King v. Burwell, U.S. Supreme Court. Legal Analysis from Hondo
Comments
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Why? Please explain why states should refuse obamacare.DugtheDoog said:
Exxxactly. It's called nullification. More states should use it.Tequilla said:I don't claim to be a lawyer ...
But last time I checked, the states do have a right to operate in their own best interest and are free to opt out of federal driven programs if not in their best interest.
As someone that worked in the healthcare industry leading up to and during the early stages of ObamaCare, there was widespread opinion that the plan was bad for the healthcare industry ... which considering that 36 of 50 states decided to not operate in a manner consistent with ObamaCare would suggest that they were exercising their desire to act in the best interest of their people.
In the big picture, all that this is is a checking of the executive branch from having too much power. In my opinion, the Obama Administration has consistently acted in a manner that the government knows best and acts accordingly. The reality is that they don't know best and instead are operating in a manner inconsistent with the duties and responsibilities of the executive branch. This lawsuit is just an example of that. -
It was my understanding that nullification is in fact illegal, or else schools in the south would still be segregated.DugtheDoog said:
Exxxactly. It's called nullification. More states should use it.Tequilla said:I don't claim to be a lawyer ...
But last time I checked, the states do have a right to operate in their own best interest and are free to opt out of federal driven programs if not in their best interest.
As someone that worked in the healthcare industry leading up to and during the early stages of ObamaCare, there was widespread opinion that the plan was bad for the healthcare industry ... which considering that 36 of 50 states decided to not operate in a manner consistent with ObamaCare would suggest that they were exercising their desire to act in the best interest of their people.
In the big picture, all that this is is a checking of the executive branch from having too much power. In my opinion, the Obama Administration has consistently acted in a manner that the government knows best and acts accordingly. The reality is that they don't know best and instead are operating in a manner inconsistent with the duties and responsibilities of the executive branch. This lawsuit is just an example of that.
Also that Obama Care cuts into profits for the sake of getting more people on health insurance is not a good argument against it. Too simplistic. -
???2001400ex said:
This bill was passed through both houses of Congress. Obama pushed the bill, but obamacare is in no way a reflection of Obama not acting weighing his duties.Tequilla said:I don't claim to be a lawyer ...
But last time I checked, the states do have a right to operate in their own best interest and are free to opt out of federal driven programs if not in their best interest.
As someone that worked in the healthcare industry leading up to and during the early stages of ObamaCare, there was widespread opinion that the plan was bad for the healthcare industry ... which considering that 36 of 50 states decided to not operate in a manner consistent with ObamaCare would suggest that they were exercising their desire to act in the best interest of their people.
In the big picture, all that this is is a checking of the executive branch from having too much power. In my opinion, the Obama Administration has consistently acted in a manner that the government knows best and acts accordingly. The reality is that they don't know best and instead are operating in a manner inconsistent with the duties and responsibilities of the executive branch. This lawsuit is just an example of that.
Of course the health care industry is against obamacare, it cuts into their profits. The oath of every government officer is to work for the people. Cutting into profits of multi millionaires to reduce costs for the every day person is a perfect example of upholding that oath.
While Romneycare isn't perfect, it's better than the system before it. And it's accomplishing it's intended goals.
Where did you get that? Why would the health care industry be AGAINST millions of new people paying for health insurance and using its services? Look up the Oregon Medicaid expansion on how expanding insurance among the poor increases health care use and utilization.
Private insurance likes the ACA because, despite the increased costs of high-risk, super-sick people that signed up, young people are forced to purchase insurance which they do not fully utilize. In fact, most of the healthy young people signing up aren't signing up for the bronze plan (which is what you'd probably expect given their use of health care) but the 2nd lowest silver plan which is beneficial for private insurance (they're buying services they're not using). Additionally, private insurance can adjust premiums and coinsurance up and down to improve profits. In fact, since the ACA has passed, private insurance has seen an increase in membership and profits.
Hospitals like the ACA because it means more people are coming in with insurance and not needing to rely on charity care for so many cases. Harborview, which has the highest costs of charity care in the state, has seem it drop drastically, meaning they have a steady and reliable source of income now for these impoverished patients. Here is a graph for local hospitals and the reductions in charity care:
What does this mean? It means the hospital is keeping more of its own money. This is a positive for them, too. And as I mentioned earlier with increased utilization, more people are using their services which helps out even more.
There isn't much data for individual providers or the pharmaceutical industry, but there are more office visits and more prescriptions filled now than before.
Also @Tequilla what kinda job did your TCU MBA get you in the healthcare field? You don't have to answer in this thread, but I'm curious what your role and perspective were given your statement earlier. -
Romney care as hondo calls it was a state plan. Hondo cites a state plan to defend a federal power grab.
But how is he a horrible poster? -
Never ask a question that you don't already know the answer. First week of law school.2001400ex said:
Why? Please explain why states should refuse obamacare.DugtheDoog said:
Exxxactly. It's called nullification. More states should use it.Tequilla said:I don't claim to be a lawyer ...
But last time I checked, the states do have a right to operate in their own best interest and are free to opt out of federal driven programs if not in their best interest.
As someone that worked in the healthcare industry leading up to and during the early stages of ObamaCare, there was widespread opinion that the plan was bad for the healthcare industry ... which considering that 36 of 50 states decided to not operate in a manner consistent with ObamaCare would suggest that they were exercising their desire to act in the best interest of their people.
In the big picture, all that this is is a checking of the executive branch from having too much power. In my opinion, the Obama Administration has consistently acted in a manner that the government knows best and acts accordingly. The reality is that they don't know best and instead are operating in a manner inconsistent with the duties and responsibilities of the executive branch. This lawsuit is just an example of that. -
There are many who claim that Romneycare is bankrupting Massachusetts. I would argue that Michael Dukakis bankrupted Massachusetts long ago, but Romneycare is a huge drag on the Commonwealth.RaceBannon said:Romney care as hondo calls it was a state plan. Hondo cites a state plan to defend a federal power grab.
But how is he a horrible poster? -
Consulting working primarily in transactions, partner buy-in and buy-outs, and creation of joint ventures.
I 100% understand people that look at healthcare and hate the concept of profits. I get that there are a lot of people that look at healthcare as a right and not a commodity.
I worked with a lot of very smart people ranging from high end industry experts, hospital executives, healthcare lawyers, etc. Almost universally, people didn't like the ACA.
Here's the problem that I have with healthcare in general:
We create a number of barriers in healthcare to protect the consumer through things like the anti-kickback laws that make it illegal for self-referrals or for physicians to be paid for their referrals. Yet, in the process of doing things like this, we create a number of inefficiencies within healthcare that create higher costs. From where I sat looking at healthcare, I saw so much money wasted tied up in bureaucratic red tape - and that eventually ends up getting passed on to the consumer one way or another. The ACA created even more layers of red tape and one of the things that started happening was that the inability for independent physician practices and other private entities to survive on their own and ultimately creating a mass consolidation within hospital systems.
In general, we need to review the entire healthcare system and figure out what actually makes sense and what doesn't. The system by and large is broken and is outdated with what is required in today's technology driven world. -
First, thanks for bringing a little higher level of discussion to this raging dumpster fire.Tequilla said:Consulting working primarily in transactions, partner buy-in and buy-outs, and creation of joint ventures.
I 100% understand people that look at healthcare and hate the concept of profits. I get that there are a lot of people that look at healthcare as a right and not a commodity.
I worked with a lot of very smart people ranging from high end industry experts, hospital executives, healthcare lawyers, etc. Almost universally, people didn't like the ACA.
Here's the problem that I have with healthcare in general:
We create a number of barriers in healthcare to protect the consumer through things like the anti-kickback laws that make it illegal for self-referrals or for physicians to be paid for their referrals. Yet, in the process of doing things like this, we create a number of inefficiencies within healthcare that create higher costs. From where I sat looking at healthcare, I saw so much money wasted tied up in bureaucratic red tape - and that eventually ends up getting passed on to the consumer one way or another. The ACA created even more layers of red tape and one of the things that started happening was that the inability for independent physician practices and other private entities to survive on their own and ultimately creating a mass consolidation within hospital systems.
In general, we need to review the entire healthcare system and figure out what actually makes sense and what doesn't. The system by and large is broken and is outdated with what is required in today's technology driven world.
Second, I think we're talking past each other to some extent. Costs have likely risen for people on the board because they're in higher income brackets; for any college kids or poorer people, costs have likely declined. Wasn't the main goal of the ACA to increase coverage at the expense of strict cost control?
I respect the motives of the people working in healthcare that disagreed with the reforms, their interests and job security are generally tied to increased efficiency and lower costs. I just happen to believe that the old system privileged the healthy and wealthy, and that expanding coverage is essential. It seems apparent now though that you can't do coverage without cost controls.
On what race said about healthcare as a right, it's probably wrong to say that "good" health is a right, but that there should be minimal standards and services. -
Cost controls equate to reductions in supply. If you're really interested in reducing cost and expanding access, deregulation is needed to increase competition and free up the market. It works every time, and anyone with a basic understanding of economics can grasp this concept.doogsinparadise said:
First, thanks for bringing a little higher level of discussion to this raging dumpster fire.Tequilla said:Consulting working primarily in transactions, partner buy-in and buy-outs, and creation of joint ventures.
I 100% understand people that look at healthcare and hate the concept of profits. I get that there are a lot of people that look at healthcare as a right and not a commodity.
I worked with a lot of very smart people ranging from high end industry experts, hospital executives, healthcare lawyers, etc. Almost universally, people didn't like the ACA.
Here's the problem that I have with healthcare in general:
We create a number of barriers in healthcare to protect the consumer through things like the anti-kickback laws that make it illegal for self-referrals or for physicians to be paid for their referrals. Yet, in the process of doing things like this, we create a number of inefficiencies within healthcare that create higher costs. From where I sat looking at healthcare, I saw so much money wasted tied up in bureaucratic red tape - and that eventually ends up getting passed on to the consumer one way or another. The ACA created even more layers of red tape and one of the things that started happening was that the inability for independent physician practices and other private entities to survive on their own and ultimately creating a mass consolidation within hospital systems.
In general, we need to review the entire healthcare system and figure out what actually makes sense and what doesn't. The system by and large is broken and is outdated with what is required in today's technology driven world.
Second, I think we're talking past each other to some extent. Costs have likely risen for people on the board because they're in higher income brackets; for any college kids or poorer people, costs have likely declined. Wasn't the main goal of the ACA to increase coverage at the expense of strict cost control?
I respect the motives of the people working in healthcare that disagreed with the reforms, their interests and job security are generally tied to increased efficiency and lower costs. I just happen to believe that the old system privileged the healthy and wealthy, and that expanding coverage is essential. It seems apparent now though that you can't do coverage without cost controls.
On what race said about healthcare as a right, it's probably wrong to say that "good" health is a right, but that there should be minimal standards and services.
I know you're not simple enough to not recognize that the real goal and end game of Obamacare is government control via a single payer system. Cost reduction was never a serious consideration, only a red herring put forth by Obama and his minions. -
It varies, depending on their previous coverage, their new coverage and their new utilization. If people did not have health insurance before, they avoided services where they would pay (instead opting for free clinics and other inexpensive options). With coverage, people will be more likely to use the health care system. If they are on Medicaid and don't have to pay, costs will go down. If they went through the exchange and bought a silver plan, costs will go up unless they have to go to the ED, have surgery or be hospitalized.doogsinparadise said:Second, I think we're talking past each other to some extent. Costs have likely risen for people on the board because they're in higher income brackets; for any college kids or poorer people, costs have likely declined.
The main goal of the ACA was to slow down the continuous growth of costs for the federal government. Medicare is always growing, and with the aging population transitioning from private to Medicare, there is a need to reduce healthcare costs while also improve health outcomes. Most of the policies and laws that @Tequilla mentioned that the healthcare industry were dreading were in reference to that.doogsinparadise said:Wasn't the main goal of the ACA to increase coverage at the expense of strict cost control?
The points of expanding coverage were to provide coverage to encourage appropriate healthcare utilization as a means to prevent ED and hospitalizations for poor people (which would come out of hospital's budgets, like Harborview, which is funded by tax dollars). So the cost control (Medicare) and expanded coverage (Medicaid) are two separate points, really.
In fact, the marketplace doesn't really have any limits on costs except for those inherent in the pressures of an open and free market. In fact, premiums are going down in the market place this year because more managed care organizations are entering the market place after waiting and watching for the first year (among other factors). As Southern mentioned, it's the free market enterprise that's helping control costs in the marketplace.
If you're really interested in this stuff, you should read up on the Oregon Medicaid expansion or the RAND Health Insurance Experiment. Two fascinating studies on how expanding health insurance in the US works and what it really does.doogsinparadise said:I respect the motives of the people working in healthcare that disagreed with the reforms, their interests and job security are generally tied to increased efficiency and lower costs. I just happen to believe that the old system privileged the healthy and wealthy, and that expanding coverage is essential. It seems apparent now though that you can't do coverage without cost controls.
