Posts Tagged ‘Obamacare’

Do you still want to repeal Obamacare?

May 30, 2012

Do you really want the Supreme Court to rule the whole act unconstitutional? Do you really want to put the health insurance conglomerates back in complete control of your health care?  Then, to put it politely, what ARE you thinking?

The Patient Protection and Affordable Care Act is over 2 years old.  Though not all provisions have kicked in, enough have to be of genuine benefit to millions of Americans already.  I’m one who’s already benefitted and you might be too.

2.5 million more young adults have insurance coverage thanks to the provision that allowed them to stay on their parents’ plan until age 26.

More than 5 million seniors have saved more than $3.1 billion on prescription drug costs.  Some, caught in the “doughnut hole” where prescription coverage dropped off, got direct rebates of $250 and, in time, the doughnut hole will be complexly erased.

Millions of people (including me) have not paid a copayment for annual checkups and preventive care such as cancer screenings and contraceptives.  They’re not free – we pay for those in our premiums.

Insurance companies can no longer drop your coverage when you most need it or deny benefits to any of the 17.5 million children with pre-existing conditions. 62,000 adults have been able to get insurance from Pre-Existing Condition Insurance Plans and in 2014 everyone with pre-existing conditions must be insured.

When someone faces a devastating diagnosis, they no longer need to worry about their insurance having a lifetime limit on benefits. If they are uninsured, they will have access to new coverage when insurers refuse to offer it.

Insurance companies now have to justify excessive proposed rate hikes, with states establishing review procedures that limit annual increases.  Some rate hikes exceeding 10% have already been ruled improper and rolled back, benefitting millions of customers. (Unfortunately for Texans, the Texas Department of Insurance, under heavy pressure from lobbyists, is dragging its feet on this process.)

Performance standards are being enhanced to improve patient care and reduce injury or deaths from medical or hospital errors, a serious problem in the US.  The network of community federally-funded health centers is already being expanded.  The health care provider industry is among the fastest growing sectors of the American economy, contributing to our recovery from recession and providing millions of good-paying jobs that can’t be outsourced to other countries.  For example, one young adult I know is completing training as an assistant physical therapist and another just received certification as a massage therapist.

In January 2011, a requirement became effective that insurance companies spend 80% of premiums dollars on direct care, not on administrative costs, CEO salaries and profits.  If they fail to spend 80% they have to return the extra money to consumers.  Already insurers have had to return $1.3 billion to consumers they overcharged.

Worried about our national debt?  Obamacare is beginning to slow the growth in health care spending.  Medicare projections of cost increases are $70 billion lower than predictions before Obamacare.  As a matter of fact, the Congressional Budget Office reported that, because it contained a number of cost control measures, repealing the act would add significantly to Medicare and Medicaid costs.  Repeal would add to our national debt.

And, in case your sympathies lie with the insurance companies, their profits have never been better and, if the law were repealed, they would lose $1 trillion in future revenue.  In place of 32 million more customers, they have to meet reasonable standards that protect those customers from abuse.

Still hate that “mandate” even though it hasn’t become effective?  Well, if you have insurance, as 60% of Americans do, it won’t even apply to you at all. And, when it becomes effective, all it will amount to is a penalty on your income taxes that is less than the amount you would pay in insurance. For the tax penalty you would get nothing, but for the health insurance you might get care you would not have otherwise received.

Before the Patient Protection and Affordable Care Act was enacted, 70% of Americans wanted health care reform that would cover everyone.  When it passed, Republican leaders said they supported 80% of it.  Now, they want to repeal the whole thing and replace it with what?  They now say they’ll replace it with nothing, nada, zip for millions of Americans.  What reason do they give for wanting to repeal it?  Again, none except an irrational hatred for our President with such a passion that you and I and our welfare have become irrelevant to them.

Here’s the point of the whole thing.  Millions more Americans are now able to go to a doctor or be hospitalized or buy medicine and get health care THEY WOULD NOT OTHERWISE have received without Obamacare.  How many lives do you suppose have already become healthier, longer or happier?  Anyone’s guess, but it’s sure to be many.  For those who would do away with Obamacare, what is it about healthier, longer and happier that you don’t like?

Why the Patient Protection and Affordable Care Act Should be Found Constitutional

April 8, 2012

While the Supreme Court considers appeals regarding the Patient Protection and Affordable Care Act (PPACA) – which some pro and con now call “Obamacare” for different reasons – we citizens can apply our own common sense to the question.   When we do, we see that, unless this Court engages in rampant judicial activism driven by political ideology, they should uphold the act.

Consider these portions of the US Constitution:

Article I The Legislative Branch

Section 8 – Powers of Congress

The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States;

To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;

And; To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers, and all other Powers vested by this Constitution in the Government of the United States, or in any Department or Officer thereof.

Look at the second of the powers listed: To regulate Commerce  “among the several States….,” in other words, “interstate commerce.”  Is buying and selling health care insurance interstate commerce?  Seems pretty clear that it is since customers buy coverage from nation-wide companies.  Is buying and selling health care itself – paying the doctors, hospitals, drug companies, etc. to care for us – interstate commerce?  Again, it surely is, as the providers, the medicines and the equipment come from all over the world.

Look at the last of the powers listed, the power “To make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers….”  Under this section, Congress is authorized to enact detailed standards and requirements “necessary and proper” to accomplish their goals.  We should not be surprised the act takes up two thousand pages and has to be phased in.  It’s a big deal benefiting millions of Americans and something 70% of us asked Congress to do in 2008.

So, how did Congress choose to enforce a requirement that everyone obtain health insurance coverage?  Read the first of the enumerated powers:  “The Congress shall have Power To lay and collect Taxes….”  They chose to enforce PPACA through the tax code.  The “individual mandate” is actually in 2 parts of the act.  The first part says everyone must buy insurance and the second part says that, if they don’t do so, they will have a penalty added to their taxes.  No one goes to jail or faces criminal or civil penalties.  And if we are unable to pay for the insurance, assistance in getting good coverage will be provided.  By the way, the “individual mandate” has no effect whatsoever on people who have health insurance – over 60% of the population.

With authority to tax, Congress could have taken other routes in assuring health care that would also be constitutional. Congress could have simply left out the first part of the individual mandate and left in place the tax penalty clause to have exactly the same effect. Alternatively, they could have just raised everyone’s taxes to fund a single-payer insurance program like Medicare and made it available to everyone. Either way, the authority of the government to lay and collect taxes and thus enforce the mandate is provided in the Constitution.

Regarding the requirement to purchase insurance from private companies, government often requires that we pay for certain things we may not want to purchase – like care insurance we may never use.  Intuitively we know that health care isn’t the same as cars. Virtually, all of us will at some time need health care, yet we don’t know in advance when and what we will need; and at the time of need we likely won’t be able to pay out of pocket.  So we must pre-pay for some unknown but virtually certain need.  Those of us who don’t pay are costing those of us who do over $1,000 on average per year to cover their care. There’s evidence in the questions asked by the Supreme Court justices, that they understood how this market works and why everyone has to pay so everyone is covered.

Finally, in previous decisions, the Supreme Court has asserted its authority to rule on the constitutionality of legislation, a claim unchallenged by Congress and the President. However, the Court also has ruled that acts of Congress are presumed to be constitutional because House and Senate members are elected by the people and take the same oath of office the justices do to uphold the Constitution of the United States.  The Legislature is a branch of government coequal with the Supreme Court; thus the Court has recognized that ruling legislation unconstitutional “…frustrates the intent of the elected representatives of the people.”  The Supreme Court has previously upheld many interstate commerce and tax laws. If they now were to rule PPACA unconstitutional it would call into question other programs (like Medicare) that have long provided “…for the common defence and general Welfare of the United States…”

An “activist court” steps beyond its proper authority by ignoring the actual wording of the Constitution and ignoring previous court decisions in order to write its own laws based on its own ideology.  Odds are good that a majority of the members of this Court know both the Constitution and the previous decisions of their Court. When they were confirmed before the Senate they all testified under oath that they would follow “stare decisis” and abide by the rulings of previous Courts.  Thus it would be an extremist and activist court that failed to uphold PPACA.

By the way, if you think PPACA erodes your individual freedom, consider how free you’d feel ill, aged or disabled and unable to get care because you didn’t have insurance or your insurer had dumped you.  A whole other article could be written on the “powers” individuals have already or will gain from “Obamacare.”  It’s likely a majority of the Supreme Court justices know this as well and are reluctant to take those away from the people.