Printed from at 05:23 PM, Jan 18 2017
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President Barack Obama’s health-care reform law’s provision requiring individuals obtain coverage “exceeds Congress’s commerce power” and is unconstitutional, a U.S. appeals court ruled, affirming a federal judge’s January decision to invalidate that portion of the act in a lawsuit brought by 26 states.

The Atlanta-based appellate court today upheld portions of U.S. District Judge C. Roger Vinson’s ruling that Congress exceeded its power in requiring that almost every American obtain insurance starting in 2014.

That's unconstitutional(Need a new keyboard)

what does this have to do with ny real estate?

Alan Hart!

It is amazing this is even a controversial issue. If the individual mandate were deemed constitutional, the Commerce Clause would have no limitation whatsoever anymore, and it would be a travesty to the Constitution.

It is unconstitutional to mandate insurance but it is also unconstitutional not to provide an uninsured person with treatment in the hospital ER.It is constitutional to have my tax dollar cover the uninsured. explain the constitution please?

We definitely need health care reform. Right now anyone walks into a hospital and gets treated,and the rest of us pay through higher costs. Plus the current system of coverage through work reduces choice and ties us to employers. But it's hard to see how what was done really fixed anything, plus the timing was odd as the number one issue we need to focus on is the economy. What most surprises me about the current ruling is that Obama taught constitutional law, so either should have known or knew who ask before hand about the legality..

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"We definitely need health care reform. Right now anyone walks into a hospital and gets treated,and the rest of us pay through higher costs. Plus the current system of coverage through work reduces choice and ties us to employers."

I agree. In fact, you just made a very strong argument for single payer health insurance.

Why do not we limit health care only to the ones who have insurance? We are a heavy debtor nation and can not afford to take care of every one who is sick. Medicaid should only cover some basic treatments which is all we can afford. There should be a small co-pay for using medicaid - say $5 so that people do not waste doctor's time for a tylenol prescription.

That's a great idea 300 Mercer. Denying healthcare to uninsured people with contagious diseases is brilliant. What could possibly go wrong?

Nothing has gone wrong in China and India who do have generous healthcare.

Solution to health care has always been simple
1)outlaw denial based on pre-existing condition
2)end employer paid health care
3)insurance companies are required to offer two health care options(basic which is regulated like utility) and a second that offers premium options that's not regulated. People below a certain income level who can't afford basic gets a tax credit.

I have a simpler solution. Outlaw all professions that currently require a medical degree. No more doctors and prescription drugs. It will solve most of society and the planet's biggest problems.

I left out reforming tort law and malpractice suits.

"Nothing has gone wrong in China and India who do have generous healthcare."

Exceot SARS. Except the avian flu. Except the swine flu.

"1)outlaw denial based on pre-existing condition
)insurance companies are required to offer two health care options(basic which is regulated like utility)"

You want more govt. regulations? My my. I'm sorry to hear you have contracted Socialism. You should go and get that treated by your ObamaCare doctor.

about 3 hours ago
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Nothing has gone wrong in China and India who do have generous healthcare.

300_mercer, do you mind elaborating on the generous healthcare available to the average chinese or indian. thank you.

I don't believe health care is available to "average" Chinese or Indians.

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You all seem to forget that ANOTHER appellate court upheld the whole law. Most of the cases have gone Obamas way in fact. Obviously the high court will decide.

Yes good health care is not available to average indian or chinese unless you pay for it. That is the main point of my argument. Debtor nations like us can not afford to provide good health care for average person unless the individuals are willing to pay for it.

That's why poor Cubans have better health outcomes than the bottom 20% of Americans.

Sorry for typo before

"Nothing has gone wrong in China and India who do NOT have generous healthcare."

And by poor Cubans i mean 90% of them.

What do you mean nothing has gone wrong? Is it OK to step over people who can't afford health care on your way into the hospital? The reason the Chinese are such huge savers is because they have no health care or social security to count on.

NYRENEWBIE is right. Adding gov't benefits such social security and free health care takes away from reasons to save. The Chinese are looking to do more of this as a way to boost local consumption and decrease the savings rate. But this isn't our problem, in the United States our savings rate is too low, not too high.

Riversider is exactly right on fixing healthcare. Single payer is starting to fall apart in England and France.

OP is stating that requiring individual to obtain coverage is unconstitutional and the first item in the 'simple soultion' is "outlaw denial based on pre-existing condition"?????

"Single payer is starting to fall apart in England and France."

How do you know? What evidence do you have?

"Adding gov't benefits such social security and free health care takes away from reasons to save."

THat assumes one has the ability to save. It's hard to save when your unemployed or udneremployed.

"Nothing has gone wrong in China and India who do NOT have generous healthcare."

Your still wrong. SARS, avian flue, and swine flu all started in China.

OP is stating that requiring individual to obtain coverage is unconstitutional and the first item in the 'simple soultion' is "outlaw denial based on pre-existing condition"?????

We do stuff like this all the time. Reverse mortgages can't take health into account. A law that prevents denial due to pre-existing condition is not the same as mandating universal coverage. It's more similar to discrimination laws.

But shouldn't the free market determine who is qualified to get health insurance instead of the govt.? I thought you were a libertarian.

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RS, you missed my point. Why would you obtain coverage before you get seriously ill, unless you're poor and the coverage is paid for gov tax credit?

Because insurance compnaies magically find pre-existing conditions when you file a claim and kick you off.

Socialist, read these comments together...

"OP is stating that requiring individual to obtain coverage is unconstitutional and the first item in the 'simple soultion' is "outlaw denial based on pre-existing condition"?????

...Why would you obtain coverage before you get seriously ill, unless you're poor and the coverage is paid for gov tax credit?"

did you know that a pregnant woman can't get new insurance because pregnancy is considered an underlying condition?

and i forget the details, but while there is no such thing as not laughable maternity leave benefits (for employed married women), in nj you can get temporary disability benefits. because in the eyes of the law, a pregnant (employed, married) woman and a new mother are just disabled workerbees. why not just call it maternity leave? isn't creating and nurturing a new life just a little bit different from being just "disabled"? that always struck as incredibly offenssive, to both pregnant (married, employed) women AND the disabled.

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Well Sunday,
the Swiss(the country with the health care system I most think we should emulate) does require coverage. I guess their constitution is different. But the required health care is the basic plan, which I think is important. Make the plan to generous and you bankrupt the country, make it to minimal and your not solving anything. What I think is a huge mistake is having government set up it's own insurance system, in the end we just create another post office bureaucracy.

because the words "maternity leave" (for employed, married women) are a hot topic and apparently the epitome of a "welfare" culture. people who say this usually turn around and lament the death of family values and personal responsibility in this country.

In Switzerland, health insurance companies are even prohibited from making a profit. So essentially, it is ObamaCare on steroids. Good luck selling that to the Tea Party!

Swiss insurance companies may not make a profit on the basic mandated plan but the premium options are not regulated and are free market.

""Single payer is starting to fall apart in England and France."

Ummmm, ignoramus, France does NOT have single-payer. Nor really does the UK. You are thinking Canada. And if by falling apart, you mean similar or better health outcomes than the US, with more people covered for about half the cost per person, then I hope we, too, "fall apart."

On the eve of his election victory in 1997, Tony Blair famously declared that Britain had 24 hours to save its derelict National Health Service.

So it is acutely awkward for his successor, Gordon Brown, that, 10 years on, his government is scrambling to fend off accusations of crisis in the NHS following a damning report about hospital infections that critics say is symptomatic of a wider malaise in British healthcare.

Health Secretary Alan Johnson was forced to apologize in Parliament this week after it emerged that at least 90 patients in southeast England died as a result of infections picked up in the hospital.

The Healthcare Commission, a national watchdog, blamed safety lapses and overcrowding. It painted a bleak picture of teeming wards where overworked nurses didn't even help patients to the bathroom.

Government officials have sought to portray the crisis at hospitals in the Maidstone and Tunbridge Wells district as a one-off. But opposition members of Parliament and health-service experts say the cost and staffing pressures affecting the trust are widespread, and that many other "primary care trusts" that manage local health services are struggling.

"The problem is not just Maidstone and Tunbridge Wells," says John Lister of the Health Emergency pressure group. "The outbreak ... exposed a weakness that exists in trusts up and down the country, given the way they are forced to run."

Dr. Lister says government-imposed targets have instilled a commercial culture, resulting in "perverse" imperatives like cost-control and "productivity" driving decisionmaking in hospitals. "It's the burger-bar style of efficiency – the more you can do with fewer staff the better," he says. "But patient safety seems to come at the bottom of the list.... The Hippocratic oath has gone out of the window."

From David Gratzer:

My book’s thesis was simple: to contain rising costs, government-run health-care systems invariably restrict the health-care supply. Thus, at a time when Canada’s population was aging and needed more care, not less, cost-crunching bureaucrats had reduced the size of medical school classes, shuttered hospitals, and capped physician fees, resulting in hundreds of thousands of patients waiting for needed treatment—patients who suffered and, in some cases, died from the delays. The only solution, I concluded, was to move away from government command-and-control structures and toward a more market-oriented system. To capture Canadian health care’s growing crisis, I called my book Code Blue, the term used when a patient’s heart stops and hospital staff must leap into action to save him. Though I had a hard time finding a Canadian publisher, the book eventually came out in 1999 from a small imprint; it struck a nerve, going through five printings.

Nor were the problems I identified unique to Canada—they characterized all government-run health-care systems. Consider the recent British controversy over a cancer patient who tried to get an appointment with a specialist, only to have it canceled—48 times. More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months. A while back, I toured a public hospital in Washington, D.C., with Tim Evans, a senior fellow at the Centre for the New Europe. The hospital was dark and dingy, but Evans observed that it was cleaner than anything in his native England. In France, the supply of doctors is so limited that during an August 2003 heat wave—when many doctors were on vacation and hospitals were stretched beyond capacity—15,000 elderly citizens died. Across Europe, state-of-the-art drugs aren’t available. And so on.

But single-payer systems—confronting dirty hospitals, long waiting lists, and substandard treatment—are starting to crack. Today my book wouldn’t seem so provocative to Canadians, whose views on public health care are much less rosy than they were even a few years ago. Canadian newspapers are now filled with stories of people frustrated by long delays for care:


And now even Canadian governments are looking to the private sector to shrink the waiting lists. Day’s clinic, for instance, handles workers’-compensation cases for employees of both public and private corporations. In British Columbia, private clinics perform roughly 80 percent of government-funded diagnostic testing. In Ontario, where fealty to socialized medicine has always been strong, the government recently hired a private firm to staff a rural hospital’s emergency room.

This privatizing trend is reaching Europe, too. Britain’s government-run health care dates back to the 1940s. Yet the Labour Party—which originally created the National Health Service and used to bristle at the suggestion of private medicine, dismissing it as “Americanization”—now openly favors privatization. Sir William Wells, a senior British health official, recently said: “The big trouble with a state monopoly is that it builds in massive inefficiencies and inward-looking culture.” Last year, the private sector provided about 5 percent of Britain’s nonemergency procedures; Labour aims to triple that percentage by 2008. The Labour government also works to voucherize certain surgeries, offering patients a choice of four providers, at least one private. And in a recent move, the government will contract out some primary care services, perhaps to American firms such as UnitedHealth Group and Kaiser Permanente.

Sweden’s government, after the completion of the latest round of privatizations, will be contracting out some 80 percent of Stockholm’s primary care and 40 percent of its total health services, including one of the city’s largest hospitals. Since the fall of Communism, Slovakia has looked to liberalize its state-run system, introducing co-payments and privatizations. And modest market reforms have begun in Germany: increasing co-pays, enhancing insurance competition, and turning state enterprises over to the private sector (within a decade, only a minority of German hospitals will remain under state control). It’s important to note that change in these countries is slow and gradual—market reforms remain controversial. But if the United States was once the exception for viewing a vibrant private sector in health care as essential, it is so no longer.

From the WSJ: French taxpayers fund a state health insurer, Assurance Maladie, proportionally to their income, and patients get treatment even if they can't pay for it. France spends 11% of national output on health services, compared with 17% in the U.S., and routinely outranks the U.S. in infant mortality and some other health measures.

The problem is that Assurance Maladie has been in the red since 1989. This year the annual shortfall is expected to reach €9.4 billion ($13.5 billion), and €15 billion in 2010, or roughly 10% of its budget.

Socialists don't react well when reality meets their fantasies . . .

I enjoyed reading you posts LICComment.

In my opinion, as long as there is the potential for profit there is the potential for equity.
And this does not mean "Socialism" as we understand it in the historical sense. We need to evolve past that. This all boils down to how our energy and resources are channeled. The question that I always return to is: If there is a big enough profit potential in Insurance "market" then why can't the people be the beneficiaries rather than making a handful of parasites wealthy?

The most hideous inequity in this is that an uninsured person's situation is made worse when hospitals are allowed to charge them a steeply inflated cost of care while charging an insurance company a fraction of that. Why is THAT Legal? A friend of mine needed an emergency appendectomy which he was billed over 40k. An insurance company would pay about 5k. If he were destitute he would just walk away. But many uninsured people do have respectable lives with assets and a great deal to loose. But they are forced into destitution while attempting to rectify their unexpected misfortune.

So there are two factors working against the uninsured, gouging by the insurers AND gouging by the Hospitals themselves.

So why is it that governments are always in the red when they try be the insurer yet private parasites always seem to flourish. It doesn't add up. The answer is: The private sector can turn it's head while some citizens die. Civilized Governments can't.

The bottom line is that in a winner-takes-all social structure there will always be those who loose. In the case of health care that might mean you lose… you die.

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"...he was billed over 40k. An insurance company would pay about 5k. If he were destitute he would just walk away. But many uninsured people do have respectable lives with assets and a great deal to loose."

1. Maybe that friend of yours should've bought insurance.
2. 40K vs. 5K should be illegal? So should all forms of group/volume discount be illegal?
3. Given the high monthly premium, how many would buy insurance if 'emergency appendectomy' only cost $5k.
4. If you're uninsured because you can't afford it, you won't end up paying 40K, not even 5K.

You mean the David Gratzer employed by the Manhattan Institute, another organization funded by the Koch's and the Scaifes? I am beginning to think these guys are directly funding some of the idiot posters on streeteasy based on the volume of non-real estate drivel posted on this board as facts by morons like LICC. Pathetic.

So with single payer in Eruope "falling apart" as LICC claims, it must be so awful that the British want private, free market healthcare like we have in the u.S., right? RIGHT?

From the LA Times:

British fear ‘American-style’ healthcare system

As leaders debate ways to reform healthcare, politicians repeatedly tell a worried public that Britain will not turn the National Health Service into an ‘American-style’ private system.

Two years ago, Britons were outraged when U.S. politicians like Sarah Palin, in the debate over healthcare reform, turned this country’s National Health Service into a public whipping boy, denouncing it as “evil,” “Orwellian” and generally the enemy of everything good and true.

It’s time for some payback.

Britain is now embroiled in a healthcare argument of its own, prompted by a proposed shake-up of the NHS. And the phrase on everyone’s lips is “American-style,” which may not be as catchy as the “death panels” that Palin attributed to socialized medicine but which, over here, inspires pretty much the same kind of terror.

Ask a Briton to describe “American-style” healthcare, and you’ll hear a catalog of horrors that include grossly expensive and unnecessary medical procedures and a privatized system that favors the rich. For a people accustomed to free healthcare for all, regardless of income, the fact that millions of their cousins across the Atlantic have no insurance and can’t afford decent treatment is a farce as well as a tragedy.

But critics here warn that a similarly bleak future may await Britain if a government plan to put more power in the hands of doctors and introduce more competition into the NHS succeeds — privatization by stealth, they say.

So frightening is the Yankee example that any British politician who values his job has to explicitly disavow it as a possible outcome. Twice.

“We will not be selling off the NHS, we will not be moving towards an insurance scheme, we will not introduce an American-style private system,” Prime Minister David Cameron emphatically told a group of healthcare workers in a nationally televised address last week.

In case they didn’t hear it the first time, Cameron repeated the dreaded “A”-word in a list of five guarantees he offered the British people at the end of his speech.

“If you’re worried that we’re going to sell off the NHS or create some American-style private system, we will not do that,” he said. “In this country we have the most wonderful, precious institution and also precious idea that whenever you’re ill … you can walk into a hospital or a surgery and get treated for free, no questions asked, no cash asked. It is the idea at the heart of the NHS, and it will stay. I will never put that at risk.”

ok LICC, no more psoting for today. Time to go back to your job at Americans for Prosperity.

U.S. Supreme Court justices indicated during three days of arguments that they may reject the centerpiece of President Barack Obama’s health-care overhaul -- its requirement that Americans obtain insurance -- and bring down other parts of the law with it.

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This is the fascinating part of the arguments.
The forced buying of health care insurance makes tremendous sense from an economic standpoint however the
argument about forcing Americans to purchase cell-phones really makes this appear unconstitutional.

Can the gov't force you to pay for your burial? Keep in mind that on a state level this doesn't pose an issue. We can force drivers to purchase auto-insurance.

It's also amazing that this issue wasn't vetted ahead of time by the proponents of the health care mandate.

do you have a suggestion to make anything better? or is this your endless ranting and raving?

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.”

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The irony is that the individual mandate idea came from the Republicans and first arose in the 90s as an alternative to the Clinton plan. It was seen as more in keeping with freedom of choice, free enterprise and all that claptrap. Now the Republicans are using their own idea to attack healthcare reform. A cynic (realist?) would say that the Republicans went along with "Obamacare" in the hope that this potential fault could be exploited. (I still think they'll fail, but the vote will be more like 5-4 or 6-3 because of the Republican hacks on the SCT.) I don't see why this is any different from Social Security in which the government is essentially "forcing" you to buy a pension plan. The only distinction between Social Security and the individual mandate is that the former was cast as a tax, which is certainly within the powers of Congress, while the latter went through the Commerce Clause because a tax was not politically feasible. Given the tremendous extension of the Commerce Clause, it is silly to suggest that Congress has overreached here. If this case were not so infused with partisan politics, it would be 7-2 or 8-1 in favor of upholding it.

And it begins:

Less clear are the short-term political implications of a Supreme Court decision to throw out the law. A number of allies of the measure, including Senate Majority Leader Harry M. Reid (D-Nev.), said it’s possible that such a ruling could help Obama’s reelection campaign by galvanizing Democratic voters.

These Democrats did not think the oral arguments went well for the president. But they see an opportunity to rally voters who are passionate about health-care reform — and to portray the Supreme Court as a partisan body.

You are making the classic mistake of reading too much into the oral argument on the second day. Clement got hammered on day three, so does that equal things out. All the oral argument indicates is that it may be closer than the 7-2 that some predicted. It is by no means a foregone conclusion either way.


Yes, upholding the law.

Done here. And you missed a key point. You were doing exactly what Reid has threatened.
I hope this is not what we get. Nobody has faith in the presidency, the congress is clearly partisan. Claiming the supreme court is partisan if the law is declared unconstitutional is nothing short of a scorched earth policy.

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It is amazing how the liberal justices will disregard the Constitution to further their ideological agendas.

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jim used to like me until i offended him somehow.

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and i have it on good authority that jim likes his coffee like he likes his men

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popular mechanics and jalouse

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ok, he tries to get in a newsweek here and there.

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oh the jewish athletes pamphlet. but why would jim read that

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cousin oliver was american. what is your point?

plus there is a whole crop of little olivers roaming the streets of brownstone brooklyn. so i've heard.

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