Reason’s Damon Root attended the final day of the ObamaCare oral arguments at the Supreme Court yesterday and has extensively analyzed the proceedings from earlier in the week as well, and concludes that the White House underestimated the difficulty of its task. While the Left has focused most of its blame on the performance of Solicitor General Donald Verilli, Root says that the problems stem from the arguments that the Obama administration made about the PPACA, and how quickly the justices poked significant holes in them:
“If I was in the Obama administration, I would not be comfortable with how the last three days went.”
Reason‘s Damon Root was in attendance for the third and final day of oral arguments before the Supreme Court on the Patient Protection and Affordable Care Act (ACA), which focused primarily on the issue of severability, which brings into question whether the individual mandate be excised from the law, or if the law in its totality must be struck down.
Now that the case is in the hands of the Court and a decision isn’t expected until late June, Root thinks the Obama administration has reason to be concerned not only because their Solicitor General’s performance rated poorly, but because “their arguments were nowhere near as strong as they thought they were going to be.”
Democrats are starting to hit the panic button, as this Washington Post article makes clear. While a few publicly say that a Supreme Court rejection would make for good politics for Barack Obama and other Democrats in the fall election, most understand privately that losing the entire bill or even just the mandate would be a huge political embarrassment:
The Supreme Court’s skeptical consideration of President Obama’s landmark health-care legislation this week has forced his supporters to contemplate the unthinkable: that the justices could throw out the law and destroy the most far-reaching accomplishment of the Obama presidency.
The fate of the Patient Protection and Affordable Care Act is uncertain. A ruling is not expected until June. White House officials are refusing publicly to consider that the law might be struck down or to discuss contingency plans, insisting that they do not address hypothetical questions.
Other Democrats have begun assessing how such an outcome could affect the political landscape of 2012, with some surmising that a backlash against Republicans could follow a ruling against the law. But supporters argue that on a substantive level, the results would be devastating. …
The court will effectively render judgment on the leadership of the president. It was Obama who, at every turn during the original health-care debate, pressed for a more ambitious package that required Americans to purchase insurance.
A nullification would serve as a dramatic rebuke of that decision as well as the judgments Obama and his advisers made about the legality of the law.
“He’s mortgaged his presidency, at least his first term, on health care,” said George C. Edwards, the author of a new book on Obama called “Overreach” and a historian at Texas A&M University. The law “would have restructured a major aspect of life in America. It would have been a major, major legacy for the president. If that is thrown out, he has much less to show for it.”
Meanwhile, the White House is keeping a stiff upper lip, at least publicly. Yesterday, deputy press secretary Josh Earnest insisted that the Obama administration hadn’t begun gaming out a Plan B in case the court tossed ObamaCare out:
Guessing about what the Supreme Court is going to decide is a little like guessing how a fiction will end. Nobody knows, but everybody has their own particular dream ending. I guess my guess is as good as anyone’s: I’m going to guess that Justice Kennedy will come up with a compromise decision that Justice Roberts will be glad to write; and the Affordable Care Act will continue in one form or another–with some possible addition legislation required. How about that?
Just this week, I just signed up for the best major health insurance plan in America …. Medicare…largest provider and hospital network; unlimited lifetime benefits; no pre-existing medical exclusions…highest consumer satisfaction…fewest medical bankruptcies…lowest total overall costs to the system…unsurpassed outcomes…
65 year old Americans who have Medicare have the highest life expectancies in the world, e.g. which means that, once we get to the point where almost everyone has health insurance; the US health care system is the best in the world — the reason we have such a poor overall life expectancy overall is that we have so many uninsured, and uninsured people with serious health problems are twice as likely to die, e.g.
— which is why it’s such a disgrace that Republicans won’t agree to an actual plan to cover everyone. All of their so-called “market based solutions” would still leave many tens of millions of people without health insurance.
Contrary to conventional wisdom, Medicare costs (to the US treasury) are actually moderating. http://www.nejm.org/doi/full/10.1056/NEJMp1201853?query=TOC&
RomneyCare is working absolutely great in Massachusetts. They now have coverage for 98.1% of all residents, including 99.8% of all children. More employers than ever are providing coverage (contrary to predictions). 63% current voter approval. 73% physician approval. Total increased cost to the state less than 1% of state budget. Costs rising by 1.2% (that’s one point two percent) per year, compared to 17% (that’s seventeen percent) in the private health care sector outside of Massachusetts.
The state with the largest percentage of uninsured “legal” citizens? Texas, of course, the so-called model for the nation.
If ObamaCare is struck down, CA is hopefully going to go forward with its own version of RomneyCare.
But you go to any conservative blog and they all trash RomneyCare; because they would much rather believe in beautiful theories (e.g. “market solutions”) as opposed to ugly facts (“market solutions” don’t work for health care, because health care doesn’t follow traditional market economic principles).
– Larry Weisenthal/Huntington Beach CA
Wow, I can’t believe you made such a boldfaced lie about RomneyCare about being a success…
Well of course if you consider forcing prices for single individual package preminums to shoot up roughly 80 more dollars to a roughly to a family plan package jumping an additional 240 ontop of established yearly rates a success.
Oh and this:
Almost 20 percent of the population who now has mandated Insurance coverage can’t seem to find access to a Doctor that’ll accept the Insurance packages being shoved on the scene. And the doctors who do accept it are booked beyond their capacity. That’s not exactly helpful to force full insurance coverage on all State citizens when private practices refuse such plans. Hint: there’s a growing opinion to not accept the insurance plans in younger genreation MD students. While patient loaded doctors are reconsidering their support of such insurance plans. That means one in 5 are paying for something in Mass that they’re getting almost no use out of when they need it applied.
Hi Mr. Irons,
I don’t engage in discussions with people who impugn my integrity on a personal level.
I stand by everything I wrote. In fact, your link nicely confirms it.
80% of Massachusetts residents have received care from a primary care physician in the past year; that’s vastly better than in any other state.
Of course, there was a bit of pressure on the existing health care system, but it’s nicely adapting. You bring in a lot more customers, it takes the system a little while to adapt. But it did what it was designed to do, namely cover all of the citizens in the state at a reasonable cost (again, only 1% of the total state budget). And it’s overwhelmingly popular with both voters (I quoted 63% approval; your linked article says it’s 68.5%) and doctors (closer to 75%). Try and find any other political issue which has that level of approval.
The main people who don’t like RomneyCare are conservatives living in states that don’t have it.
– Larry Weisenthal/Huntington Beach CA
@Liberal1 (objectivity): Thank you BOHICAman for your pointless prognostication.
I keep running across far-lefties using phrases from the Declaration of Independence to justify Obamacare’s Constitutionality.
It creates in me an extremely strong urge to reach through the computer screen, slap them silly, then force the to sit through remedial History classes.
@openid.aol.com/runnswim:
We have a Constitution. I don’t understand why Democrats won’t agree that it is not the role of the federal government to stick their noses in every single aspect of people’s lives. If Romneycare is so great, why aren’t other States adopting it. Why aren’t they even talking about it?
And there is one argument I did not hear from the State’s lawyers during the Obamacare hearings. If congress wants to regulate interstate commerce as it pertains to healthcare, shouldn’t they at least allow interstate commerce of health insurance to exist?
Congrats on turning 65 Larry, seriously.
Good luck finding and keeping a doctor that takes medicare. As much as the patients might love medicare, it doesn’t seem the doctors do.
http://www.physicianspractice.com/healthcare-reform/content/article/1462168/1939841
http://www.meandmydoctor.com/2012/03/more-doctors-leave-medicare.html
http://thespiritualherald.org/article.php?id=191
http://articles.businessinsider.com/2012-01-31/news/31008260_1_medicare-patients-physicians-medicaid-services
http://www.npr.org/blogs/health/2012/02/16/147002801/doctors-disgruntled-and-frustrated-by-looming-medicare-cuts
http://www.ama-assn.org/amednews/2011/10/10/gvsd1013.htm
~Snip
I thought this part was very telling:
Hi Aqua; I’m not in a mood to debate the constitutionality of either RomneyCare or ObamaCare. It’s moot, anyway, because SCOTUS will decide all of this soon enough.
I thank you for the birthday wishes. Seriously (although I HATE the fact that I suddenly find myself to be this old; where on earth did the time go? Well, the one good thing is that I do get Medicare. Don’t intend to file for Social Security for another 13 years, however. Having too much fun working for a living).
Anyway, I actually do know a thing or two about Medicare (see below). Allow me to explain.
Medicare is doing a very good job of providing excellent, universal health coverage and also controlling costs (references in my earlier post). You raise the issue of physician “opt outs.” We’ve discussed this before. My old friend Aye takes ceaseless delight in pointing out that I’m one of the physicians who did, indeed, opt out of the Medicare program (effective July 1, 2008). I’m a special case, however, of no relevance to 99.9% of medical practice, owing to the highly specialized nature of what I do (http://weisenthalcancer.com).
Let’s get down to brass tacks. You cite an article that “only” 92.9% of doctors participate in Medicare. But I, as a Medicare beneficiary, can see every one of those 92.9% of all the doctors in the country. Most of the opt outs are certain surgical specialists or doctors who run concierge-type practices. This is a very good thing, actually. This is similar to the situation in the UK, Sweden, Switzerland, Australia, France, etc. Parallel public and private providers. If you think you can get better health care from a concierge type doctor and have either the insurance or wherewithal to pay him/her, you are perfectly free to do so. No death panels.
I just went to the following handy web site to obtain a list of primary care physicians within 15 miles of my current location (zip code 92647). http://www.medicare.gov/find-a-doctor/provider-search.aspx
I have my choice of 460 primary care doctors. The web site allows you to enter whatever specialty you want.
I have an exercise for you. Enter your own zip code. Enter “primary care” and enter “ophthalmology” and enter “general surgery” or “orthopedics” or whatever you want. Now, pull up your own private insurance policy and compare and contrast your “in network” physicians with the list of Medicare physicians. I’m betting Medicare blows away your policy. But here’s the kicker. I’m not limited to 15 miles. I’m not limited to Orange County CA. I’m not limited to Southern California. I’m not limited to California. I can go just about anywhere I darn well please, anywhere in the USA. Medicare even pays for 80% of my health care expenses, if I travel overseas (as I not infrequently do) and receive health care overseas. I don’t need pre-authorizations to see anyone. I can self refer myself straight to a specialist — the best specialist in the world. Mayo Clinic. Cleveland Clinic. Massachusetts General Hospital. Stanford University Hospital. NYU. MD Anderson. Memorial Sloan-Kettering. UCLA. The University of Chicago. Emory University. ANYWHERE!
Now, you compare and contrast your policy with my policy (Medicare) and my policy blows your policy away, hands-down.
Why do some doctors opt out of Medicare? For the same reason why many doctors choose not to join the Blue Cross providers network or the Aetna Providers network or the US Healthcare Providers network or the Human providers network, etc. All of these insurance companies (including Medicare) try to drive the hardest bargains they can. This is how capitalism works. If Medicare had 100% participation, they’d be over paying. So they cut back the payments until providers start to drop out. If too many drop out, then they know they’ve gone to far; so they back off. They reimburse more in New York City than they do in Amarillo, TX, because too many doctors would drop out in NYC if they only paid what they do in Amarillo.
With respect to 62% of doctors saying that they’d drop out if thus and so happened, that’s all just poppycock posturing. Medicare has been running brilliantly for more than 50 years now. After 50 years of experience in the real world providing such a huge chunk of America’s health care, they’ve pretty much learned how to do it right. The health care system as a whole has serious challenges — globally; but Medicare is better positioned than any large scale purely private health care to meet these challenges.
With regard to my own Medicare expertise, I’ve participated in and testified at about a half dozen coverage conferences, including testifying twice at the Medicare Executive Committee meetings (at Medicare HQ, in Baltimore). I was instrumental in calling attention to an area where physicians in my specialty (oncology), were basically milking the system. This lead to both beneficial changes in the system and also a series of New York Times stories on the problem.
http://weisenthal.org/medicare_payment_for_cancer_chemotherapy.htm
Here’s how I introduced the problem, at one of these Executive Committee meetings:
http://weisenthal.org/transcript_dec8_1999_medicare_executive_committee.htm
– Larry Weisenthal/Huntington Beach CA
http://medpedia.com/users/110