John Roberts is a liar.
Acting as Obama’s champion for the second time, The Supreme Court has upheld Obamacare.
From the ruling:
The argument that the phrase “established by the State” would be superfluous if Congress meant to extend tax credits to both State and Federal Exchanges is unpersuasive. This Court’s “preference for avoiding surplusage constructions is not absolute.”
Lamie v. United States Trustee
, 540 U. S. 526, 536. And rigorous application of thatcanon does not seem a particularly useful guide to a fair constructionof the Affordable Care Act, which contains more than a few examples of inartful drafting. The Court nevertheless must do its best, “bear-ing in mind the ‘fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.’ ”
Utility Air Regulatory Group v. EPA
, 573 U. S. ___, ___. Pp. 9–15. (c) Given that the text is ambiguous, the Court must look to the broader structure of the Act to determine whether one of Section 36B’s “permissible meanings produces a substantive effect that is compatible with the rest of the law.”
United Sav. Assn. of Tex. v. Timbers of Inwood Forest Associates, Ltd.
, 484 U. S. 365, 371. Here, the statutory scheme compels the Court to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. Under petitioners’ reading, the Act would not work in a State with a Federal Exchange. As they see it, one of the Act’s three major reforms—the tax credits—would not apply. And a second major reform—the cov-erage requirement—would not apply in a meaningful way, because so many individuals would be exempt from the requirement without the tax credits. If petitioners are right, therefore, only one of the Act’s three major reforms would apply in States with a Federal Exchange.The combination of no tax credits and an ineffective coverage re-quirement could well push a State’s individual insurance market intoa death spiral. It is implausible that Congress meant the Act to op-erate in this manner. Congress made the guaranteed issue and community rating requirements applicable in every State in the Nation, but those requirements only work when combined with the coverage requirement and tax credits. It thus stands to reason that Congress meant for those provisions to apply in every State as well.Pp. 15–19.
Roberts has interpreted the law to mean something other than what is written in order to save it. At one time he promised not to do that.
“We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation’s elected leaders.”
“Members of this Court are vested with the authority to interpret the law; we possess neither the expertise nor the prerogative to make policy judgments. Those decisions are entrusted to our Nation’s elected leaders, who can be thrown out of office if the people disagree with them. It is not our job to protect the people from the consequences of their political choices.”
Yet that is exactly what they did. They protected the political choices. Somehow all the Gruber evidence, which made absolutely clear that the law was written intentionally to be extortionary, meant nothing in the end.
The Roberts Court sets a remarkable precedent- laws no longer have to mean what is written. That pretty much opens the door for any law to be interpreted in any fashion one sees fit. Now Obama is free to interpret anything not as written, but as he desires and he can expect Roberts to have his back.
Boy, was I ever wrong about Roberts.
Now a democrat President can have a law written with one word.
“Environment”
Nothing else is needed. If laws no longer have to mean what’s written and can mean whatever a left wing President wants them to mean, what about this one?
Amendment I
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.
DrJohn has been a health care professional for more than 40 years. In addition to clinical practice he has done extensive research and has published widely with over 70 original articles and abstracts in the peer-reviewed literature. DrJohn is well known in his field and has lectured on every continent except for Antarctica. He has been married to the same wonderful lady for over 45 years and has three kids- two sons, both of whom are attorneys and one daughter who is in the field of education.
DrJohn was brought up with the concept that one can do well if one is prepared to work hard but nothing in life is guaranteed.
Except for liberals being foolish.
Another prime example of why we no longer have a system of checks and balances in this country. Probably the single worst decision of G.W. Bush was appointing Roberts to SCOTUS. He’s another back stabber. This is the second time public statements as to intent backed up what was written in the law were completely ignored. The first time it was ‘penalty’, this time it was Gruber’s statements and his ties to those who wrote the bill and to the person who signed it into law. One more nail in the coffin of our Republic.
Time to find out what the Lefties have on him.
Obviously, the Doomsday Device built into Obamacare (as screwed up as it is, just IMAGINE how screwed up the effort to fix it would be) is doing its job.
wow a tough week for the GOP first they lost out on flying their battle flags on public property and now this. Even without Roberts the case would have lost 5-4
6-3 isn’t close Roberts is looking at the future and the Dems are going to be choosing the future Supremes
The court got this right.
They decided what counted was correct interpretation of what congress (overwhelmingly D) wanted. Congress WANTED to compel all americans to buy Obamacare.
Congress wanted to BLACKMAIL the states into exchanges and medicaid expansion and was SHOCKED when the majority rejected them.
The composition of that congress reflected what the voters wanted.
The court decided THE SPIRIT of this law was more important that the words of the law (since the words were …unimpeachable). THey then made the ridic effort to get some tortuous logic around this about the word ‘state’.
But never mind.
That president was SOLIDLY elected. That congress and senate was OVERWHELMINGLY defined by party, and the law was passed without a SINGLE R vote needed.
And now…..
we are GETTING THE GOVERNMENT WE DESERVE
GOOD AND HARD
@john:
I doubt we’d notice any difference.
@john:
As I would expect from a leftist, truth has no meaning nor value when it obstructs the march to your collectivist dystopia. This SCOTUS ruling has set the precident for active legislating from the bench, but solely in favor of the socialist destruction of first medicine, then any and all individual liberties that the US Constitution was designed to protect.
The words of the demonically inspired obamacare CLEARLY state that states must set up state run exchanges to obtain their federal subsidies of the grossly misnamed “Affordable Care” policies. The repeated videos of Gruber confirming exactly that, showing clearly that the obamacare law was written precisely as all other leftist programs in blatant bribery attempts to the states, is even admitted in the majority opinion. SCOTUS has absolutely followed Obama’s disgusting pattern of behavior in overstepping the clear limitations devised in the separation of powers between the executive, the legislature and the judiciary. The majority admits they are legislating, not practicing judicial oversight, when they write that they ruled this way against the clear wording (and the true intent of the Gruber-devised bribery attempt that failed in the majority of states refusing to run their own state exchanges) of the democrat imposed law because handing down the correct ruling would cause harm to people living in states that were smart enough not to accept the leftist federal bribe. This is unconscionable, as it completely destroys the concept of “rule of law”. The political elite isn’t even trying to hide their contempt for the Constitution, as this brazenly unethical ruling shows a contempt for our founding charter unlike any I have ever seen.
This should be a clear signal that the so-called gay “marriage” decision will also be of heavy leftist tilt. We will see even more obscene fascist state tactics against those who falsely believe their First Amendment right to free expression of religion is worth anything other than what the memory hole stuffers will say it believes.
Time for a third party that is based on true conservative, American values. The GOP elitists are naught but progressive traitors pretending to be conservative during election run-ups. The democrats are blatant anti-American, totally amoral collectivists no better than the muslim terrorists the leftists frenetically protect.
The SCOTUS ruling has now defined that “2+2=5” when the political overlords say so. That is the bottom line. The republic is in V-fib and very close to asystole.
The Patient Protection and Affordable Care Act isn’t going away. It’s a good law that benefits millions of Americans. None of the dire consequences its opponents predicted have materialized. It could have been better by this point, had republicans devoted even a tenth of the time and energy they’ve wasted trying to destroy it to honest efforts to improve it.
@john: I wonder when you cowardly, ball-less liberals will finally have the guts to fully implement the Abysmal Care Act so your useful idiots (Gruber’s Goobers) can finally feel the full sting of left wing failure and betrayal? You are always afraid of the next election… but there is ALWAYS another election?
@Greg:
ALL of them have, even without the entire law enacted (see comment above). While some have benefited, millions have taken a hammering, both financially and losing life-saving coverage WHEN they needed it.
Keep on deluding yourself, Greg.
@Greg:
The celebration might be a bit premature, Greg
@Greg:
It doesn’t provide any protection for patients. And if you have to use someone else’s money to buy it, it ain’t affordable.
The DOUBLE Supreme Court decision on this law puts the nail in the coffin of distinctly ‘separated’ arms of government.
The Supreme Court is NOT supposed to bend interpretation of a law or word to suit Congress’ and Admin’s malfunction and incompetence.
It should have rejected it, sent it back to be redone/rewritten.
This does not bode well.
@retire05, #12:
Anyone who develops a serious, long-term health problem will likely consider the elimination of annual and lifetime coverage limits to be a very important patient protection.
Any families having members who had been denied health insurance coverage due to preexisting medical conditions will likely understand what the word “protection” means in real world terms.
Full coverage of routine preventive medical services is certainly protective of patients.
Affordable implies nothing more than the fact that something is within one’s financial means. How something comes to be affordable is a separate question.
Was the invasion of Iraq and over a decade of military occupation “affordable?” It’s now being estimated that the long-term cumulative costs to the nation of that exercise will be in excess of $6 trillion. It sure as hell isn’t going to be paid for with voluntary contributions.
Perhaps some of us have different ideas about what sort of activities it’s most beneficial to subsidize.
@retire05:
Obama will guarantee the Chinese have all Americans’ private health records
@drjohn: Highly probable given the Chinese already have my military records (confirmed via letter from the U.S. government which also claimed no liability even thought they are the custodians). For millions like me, the Chinese having our private medical records is probably a moot point at this stage.
@Greg:
Only a left wing moron would think a product becomes more affordable within one’s financial means when it is funded by coercive taxation of another.
Perhaps you would like to provide the portion of the U.S. Constitution that makes the services of another (health care) a right? If health care is a right, due to being a requirement some need to stay alive, then why do we not have a right to running water since it is an even greater requirement to sustain life? Try not paying your water bill, tell the water provider you have a right to that water and see how far you get.
@retire05:
Amazing beyond belief.
@retire05, #17:
Perhaps you should read the definition of the word:
As I pointed out, what makes a thing affordable is a separate issue.
I have no problem with the idea that I must pay taxes to support the various things my government does. I consider myself fortunate to be affluent enough to do so. Those who are far more affluent than I am should feel the same way. They’ve benefited even more than myself from the system that makes it all possible. I don’t know why so many of them are so full of themselves that they can’t see that.
I realize that I won’t necessarily approve of everything that my government undertakes and uses my taxes for. That’s never been the case for anyone. It’s childish to think otherwise. You can’t always have everything exactly the way you want it. From what I can guess by the attitudes you sometimes express, that’s a very good thing.
@Pete #7 – Your intelligent words mean nothing to John why do you waste your time. He is obviously is a hard core leftist..it means nothing to him our history, our Constitution…our Republic…he wants the United States to be just like Cuba, healthcare and all. The leftist Utopia is – being rationed health care, eggs, and milk and not being able to find toilet paper to wipe your arse. and whatever other ‘gift’ the Government is ‘benevolent’ to throw us…
Oh, it may not be now, but, it will eventually come to pass as we continue down the path of hateful destruction…given a pass by extremely weak leaders…
Again this isn’t about ‘healthcare’ at all, it never was, it is way more sinister than that.
In Obama’s ‘victory lap’ speech today at the very end….he said in part ” this health care law will help ….in this “New Economy”…. New Economy??
What does THAT mean?
I thought our Economy was thriving according to Obama, and his Administration – our “Government’??
If that is the case why call it a “New Economy” instead of saying ‘as we continue to grow the economy?’
This isn’t a slip of the tongue. This should perk up some ears like “Fundamentally Transform America” should have….
The new economy is the global economy. American workers are dealing with a drastically different economic environment than that which existed during most of the latter half of the 20th Century. That environment is going to change even more rapidly in the future.
@Greg#19
Like what? Give us a thrill.
@Greg: Greg, it his was so good why is it that Republicans historically took back the House and the Senate because of it?? ACA has NOT been fully implemented yet BTW!! Also Obola lied when he said if you like your health insurance and/or doctor you can keep them “period”!! Sadly you won’t admit it but it’s till true. Obolacare will NOT stand!!
@FAITH7, #23:
I already provided an example.
Common Sense: its over. Obamacare is the law of the land. Western Civilization is DOOMED
We all know this has not been a good week for conservatives what with the loss of your battle flags and now this, but just sit down and take a deep breath. Maybe some milk and cookies would help, but try not to think about 2016 that will not help at all
@Greg:
Perhaps you should get a 5th grader to explain to you what “one’s” means, mean.
It is not affordable if you cannot manage the cost on your own and require a confiscation of money from others via taxation to provide it for you.
Damn, you’re an idiot.
Get with the program dinosaurs, or just go die off. The ACA is here to stay, it works and it saves lives.
One of the Justice’s remarks reminded me of a similar remark by a justice of the Kelo decision.
Basically, this is what we decided.
If you don’t like it, vote in different leaders.
Kelo has been overturned by most states in the country.
But it didn’t save the home of the Kelo family……it is a vacant lot to this day!
If you want more of the same, elect another Dem to the Presidency.
He/she picks SCOTUS choices.
All the Senate can do is confirm of not.
PS, Obama got caught spying on Merkle (head of Germany.)
http://www.nbcnews.com/storyline/nsa-snooping/u-s-spy-scandal-triggers-outrage-paranoia-germany-n170366
Now he’s got caught spying on the head of France.
http://www.reuters.com/article/2015/06/24/us-france-wikileaks-idUSKBN0P32EM20150624
He has made it clear he considers Republicans worse ”enemies” than Iranians or Cubans.
http://www.theguardian.com/us-news/2015/apr/12/kerry-defends-obama-cuba-iran-foreign-policy
Think for a second he doesn’t spy on the members of the other two branches of gov’t?
@Greg#22 – We’ve been ‘global’ for some time. He means something else…Obamacare isn’t ‘global’.
@Greg:
You are out of your mind.
If obamacare is so damnably “affordable” then why do 80% of obamacare policies need to have 70-75% of the monthly premium costs paid for by taxpayers?
If obamacare is so beneficial, why has the employer mandate been postponed by unconstitutional executive fiat until after Obama leaves office?
If obamacare was designed to decrease ER usage through providing falsely portrayed “affordable” health insurance, why has ER usage INCREASED?
The CBO falsely claimed passage of obamacare would cut the cost of the average annual health insurance policy by $2500 per year. Instead, we are seeing double digit percentage cost increases, with some i surers asking for over 50% premium increases.
Can’t keep your doctor or insurance plan as Obama promised multiple times, PERIOD. Millions of people lost their pre-obamacare coverage, and obamacare has not come close to covering even half of the 45 million obamacare supporters claimed were uninsured.
The only thing obamacare has succeeded in doing is showing the criminal disdain the political class has for the rule of law.
@JisterJ:
You obviously don’t work in the medical field.
Democrats, for example the socialist thug Steny Hoyer, floated a trial balloon a couple of months back regarding the high deductibles associated with obamacare plans. He was lamenting that people were foregoing medical care because they could not pay the doubled policy deductibles, so they went without care, boping their ailment would go away on its own. The groundwork is being laid for more socialist legislation to limit deductibles, which will require an even greater increase in premium costs, at least at first. The next step will be the government bureaucrats meddling in medical decisions between you and your physician to cut the cost of medical treatments. The practical effect of this manifests as doctors being limited to government approved meds and treatments, in a “one size fits all” treatment protocol that may not be in the best interest of the patient. If a doctor implements a non-approved therapy, the government denies payment for services. Any moron can see what this will mean, since doctors will not long prescribe treatments for free, when doing so impacts their ability to pay their practice bills.
As I have repeatedly written here, in the city where I work, none of the private pediatricians accept medicare patients, because it costs them more to see and treat the patient than the reimbursement they get months later from medicare. You can’t “make it up in volume” if you lose $10 for every medicare patient you see. Obamacare policies in California pay less than medicare rates. So what good does it do to have insurance that no one accepts?
The only way the socialist devised health system can cut costs is by limiting medical care through setting price controls so low for medical interventions that they aren’t used, or through capping physician salaries. Good luck with that.
Imagine the uproar from the entitlement class if they were ever asked to work for free, or at a loss. Yet that is exactly what the left thinks should be imposed on physicians. Think it is hard to see a good doctor now? Just wait until socialist medicine is fully enacted.
Hi Pete,
You say:
Pediatricians don’t accept Medicare patients because Medicare provides health insurance coverage for Americans 65 and older and for a much smaller number of Americans with permanent disabilities, end stage renal failure, and ALS (the “ice bucket challenge” disease). Pediatricians take care of children. Children don’t customarily fall into the categories listed above. This is why pediatricians don’t accept Medicare patients.
– Larry Weisenthal/Huntington Beach CA
@Larry Weisenthal: I’m confused. I went to this web site and typed in “Illinois city” and found 82 pediatricians who accept Medicare assignments. Am I missing something?
http://www.medicare.gov/PhysicianCompare/results.html#expanded=dvcon2&viewmap=0&keyword=pediatrics&loc=ILLINOIS%20CITY%2C%20IL&lat=41.3973234&lng=-90.8996913&type=All&xpnd=1&vflg=1
@Larry Weisenthal:
Medicaid, Larry. My bad referring to medicaid payment rates as medicare payment rates. But I am sure you knew that already. Grats on the snark points, but fail on deliberately missing the point for propaganda purposes.
@Pete: I am still confused. According to the Medicare web site I linked, there are pediatricians who accept Medicare which means there are pediatricians who can stop accepting Medicare.
Hi Pete and Vet: With regard to pediatricians accepting Medicare; there are two possibilities. Firstly, they may be members of a multidisciplinary group practice or they are employed by a clinic or hospital or health provider like Kaiser. That’s probably most of them. They aren’t seeing Medicare patients, but rather other members of their group, who do treat adult patients, provide health care for Medicare patients. Secondly, there is a specialty of pediatric renal medicine (pediatric nephrology). Very few kids get end stage renal failure, but some do, on a nation-wide basis.
With regard to the point about doctors either opting in or opting out of government supported Medicaid — the point is that this is a safety net. The point isn’t to provide Tesla-level health insurance; rather it’s basic health insurance, for people who couldn’t otherwise afford health insurance.
Participation among doctors is voluntary. So you see, it’s not some government “takeover” of Medicine! Docs can opt in, if it makes sense to them, or they can opt out. If the government is responsible with the taxpayers’ money, it won’t overpay the doctors. They want to find a sweet spot, where they have enough good doctors opting in to provide care for people who need it, but if every doctor in America were to opt in, they would be clearly overpaying.
That’s the way Medicaid has always worked . When there are “too many” docs opting in, they’ll cut back reimbursement until there are too many opt outs. I don’t know the situation with regard to Medicaid in the jurisdiction under present discussion. But I guarantee you that what will be done, if there aren’t enough pediatricians, will be to increase the reimbursement rates until they get enough pediatricians opting in to serve the population requiring these pediatric services.
– Larry Weisenthal/Huntington Beach/CA
@retire05, #27:
Is your retirement “affordable,” or do you require “a confiscation of money from others via taxation” to provide for you?
@Larry Weisenthal: Actually, you are considering this from the viewpoint of following rules, regulations and laws. Obviously, such archaic concepts as following rules and laws no longer have any meaning or impact.
When a law is written that says “shall” or “shall not” this or that, it denotes a specific meaning. What the SCOTUS has now said is that, well, “we” are pretty sure (despite all the evidence to the contrary) that what they MEANT was…. this or that. So, why not have pediatricians giving mammograms? Why not have podiatrists performing brain surgery? Who are THEY to say what they can or cannot do? We have a GREATER GOOD that needs to be fulfilled and, in today’s world, the ends always justifies the means.
To hell with laws, f**k rules and regulations, personal freedom can kiss a$$. The government wants that $250 billion a year it was giving up by employees receiving pre-tax health care benefits, so this country, all the way up to the SCOTUS, no longer has to be a nation of laws.
@James raider: This court’s majority does not have the mind or heart to OVERRULE both other branches on a hot issue. Roberts TOLD US they are not replacing the voters will in the 1st Ocre decision. Now imagine Taney again and those times. That’s where we are right now. SCOTUS on hot issues will rubber stamo what they regard as the will of the voters
@Larry Weisenthal:
Larry, please understand this, in the most respectful manner possible, when I say you are blinded by your leftist views, in the same manner that 5 year olds believe in the Tooth Fairy.
I live in a town of just under 200,000 people. There are 3 separate private pediatric groups, 2 individual private pediatricians, and one medical school that has pediatricians. I work in a hospital based practice, on salary, so I am relatively shielded from the effects of government insurance payment rates, at least for now. The outpatient pediatricians are directly affected by the outrageously low medicaid and Obamacare payment rates. Overhead costs (clinic facilities, employees, government EMR requirements, lab supplies, office supplies, government and private insurance compliance requirements) are such that just to have a patient walk in their door costs them $45-50. Medicaid pays the pediatrcian $38 for an office visit. These are real numbers from an excellent outpatient pediatrician. To add insult to injury, this pediatrician tells me medicaid is the slowest of all insurance plans to pay for services. When he finally had to opt out of medicaid 3 years ago, the government medicaid bureaucrat told him that if he chose to opt out of medicaid, all the pending reimbursements from medicaid for services the pediatrician had already provided months previously but not yet been paid for, would be cancelled. He lost tens of thousands when he opted out, beyond what he had already lost caring for patients for less than what it cost him to treat the patient.
You can keep wearing your rose-colored glasses and writing in your smiley-faced manner, telling us all how smooth the sailing trip will be, and don’t worry about those little icebergs all you want. Denial doesn’t stop reality. Socialist medicine is a disaster, and your “overpaying doctors” rhetoric reveals your disingenuous ideology.
Keep fooling yourself into believing doctors are overpaid for what we do, and see how long it takes – after you leftists impose totalitarian salary caps on doctor pay – before you start seeing the effects of an even greater physician shortage.
@Greg:
I would opt of of the horrendous Ponzi scheme of SS the instant the government allowed me to do so, and would be FAR better off in retirement. It was the leftist scumbag FDR who imposed that socialist crap on the country, just like medicare came from the leftist jerk LBJ, and obacare came from the despicable offal Obama.
Your leftist talking point is as effective as a wet noodle trying to open a can of tuna….
Hi Dr. Pete,
As you may know, I’m a physician MD, one of my daughters just completed her first year of residency in OB-GYN; my other daughter is a 3rd year medical student. So my interest in all of this is more than theoretical. I have a good friend who lives in Bath, England. He has three children. All MDs.
Let me tell you about socialist medicine. The UK has socialized medicine. The government owns the hospitals. The government owns the clinics. The doctors work as salaried employees for the government. Everyone in the UK has a right to medical care provided by the government. The so called “conservative” government just elected strongly supports continuing this truly socialized system.
According to your views, the doctors must be miserable and no one would want to ever go into medicine. Not true. Just as in the USA, there are many more young people who want to go into medicine than there are openings in British medical schools. But the people who go into medicine don’t have the expectation of becoming wealthy. If a Brit wants to become wealthy, he/she starts a business or goes to work for an investment bank. That’s the sort of thing that entrepreneurs do.
As you well know, past generations of bright young Americans did view medicine as a ticket to (at least relative) wealth, among its other attractions. But there are enormous numbers of bright young people (like my daughters, graduates of Harvard and Yale, respectively) who don’t view medicine as the road to wealth. My younger was an economics major at Yale, who had an internship and job offer with an East Coast equities research and investment firm. She hadn’t taken any of the requisite pre-med science courses. She decided that she wasn’t really motivated by pursuit of wealth; she got a job as a scheduling clerk in oncology at a Boston hospital; liked the doctors, nurses, and most of all patients, and decided that she wanted to go into medicine. So she worked for three years, while fulfilling her pre-med requirements and taking the MCATs. She’s, as stated, now a third year at an Ivy league med school. Both of my young doctor daughters know all about the changing landscape of medicine. But they agree it’s still the best job in the world (and all around the world, it’s the same great job, with many more qualified applicants than positions).
ObamaCare isn’t socialized medicine. Neither is Medicare. It’s private practice medicine with the government paying (or, in the case of ObamaCare, partially paying) what are effectively private physician contractors. It’s like saying that Lockheed-Martin and Raytheon and Boeing are “socialized,” because they are paid by the government and must bid for government contracts. Or private security contractors. Or private janitorial contractors. All of which must deal with the requirements and stipulations put in place by the government.
That’s what’s happening in Medicine. ObamaCare is no different from RomneyCare, which was built on a model first proposed by the Heritage Foundation. In 1993, this model was the “sensible conservative alternative to HillaryCare.” Today this “sensible conservative alternative” is socialized medicine. Not.
I have no doubt whatsoever that many otherwise would be doctors will be dissuaded from entering medicine because of the changing payer structure and changing model in general. But there will never be a shortage of highly qualified idealistic people who will wish to spend their lives working as doctors, in service of their patients.
With regard to Medicare, it is, by objective criteria, the best large scale health care plan in America. It has the largest provider network. It has the fewest gatekeepers through which patients must traverse in order to obtain specialist care. It has the lowest cost, adjusting for age. It has the highest consumer satisfaction. It has the lowest rate of personal bankruptcies for health care expenses. It has unsurpassed clinical outcomes. And it covers virtually everyone. No exclusions for pre-existing conditions. No cap on lifetime payouts.
If you got rid of Medicare, you’d have to replace it with something else. And that something else would cost more, cover less, and provide less consumer satisfaction.
I believe that I’d be accurate in saying that many if not most private practice doctors today have more headaches from private insurance companies than they do from Medicare, in terms of the abject crap put in the way of providing patient care.
– Larry Weisenthal/Huntington Beach CA
@Larry Weisenthal:
Larry, I have no idea what world you are living in that you think medicaid/medicare has fewer hassles and better overall outcomes than private insurance.
It is only with medicaid and TRICARE patients in my NICU that I have problems with having to argue with insurance gatekeepers for treatments.
The fact that so many physicians refuse to accept medicare/medicaid patients contradicts your doe-eyed impression of socialist and government controlled medicine.
Dear Dr. Pete, Don’t conflate Medicaid with Medicare. As I wrote, Medicaid is bare bones, basic, safety net style medical care, for people who’d otherwise have no care at all.
Medicare is entirely different. It’s accepted at all the great medical centers in the country, with no gatekeepers, and by the vast majority of physicians. By far the largest provider network. If you’ve got Texas Blue Cross, just try going to the Cleveland Clinic — the real Cleveland Clinic, in Cleveland — to get your cardiac ablation for atrial fib. With Medicare, it’s no problem whatsoever. Medicare puts fewer obstacles in the way of doctors providing health care than does private insurance. If Medicare ever denies coverage for something, there is a formal appeals process, with independent adjudicators, including administrative law judges (for which lawyers aren’t utilized). Virtually all congressmen have a staffer who’s job it is to help constituents with any problems in the Medicare system.
With Blue Cross, both the doctors and patients are virtually at the mercy of whatever Blue Cross wants to do. Fighting them is frustrating and there is no recourse for finally denied claims beyond the civil court system, with lawyers arguing with lawyers in front of judges. The government (in the Medicare system) does a far more transparent and humane job in dealing with claims and denied claims.
I stand by everything I wrote about Medicare. If you want to trash Medicare, what are you going to replace it with which will cover everyone, with the same degree of consumer satisfaction, and all the other good things that Medicare does, without truly bankrupting the country.
The GOP politicians are turning cartwheels over the SCOTUS decision, because if ObamaCare had been trashed, they’d have been squarely on the hook to replace it, and they don’t have a clue how to start. Now they are off the hook. The GOP Presidential candidates are all huge winners because of SCOTUS. They can run against the Supreme Court, without having to come up with workable programs of their own.
– Larry Weisenthal/Huntington Beach CA
@Epa Minondas: #40
. . . . And now that the Supreme Court has so willingly relinquished and abrogated its own power and the very balancing reason for its existence — the future of America’s slide into a dictatorially governed nation is assured. IMHO, Fear had everything to do with the last two decisions we have seen handed down. FEAR! WTF?
A political class, bought and paid for by senior bankers and big money will impose itself on the people.
You can’t turn this ship around. Half the Nation doesn’t understand its own constitution but believes whatever it is bought to believe and lies it is fed.
@Pete:
Social Security has existed and enormously improved the later years of the majority of Americans for over 75 years. Medicare has done the same for half of a century. The provisions of the Patient Protection and Affordable Care Act have already made health insurance available to some 10 million Americans who couldn’t previously buy it. Everyone who has health insurance now has protection from lifetime and annual limits that previously could deprive people of their coverage at the worst possible point. I don’t see any insurance companies going bankrupt as a result.
I don’t think you’re going to get far with most people arguing that such programs should be eliminated. Improving the lot of the average American family is the entire point of national prosperity. The point isn’t to provide the absurdly rich with improved opportunities to grow even richer, by cutting their taxes at the expense of social programs intended to benefit the poor, children, the elderly, and the middle class.
@Larry Weisenthal:
Larry, you make Medicare sound like a dream. It’s a dream for seniors only if they don’t really get sick. Go into the hospital for an emergency colostomy and find out just how much Medicare covers and how much the patient is responsible for. If Medicare was the panacea that you claim it is, why do seniors have to carry “supplemental” insurance policies like BC/BS Plan F?
Here is an example of what Medicare pays to physicians: my doctor, who is a family practitioner, charges $65.00 for an office visit. Medicare pays him 80% of a R & C fee of $48.11. Can you do the math? What is 80% of $48.11 and would you take a 41% pay cut? And while doctors are needed in small communities, Medicare pays doctors in large metropolitan areas more than doctors in small communities. If a doctor takes Medicare, and wants to earn more money, he/she’ll get the hell out of a small town. So what if that town is left without a doctor.
You said about your daughter:
“She decided that she wasn’t really motivated by pursuit of wealth”
Well, that may be admirable, but what if she wasn’t lucky enough to have a physician father, or a job, that allowed her to go through med school, internship and residency without accumulating massive debt? Someone is picking up the tab for her med school. I know few people who managed to save the $150K for the two years of med school somewhere like Harvard or Yale.
http://hms.harvard.edu/departments/office-registrar/student-handbook/6-financial-obligations/601-tuition-and-fees
Single payer health insurance is the goal of lefties like you. And if you think that UK system is so great, why are so many doctors complaining about it? I have friends that were born in Canada, have siblings that still live in Canada, and they all come to the states for medical treatment. In the western provinces, there is that whole lottery thing going on due to the shortage of doctors.
And if Medicare is so damn great for doctors, why is it that the Houston Physician’s Journal reported that 52% of all general practitioners in Texas will not accept Medicare patients?
There is no Amendment that can fix this, after all, it would just be more words that are to be ignored in favor of the current ruler and his nine jesters.
@john:
But I’m guessing the ‘rainbow lights’ on the white house is ok?