Since the U.S. Supreme Court upheld the constitutionality of the "individual mandate," the centerpiece of the Affordable Health Care Act that President Obama signed into law last year, Patch readers have weighed in by the hundreds to share their opinions.
Though the ruling happened more than a week ago, our readers continue to debate the proposal, so we're re-featuring the poll that led to this debate. Because the argument hasn't died down, we figure some of you who missed the original story may have new opinions to offer.
To review, five of the nine justices agreed that the key to the act—the requirement that people either buy health insurance or pay a tax penalty—is allowed under Congress' ability to impose using its taxing power.
Local Reaction:
Because that mandate survived, the Court did not need to decide which other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding.
On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.
Other details of the high court's ruling on what is often referred to as "Obamacare" are still being examined.
The controversial law has been the subject of recent TV commercials, political speeches and protests.
Since everyone else is weighing in, we want to know what you think.
Answer our poll question and tell us in the comments how you feel about the court's decision.
We have a duty as citizens and neighbors to care for one another, and help those in need. I agree. This is called charity. It is virtuous. It used to be called "Christian charity". The problem is that there is no such thing as third party charity. If I force you to pay for my charitable urges, three people are harmed. You have your ability to care for yourself, and your ability to realize your own charitable urges stolen from you. The recipient of the charity becomes the recipient of something coerced from a neighbor, and I become a tyrant. Voluntary charity is good. Third party charity, coerced from one another through the political process is destructive of the very virtue it purports to be. Collective charity is a hybrid, with none of the virtue of voluntary charity, and the problems of clumsy, collective, political decision making. (and is less honest) I recommend a book: "Robert E Lee on Leadership" ( http://www.amazon.com/Robert-Lee-Leadership-Executive-Character/dp/0761525548/ref=sr_1_1?ie=UTF8&qid=1342835197&sr=8-1&keywords=leadership+Robert+E+Lee ) The chapter on Gen Lee's College presidency is inspiring.
But what if you’re diagnosed with ALS? Your initial costs could run from $10,000 to $20,000, just to figure out what you have. Treatment over the next five years – your last five years – could range anywhere from $80,000 to $200,000 per year. So what’s your doctor supposed to do when your $50,000 savings is gone? Treat you? Or just walk away because you can't afford treatment? Who makes up the difference between the pot of cash you thought would cover your medical needs, and what they actually ended up costing? Why should others’ health care dollars go towards keeping you alive if you explicitly opted-out of the system? The average cost of a hospital stay for all diagnoses in 2011 was $9200 (Healthcare Cost and Utilization Project, AHRQ Oct. 2011). There are many employed, hard-working individuals in this country that would be hard pressed to pay for even one day. So, are you really advocating for a system where only rich people can afford health care and everyone else can just go hang?
And Donald Lee, if you want to call around looking for the best deal in emergency room care while you are having heart attack symptoms, be my guest - as for me, I'll get an ambulance to take me to the nearest ER.
Maybe Mr. Lee has that kind of money at his disposal, but most people do not; one of my friends had 2 heart attacks, each one came with a bill for about $200,000. Does Mr. Lee think the average family has that kind of money saved for medical emergencies? A friend's wife died of breast cancer a few years ago; the total cost of her care was well over $1 million. Does Mr. Lee have several million dollars stashed away for medical care?
These things **will** be fixed. The supply of "health care" is limited. We will either use markets and voluntary exchange to get our health care, or we will go yet further down the road of the "planned economy" of health care. Each path has its flaws, but one relies on the virtue and humanity of neighbors, friends, and family. The other relies on the "fairness" of government. What happens when there is not enough to go around? There are those who persists in believing that the "planned economy" can be made to work. I am unlikely to convince them that it cannot. Utopian schemes based on "a little more money, and a little more power" are as old as dirt, and will be around forever. I have laid out where I stand, and I will continue to press the case for free markets, voluntary association and private property as both the most practical, and the most morally enlightened path. Thank you all for posting.
But yeah, our current system is perfect if you are wealthy enough and have a good enough plan to pay for it.:0) Thank you all for posting. I'm cutting of this conversation now with me having the last word. Hee-hee!
I have yet to hear Donald to reply to my statement about the lack of choice in our health care system. One can not CHOOSE not be be a consumer of health care, even if one can not afford it. The charity argument will never work, because charity will never keep up with REAL need....and don't go splitting hairs and try to define what need is, you know as well as I do that it doesn't keep up, or we wouldn't have so many homeless people.
I'm not sure how long you have been monitoring this conversation, but if you knew my position on welfare, you would not have made your points above. To make a longer story short, I believe in real welfare reform that puts restrictions on the scope and length of time one can use the "safety net". I also think that those getting some kind of welfare should be required to better themselves, by way of education, and they should be paying it forward, in the form of community service. Also from the conversation above is my reasoning for using the "choice" word. Donald advocates for people to be able to make choices, yet health care is not a choice. There is more above, if interested.
"US Poverty on Track to Rise to Highest Since 1960s." "The Associated Press surveyed more than a dozen economists, think tanks and academics, both nonpartisan and those with known liberal or conservative leanings, and found a broad consensus: The official poverty rate will rise from 15.1 percent in 2010, climbing as high as 15.7 percent. Several predicted a more modest gain, but even a 0.1 percentage point increase would put poverty at the highest since 1965." "Poverty is spreading at record levels across many groups, from underemployed workers and suburban families to the poorest poor. More discouraged workers are giving up on the job market, leaving them vulnerable as unemployment aid begins to run out." "Few people advocate cuts in anti-poverty programs. Roughly 79 percent of Americans think the gap between rich and poor has grown in the past two decades, according to a Public Religion Research Institute/RNS Religion News survey from November 2011. The same poll found that about 67 percent oppose "cutting federal funding for social programs that help the poor" to help reduce the budget deficit." http://kstp.com/news/stories/S2698849.shtml?cat=1
First - the toxic idea that "they can't". I was raised with the idea that "can't" was a bad word. If you insist that you can't, then you're right. If I am your friend, and agree with you, then I am not much of a friend. Real friends say "Sure you can. I believe in you, and I'll help you do it.". The "friends of the poor" seem to put great energy into saying "they can't", and then defending (and ensuring) their helplessness. Second - the idea that "poverty is growing" in the US. There is no question that there is tragedy and struggle, and human weakness all around us, but the idea that we are descending into unprecedented poverty unmatched in history is nuts. Look around you. Even the poor among us are wealthy beyond imagination compared to world standards, and compared to historical standards. It is easy to find statistical evidence of decline, and again, great energy is expended in the world of leftist academia to find and hype this data. My experience, and anecdotal evidence tells me that we have made progress. I could list good books that make this case, but this article is a good summary: http://www.heritage.org/research/reports/2011/07/what-is-poverty Read it. Think about it. Think about the dust bowl, and the Irish potato famine where millions starved. Sure, there is work to do, but don't pretend that the enormous progress of the last 100 years is for for nothing.
"CAN'T do" attitude? The poverty issue in this country is not about a bad or negative attitude, and implying so goes beyond insulting. Secondly, and we touched on this about gay Americans, I really don't care what your rationale is, you can not understand what it is to be poor in this country, to try and dig out of a hole to better yourself, to struggle against a stereotype, and to have one financial hardship wipe you out, until you have been there, so please don't assume that you know better. I think it is probably safe to say that anyone living in poverty is not going to be living "around" anyone that is still posting here (my apologies if they are). No, I do not look out my front door and see poverty, but that doesn't mean that it does not exist. Donald: "My experience, and anecdotal evidence tells me that we have made progress." Progress in this area is subjective, but I guess you can go ahead and believe your own experience vs. what is really happening in this country. I will wait for the final data to come out, and the nonpartisan experts give their opinions.
The Heritage Foundation describes itself as "a research and educational institution -- a think tank" and boasts of "performing timely, accurate research on key policy issues and effectively MARKETING these findings ... to the mainstream news media." Without even getting into its thoroughly absurd economic projections, Heritage is comically dishonest. It credits tax cuts with economic growth that preceded them. It claims a reduction in tax rates isn't a tax cut. It suggests nobody claimed the Bush tax cuts would pay for themselves, when in fact both the Bush administration and Heritage itself made exactly that claim. Again and again, Heritage crosses the line between "wrong" and "dishonest."
"how are you going to get insurance companies to cover people with preexisting conditions, or people who are likely to have expensive illnesses, like the elderly or the disabled?" In a true free market, the people you described could get insurance. The premiums would be much higher of course. If you're a poor driver, you can still get insurance, it simply costs a lot more. There is an incentive to be a safe driver as there is an incentive to be healthy. Most heart disease and cancer are lifestyle related. (The expensive illnesses). Should there be no culpability for poor lifestyle choices? Let's be honest. If you force insurance companies to cover people who are essentially uninsurable, is it really insurance or is it simply coerced payment for medicine? I would argue the latter. Insurance companies like any business should exist to make a profit and nothing else. Obviously there are those who find themselves in situations due to no fault of their own. If you believe the government should directly help the people you described, argue for that. Not that I'm necessarily an advocate, but it's more rational than coercing private business to do it.
Actually, the most medically expensive "lifestyle choice" is aging, which has nothing to do with poor choices; if it weren't for the government, people who "chose" to get old would not be able to get health care because private insurers would not cover them, and most people are not able to put aside over a million dollars for health care in addition to the million dollars they need to put aside for retirement. A completely free market in health insurance and health care would result in the "death panels" the tea partiers warned about, because no insurer would cover the elderly, and most of the elderly could not afford to pay for health care out of pocket. I suppose that's a free-market Randian wet dream - let all but the wealthiest among the elderly die off. As for "forcing insurance companies", that's why the mandate is necessary - to prevent people for gaming the system and buying insurance only when they get sick. By expanding the risk pool, it provides more money to cover the sick.
Therein lies the problem, because health care is not like any other business in that consumers cannot choose not to patronize health care; sooner or later, EVERYONE needs health care. That is why, ideally, I would remove the profit motive from health insurance entirely - single payer, Medicare for all, providing access to basic health care for everyone. The wealthy could still buy "concierge" medical care if they want, but no one would be denied health care because of an inability to pay, and no one would be bankrupted by illness.
Government, however, is a terrible vehicle for what you want, because by nature *everyone* pays for it, whether you like it or not, and *everyone* gets the same thing out of it - be it wars, postal services, or health care. Milton Friedman said it best. He told us that in the marketplace, if 60 people want red ties, and 40 people want green ties, 60 people get red and 40 people buy green, because in the market, each one gets to choose. In government (democracy), those same 100 people vote, and if 60 of them want red, then 100 people get red ties, because that is the result of the vote. The red-tie people "win" and the green tie people "lose". This is why government generates conflict, because in the market, there are no winners or losers, only those who choose. Government pits people against one another. Whenever possible, choices should be left to individuals.
What about if 100 neighbors need their trash hauled away? 10 choose red, 30 choose blue, 50 choose green. All one hundred neighbors pay too much, have too much traffic, and need to pay street assessments to fix their roads years earlier than normal because heavy trucks cause hundreds or thousands of times more damage. Imagine if every single neighbor had to hire a street repair company or snow plow for their small section of the street. You would never get to work.
Look at the controversy in Maplewood. Trash hauling is a good case where the pros and cons are close enough for a good argument, and recently the city council forced all residents to go through a specified hauler. Predictably, those who don't like that hauler - for various reasons - are unhappy. Those who favored the reduced traffic, etc, are happy. Longer term, bet on the newly created monopoly raising prices, and being accused of corruption. Bet on it. The bottom line, though, is that the people getting their trash hauled all got "red ties". The truly bizarre comment is that government "accommodates choices .... like Obamacare". This reminds me of the parent who wants a child to choose a food. Knowing that the child would choose candy, the parent presents a choice - peas or carrots. In the same way government "accommodates choice". First it takes choice away, and then presents a very narrow choice of "approved" choices. This is exactly what Obamacare does, and is not "choice". The point is not that government cannot present choices, or that it should do nothing. The point is that whenever possible, it should not intervene, because wherever it chooses for us, we lose our power to choose. That's not bizarre, it's simple logic.
http://healthreformquestions.com/ Follow the links. It is well researched and sourced.