish when appropriate–when, that is, their fundamental beliefs are being violated. (There are complications, of course: Employment Division v. Smith is sometimes used to modify this logic, but the general logic nonetheless holds).

    Moreover, the Amish are exempt from all kinds of programs that are “general” and that apply to “ALL” citizens and groups. Almost all federal programs that apply to everyone are supposed to contain latitude for religious exemptions. If Medicare violates your religion’s conscience, your religion can refuse to pay those taxes. Etc.

    Frank, it’s not that I don’t understand your logic. It’s that your logic is just wrong on a simple, factual basis. The HHS mandate isn’t a tax. The federal government can’t make CC do whatever it wants simply because it receives federal funds. Both Catholics and Amish are entitled to the exact same rights of conscience, regardless of whether they participate in federal programs. Again, you’re entirely free to disagree with me regarding whether the HHS mandate (and ACA in general!) is a good or bad idea, but you’re not free to invent the facts.

  • Grace

    The poem below reminds me of my mother!

    The lovely piece below is from JAMA – Poetry and Medicine | January 10, 2007

    PICKING FLOWERS

    Your refrigerator door
     is a crazy quilt
    of death and life:
     a yellowed form
    from the state
     reads, “Do Not Resuscitate”;
    dog-eared photos
     show you beaming
    as mother and wife.
     Those instructions
    I sent you
     for stopping nosebleeds—
    sit up, lean forward, compress—
     sit right beside
    your grandson’s
     crayon sketch:
    dressed
     in your Julia Child apron,
    Mother,
     you are ever
    the reigning spirit
     of this house.
    Today, you wheel yourself
     into the kitchen,
    pause before the fridge
     and sigh.
    You nudge
     that Monet magnet
    to the right.
     The “DNR”
    disappears
     beneath a blue sky
    and a field
     of wild poppies.

    Lexington, Mass

    Poetry and Medicine Section Editor: Charlene Breedlove, Associate Editor.

  • Grace

    The poem below reminds me of my mother!

    The lovely piece below is from JAMA – Poetry and Medicine | January 10, 2007

    PICKING FLOWERS

    Your refrigerator door
     is a crazy quilt
    of death and life:
     a yellowed form
    from the state
     reads, “Do Not Resuscitate”;
    dog-eared photos
     show you beaming
    as mother and wife.
     Those instructions
    I sent you
     for stopping nosebleeds—
    sit up, lean forward, compress—
     sit right beside
    your grandson’s
     crayon sketch:
    dressed
     in your Julia Child apron,
    Mother,
     you are ever
    the reigning spirit
     of this house.
    Today, you wheel yourself
     into the kitchen,
    pause before the fridge
     and sigh.
    You nudge
     that Monet magnet
    to the right.
     The “DNR”
    disappears
     beneath a blue sky
    and a field
     of wild poppies.

    Lexington, Mass

    Poetry and Medicine Section Editor: Charlene Breedlove, Associate Editor.

  • Grace

    I’m sorry, the piece I just posted PICKING FLOWERS was written by: Ronald Pies, MD. Lexington, Mass.

  • Grace

    I’m sorry, the piece I just posted PICKING FLOWERS was written by: Ronald Pies, MD. Lexington, Mass.

  • fws

    helen @ 234

    I was a member of a very conservative LCMS congregation for over years. I believe that abortion is murder even in cases of rape and incest. My current congregation in Brasil is conservative and confessional and is a member of a church body that was a full district of the LCMS till aroudn 1970.

    I am going to resist slandering you the way you just did me. I would like an apology actually.

  • fws

    helen @ 234

    I was a member of a very conservative LCMS congregation for over years. I believe that abortion is murder even in cases of rape and incest. My current congregation in Brasil is conservative and confessional and is a member of a church body that was a full district of the LCMS till aroudn 1970.

    I am going to resist slandering you the way you just did me. I would like an apology actually.

  • fws

    cinn @ 235

    1) It is the ACA “mandate” and not the HHS mandate that requires ALL private entities over a certain size to provide healthcare to all employees. Tax or not tax? next.

    Republicans to Obama: Tax! Obama: Not! Supremes: Tax! Republicans (now) not! WhatEVER Cinn.

    The ACA requires ALL private entities to provide health care insurance coverage for their employees.

    My point here is that taxes are used for other things CC finds immoral that they pay for with taxes. Executions are one. They oppose many of our immigration enforcement actions.
    I am not seeing your distinction here.

    Why should I have to pay property taxes that support fire and police protection for exempt churches such as the mormons and JWs who are perverting their children ? Why should I have to pay taxes if I am a JW who doesnt believer in blood drives that are paid for with tax dollars or wars? Where is that line draw? How is this situation different from those?

    I am not sure what the Amish religious exemptions are so I have no way to compare them to this situation. Do those details not matter? I dont know enough about what the quakers or amish or others are exempted from to be qualified to make the comparison you do. Tell me more about how the amish are exempted.

    Churches are exempted. Church related insurance companies are not. They are regulated as all other insurance companies. Are Amish insurance companies exempted? Are amish organizations that contract with the government exempted? apples vs apples please. Give me some specifics. You seem to be claiming to know. Ok.

    2) The HHS mandate is not a tax. I never said it was. it defines what must be covered in that ACA mandate. It is a regulation for the insurance industry. If CC acts as a self insurer, then they are governed by it.

    I can find something on the HHS that says “contraceptives” must be made available, except for certain exempt religious organizations. Here: http://www.hhs.gov/news/press/2012pres/01/20120120a.html/
    I could not find any primary source material (ie HHS) that says it is mandatory to also make sterilization available. O would like a footnote for that Cinn please.
    I also could not find that abortions will also be part of the HHS mandate that defines what must be covered by insurance companies under the ACA. If it exists… a footnote/link would be cool.

    Cinn. I am a CPA who has actually written lots of grant proposals and bid for contracts from various levels of Government. What you said makes no sense to me. If the CC contracts with a govt to repair car engines, they would be require to follow the HHS guidelines. Because of their contract? No. Nothing to do with that.

    why then? because ALL employers are required to provide insurance to all employees (ACA) and the insurer is , in turn, governed by the HHS to make available contraceptives. Not abortifacents. not abortion. not sterilizations. Nothing to do with grants or contracts with the Government.

    I repeat. there are two separate issues here. And now three!

    Issue #1:
    The ACA mandates all employers to provide health insurance. the HHS mandates what is to be covered by the ACA.

    Issue #2:
    If the CC apply for a grant to be an insurer, then the HHS mandate would govern that grant. If they bid for a contract to offer HEALTH services as a hospital, the HHS mandate would govern that., it would depend upon what the feds define in that contract .

    Issue # 3:
    What is it that the HHS mandate mandates:
    “”The LCMS objects to the use of drugs and procedures that are used [to abort babies]” http://www.lcms.org/hhsmandate

    So they dont object to mandated contraceptives. And they dont claim that the HHS mandate mandates anything beyond contraceptives. And a pdf they produce say it is unknown if some contraceptives such as plan be can destroy embryos. They would like to know more before they are ok with those being mandated.

    So again: where is your footnote for your claim that the HHS mandate mandates the availability of sterilization. And why does that matter in this context? Again what about the JW, quakers, amish etc who object to how their sales taxes , property taxes and income taxes and federal excise taxes, and medicare and medical taxes are used? Are they exempted from those taxes? If not why not. If so then how so and on what basis.

    You base your argument on such parallels. What are the details since you claim to know them well enough to insist on such a parallel.

    Again: No one has a gun pointed to their head making them use services that are mandated to be only made available. My tax dollars are used all the time to enable someone, somewhere to do something immoral. Welfare often is that. So can I refuse, on religious grounds to pay a fee/tax/penalty whatever on that basis? Why or why not?

  • fws

    cinn @ 235

    1) It is the ACA “mandate” and not the HHS mandate that requires ALL private entities over a certain size to provide healthcare to all employees. Tax or not tax? next.

    Republicans to Obama: Tax! Obama: Not! Supremes: Tax! Republicans (now) not! WhatEVER Cinn.

    The ACA requires ALL private entities to provide health care insurance coverage for their employees.

    My point here is that taxes are used for other things CC finds immoral that they pay for with taxes. Executions are one. They oppose many of our immigration enforcement actions.
    I am not seeing your distinction here.

    Why should I have to pay property taxes that support fire and police protection for exempt churches such as the mormons and JWs who are perverting their children ? Why should I have to pay taxes if I am a JW who doesnt believer in blood drives that are paid for with tax dollars or wars? Where is that line draw? How is this situation different from those?

    I am not sure what the Amish religious exemptions are so I have no way to compare them to this situation. Do those details not matter? I dont know enough about what the quakers or amish or others are exempted from to be qualified to make the comparison you do. Tell me more about how the amish are exempted.

    Churches are exempted. Church related insurance companies are not. They are regulated as all other insurance companies. Are Amish insurance companies exempted? Are amish organizations that contract with the government exempted? apples vs apples please. Give me some specifics. You seem to be claiming to know. Ok.

    2) The HHS mandate is not a tax. I never said it was. it defines what must be covered in that ACA mandate. It is a regulation for the insurance industry. If CC acts as a self insurer, then they are governed by it.

    I can find something on the HHS that says “contraceptives” must be made available, except for certain exempt religious organizations. Here: http://www.hhs.gov/news/press/2012pres/01/20120120a.html/
    I could not find any primary source material (ie HHS) that says it is mandatory to also make sterilization available. O would like a footnote for that Cinn please.
    I also could not find that abortions will also be part of the HHS mandate that defines what must be covered by insurance companies under the ACA. If it exists… a footnote/link would be cool.

    Cinn. I am a CPA who has actually written lots of grant proposals and bid for contracts from various levels of Government. What you said makes no sense to me. If the CC contracts with a govt to repair car engines, they would be require to follow the HHS guidelines. Because of their contract? No. Nothing to do with that.

    why then? because ALL employers are required to provide insurance to all employees (ACA) and the insurer is , in turn, governed by the HHS to make available contraceptives. Not abortifacents. not abortion. not sterilizations. Nothing to do with grants or contracts with the Government.

    I repeat. there are two separate issues here. And now three!

    Issue #1:
    The ACA mandates all employers to provide health insurance. the HHS mandates what is to be covered by the ACA.

    Issue #2:
    If the CC apply for a grant to be an insurer, then the HHS mandate would govern that grant. If they bid for a contract to offer HEALTH services as a hospital, the HHS mandate would govern that., it would depend upon what the feds define in that contract .

    Issue # 3:
    What is it that the HHS mandate mandates:
    “”The LCMS objects to the use of drugs and procedures that are used [to abort babies]” http://www.lcms.org/hhsmandate

    So they dont object to mandated contraceptives. And they dont claim that the HHS mandate mandates anything beyond contraceptives. And a pdf they produce say it is unknown if some contraceptives such as plan be can destroy embryos. They would like to know more before they are ok with those being mandated.

    So again: where is your footnote for your claim that the HHS mandate mandates the availability of sterilization. And why does that matter in this context? Again what about the JW, quakers, amish etc who object to how their sales taxes , property taxes and income taxes and federal excise taxes, and medicare and medical taxes are used? Are they exempted from those taxes? If not why not. If so then how so and on what basis.

    You base your argument on such parallels. What are the details since you claim to know them well enough to insist on such a parallel.

    Again: No one has a gun pointed to their head making them use services that are mandated to be only made available. My tax dollars are used all the time to enable someone, somewhere to do something immoral. Welfare often is that. So can I refuse, on religious grounds to pay a fee/tax/penalty whatever on that basis? Why or why not?

  • fws

    Cinn

    when I google “what is the hhs mandate” ALL the hits are from conservative groups. NONE of those groups start by answering that question. they seem to assume that “we already answered that question” “we already covered that”. Your attitude!

    And even my LCMS didnt do a great job. they should have said this

    “we object to the HHS mandate because there is no scientific proof that some contraceptive drugs do not function by not allowing fertilized eggs to attach to the uterine wall. And we want scientific proof to rule this possibility out 100%!”

    The are not terribly obvious. They start out with “we are against abortion” This implies that the HHS mandate somehow is mandating abortion drugs. No they dont SAY that. In a pdf is the information that we really dont know one way or the other if this is so, but SOME studies suggest that MAYBE this happens. This doesnt seem to merit the frenzy of discussion I am seeing here . And I already quoted one poster as assuming that HHS Mandate= abortifacents being mandated. Not so.

  • fws

    Cinn

    when I google “what is the hhs mandate” ALL the hits are from conservative groups. NONE of those groups start by answering that question. they seem to assume that “we already answered that question” “we already covered that”. Your attitude!

    And even my LCMS didnt do a great job. they should have said this

    “we object to the HHS mandate because there is no scientific proof that some contraceptive drugs do not function by not allowing fertilized eggs to attach to the uterine wall. And we want scientific proof to rule this possibility out 100%!”

    The are not terribly obvious. They start out with “we are against abortion” This implies that the HHS mandate somehow is mandating abortion drugs. No they dont SAY that. In a pdf is the information that we really dont know one way or the other if this is so, but SOME studies suggest that MAYBE this happens. This doesnt seem to merit the frenzy of discussion I am seeing here . And I already quoted one poster as assuming that HHS Mandate= abortifacents being mandated. Not so.

  • Cincinnatus

    fws:

    I don’t have time tonight to respond to everything you’ve said in your last several comments, especially the red herring about what conservatives have to say on the internet about the HHS mandate. I really don’t care what the blogs have to say.

    However, I just want to correct yet another factual error in your account of the issues at hand. The ACA mandate–i.e., the individual mandate–is a tax, according to the Supreme Court as of Thursday. Gotcha. I’m with you there. But it’s a tax on individuals, and all it is is a penalty for not buying insurance. Remember? The individual mandate says this: you, as an individual, must buy some kind of health insurance or pay a monetary fee/penalty. The fee is the tax, not your purchase of insurance. Make sense? Maybe not, but that’s what the Court decided. I’m opposed to the individual mandate, but not on religious grounds–and neither is anyone else. There’s no free exercise claim to be made here. The penalty fee for not purchasing insurance has been declared a tax and that’s that.

    The HHS mandate, on the other hand, is something completely different, and it is not a tax. The HHS mandate says that if you, as an employer, offer insurance to your employees, that insurance must cover contraceptives and sterilizations (though allegedly none of those contraceptives are, strictly speaking, abortifacients). Again, this is not a tax in any sense of the word, and even under the logic of Thursday’s Court ruling would not be considered a tax. I don’t know how many times I have to repeat myself on this point. You may want to believe it’s a tax, or think it’s analogous to a tax. But it’s not a tax. Period.

    You’re also wrong (or at least apparently unclear) about the actual content of the HHS mandate. Fact: the HHS mandate requires that insurance plans offered by employers cover elective contraceptives and sterilizations (yes, sterilizations) (http://en.wikipedia.org/wiki/Contraceptive_mandate#United_States_2012). Fact: the Catholic Church is deeply and morally opposed to all forms of contraception, including condoms. You did know that, right? The Catholic Bishops don’t oppose the HHS mandate on trumped up charges that it requires abortions; they oppose it on its plain and obvious face because it requires them to violate their plain and obvious beliefs, even given the cynical “compromise” offered by the Obama Administration after the mandate was initially announced. Catholic Bishops don’t want to pay for contraceptives. I don’t blame them. It would be like asking me to pay out of pocket specifically and directly for someone else’s abortion (yes, that’s how serious the Catholic Church regards artificial contraception) as opposed to merely using my general tax dollars to send a grant to Planned Parenthood.

    Conclusion: The Catholic Bishops (and many others) aren’t trying to exempt themselves from a tax. Please, please, please understand this. Discussing taxes in relation to the HHS mandate (not the ACA individual mandate!) is a gigantic red herring/straw man you’ve erected for yourself. Catholics are objecting to a regulation that requires them to purchase directly a commodity to which they are gravely opposed. You’re entirely right on one point: the Supreme Court has ruled on several occasions that taxes can be used for all sorts of things we morally oppose; that’s just how the system works. But again, this isn’t a tax; Congress/the President can make you pay taxes that eventually pay for contraceptives (for example), but they can’t make you buy contraceptives directly (unless the HHS mandate is upheld in court)–which is exactly what they are trying to do in this case.

    There are many other issues I’d like to address in your comments, but I’ll stop there for now. Put simply, it seems that this whole time you’ve simply been conflating the ACA individual mandate and the HHS mandate–without really understanding what either one is in the first place. They’re entirely different things.

  • Cincinnatus

    fws:

    I don’t have time tonight to respond to everything you’ve said in your last several comments, especially the red herring about what conservatives have to say on the internet about the HHS mandate. I really don’t care what the blogs have to say.

    However, I just want to correct yet another factual error in your account of the issues at hand. The ACA mandate–i.e., the individual mandate–is a tax, according to the Supreme Court as of Thursday. Gotcha. I’m with you there. But it’s a tax on individuals, and all it is is a penalty for not buying insurance. Remember? The individual mandate says this: you, as an individual, must buy some kind of health insurance or pay a monetary fee/penalty. The fee is the tax, not your purchase of insurance. Make sense? Maybe not, but that’s what the Court decided. I’m opposed to the individual mandate, but not on religious grounds–and neither is anyone else. There’s no free exercise claim to be made here. The penalty fee for not purchasing insurance has been declared a tax and that’s that.

    The HHS mandate, on the other hand, is something completely different, and it is not a tax. The HHS mandate says that if you, as an employer, offer insurance to your employees, that insurance must cover contraceptives and sterilizations (though allegedly none of those contraceptives are, strictly speaking, abortifacients). Again, this is not a tax in any sense of the word, and even under the logic of Thursday’s Court ruling would not be considered a tax. I don’t know how many times I have to repeat myself on this point. You may want to believe it’s a tax, or think it’s analogous to a tax. But it’s not a tax. Period.

    You’re also wrong (or at least apparently unclear) about the actual content of the HHS mandate. Fact: the HHS mandate requires that insurance plans offered by employers cover elective contraceptives and sterilizations (yes, sterilizations) (http://en.wikipedia.org/wiki/Contraceptive_mandate#United_States_2012). Fact: the Catholic Church is deeply and morally opposed to all forms of contraception, including condoms. You did know that, right? The Catholic Bishops don’t oppose the HHS mandate on trumped up charges that it requires abortions; they oppose it on its plain and obvious face because it requires them to violate their plain and obvious beliefs, even given the cynical “compromise” offered by the Obama Administration after the mandate was initially announced. Catholic Bishops don’t want to pay for contraceptives. I don’t blame them. It would be like asking me to pay out of pocket specifically and directly for someone else’s abortion (yes, that’s how serious the Catholic Church regards artificial contraception) as opposed to merely using my general tax dollars to send a grant to Planned Parenthood.

    Conclusion: The Catholic Bishops (and many others) aren’t trying to exempt themselves from a tax. Please, please, please understand this. Discussing taxes in relation to the HHS mandate (not the ACA individual mandate!) is a gigantic red herring/straw man you’ve erected for yourself. Catholics are objecting to a regulation that requires them to purchase directly a commodity to which they are gravely opposed. You’re entirely right on one point: the Supreme Court has ruled on several occasions that taxes can be used for all sorts of things we morally oppose; that’s just how the system works. But again, this isn’t a tax; Congress/the President can make you pay taxes that eventually pay for contraceptives (for example), but they can’t make you buy contraceptives directly (unless the HHS mandate is upheld in court)–which is exactly what they are trying to do in this case.

    There are many other issues I’d like to address in your comments, but I’ll stop there for now. Put simply, it seems that this whole time you’ve simply been conflating the ACA individual mandate and the HHS mandate–without really understanding what either one is in the first place. They’re entirely different things.

  • Fws

    Cinn

    I keep agreeing that the hhs mandate is not a tax.
    Over and over and over and….
    How many times do i need to say thAt for u to read it?

    I already indicated i know the rc church is even against condoms. I wrote about that. I am well aware of their natural law moral theories. In some detail actually. Rhythm method only doesnt interfere with flourishing and working towards telos. Got that!

    The cc doesnt want to pay for insurance policies nor self insure employees where anything they morally disagree with is required to be made available. Nor do they want to make it available to their employees at no cost to them. Uhuh! they want an exemption from those hhs mandates. They are not seeking exemption from the requirement to provide insurance per se. And they self insure. Got that too.

    i got all that. Ergo. No strawman edifice. U are not reading what i wrote is all. What i just wrote is already in all the other stuff i wrote very explicitly. .

    The wikipedia page states that the mandate also includes sterilizations. They support this with footnote 4. There is just one tiny problem : I cant see anywhere that the linked article in footnote 4 says that!

    Can we engage on things I DID say? It might make for a more interesting conversation.

  • Fws

    Cinn

    I keep agreeing that the hhs mandate is not a tax.
    Over and over and over and….
    How many times do i need to say thAt for u to read it?

    I already indicated i know the rc church is even against condoms. I wrote about that. I am well aware of their natural law moral theories. In some detail actually. Rhythm method only doesnt interfere with flourishing and working towards telos. Got that!

    The cc doesnt want to pay for insurance policies nor self insure employees where anything they morally disagree with is required to be made available. Nor do they want to make it available to their employees at no cost to them. Uhuh! they want an exemption from those hhs mandates. They are not seeking exemption from the requirement to provide insurance per se. And they self insure. Got that too.

    i got all that. Ergo. No strawman edifice. U are not reading what i wrote is all. What i just wrote is already in all the other stuff i wrote very explicitly. .

    The wikipedia page states that the mandate also includes sterilizations. They support this with footnote 4. There is just one tiny problem : I cant see anywhere that the linked article in footnote 4 says that!

    Can we engage on things I DID say? It might make for a more interesting conversation.

  • Fws

    Cinn

    Aca is about an individual mandate mostly but not entirely…

    “Firms employing 50 or more people but not offering health insurance will also pay a shared responsibility requirement if the government has had to subsidize an employee’s health care.[36]”
    http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

    ONCE AGAIN. At 235 you said this:

    “HHS mandate is not a tax, nor does it function even remotely as a tax. (agreed!!!!) the mandate says this: you have to provide insurance to your employees. ”

    No it does not.

    That insurance must cover elective contraception and sterilization.
    http://www.hhs.gov/news/press/2012pres/01/20120120a.html/

    This is ALL the HHS mandate mandates. Sterilization? Footnote please. The wikipedia footnote does not support this assertion. primary source this time? Something from the HHS? Try this:
    http://www.gpo.gov/fdsys/pkg/FR-2012-02-15/pdf/2012-3547.pdf
    And this:
    http://cciio.cms.gov/resources/files/Files2/02102012/20120210-Preventive-Services-Bulletin.pdf

    I don’t see sterilization there. do you Cinn? so where IS that idea originating from if it is nowhere said by HHS?

    Ah but wait. It isn’ there! The word “contraceptive” is…. Assumed!!!!! to include that. Hmmm. As this letter states…From… You guessed it! The us conference of catholic bishops…

    2 We assume …. that the Administration’s use of the term “contraceptive coverage” in the 2011 guidelines and the February 2012 regulation is intended as shorthand …for all FDA-approved contraceptive methods as well as sterilization procedures,…We think it essential that the Administration clarify…that its use of the term “contraceptive coverage” is intended also to include sterilization, education and counseling. If, instead, the term is meant narrowly, to describe only contraception….(blah blah blah)
    http://www.usccb.org/about/general-counsel/upload/2012-hhs-mandate-public-legal-memo.pdf

    The wikipedia article that was your footnote should have been title “the roman catholic objection to the hhs contraceptive mandate explained”

    It had this irrelevant gem for example: “Fr. James V. Schall, professor at Georgetown’s Department of Government, addressed a much broader framing. Constitutional questions of liberty of citizens from oppressive government interference, grounded in natural law arguments of Aquinas based on the classical metaphysics of Aristotle.[17]”

    As a Lutheran i would object to using The Summa of St Thomas to sort out the constitutionality of laws. Hard to decipher the sentence since it seems to be missing a verb.

    Just as an aside.

  • Fws

    Cinn

    Aca is about an individual mandate mostly but not entirely…

    “Firms employing 50 or more people but not offering health insurance will also pay a shared responsibility requirement if the government has had to subsidize an employee’s health care.[36]”
    http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

    ONCE AGAIN. At 235 you said this:

    “HHS mandate is not a tax, nor does it function even remotely as a tax. (agreed!!!!) the mandate says this: you have to provide insurance to your employees. ”

    No it does not.

    That insurance must cover elective contraception and sterilization.
    http://www.hhs.gov/news/press/2012pres/01/20120120a.html/

    This is ALL the HHS mandate mandates. Sterilization? Footnote please. The wikipedia footnote does not support this assertion. primary source this time? Something from the HHS? Try this:
    http://www.gpo.gov/fdsys/pkg/FR-2012-02-15/pdf/2012-3547.pdf
    And this:
    http://cciio.cms.gov/resources/files/Files2/02102012/20120210-Preventive-Services-Bulletin.pdf

    I don’t see sterilization there. do you Cinn? so where IS that idea originating from if it is nowhere said by HHS?

    Ah but wait. It isn’ there! The word “contraceptive” is…. Assumed!!!!! to include that. Hmmm. As this letter states…From… You guessed it! The us conference of catholic bishops…

    2 We assume …. that the Administration’s use of the term “contraceptive coverage” in the 2011 guidelines and the February 2012 regulation is intended as shorthand …for all FDA-approved contraceptive methods as well as sterilization procedures,…We think it essential that the Administration clarify…that its use of the term “contraceptive coverage” is intended also to include sterilization, education and counseling. If, instead, the term is meant narrowly, to describe only contraception….(blah blah blah)
    http://www.usccb.org/about/general-counsel/upload/2012-hhs-mandate-public-legal-memo.pdf

    The wikipedia article that was your footnote should have been title “the roman catholic objection to the hhs contraceptive mandate explained”

    It had this irrelevant gem for example: “Fr. James V. Schall, professor at Georgetown’s Department of Government, addressed a much broader framing. Constitutional questions of liberty of citizens from oppressive government interference, grounded in natural law arguments of Aquinas based on the classical metaphysics of Aristotle.[17]”

    As a Lutheran i would object to using The Summa of St Thomas to sort out the constitutionality of laws. Hard to decipher the sentence since it seems to be missing a verb.

    Just as an aside.

  • Fws

    Cinn

    At 235 u said this: the [hhs] mandate says this: you have to provide insurance to your employees. ”

    No. The hhs mandates that any insurance provided to employees must include coverage for contraceptives. this is not the mandate that requires employers to provide insurance . Rather it mandates what all health insurance must cover and include.
    Churches are exempted from this mandate if they apply for the exemption. but not church related orgs. that is the rub for cc.

    The aca indirectly does (requires insurance ) that as i footnoted at the very start of 243. Are there other laws that require firms to provide health insurance to employees? Not that i am aware of.

    One way or the other, this part smells like a tax to me. It is mandatory and universal. Tax! Cc will contribute one way or another. Provide insurrance or pay a sort of penalty or contribution. Does it matter how?

    If CC CHOOSES to act as their own insurance company they are involved. And they then are regulated, by HHS **AS** an insurance company. If they use blue cross or similar, then it is between blue cross, the individual, and the hhs that regulates health insurance plans. In that case it is not a dictum to catholic charities! It is one to insurance companies!

    Church related orgs like cc and hospitals are not exempted. The administration says they will foot the bill for church related institutions I think i read somewhere.

  • Fws

    Cinn

    At 235 u said this: the [hhs] mandate says this: you have to provide insurance to your employees. ”

    No. The hhs mandates that any insurance provided to employees must include coverage for contraceptives. this is not the mandate that requires employers to provide insurance . Rather it mandates what all health insurance must cover and include.
    Churches are exempted from this mandate if they apply for the exemption. but not church related orgs. that is the rub for cc.

    The aca indirectly does (requires insurance ) that as i footnoted at the very start of 243. Are there other laws that require firms to provide health insurance to employees? Not that i am aware of.

    One way or the other, this part smells like a tax to me. It is mandatory and universal. Tax! Cc will contribute one way or another. Provide insurrance or pay a sort of penalty or contribution. Does it matter how?

    If CC CHOOSES to act as their own insurance company they are involved. And they then are regulated, by HHS **AS** an insurance company. If they use blue cross or similar, then it is between blue cross, the individual, and the hhs that regulates health insurance plans. In that case it is not a dictum to catholic charities! It is one to insurance companies!

    Church related orgs like cc and hospitals are not exempted. The administration says they will foot the bill for church related institutions I think i read somewhere.

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