So Bill can have a Seizure: Healthcare Bill Summary

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Bill Glasheen
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Post by Bill Glasheen »

From the Boston Herald...
Va. gov. to sign law blocking health coverage
By Associated Press
Wednesday, March 24, 2010

RICHMOND, Va. — Gov. Bob McDonnell is expected to sign legislation that puts Virginia at odds with the new federal health insurance overhaul.

The Virginia Health Care Freedom Act bucks federal requirements that individuals must purchase health care insurance or face penalties.

McDonnell is expected to sign the bill Wednesday, a day after state Attorney General Ken Cuccinelli filed a lawsuit seeking to declare the new federal law unconstitutional.

***
The entire article can be read here.

Remember that Virginia is a "purple" state. They went from Democratic governor (Tim McKaine, who almost became Obama's VP) to Republican (McDonnell who - like McKaine - was chosen to give rebuttals to the president's SOTU addresses). Virginia went strongly Republican in November largely because of the health care debate.

And Teddy Kennedy's seat went to a (gasp) Republican. Until it did, the Reid/Pelosi/Obama legislation was supposed to be in honor of Teddy and his life-long struggle to get universal health care in this country. And what did the Massachusetts voters say about this? Shockingly enough, they punked the Democratic candidate. And why? Well... Massachusetts has THEIR OWN health care plan. Quite possibly the voters sent a "Thanks, but no thanks" message to Obamacare.

And IMHO, that is their prerogative. A federal mandate that requires the purchase of services for life and health is an overreach of federal authority.

Anyone remember McKain-Feingold? That was supposed to reform election financing. Remember that the Supreme Court said no. And Obama got in front of Congress - and within feet of the Supremes - to bicker with the rejection. It led to Sam Alito's rare but emphatic "Not true!" statement.

Judge Alito correctly mouths, "Simply not true." *

Arrogance diminishes wisdom.
- Arab proverb

- Bill

* Obama's statement "with all due deference to separation of powers" was not in the written transcript of his speech. Apparently when faced with the proximity of the court right in front of him, he began to parse his words. Go figure...
Last edited by Bill Glasheen on Wed Mar 24, 2010 2:43 pm, edited 1 time in total.
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Glenn
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Post by Glenn »

Bill Glasheen wrote:

Va. gov. to sign law blocking health coverage
Not exactly the best worded title! Written by his opponents maybe?
Glenn
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Post by Bill Glasheen »

Good catch!

- Bill
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Post by IJ »

Bill: "I read it. Now your read what I wrote, no?"

Great, then we know I wasn't pretending to have a JD and you knew my response to the states/federal supremacy issue ahead of time.

Bill: "First - The executive branch cannot write law. Period. Declare war? Sure. Get funding for the war? Not so much."

Tell that to Bush-Cheney and their legal team, but ok. It turns out the executive branch does NOT declare war.

"The Constitution's division of powers leaves the President with some exclusive powers as Commander-in-Chief (such as decisions on the field of battle), Congress with certain other exclusive powers (such as the ability to declare war and appropriate dollars to support the war effort)..."
http://www.law.umkc.edu/faculty/project ... treaty.htm

See also Article 1, Section 8.

"Here's the thing, Ian. You're going to subsidize insurance for a good portion of the population that can't afford it, right? That's using federal money for a health benefit that - you guessed it - pays for abortion. So voila - you have a federal subsidy for abortion. Pretty cool, eh? (Not)"

No, the health benefit does not pay for elective abortion (are you referring to those exceptions for life of mother?). The same exclusion amendment went into this bill that went into ALL the healthcare bills in recent history. THIS is not a new issue; this is being seized by the teabaggers to raise a fuss. Nothing has changed. And IF tax dollars were going to subsidize abortion, it's not as if plenty of people didn't want their tax dollars going to raze countries in the middle east, but boo hoo for them, right? That was the semi-elective abortion of thousands and thousands of grown-up fetuses (children and adults), much of it occurring through our mismanagement: http://en.wikipedia.org/wiki/Casualties_of_the_Iraq_War

Justin: botox is a legal medical procedure. So is lasik. Boobies. Tucks. You want that in insurance you pay for? I didn't think so :) I will support you on the idea that abortion may be cost saving--more study needed--not just in the sense of welfare, but also in the sense of crime reduction. Unwanted kids go bad. See discussion in Freakonomics.

As for your suggestion that a fetus is not a human life, WTF are you talking about? Of course it's human life. Human life doesn't start; it's continuous, and just ends occasionally. Adults and their gametes and the embryos and fetuses and then babies that result are all human life. The VALUE we tend to place on human life varies with time in gestation. I have no respect for the idea that a fertilized egg is a "full individual human life" and will continue to disrespect that idea until we live in a world that has a funeral everytime a woman has a late period that represents the death of a 1-2 week old "full human individual." But you should watch "The silent scream." Abortion must be disturbing, it must be considered a failure, it must be considered a wrong, not just a choice. A necessary evil at times, a sad choice, but not just picing out what kind of bagel you want. If you do not feel SOMETHING contemplating the destruction of a human fetus with fingers and eyes and a beating heart, well, this atheist suspects something is wrong with your ...soul? But I'm sure some exposure to actual abortion procedures would fix you right up.

Bill then replied: "YOU were the one who chose to endorse the BRAND NEW use of PUBLIC FUNDING to pay for the consequence of others' bad choices."

Perhaps Bill, you are unaware that huge proportions of medical expense go to the consequences of bad choices? Smoking, eating wrong, not exercising, not getting vaccines, not getting screened, using drugs, drinking too much, getting too much sun and noncompliance with meds and on and on and on. IF you propose to follow through with your plan to limit publicly funded healthcare to unavoidable nonfault situations, you will have an enormous and impossible task of teasing apart factors that contribute to illness. Let's be honest: abortion is a touchy issue for its own reasons not because it's just about consequences of bad decisions. There are good reasons for this. I just accept it.

"Arrogance diminishes wisdom.
- Arab proverb"

Ahh, experience is the best teacher. Too much overconfidence in their magic truths in that region not to have learned about the dark side of zealotry.

Last little comment: Bill, you don't want people to be forced to buy insurance. GREAT! I'm ALL for it. As soon as each of these people signs over their EMTALA rights and agrees not to push for charity care when they get sick and come to me with their freaking hat in their hand. Until then, these people are obstacles to health insurance continuity and stabilization. We can't have people waiting for need then signing up for care.
--Ian
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Bill Glasheen
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Post by Bill Glasheen »

Ian

You might want to follow the legalese in this piece.

Health Care Bill Will Fund Abortions Despite Promised Obama Executive Order

Understand, Ian, that I support the right of a woman to have control over her health care. I just don't want to have public money funding health care that is objectionable to a good portion of the population. That's just plain wrong, and it's way more than arrogant of others to assume that supplying others' tax dollars to this cause is a good thing. Some might argue that it's genocide of the socioeconomically deprived. And while that's a stretch, they do have an interesting story to tell.

It has nothing to do with being pro life or pro choice. It has to do with the reach of tax dollars that are collected from all in spite of their political persuasion. Obviously when you start carping about Middle East wars, this strikes a chord with you.

Second... Last I checked, Bush wasn't president. If he is, then my apologies. I must have had a very bad dream. :P
IJ wrote:
Last little comment: Bill, you don't want people to be forced to buy insurance. GREAT! I'm ALL for it. As soon as each of these people signs over their EMTALA rights and agrees not to push for charity care when they get sick and come to me with their freaking hat in their hand. Until then, these people are obstacles to health insurance continuity and stabilization. We can't have people waiting for need then signing up for care.
It's neither the responsibility nor the right of the federal government to be our nanny.

My parents did just fine raising eight kids without ever having insurance until it was required by the colleges we went to. It's worth noting that a portion of the population NEVER goes to the doctor. My dad was one of them. It took a strangulated hernia in his sixties to get him some medical care. Now that he's 88, he has his Medicare and BCBS Medicare extended. And I make sure he takes his meds and gets treatments he needs.

Others need and/or want insurance. And that's fine by me. Need subsidies? That's fine.

FORCE someone to buy insurance? By federal mandate? Now you're grating on my principles.

There are some kinds of insurance I choose to have, and others I choose not to have. Why? Because I'm better/smarter with my life and my money than any insurance company that will always make money on me at the end of the day.

Principled arguments are important. The end cannot justify the means if the means are noxious to the individual and his/her liberties. Slippery slope arguments apply.

On EMTALA, you might find this article interesting. Maybe you can get Michelle to show you how she did it. After all... we all know that in socialist societies, some people are "more equal" than others.

Michelle Obama's Patient-Dumping Scheme

- Bill
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Glenn
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Post by Glenn »

Bill Glasheen wrote: I just don't want to have public money funding health care that is objectionable to a good portion of the population. That's just plain wrong
There is a definite slippery slope to this argument though. A good portion of the population has at times objected to public money funding health care for minorities, to women being able to vote, etc...and I'd say there is still a good portion of the population that objects to these. We cannot base important decisions solely on what percentage of the population objects to something.
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Post by Bill Glasheen »

Glenn wrote:
We cannot base important decisions solely on what percentage of the population objects to something.
Well then hail to King Obama!

You REALLY didn't mean that, Glenn.

- Bill
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Post by MikeK »

Sadly I think things are going to get worse between folks over this "win".
I was dreaming of the past...
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Bill Glasheen
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Post by Bill Glasheen »

MikeK wrote:
Sadly I think things are going to get worse between folks over this "win".
A former karate student of mine (in my first class of black belts) who turned out to be uber liberal posted a Huffington Post (liberal) article today on his Facebook page, and then commented "They are all Nancy's b1tches now." Out of protection for him, I won't reveal his identity. It was really a stupid comment, and I was all over him for it.

You're right, Mike. When even the "winners" can't behave, you know this is going to get very ugly. That kind of behavior is not forgotten.

No (zero) minority party votes for a major bill like this is both historic and frightening. Both social security and Medicare got significant numbers of Republicans voting for the programs. Not this. That too does not bode well for politics and politicians in the near future.

- Bill
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Post by Glenn »

Bill Glasheen wrote: Well then hail to King Obama!

You REALLY didn't mean that, Glenn.
Didn't I? Kingship is not needed, our whole system of government is based on ignoring the objections of an often sizable portion of the population, every election or congressional vote for example. Heck, we have a system in place where a presidential candidate who loses the popular vote can still win the election, in those cases the objections of the majority are ignored.

I stand by what I said, withholding public funding for health care based solely on the objections of a segment of the population is a slippery slope.
Last edited by Glenn on Thu Mar 25, 2010 5:10 am, edited 2 times in total.
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Post by IJ »

Bill, I read thru your legalese (from lifenews.com) and remain unimpressed. It actually catalogs how other funds (not the federal funds being collected) must be charged by insurance for any abortion coverage in a plan. The thing that annoys the pro-life set is that the bill will fund insurance that covers abortion. But it will not fund the abortion. It's as if they don't want any federal funds to go to radios in cars. Now the government is going to subsidize some kind of car (american, hybrid, whatever) and the makers of those cars are going to put radios in some and charge the buyers an extra fee for the radios. I think it's unreasonable that pro-lifers expect any insurance that dares to offer abortion will automatically be DQ'd, because let's face facts here, the majority of Americans support abortion access although they have serious concerns about exercising the choice to abort. Insisting that any program a national reform effort touches be completely free of abortion's taint (if they had their way, this would probably mean no exceptions for rape, incest, and plenty of serous health of mother concerns) is unreasonable. It's as if I insisted that the government touches no healthcare system that funds alcohol dependence treatment, services for hepatitis C contracted via drug use, any STD therapy, birth control, yadda yadda. This are more or less the same people who brought us no HPV vaccine to use the threat of death by cervical cancer to keep their daughters virgin, and the people who supported ineffective abstinence only sex ed with factual errors, and they're the same people or the kids of the people who did nothing while the early AIDS epidemic took out mostly drug users and gays. They're not the best at the medical decisions, in short. Sorry to mention the Iraq war yet again, but if a minority's offended morals could derail legislation like this, we'd have no wars or healthcare bills. Suk it up, people. Note that I'm "carping" about the war, and pointing out that we don't get to veto government by line item. What, do the pacifists really think they can have a government funded army but no army program that uses unguided bombs or overly sharp bullets or depleted uranium shells is automatically DQ'd for the whole nation based on their concerns?

As for your whole nanny thing, yeah, I know. I addressed it. The government is ALREADY in your pants with EMTALA and healthcare provision. Your free market wisdom and your Darwinian reward the smarties forget the dummies is irrevocably poisoned by current intervention in the market. The government and hospitals provide guaranteed care at hospitals. How good? Good enough for you to champion this backup as negating any need for a healthcare overhaul in recent threads. So it's good enough for a person to reconsider insurance because he knows the state has his back. I've met such people, like a professional guy with no insurance on his kids because overall, out of pocket for small stuff is cheaper and when they get lymphoma, well, you know the government steps in then. As a result, the market is deprived of people who are buying their insurance, and are relying on luck and a backup plan. They are just like Wall Street. AIG bets and wins?? BIG MONEY! AIG bets and loses?? Ian and Bill bail them out. THAT isn't libertarian, it isn't free market, and the incentives are not aligned for the most productive choices.

So as I've already said, you either can "force" these people to buy insurance (not really at all, Bill; they're simply going to pay a tax if they don't buy, and we make up crazy taxes and crazy tax breaks all the time with no fuss from teabaggers like we've seen over this), or, you have to remove the safety net for people who didn't think to plan ahead, or figured they could game the system. So which is it, mandatory insurance or would you like to remove EMTALA and charity? Hmm?

I'm glad your Dad was well for so long. If he wasn't, he either would have been 1) financially devastated, and I'm sure distraught about those effects on his kids 2) not given proper care 3) the beneficiary of a charity or government safety net.

As far as Michelle's work, well, goes to show we need to align people's incentives right. She was in business, like Halliburton or Blackwater or big pharma twisting the truth, and business is profits first nice guy second. If they violated EMTALA, and it sounds like with the kid they did, they should be slammed with fines / sued. Funny thing is at UCSD we're the dumped on hospital. I've had docs at other facilities tell their undesirable patients in other systems to come see us for admissions, and I've taken care of people with chronic expensive conditions (bad diabetic foot infections) needing 6 weeks inpatient care when the other hospital sent em home with tylenol and some oral antibiotics. And yet at UCSD, we do try to shunt people with poor funding to other clinics and systems. We want to do our fair share, not everyone's fair share. And our clinics aren't enrolling unfunded patients at present. Sounds like something needed to be done....
--Ian
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Post by Glenn »

Bill Glasheen wrote: From Kenneth T. Cuccinelli, II, Attorney General of Virginia:
There has never been a point in our history where the federal government has been given the authority to require citizens to buy goods or services.
The mandatory social security deduction from my paycheck argues otherwise. And for that matter the taxes taken out (or added onto purchases, properties, etc), which go to pay for services so in a way I am buying those as well, even if it is buying a service that someone else may use.
Bill Glasheen wrote: A federal mandate that requires the purchase of services for life and health is an overreach of federal authority.
How is this different from Social Security? Forcing me to pay into retirement and forcing me to pay for health insurance are conceptually the same.
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Post by Glenn »

An article from the Miami Heraldabout how conservatives have been advocating mandatory insurance for over a decade. It also has a quote from Mitt Romney, who instituted mandatory insurance in Massachusetts when he was governor, about how it fits Libertarian views as well as Republican.
Health bill included big Republican idea: individual mandate
By John Dorschner, The Miami Herald John Dorschner, The Miami Herald

The lawsuit against the health care overhaul filed Tuesday by Florida Attorney General Bill McCollum is focused on a provision that has long been advocated by conservatives, big business and the insurance industry.

The lawsuit by McCollum, a candidate for governor, and 12 other attorneys general, focuses on the provision that virtually all Americans will need to have health insurance by 2014 or face penalties.

The lawsuit calls this an "unprecedented encroachment on the liberty of individuals." It states the Constitution doesn't authorize such a mandate, the proposed tax penalty is unlawful and is an "unprecedented encroachment on the sovereignty of the states."

"The truth is this is a Republican idea," said Linda Quick, president of the South Florida Hospital and Healthcare Association. She said she first heard the concept of the "individual mandate" in a Miami speech in the early 1990s by Sen. John McCain, a conservative Republican from Arizona, to counter the "Hillarycare" the Clintons were proposing.

McCain did not embrace the concept during his 2008 election campaign, but other leading Republicans did, including Tommy Thompson, secretary of Health and Human Services under President George W. Bush.

Seeking to deradicalize the idea during a symposium in Orlando in September 2008, Thompson said, "Just like people are required to have car insurance, they could be required to have health insurance."

Among the other Republicans who had embraced the idea was Mitt Romney, who as governor of Massachusetts crafted a huge reform by requiring almost all citizens to have coverage.

"Some of my libertarian friends balk at what looks like an individual mandate," Romney wrote in The Wall Street Journal in 2006. "But remember, someone has to pay for the health care that must, by law, be provided: Either the individual pays or the taxpayers pay. A free ride on government is not libertarian."

Romney was referring to the federal law that requires everyone to be treated in emergency rooms, regardless of their ability to pay.

During his presidential election campaign, Barack Obama was opposed to an individual mandate, preferring instead strong requirements that employers be required to provide coverage. "I'm not sure how ready the country is politically to accept the overall mandate," Irwin Redlener, a Columbia University physician and adviser to Obama, told The Miami Herald during the campaign.

Still, the concept was gathering a strong momentum. The Business Roundtable, an association of chief executives of America's largest companies, supported it in the summer of 2008, thinking it much better than a broad requirement to force businesses of all sizes to offer coverage — something that could increase business costs and make them less competitive.

Others joined the bandwagon, including the liberal Service Employees International Union and the Commonwealth Fund, a nonpartisan nonprofit that studies American healthcare problems.

In November 2008, just days after Obama's landslide victory, America's Health Insurance Plans, a trade group, made a stunning announcement, saying it favored universal coverage and supported a law that would stop insurers from rejecting applicants because of preexisting conditions.

"Universal coverage is within reach," the group said in a historic press release.

After being adamantly opposed to reform during the Clinton years, AHIP said it had changed its mind — based on one condition: Any reform plan had to require that all individuals have insurance or pay stiff penalties.

AHIP's reasoning was simple: Many of the uninsured are healthy and under age 35. They either have jobs that don't offer insurance or they didn't pay for insurance because they were certain they wouldn't get sick.

Having this group in an insurance pool spreads risk. Without an individual mandate requiring them to get insurance, Americans could wait until they got sick and then sign up for insurance — a trend that would mean only sick people would be paying premiums while running up huge bills. In this scenario, healthy people would have no need to buy insurance — a financially disastrous situation for insurance companies.

The Obama administration saw that the mandate was the only way to get a reform package passed and it became a foundation of the legislation, along with subsidies for those who couldn't afford coverage.

On Monday, the day after it was passed, McCollum was ready with a press release: "The healthcare reform legislation passed by the U.S. House of Representatives last night clearly violates the U.S. Constitution and infringes on each state's sovereignty."

He objected to Thompson's car insurance analogy because people could choose wether or not they wanted to drive a car, while people had no choice about buying health insurance under the reform act. What's more, car insurance was rightly a state requirement, not a federal one.

He was joined in the lawsuit by attorneys general from Alabama, Colorado, Idaho, Louisiana, Michigan, Nebraska, Pennsylvania, Washington, South Carolina, South Dakota, Texas and Utah and Washington.
Glenn
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Post by Bill Glasheen »

Glenn wrote:
I stand by what I said, withholding public funding for health care based solely on the objections of a segment of the population is a slippery slope.
You're missing the point, Glenn.

We ALREADY have public funding of health care. Do you not understand the conversation Ian and I are having about EMTALA? A woman can cross the Rio Grande 9 months pregnant and get free delivery services in the ER. By law no less. You can get the same services in any emergency. So I don't get what you don't get.

The "slippery slope" is the federal government mandating that I purchase a service simply because I am alive. That service would be the 3rd party administration of my health care dollars. And if I don't do that, the federal government will fine me and use my own money for others. Can you say unconstitutional?

The Constitution doesn't care what bonehead came up with the idea. All that matters now is that a single party ushered it in to law. There was no (zero, none, nada, zippo) bipartisanship. That alone should give pause.

Hail to the King!

FWIW, I have visited several governments with universal health care systems. One was the collapsing Soviet Union. There an MD made $35 a month, and needed a second job (e.g. driving a taxi) to feed the family. Note I didn't say "his" family; most Russian doctors are women (like nurses here).

Be careful what you wish for. There is no free lunch. And when seventeen percent of the GDP (and rising) becomes an entitlement, you're on the verge of losing that which makes this country unique. The only major power left without it would be China, which is slowly growing to own our country. And that isn't a very good thing (for us).

However... there should be no mystery about the drive of people who work or starve/die. If China becomes the next great world power, we shouldn't be surprised. Better start learning Mandarin.

- Bill
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Post by Glenn »

Bill Glasheen wrote:
You're missing the point, Glenn.

We ALREADY have public funding of health care. Do you not understand the conversation Ian and I are having about EMTALA? A woman can cross the Rio Grande 9 months pregnant and get free delivery services in the ER. By law no less. You can get the same services in any emergency. So I don't get what you don't get.
That point was a different conversation and not relevant to my point. I was commenting on your advocacy for withholding public funding for abortion based on the objections of a segment of the population. My comments are about the logic behind what you are advocating, not about what public funding already pays for. I am not even saying I agree that abortions should be publically funding, I am just saying that your stated reason for objecting to it cannot be the only consideration and runs contrary to how our governmental process really works.
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