Quote:
Originally Posted by ellias
"Shitting" on the Constitution is not subjective when a number of his executive orders were overturned by the courts as unlawful. And as far as the allegedly "Affordable" Care Act, the SC should have declared the entire law as unlawful except for a curious re-interpretation of the law by the chief justice.
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It's not the job of the courts to interpret the law passed, only judge Constitutionality. That's the whole reason why the SCOTUS was given most power, because it cannot pass laws, only validate if passed laws are not in conflict with the Supreme Laws which were passed by a supermajority of the US States.
In that regard, on the ACA, the SCOTUS ...
- Upheld the right of the 'mandate,' but called it what it is .. 'a tax," which the US Federal goverment is allowed to do
- Struck down the use of the Interstate Commerce Clause to 'pass the buck' on costs to the states, nullifying the rather disingenuous 'no cost' argument by President Obama, which was to make the states pay for it, the reason why over 2/3rds of US states sued, including even those with Democractic party AGs
- Most specifically, the ACA is a US Federal program that must be paid by the US Federal government, by tax, by fees, by whatever means, under the power by, but only of, the US Federal government, without adding any liabilities to the state governments without their consent
That's basically how the SCOTUS ruled, not to 'judge' the 'fairness' or 'goodness' of the ACA terms, but only against the powers and rules of US Federal v. US State v. US Citizen, based on the US Constitution.
Now, if you want to talk about how it failed, just ask anyone objective back in 2009 when it was first being drafted.
- The 'you get to keep your doctor' was always a load of bullshit, because the plan defined 'ACA minimums' which allowed all sorts of games, and made things worse for most people, ranging from losing their doctor to losing their healthcare, especially considering ...
- Several of the new mandates could not be afforded by many smaller employers, and they 'got creative' to just cut off all healthcare for their employees together, making things totally worse for them, but even if they didn't lose it ...
- Many healthy people now had worse healthcare from their employer, many went to 'ACA minimum' programs as premiums rose, but those with employer healthcare who wanted to use the Exchanges, could not without tax penalty (they lost the pre-tax benefit).
For example, a friend of mine had his employer go to 'ACA minimums' plans after a year because premiums skyrocketed to keep costs down, which he didn't want. He was willing to pay more. So he spent $20K/year, 2.5x as much (employer was only $8K/year) to get his own healthcare, not from his employer. But then was taxed on his premiums because the ACA specifies that if your employer has at least 'ACA minimums,' you must take your employers to get pre-tax premiums. So they ended up paying almost 4x as much in the end, after taxes, literally almost $30K/year, including the taxes.
BTW, people wonder why I'm self-employed ... and why I say we do not have 'free market healthcare' at all.
And atop of all that ...
- There is *0* incentive for healthy people to get good healthcare and invest in their future, so ...
- The Exchanges became exactly as self-employed people like myself said they would, only used by really sick and unemployed people, and a spiralling mess that was completely unsustainable, and would cost far, far more than anything we've ever seen.
- And the whole issue of 'pre-existing conditions' is because, well, in the US ... you change your healthcare provider when you change your job! If you don't get healthcare from your employer, you get taxed on your premiums -- my #1 issue with the ACA, it never addressed that simple problem!
McCain suggested in 2008 that we should give everyone a $5,000 tax credit to get their own healthcare, spend as much as you want or as little as you want, and he was demonized for saying 'he'll take away the pre-tax benefit.' Of course he will, because there will no longer be employer-based insurance, and you get a $5K tax credit to get what you want!
Romney had many ideas, but he too was demonized ... quite ironic since much of Obamacare was based on what Romneycare did in MA! Including the individual mandate! One of my clients was MA-based, and I saw all these Democratic voters bitching and moaning that if they made $90K/year, but didn't get the 'Romneycare minimums' (which were much, much higher than ACA), they were penalized several thousand dollars. But when the ACA does it, with much worse terms, suddenly my Democratic colleagues love it?!
This level of political partisan bullshit is what is doing us in. It's bad when Romney does it at a state level (and far better in my view -- I can easily go into the specifics), but good when Obama does it at a federal level (and it was a colossal oversold load of bullshit that even the state AGs sued over). But in the end, neither Romneycare or Obamacare did what is really required, which was what McCain put forth, which the Republicans argued way back in 1993 against Hillary.
Simply put ...
You basic have to outlaw employer healthcare programs, at least (to start) for everyone under 30 years of age (and eventually everyone), to force them into free market ... real, actual free market. That way, young people -- who are statistically far more healthy and a major net positive -- pay premiums and fund the system way more than the benefit they get. That counter-balances those who are older and sick.
Until that happens, no 'plan' will work ... which is why even Democratic staffers who are friends of mine will say it, but only behind closed doors. The ACA was designed to break it all, and make people think the 'exchanges,' which the Republicans countered Hillary Clinton on way back in 1993, 'don't work.' The 'exchange' will never work if we don't outlaw employer healthcare, at least for young people, and force young, healthy people into them.
It doesn't matter if it's funded in free market or in government taxes, someone has to fund it! There is not a magical pool that just makes cheap healthcare.
The idea that Americans can afford the latest procedures for everyone, is something that not even the UK or Canada is able to do. There will be waiting lists ... and the only question is if you make it single payer, and everyone is on those waiting lists, or you make it multi-player, and only government people are on waiting lists while those who can afford to pay $20-50K/year for insurance can take advantage of the latest procedures without waiting lists.
But then you get into really fucked up situations, like the UK taxpayer paying for breast augmentation, and you can often get it faster than some other procedures (look it up).
Then there's the additional problem where many countries just ignore US patents on drugs, so Americans end up paying for R&D of those drugs, which is why drugs costs more in the US. To solve that we'd need to smash patents, but that would also take away all of the incentive for R&D that we have in the US with it. Of course I think a lot of drug companies abuse that too, and I think we should regulate how much they get to spend on marketing free samples, but that's not just the only issue.
These are the realities of healthcare in the US.
I just want someone to fucking solve it. I'm open to socialized medicine, especially preventive, which will keep people having "ER Healthcare" (no insurance) because the go to the ER as Reagan signed the law in the '80s that no one can be denied at the ER. That there is total waste. Then there is simple, preventive medicine that is much cheaper than if people get sick. Then there's the argument that many expensive machines sit unused, and that would bring costs-per-patient down, etc...
But if everyone thinks every American can have the best healthcare for free, think again. It's people willing to pay $20-50K/year in premiums that will always get the best healthcare, because they are subsidizing a lot. Single payer is a major compromise that even other countries don't have for a reason.
Or as every one of my middle aged Canadian friends in the US say, "I love the Canadian healthcare system ... for when I retire. Until then, I have any major procedures done in the US under my company's health insurance."
I'd actually like to try free market healthcare in the US ... for once (we've never had it) ... by outlawing healthcare from our employers, or at least for those under 30, and preventing their parents from covering them after 18. That would be step 1, and one way to start 'refunding' the ACA, with other changes.
The biggest problem is that the Republicans don't have the 60 votes in the Senate to do much, so it's going to only get worse with the Democratic part now being the 'obstructionalists.' Maybe Trump will turn some Senators, but he's got his own issues with Republicans too. Most didn't want him, and many still don't want to work with him.
Maybe he can Twitter them into submission ... maybe.