published Sunday, March 25th, 2012

An epic health care battle

The Affordable Care Act has just turned two years old, yet tomorrow begins the Supreme Court challenge that will determine whether the ACA lives and thrives, or shrivels, or dies. For all the ways that it would secure the promise of affordable, comprehensive health care for most all Americans, it is regrettable -- indeed, almost incomprehensible -- that the ACA faces this legal battle.

As the huge stakes in this lawsuit suggest, however, the battle will be epic, a rarity for the decades. While the Supreme Court customarily allots just an hour for the cases it hears, it has set aside three days for hearings on the ACA. A big chunk of that time will be devoted to the issue of constitutionality of the ACA's mandate for all non-poor Americans to obtain insurance. Another will revolve around its severability clause, which, if upheld, would allow other parts of the law to remain in force even if the purchase mandate was found to be impermissible under federal interstate commerce precedents.

This battle was always predictable. Republicans fought tooth-and-nail to defeat the creation of the nation's two other vital leavening social benefits -- Social Security and Medicare. Their fight to keep health care under the unbridled control of the nation's most cold-blooded for-profit industries -- the rich health insurance and pharmaceutical insurance industries which fill their campaign coffers -- was to be expected.

The court has promised a ruling by the end of June, guaranteeing huge political ripples whatever the verdict.

If it goes in favor of the administration, Democrats would be able to build on the victory by implementing other major reforms and benefits that are set to take effect in 2014. Chief among these would be the establishment of regulated health insurance exchanges in every state that would allow for-profit companies to compete for customers under rules requiring comprehensive, no-exclusion plans that would limit companies over-head cost, require flat-rates for all customers, and set a floor on benefit provisions.

Any of the 56 percent of adult Americans under 65 who receive employer-sponsored insurance could simply keep the insurance they've got. The mandate wouldn't affect them. But for those without access to affordable comprehensive insurance, for the uninsured, and for those whose insurance is skeletal, inadequate and overpriced, the regulated insurance exchanges will be a godsend.

Most of the broad American middle class families and individuals who would want to consider the exchanges would also qualify for significant, income-adjusted federal subsidies to aid their purchase of one of three levels of insurance to be offered in the exchanges. The rules would require each company to state its benefits in plain language, so the plans could easily be compared.

Why any Americans would resist such an option for affordable, comprehensive insurance is a mystery. It is the closest thing to a Medicare-for-all type plan that Republicans would accept. Indeed, the exchanges, anchored by for-profit insurers under reasonable regulation, was actually proposed by Republicans.

Yet if the Supreme rules against the qualified mandate to purchase insurance, Republicans will claim a victory, even if it puts them on the hook to make good on their vague promise to "repeal and replace" the act. They have never defined the latter, except to say that they would keep in place a virtually unregulated for-profit health insurance and pharmaceutical industries.

Americans know what that out-of-control machine ultimately rendered to us: Broad exclusions for pre-existing conditions; unaffordable annual and lifetime limits on benefits; cherry-picking the healthy and leaving too many of the ill to die; denials for care and preventive check-ups; millions of uninsured young adults and children; limits on prescriptions; 50 million total uninsured; increasingly unaffordable deductibles; high co-pays and donut-hole costs for seniors' prescriptions; and a stunning rise in America's rate of medical bankruptcies.

That system also generated lavish administrative perks and multi-millionaire salaries for those who make the rules and denied care to juice their profits, prompting high double-digit annual cost increases for policies with same year-over-year benefits.

Many of these problems already have been or are being remedied by the Affordable Care Act. Yet truly affordable care for all awaits the scheduled 2014 start-up of the states' insurance exchanges. If the Supreme Court wisely rules that the insurance mandate is constitutional as a means of reasonable regulation for the interstate commercial activity of what has been a runaway national health care system, all Americans will benefit.

If partisan ideology by the court's arch-conservative majority results in overturning the ACA, the beast will return, with an unbridled vengeance, entrenching the United States of America as the only advanced industrial nation without affordable, universal care. Which brings to mind the adage: Be careful what you wish for; you may get it.

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joneses said...

First it is called Obamacare as it has been proven by the Government Accounting Office the cost is 1 trillion dollars more than Obama, Pelosi and Reid lied about, making it not affordable at all.

March 25, 2012 at 5:59 a.m.
joneses said...

Obamacare is not about increasing the quality of health care in America nor is it designed to make health care affordable. The sole purpose of Obamacare is to make more people dependent on government.

March 26, 2012 at 12:40 p.m.
JustOneWoman said...

And yet it is a Republican plan! Not a teaparty plan, a Republican plan. Romney knows it and so would you if you did any research.

March 26, 2012 at 1:23 p.m.
joneses said...

Justonewoman

Surely you are not that gullible to believe Obamacare was designed after the health care in Mass. I am not a Romney fan but I would vote for a full terd before I would for for a POS like Obama. Obamacare was designed by a communist/socialist faction many years ago. This plan was not designed after Romney's plan. Even if it was the health care plan in Mass. is a complete failure so what makes you think this one will work? I know it will not work because everything this foolish president does is a complete failure. It has been revealed the cost is 1 trillion dollars more than projected. That in itself is a failure just like the whole plan. Like I said the sole purpose of Obamacare is to make more people dependent on government and has nothing to do with the well being and health of the population this administration lies about caring for.

March 26, 2012 at 2:10 p.m.
joneses said...

Why Liberals Lie

Once you've watched liberals long enough to understand how they think -- scratch that, how they feel -- they become extraordinarily predictable.

To begin with, the liberal agenda is, in many respects, the same as it was in the thirties. Whether you call it communism, fascism, socialism, liberalism, or progressivism, the only real difference is how much they believe they can get away with, the way they sell it to people, and the latest trendy name for what they believe.

So, once the liberals pick a policy from their stale program to push, the next step is to get it implemented. This is where liberals have problems because whether a policy makes sense, is practical, or actually improves people's lives is of secondary importance to them. What is important to liberals is whether supporting or opposing that policy makes them feel good about themselves.

This is why liberals continue to support dysfunctional policies that have been failing miserably for decades and why they often oppose common sense programs that have been proven to work time and time again -- because it isn't about whether it works or not, it's about how it makes them feel.

In other words, a liberal will almost always prefer a policy that's extremely expensive, is difficult to implement, helps almost no one, but seems "nice" -- to a policy that is cheap, simple to implement, extremely effective, and seems "mean."

However, since most Americans make decisions about policies based on whether or not they believe the policy makes people's lives better or worse, liberals have had to become habitually dishonest about what they believe and want to do to get their ideas put into action.

March 26, 2012 at 2:58 p.m.
Rickaroo said...

Joneses, you used one phrase in your post that describes your comments perfectly: POS (piece of sh#t). You are the perfect example of someone with a sever case of diarrhea of the mouth. How can anyone say so much and yet have absolutely no substance to it?

I want you to tell me exactly what "communist/socialist faction" Obamacare was designed by. If it truly was designed by such a faction, then Romney must be every bit the communist/socialist too, because his plan is almost identical. If you cannot see the glaring similarities, you are every bit as blind and dumb as you appear to be.

As for the "dysfunctional policies" of liberals, please tell me how the basic conservative philosophy of supply-side economics - aka "trickle down" - has worked out for the country. For over 30 years, ever since your Saint Ronnie was prez, trickle down has been preached but has never worked, yet you rightwing brownshirts keep preaching it and licking the boots of the fat cats and big business. You are blind-faith, kool-aid drinking followers of your cult of unregulated capitalism, and money is your god.

It is pointless to try to engage your ilk in civil and meaningful debate. I just wish you could all secede, move to Texas or some place, and see how long you last with your guns, Bibles, no regulations, and no government. You might think it would be some sort of libertarian/rightwing utopian "Little House on the Prairie," but it would most assuredly look more like something out of "Deadwood."

March 26, 2012 at 5:04 p.m.
JustOneWoman said...

Jones, Just do the homework instead of calling names. You have no idea what I am or how I think. Nor I of you. I am requesting you to do the research before you spout. I am a conservative liberal or a liberal conservative, which is what most people are. Yours and other's name calling here is just fodder for yourselves. It shows the level of civility and intelligence we are working with here. I accept that. I hold the philosophy that what you think of me is none of my business.

. What I do find funny about this entire thing is how the Republicans have backed themselves in a corner. Or did President Obama put them there? The mandate is a Republican contribution to the Affordable Care Act. The Democrats didn't want it, but agreed because it is needed to make it sustainable. They got the votes and passed it. If the mandate goes, or for that matter the entire act, the car insurance mandate will go with it too. Do you really see that happening? Do you really think it is the Democrats in the pockets of the insurance companies?

. So think what you will, but democrats will be just fine with the mandate gone, if SCOTUS rules against it. And it will be the Republicans trying to wiggle out of this. It was their idea. If the SCOTUS finds the entire act unconstitutional, it will be the people that rise up. Because it truely does hold life for some.

. I am sure you will again call names if you choose. So far, it is a free speech country. President Obama is not perfect. But he sure can play a mean game of 18 dimensional chess.

March 26, 2012 at 5:06 p.m.
shoe_chucker said...

how jones lies.

March 26, 2012 at 6:51 p.m.
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