● The First 49,000: When Obama pimped his plan to destroy our healthcare system, he promised over and over: “If you like your healthcare, you can keep it.” That was a lie, as people are now learning. Aetna announced Saturday that they will stop selling individual insurance in California because of the new regulations imposed under Obamacare (they will still sell business policies). They will cancel around 49,000 policies. No comment from California.
● That’s Not Fair!! I: It turns out that Obamacare has a problem. It’s not affordable for low income people. To make the insurance “affordable,” the amount an employer can pass on to employees is capped at 9.5% of their income. Well, it turns out that this is way too high for most people. Take the case of a restaurant worker who makes $21,000 a year. That 9.5% works out to $1,995 or $166.25 per month – and that’s before the $3,000+ deductible they will need to pay before the insurance kicks in. For someone who most likely lives paycheck to paycheck, that is not something they can afford. Indeed, we are suddenly awash in articles pointing out all the people in the restaurant, retail, hotel and service industries who can’t afford the insurance. The service employee unions are furious.
Even worse, they are now discovering that employers can get around Obamacare by offering expensive plans that require the full 9.5%. This keeps them from being fined because they actually comply with the law by offering the insurance, but they don’t end up paying for it because none of the employees will sign up. (As an aside, no one has recognized this yet, but this will destroy the Obamacare funding mechanism.) Even more hilariously, those employees then cannot get subsidies because their jobs technically offer plans. Ha ha. Nice work donks! Way to punish your supporters.
● That’s Not Fair!! II: Reuters just discovered something dastardly which no one could have seen coming... except Obamacare critics. Employers are finding ways to avoid providing insurance:
● A survey of 52 Wal-Mart stores found that 27 were only hiring temps, 5 weren’t hiring, and 20 were hiring a combination. And it turns out there is a company directive to hire as many people as possible as temps.... because they don’t qualify for insurance. They are also planning to cut back hours on others so they don’t qualify. Liberals are shocked and called this “creepy” (noting specifically that Wal-Mart lobbied for this, so they don’t understand why Wal-Mart would do this), and they claim it will backfire in some non-specific way. This is going on all across the country right now.● That’s Not Fair!! II: “This is simply not fair,” whined Democrat John Larson (Conn). What was he talking about? Chuck Grassley slipped a provision into Obamacare which requires Congressional staffers to suffer with the rest of us by seeking insurance through an exchange rather than getting the gold-plated government plan they get now. Apparently, this has deeply upset the poor dears and they are headed for the exists. This has led to fears of a “brain drain” on Capitol Hill... which isn’t possible as no one on Capitol Hill has a functioning brain. Trust me, zombies would never attack Congress.
● Obamacare requires that insurers cover people’s kids until they turn 26... but it says nothing about spouses. The result is that policies are springing up everywhere that exclude the employee’s spouse – an alternate form allows the spouse on the policy, but only if they are primarily covered by insurance at their own workplace. The idea is to get employees to shift onto their spouse’s policy so the employer doesn’t need to cover them.
● Employers are instituting requirements in policies that allow the employer to force the employee to seek a second opinion before they can do anything expensive. There are actually firms that specialize in “finding savings” by talking employees into less expensive options. Sounds like the mob: “Be a real shame if something happened to your colon...”
Anyway, the Democrats are demanding a fix. After all, they shouldn’t be forced to endure the things they force upon us! That “is simply not fair!” The initial reports were that Boehner was onboard with fixing this as there is bipartisan upsettedness over this. But Boehner shot that one down. Said his spokesmonkey:
“The speaker would like to see resolution of this problem, along with the other nightmares created by Washington Democrats’ health law, which is why he supports full repeal. In the meantime, it is Democrats’ problem to solve. He will not sneak any language into bills to solve it for them — and the Democratic leadership knows that.”Excellent Mr. Boehner! In light of this, Harry Reid has grumbled that there will be no legislative fix... “And cancel Christmas!” He is, however, hoping that OPM will rule that the Feds can contribute to these plans on behalf of those staffers – something which isn’t clear yet.
This has been a fascinating discussion to watch because the Democrats are claiming how this is actually anti-reform to force the staffers onto Obamacare because the government program they were in is the better model of reform. Huh? Then why didn’t you make that law instead of Obamacare, you turds? In any event, this truly shows the elitist mentality and why no one would shed any tears if zombies did eat the Congress.
● Setting The Goal High: Most people typically set their goals higher than they can achieve to motivate themselves. Not Obamacare. Gary Cohen, who is involved in implementing the federal exchanges, says “As we move closer to October, my hopes are the range of things that could go wrong gets narrower and narrower.” In other words, he’s expecting problems and hoping they can be fixed as they go. How bad could these problems be? Fellow implementeer Henry Chao, put it this way: “Let’s just make sure it’s not a third-world experience.” Aim high, el Hefe.
● Rate Shock Continues: Finally, rate shock continues. In a private briefing of insurers, the big players conceded that rates are going to shock people. Said Aetna’s CEO:
“In some markets, insurance premiums could increase as high as 100 percent. And we’ve done all that math. We’ve shared it with all the regulators. We’ve shared it with all the people in Washington that need to see it. And I think it’s a big concern.”UnitedHealth, WellPoint, Humana and Cigna have all said the same thing. They blame (1) the “community rating” which jacks up the costs on the young to pay for the old, (2) forcing higher “minimum actuarial values,” (3) forcing insurers to take anyone who applies, (4) HHS forcing them to include new benefits people wouldn’t normally pay for, and (5) a tax on premium insurance.
In an article this week, Forbes outlined these things and explained how the Republicans could win votes by fixing some of these problems. To put this kindly, that is F**KING WRONG!!! NO!! DO NOT TRY TO FIX THESE THINGS!!!
This is the problem with the Republicans historically. The Democrats pass some disaster of a bill and act all smug about it. The Republicans try to minimize the negative effects of the bill. In the process, they make it tolerable because they redirect the harm it does so that most people don’t get hurt. That takes away the pain. No pain, no learning. No learning, no desire to repeal. Meanwhile, the Democrats smear them for trying to undo the “noble thing” the Democrats passed even as they are thankful the Republicans are saving their butts. This needs to stop. The Democrats created a bill that will mock poor people by offering them insurance they cannot afford and then fining them for not taking it, that will allow big business like Wal-Mart to dump their healthcare, that will turn everyone into part-timers, that will force millions of people off the insurance they currently like, that will eat into the budgets of hundreds of millions of people, and which will eventually bankrupt states and insurers.
LET IT HAPPEN.
Do NOT let the Democrats off the hook. Make them face the wrath of the public for what they have done. Do not alleviate that wrath by sparing the public from the full brunt of the Democrat’s stupidity.
Fortunately, Boehner’s words give me hope that the Republicans are on to this: ”It is Democrats’ problem to solve.” Exactly.
54 comments:
Andrew, you're forgetting that unless Boehner waves a magic wand and makes ObamaCare instantly disappear, then he's clearly a RINO in support of the Dumbocrats walking all over the Constitution®.
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tryanmax, I see you've been reading the comments at HotAir again! LOL!
All I can say is that the facts speak for themselves and the facts are that the Republicans have put up 100% resistance on everything Obama has tried since 2008, and they seem to understand that it's in their best interests to let this thing go down in flames rather than trying to land it safely.
Forbes is the one trying to tell them how to collaborate this time.
And let me add... it's always stunning how people (read: liberals) don't seem to grasp the immutable facts of human nature. Humans are highly predictable. Yet, they never seem to get that and they always rely on people acting in ways that humans have never acted.
What is going on now is exactly what anyone who watches people or knows history could have told them would happen. Yet, they are shocked. And it's only going to get worse. Human nature picks up steam... it doesn't change direction.
I don't think (and didn't think) that ObamaCare would survive a second Obama term in office. I'd be surprised if it survived intact past 2015 when you consider the pain that the non-tax paying voters will begin to suffer at the hands of THE ONE.
They've hoisted themselves on their own petard. I'm with you. Let the Democratic Party figure a way out.
The IRS Scandal has given the House every reason to delay or cancel increases in ObamaCare funding and that will hamper howls for another couple trillion.
LL, I'm of two minds on what the Democrats were thinking. On the one hand, I think they assumed that they could trust "the experts" who put this bill together to come up with something that works. But the people they trusted were cronies and fools.
On the other hand, I suspect that smarter Democrats knew this thing would be a nightmare BUT they assumed that the Republicans would bail them out by doing the dirty work of fixing the bill. Then they could claim the credit for passing the thing, while foisting the difficult choices needed to fix it on the Republicans, and blaming the Republicans for the pain of fixing it. But the Republicans aren't playing along this time and the Democrats are freaked out because they don't know how to fix the nightmare they've created.
In terms of "survival," if I had to guess at this point, I think Obamacare will eventually be scaled down to little more than a couple links on a state website and a subsidized insurance scheme for very-low income families. I suspect the rest will quietly be undone bit by bit.
Andrew.......I sure hope you're right about Boehner and the Repubs in the House, yet I am quietly hopeful. Having been disapointed again and again by the publicity hounds in Congress, I fear that the 'pat on the head' media machine will find some repub leaders who will want approving articles and interviews aired about how they "fixed" the problems insurance companies and big businesses caused in the "Affordable Health Car Act."
I hope they do...but like you say...human nature picks up steam, it doesn't change direction.
Yes, Obama Care could exist in name only as "the new face of Medicaid". I think that that's likely. Barack himself will want it as part of his legacy. In fact, that is likely.
Yeah, but those articles and interviews can't exist so long as the GOP as a group won't touch it. So long as they hold, the best the Dems can hope for is to drag a couple of "good" Republicans along and claim a "bipartisan" fix. But w/o a movement of (mostly "evil") Repubs, you can't fool enough people to convincingly blame the party.
Leaving this issue behind and taking point on something completely different (immigration) is the smartest political move the GOP could have done at a time like this. If you've noticed, we haven't heard the term "party of 'no'" in months now.
This is how people have viewed politics for some time--different parties for different issues--and the GOP is finally responding. When the country wants apples, they vote for the Apple Party; when the country wants oranges, they go for the Orange Party. The Apple Party doesn't stand a chance once the shift occurs.
It's actually a boon for the Republicans as the Democrats are heavily invested in the "one party for all issues" model. That's what generates PC culture: because you can't actually give everybody what they want, you have to declare certain things unacceptable (evil).
The Democrats are actually losing control of two issues right now. They failed to take point on immigration. And as O-care crumbles, they won't be trusted as the "Healthcare Party" anymore.
Oh, yeah, and on Friday the HHS issued a new directive that...well, here you go...
"A new rule issued late Friday requires state, federal and local agencies as well as health insurers to swap the protected personal health information of anybody seeking to join the new health care program that will be enforced by the Internal Revenue Service."
Link
Is this the same IRS that hates conservatives? I mean, just happened to target conservatives for no apparent reason whatsoever, but just a big coinkidink?
Oh, and as if thing couldn't get more bad for the Obamacare, did you hear the one about how there aren't enough primary care physicians coming out of medical school? Oh, and the seasoned doctors are moving to "concierge" practices where they charge their patients a flat fee of $50 to $100 a month for 24/7 access with housecalls and everything? And how these same concierge doctors have dramatically lowered the cost for themselves by dumping the insurance companies and to their patients by negotiating directly with labs and such for much lower fees. The only thing they encourage their patients to get is catastrophic insurance coverage just in case of emergencies which is much lower in cost?
Hmmm, unforeseen consquences? Ummm, not so much. Didn't we predict these in 2009?
this is not a good bill people.Politicians told whoppers of cosmic proportions just to get it passed, but everyone who reads this blog knows that. I'm glad that the (R's) SEEM to be getting it. BUT, they have always been particularly vulnerable to the media 's beltway bullshit. Remember, "intransigence" plays at WAPO and the Sunday talk shows as "wacky right wing tea bagger." Has anyone ever heard Nancy Pelosi portrayed that way by beltway types? It may not matter. Far too many people still say "well something had to change, didn't it?" And I answer, my health insurance annual premiums will probably increase from $22,000 to $24,000.This issue pretty much gets me into the "stay off my freakin' lawn" mode faster than anything.
"...The Democrats are actually losing control of two issues right now. They failed to take point on immigration."
Tryanmax - Interestingly enough, there was an op/ed article in the NY Post or Daily News today about how Obama has been secretly in the middle of ALL the negotiations (presumably between golf games and fundraisers) and been guiding the negotiations with his expert hand. The article also intimated that the Republicans have been fighting and fighting each other and not been able to do anything during the negotiations. I found it quite funny that now in the 11th hour Obama is stepping in and claiming HE is the REAL person behind the pending legislation. It's just those recalcitrant Repubs who keep getting in his way. (Sound familiar?)
He maybe should have waited until AFTER the bill passes to take credit. That's what Clinton would have done...
Bev, I can't say the effort by Obama to take credit surprises me. It'll be interesting to see if anyone else tries to repeat the narrative. The Rubio stamp is so embedded on immigration, it should be pretty hard to replace it. The risk to TV pundits carrying that water if they can't work it is looking like something between sycophantic dreamers or plain idiots.
Now Bev, The ONE can't do it all. He is very busy right now with negotiating a peace treaty in Syria, running free elections in Iran, confronting Russia on getting involved with civil war, bringing Africa into the 19th century, and completely overhauling the US Health system to ensure Universal coverage. I also heard he was in the desert southwest handing out water-bottles to illegals. All this while simultaneously monitoring multiple cell phone and internet conversations to protect us from terrorism. The golfing is just a front, he is really fighting crime and saving the world as Superdude.
LL, That's what I think this eventually becomes. It will become part of Medicaid and they'll eventually redefine it as "It was always just meant to help poor people get medical coverage."
I would be surprised if it went any other way.
Patriot, I have two reasons to think that won't happen. For one thing, since 2008, the Republicans have had a remarkably unified caucus and they've opposed everything Obama has done -- 100%. I see no reason why this leadership would suddenly change.
For another, they see the political benefits of letting this thing twist in the wind. As more people like the unions or WalMart employees or that teacher from the prior article discover that they've been had in a big, bad way and that they will now be fined, the ranks of people who come to distrust the government and the Democrats will grow. Boehner's comments show me that they understand that and that they are willing to take a lot of flack from people who are close to them in exchange for the long-term benefit.
The one wild card is Chris Christie. If he were elected President, I could easily see him trying to fix it. But I don't think he can win the nomination.
tryanmax, That's a really good point. All of the focus on immigration (and now scandal-arama) has taken everything else off the table politically. It's given the Democrats no way to find cover by attacking the Republicans on healthcare because shadowboxing against and empty room doesn't work when no one is paying attention to that issue. That's led to them needing to try to remain silent or infight. And the result has been a steady stream of articles about the unfolding disaster and how the Democrats are panicked and are blaming other Democrats for the problem. That doubles down on the chaos and reinforces the idea that this thing will be a mess, which amplifies the problem.
At the same time, by focusing on immigration, the usual suspects like McCain are kept busy so he can't reach across the aisle to save his friends on healthcare.
And in the end, the result will be that the Democrats will become a laughing stock on the health issue for passing a truly incompetent bill that made EVERYTHING worse. This will go a long way to hurting them, especially if the Republicans can then offer their own reform.
Bev, We did predict that exactly in 2009. I think that ultimately, the future of medicine is the concierge model except for specialists, who will need to remain in the insurance model. And the result will be that people who can afford it will find a quality doctor they can visit and those who can't will find themselves in the Obamcare system where they see nurses at low-end hospitals.
In fact, there was an interesting article about this exact thing now happening in Britain. They have a bunch of Polish immigrants and some of them are doctors. And unlike their staid, socialist British neighbors who do as they are told, these Poles decided to open up private clinics outside the system and they are booming because they offer MUCH better service all around. And people are paying for this even though they could in theory get it for free in a government clinic.
Here's the article and it's absolutely worth reading: LINK
That's the future.
Jed, "Stay off my freakin' law" is an excellent motto for the type of government we should have! :D
It will be interesting to see if the Republicans do hold out. Right now, it looks like they will, but you can never say for sure. I am hopeful. I just wish they had a decent alternative.
Bev, I saw an article that went the other way and tried to explain that the reason Obama has been completely absent is because he doesn't want to politicize the issue and he knows that if he got involved, those meany Republicans would start playing politics.
I think the MSM is starting to realize the mess their strategy has made. By trying to pin this on Rubio so that conservatives would blow up the bill, they've managed to actually pin it on Rubio. Now it's his bill, it will pass, and they suddenly realize that the Republicans will get the credit. I'm sure they will now desperately try to change that, but I don't think they can. They tagged this THE RUBIO bill and it's too late to claim Obama made it happen.
tryanmax, I don't think they can change where the credit goes. They spent too much time calling this "the Rubio bill" and focusing obsessively on Rubio. Obama has been nowhere to be seen except for the occasional awkward comment from a podium... "you people better do this!"
At this point, "immigration reform" is synonymous with "the Rubio bill" and you can't break that association.
Andrew: Ditto.
Question: How do you explain what's happening with Gov. Jan Brewer in Arizona? According to some accounts, the insurance companies, which have lots of clout are ramroding Obamacare participation over the Republican majority in both houses of the legislature. Republican deathwish or just plain ol corruption? And what's the odds this behavior gets emulated on a national level?
Koshcat, The golfing is a front! LOL! And don't forget, he's busy cooling the planet and saving us from the rising tides too.
Actually, in truth, this is a man who has yet to prove he can handle one thing at a time. And he doesn't have the energy level (or intelligence) he needs to weasel his way back into this issue. To do that, he would need to be inviting people to the White House to win their votes, giving speeches before dozens of groups, and offering his own solutions to issues where there seems to be an impasse. He's not doing any of that.
K, Just plain old corruption. This has happened in several states. One of the Dakotas for example jumped on board because of heavy insurance lobbying.
The reason I don't think this will repeat at the federal level is that the politics aren't the same. Brewer made the claim that accepting the program would mean a steady stream of federal money -- in other words, they were bought. But there's no one to buy the Republicans at the national level because there is no higher organization to fund this for them. Basically, they would need to come up with the money out of their own budget to make it happen, so they won't.
This is a bit off topic, but I was wondering if someone could explain today's SCOTUS ruling regarding AZ voter registration law. As long as a law doesn't cause specific discrimination, I don't see how the federal governments requirements supersede a states? Except for the president, those elected either work in and for the state or represent the state. One of the arguments was that the law inhibited native Americans but if they are living on a reservation the state law does not apply.
Call me crazy, but I think more than a few liberals are actually rather pleased by this--i.e. the ones who were clamoring for a full-on single-payer system. If I remember right, they were indeed saying that problems like this would occur and that the only solution was to give the government full control over health care. Of course, now there's no way to do that, as the GOP can block any such legislation, so I guess they'll be all alone in Rightville.
T-Rav, I think the liberal Democrats were under the assumption that they would have Republicans trying to fix this, and that would be their opportunity to sell the public on single-payer. I don't think the public is sold on that idea today.
Koshcat - I believe the SCOTUS ruling has to do with having to have provide proof of citizenship (i.e. documents) before one can register to vote. To us that may make sense because one should have to be a citizen to vote, but apparently there are many, many citizens who were born at home without benefit of the state to provide a valid birth certificate or couldn't afford to purchase them illegally.
T-Rav, I don't recall a lot of liberals saying that -- I think that was a conservative conspiracy theory.
From what I saw, liberals saw this as just a stepping stone toward a single-payer system, but they didn't think this law would cause any problems. To the contrary, they thought this would work and would prove that government run healthcare was good, which would lead to people clamoring to "finish" the reform by moving toward a single payer.
tryanmax, In terms of the rank and file, I don't think they thought this thing would need fixing. They assumed it would work fine, but people would clamor for it to go further once they saw how great it worked.
The smarter liberals knew there would be problems, but they assumed that the Republicans would be forced to fix those problems because (1) they assumed that once it passed, the public would love it and the Republicans would need to accept that (which is why they are shocked that polls continue to show a desire for repeal) and (2) most legislation needs some fixes and the Republicans do have a history of playing along.
I suspect what the smarter liberals thought was "just get this thing passed in any form you can and then 'fix it' to be what we really wanted once people accept the fact it's law."
Koshcat, With a few exceptions where Congress cannot act, the law works like this:
1. If Congress federalizes an area, then the states may not act.
2. If Congress imposes some laws, but doesn't take over the whole field, then the states may pass laws, BUT those laws cannot contradict the federal law.
3. If Congress says nothing, then the states may act as they wish.
In this case, Congress passes a law in 1993 which created a uniform list of documents that could be used to register to voter nationwide. What Arizona did was try to force people to provide certain documents which were not required by the 1993. That conflicts with federal law because it restricts the rights granted by federal statutes, i.e. the right to register to vote by showing the documents listed in the 1993 Act.
Bev, You'd be surprised at how hard it can be to find valid documents because the states are different. Just look at the "Certificate of Live Birth" issue. Some states won't accept that, others will -- even though that is what some states issue. It's estimated that 13 million citizens don't have the kind of proof Arizona required.
Please excuse my ignorance here. What provision in the constitution allows congress to pass this law? Again I am taking the naive position that a state should be able to decide who represents them to the federal government and who represents them in the state.
Koshcat, I haven't looked into it, but my guess is they claimed this power under the 14th Amendment's Equal Protection Clause.
I'm still not convinced the ACA will be repealed, but one sign that such a repeal could be eminent would be a big upsurge in Democrats and MSM pundits blaming the problems on Republican obstructionism. I don't think we're seeing that yet.
My mistake... Article I of the Constitution:
The Times, Places and Manner of holding Elections for Senators and Representatives, shall be prescribed in each State by the Legislature thereof; but the Congress may at any time by Law make or alter such Regulations, except as to the Places of chusing [sic] Senators.
K, We're not at that point yet. They are still trying to convince everyone that the law is the greatest thing ever and it will work once it gets implemented. They will only start blaming Republican obstructionism once the problems become insurmountable.
Thank you. I think I would have read the first line and ignored the second. In hindsight a very odd and contradictory statement. Why bother have the first line if the second line wipes it out? So could a state have a law like AZ for just state offices and below since this statement is only for senators and reps?
Andrew....What may happen with the ACA, is that as more doctors, companies, and individuals opt out of the current medical game and start offering a la carte medical choices, people will begin to see that the Obamacare only benefits the poor, out of work crowd w/o health insurance, and that everyone else has to subsidize those people. It will just bring into stark relief what Medicaid and O'care health insurance policy increases are doing and will be doing.
Long convoluted point, is that their health care will become increasingly more personally expensive and their options for said care will become fewer.
BTW...have you noticed an increase in small, stand alone, walk-in medical care treatment businesses in your area? They are sprouting up all over the DC area in VA and MD. Wonder what the deal is with these? Similar it seems to "Minute Clinics" at CVS. Could this be the wave of the future where people will go to get basic health care like aches and pains, fevers, sprains, strains, etc.? Instead of the emergency room or their own healthcare provider if they have one? I'll have to research these units to see if they prescribe medications, do minor surgery (stitches) and other common type health care issues. Know anything about them? Anyone?......Bueller? (The last one was a joke)
the purpose of my questions is I am trying to understand federalism better. One critism of the 17th amendment is it removed the states representation to the federal government. By removing this we have seen an increase in laws that dump unfunded mandates onto the state.
But the SCOTUS with Obamacare ruled that they can't do that at least in every case. What I find confusing is some laws are set that the state can go above it, for example minimum wage. Does each law have this mechanism written into it or do they fight these cases by their whim? Is there a mechanism where a state could protect its citizens from Obamacare?
Koshcat, Don't forget the structure of the whole document. It divides power between the feds, the states and the people. So what it says and what it doesn't say matters. In other words, things like this need to be spelled out. If it said nothing, then the issue wouldn't be clear at all and you would probably end up with a constitutional crisis at the first election as everyone fought about how to hold elections and who got to decide.
Moreover, this reads like a compromise to me -- states will have primary power, but the feds can intervene if necessary. That sounds like an attempt to satisfy two competing camps, with the state people thinking that they have won, but the fed people actually winning in the long term.
As for Arizona/local elections, yes and no. Under the constitution, how a state arranges its own government is up to the states. So theoretically they could impose any set of requirements. BUT the constitution does apply to the states too. So whatever requirements the state imposes can't violate the other provisions of the constitution. For example, you couldn't say "Anyone but gun owners can vote" because that would violate the Second Amendment. You also couldn't say, "Only whites can vote" because that would violate the 14th Amendment. Language and IQ tests were struck down for the same reason, that they were a violation of the equal protection clause.
Koshcat, In all honesty, the 17th Amendment thing is a red herring. The law evolved to this point through a series of decisions that had nothing to do with that change.
In terms of how federalism it works... think of it this way.
1. The feds can't do anything without the constitution giving them the right to do it. Though, they can bribe states to agree -- which is what they do with speeding limits, for example.
2. If the Feds "declare" an intent to control an area. They do this either by saying so directly in the legislation, or by imposing a set of rules so extensive that the courts believe there is no room for the states to act... in that case, the states can't do anything.
3. If the Feds only impose some rules... then the states can impose their own rules so long as they don't "conflict."
"Conflict" means basically that the states cannot do the opposite -- like allowing what the feds disallow or disallowing what the Feds allow. It also means that they can increase your rights, but they can't reduce them.
Thus, the minimum wage for example: Congress can act because wages affect interstate commerce. The feds have acted. But they have not said they are taking total control over wages, so states can act as well. But states can't reduce the amount because the feds have set a minimum right -- lowering it would conflict. States can, however, increase the amount because that doesn't the federal law sets a minimum, not a maximum, so raising the minimum is not considered a conflict.
Patriot, I haven't seen that here because this city is pretty well served by some very good hospitals and a lot of doctors. So I don't think there's much demand for something like that here. In DC, I could absolutely see the need for it though because in my experience DC (at least northern Virginia) was under-served medically.
In terms of Obamacare, I think the program dies under its own incompetence and cost.
Patriot - The "urgent care" clinics have opened all over NYC too. And they are very handy. If you have an non-emergency or non-emergency room urgent need and your doctor is not available, they are great. Most take insurance. I've been to one and I was very impressed.
Back in the days before idea of Hillarycare basically gave over medical care to the insurance companies in the mid-90's, general practice or family doctors would treat injuries like broken bones, gaping wounds, deliver babies etc. in their offices. They'd sew up and caste arms right in their offices and were the point person for all your care and actively consulted directly with the specialists for better broader Primary care. If one of these emergencies came in you might have to wait until the emergency had passed.
Then more and more family doctors became relegated to "referral givers" and frankly were not allowed to treat the whole patients anymore. They just sent you to specialist or to the emergency rooms because it took too much office time. In my experience, my primary care doctor has no idea what happens when I go to a specialist anymore. What happened then was that emergency rooms became overcrowded with taking care of these minor emergencies and we have what we have today.
The urgent care clinics have emerged to lessen the load of the emergency room and handle medical issues that are not life threatening emergencies, but urgent enough to require immediate care. They also are opened longer hours and on weekends and are a much lower cost than hospital emergency room.
Awesome. Thank you. Very complex and I even took civics in high school. I hear it has been eliminated in some school districts which I think is criminal.
You're welcome. It's not as complex as it seems at first. The problem is the boundaries aren't clear on any of it. That means it's often hard to predict.
I've heard that about civics, but I don't know anything for certain.
Bev, Just like the Polish guy!
You know what's criminal? The content of the textbooks for those civics/government classes that haven't been eliminated. A friend of mine showed me one for some high school juniors he's teaching next year, and it was written at a fifth-grade level. I'm not even kidding.
Yes, just like the Polish doctor. There are a growing number of doctors moving to "Concierge" doctors. They dumping all insurance carriers and lowering their costs by charging patients $50-$100 a month for 24/7 care. They are negotiating directly with labs for lower cost for tests too. Many are finding that they make the same amount of money, can spend more time with each patient, and give a higher quality of care for much lower cost to the patients. And they don't have to have a dedicated staff just for billing and negotiating with insurance companies. They encourage their patients to caring catastrophic care insurance for hospitalizations and emergency care.
Andrew, I probably couldn't find the articles now, but I distinctly remember several leftist columnists saying in 2009-10 that a single-payer system was the only way around the issues ObamaCare would inevitably raise. Brownie points for honesty, I suppose.
T-Rav, I haven't see one in maaaaaaany years, so I can't say. I wouldn't be surprised though. They were in the process of dumbing down textbooks when I was in school already.
On the single payer thing, it's possible some said it, but I don't really see that as a true motivation by anyone involved. I think they genuinely believed it would work or work well enough for them to justify taking the next step -- single payer.
The problem with creating problems is that people tend to look elsewhere to have the problems fixed. In other words, they don't go back to the guy who created the mess and ask him to try again... they tend to go to the other side.
That's why I think the idea that Obama wants to crash the economy is just stupid, even though a lot of people on our fringe promote it.... "he wants to destroy our economy so we will turn to him to save us with government!! It's Alinsky's secret plan!!!" Arg. No one in their right mind would think that would help them.
Bev, I've seen that too and I've run across a couple like that. I think that's the future.
Bev...That's exactly what I believed their operating plan might be. Sorta like a GP for 'anyone' who needs minor health care. Do you know if they prescribe Rx there? That would be really great if they did.
I'm all for more choices and options for all, especially in our health care. I'm glad to see these places open up and hope they succeed beyond their owners (doctors most likely) wildest dreams. Then we'll get even more and the prices will come down.
Patriot, they are fully functioning medical facilities and can prescribe meds like any other as far as I know.
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