Appeals Court Upholds Healthcare Law

[B-Large]

WASHINGTON — A conservative-leaning appeals court panel on Tuesday upheld the constitutionality of President Barack Obama's health care law, as the Supreme Court prepares to consider this week whether to resolve conflicting rulings over the law's requirement that all Americans buy health care insurance.

 

A panel of the U.S. Court of Appeals for the District of Columbia issued a split opinion upholding the lower court's ruling that found Congress did not overstep its authority in requiring people to have insurance or pay a penalty on their taxes, beginning in 2014. The requirement is the most controversial requirement of Obama's signature domestic legislative achievement and the focus of conflicting opinions from judges across the country. The Supreme Court could decide as early as Thursday during a closed meeting of the justices whether to accept appeals from some of those earlier rulings.

 

The suit in Washington was brought by the American Center for Law and Justice, a legal group founded by evangelist Pat Robertson. It claimed that the insurance mandate is unconstitutional because it forces Americans to buy a product for the rest of their lives and that it violates the religious freedom of those who choose not to have insurance because they rely on God to protect them from harm. But the court ruled that Congress had the power to pass the requirement to ensure that all Americans can have health care coverage, even if it infringes on individual liberty.

 

"That a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power surely explains why Congress has not used this authority before – but that seems to us a political judgment rather than a recognition of constitutional limitations," Judge Laurence Silberman, an appointee of President Ronald Reagan wrote in the court's opinion. Silberman was joined by Judge Harry Edwards, a Carter appointee. But, they added, "The right to be free from federal regulation is not absolute and yields to the imperative that Congress be free to forge national solutions to national problems."

 

Judge Brett Kavanaugh, a former aide to President George W. Bush who appointed him to the bench, disagreed with the conclusion without taking a position on the merits of the law. He wrote a lengthy opinion arguing the court doesn't have jurisdiction to review the health care mandate until after it takes effect in 2014.

 

The federal appeals court in Cincinnati also upheld the law. The federal appeals court in Atlanta struck down the core requirement that Americans buy health insurance or pay a penalty, while upholding the rest of the law.

 

And like Kavanaugh's dissenting opinion, an appeals court in Richmond, Va., ruled it was premature to decide the law's constitutionality. This aspect of the court challenges issue involves a federal law aimed at preventing lawsuits from tying up tax collection. Kavanaugh and the Richmond court held that taxpayers must begin paying the penalty for not purchasing insurance before they can challenge it in court.

 

Jay Sekulow, chief counsel for the American Center for Law and Justice, which filed the suit in Washington, said the group is considering whether to ask the full appeals court to hear the case or make a request directly to the Supreme Court. "We still remain confident that Obamacare and the individual mandate, which forces Americans to purchase health insurance, is the wrong prescription for America and ultimately will be struck down as unconstitutional by the U.S. Supreme Court," Sekulow said.

 

The White House said Tuesday it is confident that the Supreme Court will uphold the law, as the DC circuit did. Obama adviser Stephanie Cutter said in a White House blog post that opponents who say the individual mandate provision exceeded Congress' power to regulate commerce "are simply wrong."

 

"People who make a decision to forego health insurance do not opt out of the health care market," she wrote. "Their action is not felt by themselves alone. Instead, when they become ill or injured and cannot pay their bills, their costs are shifted to others. Those costs – $43 billion in 2008 alone – are borne by doctors, hospitals, insured individuals, taxpayers and small businesses throughout the nation."

 

The liberal interest group Constitutional Accountability Center said the ruling from a solid conservative like Silberman, as the Supreme Court prepares to take up the issue, is a "devastating blow" to opponents of the law.

 

"With two prominent conservatives, this panel was thought to be a dream come true for conservative challengers of the act," said the center's president, Doug Kendall. "Today that dream became a nightmare, as the panel unanimously rejected the challenges to the act, disagreeing only about why those challenges failed."

 

This is going to be very interesting as I assume th highest court in the land is going to hear this. I from day one I have been supportive of the ACA legislation, I think in the end this was the best fit, as it is based in free market yet covers everyone. I know alot of people hate this law, and in some sense I understand, but if you evlauate the alternatives, this was the most widely appealing option.

 

yeah, and I got it from the Huff, whatsit to ya....

 

http://www.huffingtonpost.com/2011/11/08/obama-health-care-reform-_n_1081865.html

[erynthered]

Blah blah blah blah blah..............

 

Here's the meat and potatorino's:

 

The Supreme Court could decide as early as Thursday during a closed meeting of the justices whether to accept appeals from some of those earlier rulings.

[GG]

I know alot of people hate this law, and in some sense I understand, but if you evlauate the alternatives, this was the most widely appealing option.

 

 

It's only appealing to people who don't understand math.

[Koko78]

It's only appealing to people who don't understand math.

 

Or don't give a crap about pesky things like the Constitution.

[/dev/null]

It's only appealing to people who don't understand math.

 

Or don't give a crap about pesky things like the Constitution.

 

You mean Democrats?

[Cinga]

You mean Democrats?

 

I'm not Koko, but I do believe he is referring to politicians as a whole. It just so happens that Dems are in power now, and the worst offenders historically...

[OCinBuffalo]

It's only appealing to people who don't understand math.

Or simple economics. I hate this law, because it got passed by people who should know better, but instead know nothing.

 

If you forcibly and massively increase demand, while doing nothing to increase supply, the price will go up. There's no way in hell Obamacare cuts health care costs, and therefore, there's no way in hell it will reduce the deficit. Worse, we don't have enough primary care people as it is, and their idiotic argument is: "well preventative care will save money because all the currently uninsured will go to them and get care there instead of the emergency room/get care before things go from bad to worse".

 

 

Yeah? Guess which kind of physician does "preventative care". Guess which kind of physician those who go to the emergency room will go to?

 

That's right morons: primary docs....the ones that are in shortest supply.

 

You really have to a complete moron to support this law. I didn't say moron for "supporting doing something about the working poor getting reasonable care". I did say: "you are a moron if you support this law", or any other far left non-solution solution.

Edited November 9, 2011 by OCinBuffalo

[Cinga]

Or simple economics.

 

If you forcibly and massively increase demand, while doing nothing to increase supply, the price will go up. There's no way in hell Obamacare cuts health care costs, and therefore, there's no way in hell it will reduce the deficit. Worse, we don't have enough primary care people as it is, and their idiotic argument is: "well preventative care will save money because all the currently uninsured will go to them and get care there instead of the emergency room/get care before things go from bad to worse".

 

 

Yeah? Guess which kind of physician does "preventative care". Guess which kind of physician those who go to the emergency room will go to?

 

That's right morons: primary docs....the ones that are in shortest supply.

 

You really have to a complete moron to support this law. I didn't say moron for "supporting doing something about the working poor getting reasonable care". I did say: "you are a moron if you support this law", or any other far left non-solution solution.

 

Adam??? Adam Smith??? Is that you?? Basic economics is not something our powers that be care about anymore.. Keynes did his best to destroy any semblance of economic stability, only calling for government interference in a natural swing in economic policy..

[Dave_In_Norfolk]

Adam??? Adam Smith??? Is that you?? Basic economics is not something our powers that be care about anymore.. Keynes did his best to destroy any semblance of economic stability, only calling for government interference in a natural swing in economic policy..

We have never followed Adam Smith, what do you mean, "anymore"?

 

Didn't stop us from becoming a great power

[OCinBuffalo]

Adam??? Adam Smith??? Is that you?? Basic economics is not something our powers that be care about anymore.. Keynes did his best to destroy any semblance of economic stability, only calling for government interference in a natural swing in economic policy..

 

Hey newb? Do you want to crush Dave, or should I? It's all lined up, ready for you to take the shot.....

 

Edit: you know, in the spirit of new posters joining the board and all? I will gladly give up an easy one so that you can get your first kill.

Edited November 9, 2011 by OCinBuffalo

[Dave_In_Norfolk]

Hey newb? Do you want to crush Dave, or should I? It's all lined up, ready for you to take the shot.....

 

Edit: you know, in the spirit of new posters joining the board and all? I will gladly give up an easy one so that you can get your first kill.

Lol, nothing like a confident ignoramus! Go for it OC! Chicken

[B-Large]

It's only appealing to people who don't understand math.

 

Please, enlighten me. I have not been in hospital administration for 12 years, so I will have little to no experience with this matter... Actually not true... I have been, but I am sure a will find your healthcare math lesson refreshing.

[DC Tom]

Or simple economics. I hate this law, because it got passed by people who should know better, but instead know nothing.

 

If you forcibly and massively increase demand, while doing nothing to increase supply, the price will go up. There's no way in hell Obamacare cuts health care costs, and therefore, there's no way in hell it will reduce the deficit.

 

Unless you fix the price, and ration supply.

 

But it's not socialized medicine. Not at all.

[B-Large]

Or simple economics. I hate this law, because it got passed by people who should know better, but instead know nothing.

 

If you forcibly and massively increase demand, while doing nothing to increase supply, the price will go up. There's no way in hell Obamacare cuts health care costs, and therefore, there's no way in hell it will reduce the deficit. Worse, we don't have enough primary care people as it is, and their idiotic argument is: "well preventative care will save money because all the currently uninsured will go to them and get care there instead of the emergency room/get care before things go from bad to worse".

 

 

Yeah? Guess which kind of physician does "preventative care". Guess which kind of physician those who go to the emergency room will go to?

 

That's right morons: primary docs....the ones that are in shortest supply.

 

You really have to a complete moron to support this law. I didn't say moron for "supporting doing something about the working poor getting reasonable care". I did say: "you are a moron if you support this law", or any other far left non-solution solution.

 

The ACA is the exact same plan the GOP proposed when Hillary was pushing Universal Care.....

 

Cost goes up because people live longer, we have more and more therapies in which to treat chronic disease, and we have groundbreaking therapies in develop that have a huge R and D price tag... And the uninsured/ uninsurable get treated and pass the cost onto those who pay..... Our system continues to expand through capital projects, and buildings and outfitting them for medicine is very expensive.. Those are a few factors why no matter what we do, healthcare will continue to rise in cost for decades..

 

Unless you fix the price, and ration supply.

 

But it's not socialized medicine. Not at all.

 

Our nation needs to get over the Walmart attitude toward healthcare..... It will never be cheap as long as we expect the best practitioners, therapies and diagnostic modalities..... Starting budgeting folks, you're going to need it.

[GG]

Please, enlighten me. I have not been in hospital administration for 12 years, so I will have little to no experience with this matter... Actually not true... I have been, but I am sure a will find your healthcare math lesson refreshing.

 

My healthcare math is based on irrefutable experience of supply and demand, where history is conclusive in cases where demand is left unchecked, whenever you try to influence supply, bad things come out.

 

No matter how great you think ACA may be, the one thing the law doesn't do is put the true cost of healthcare in front of the consumer. It simply continues the fallacy where people equate the cost of insurance with the cost of healthcare. As long as people think they're covered by insurance, whether it's through an employer sponsored plan or through a government edict, they will consume the entitled "free" medical care.

 

I'm sure that you can enlighten us that in your 12 years of hospital administration you're an expert in navigating the reiumbursement mechanisms of private insurance and Medicare/Medicaid and how the hospitals and doctors tailor their practices to maximize their revenues from their true main customers, as opposed to any other business, which survives on providing the best product at the best price.

 

The reason that the healthcare math will never work is that there's too much incentive for the politicians to promise benefits to the voting public, which they know can never really be paid for under normal circumstances. That's why you need the mandate of insuring healthy young participants to pay for the care of older sick patients. But just like the promise of social security safety net is falling victim to the demographic crisis, healthcare will be a bigger time bomb, because it will lead more people to consume more medical service without a tangible way to pay for the services, other than the government stepping in with more IOUs to cover the exploding share of healthcare costs relative to GDP.

 

That's why the math doesn't work.

[wyobilzfan]

My healthcare math is based on irrefutable experience of supply and demand, where history is conclusive in cases where demand is left unchecked, whenever you try to influence supply, bad things come out.

 

No matter how great you think ACA may be, the one thing the law doesn't do is put the true cost of healthcare in front of the consumer. It simply continues the fallacy where people equate the cost of insurance with the cost of healthcare. As long as people think they're covered by insurance, whether it's through an employer sponsored plan or through a government edict, they will consume the entitled "free" medical care.

 

I'm sure that you can enlighten us that in your 12 years of hospital administration you're an expert in navigating the reiumbursement mechanisms of private insurance and Medicare/Medicaid and how the hospitals and doctors tailor their practices to maximize their revenues from their true main customers, as opposed to any other business, which survives on providing the best product at the best price.

 

The reason that the healthcare math will never work is that there's too much incentive for the politicians to promise benefits to the voting public, which they know can never really be paid for under normal circumstances. That's why you need the mandate of insuring healthy young participants to pay for the care of older sick patients. But just like the promise of social security safety net is falling victim to the demographic crisis, healthcare will be a bigger time bomb, because it will lead more people to consume more medical service without a tangible way to pay for the services, other than the government stepping in with more IOUs to cover the exploding share of healthcare costs relative to GDP.

 

That's why the math doesn't work.

 

QFT. People outside the health care industry have very little knowledge about how the system "works". This might be one of the best posts I've read on the subject in a succinct manner.

 

Let me ask you all this:

 

When you go to buy a new car, don't you have some idea how much it's going to cost before you buy it? Don't you "shop around"?

 

No incentive to do so in the case of health care with all the "low deductible" cadillac plans. I wish I had a dollar for every person with <$1000 deductible who didn't give a fart how much anything costs once they meet their deductible. Why don't health care facilities ADVERTISE their prices like other business in America do to compete for business? Probably because they have such a captive audience of imbeciles who "trust their HCP" to know and do what is in THEIR best interest. There are no real incentives for reducing costs, they are merely shifted more and more to the govt.

 

Just wait and see how many large employers and small businesses start dropping health care coverage when the law goes into full effect. Walmart, largest employer in the country just announced cutbacks and dropping some part time employees (of which they try to make everyone so they don't have to provide benefits). Just look at the rate increases going on this year alone.

 

The math doesn't add up because the demographics don't add up, and you have an industry that is rife with massive amounts of fraud, a legal system that makes HCPs order 50% more procedures or tests than necessary due to "defensive medicine" (afraid of getting sued). Anytime you put such a huge amount of money in the hands of govt bureaucrats, you end up with a mess. HCPs don't want to compete as business professionals. In fact, many are terrible money managers and that is why more are turning to being hospital/HCS employees.

 

I don't think the average American is interested or motivated enough to take responsibility for their own health care. So they leave it in the hands of the govt, their "trusted" HCPs, and don't even get me started about how specialist doctors are compensated like Wall St. fat cats compared to PCPs.

 

Until people stop being ignorant of how they are getting totally ripped off, nothing will change. Not even this "health care reform" bill is going to do anything but drive up the cost of medicine even more. Bottom line, I don't care if people eat like pigs, sit on their butts all day and smoke and drink like fiends. It's their business. People should be free to live as they please, and if they don't want to pay for health insurance, fine... then don't. However, when you start having chest pain, don't expect a handout from the the govt by going through the ER and costing the rest of us a fortune.

 

Biggest mistake is forcing ERs to accept patients who cannot afford to pay or have insurance. People should be free to live the way they want, and die the way they live. We have the most screwed up sense of entitlement about life than any place on the planet. If a model of health care is forced upon us by the govt, then it should be rationed. I do not agree that health care is a basic human right.

Edited November 9, 2011 by wyobilzfan

[Alaska Darin]

QFT. People outside the health care industry have very little knowledge about how the system "works". This might be one of the best posts I've read on the subject in a succinct manner.

 

Let me ask you all this:

 

When you go to buy a new car, don't you have some idea how much it's going to cost before you buy it? Don't you "shop around"?

 

No incentive to do so in the case of health care with all the "low deductible" cadillac plans. I wish I had a dollar for every person with <$1000 deductible who didn't give a fart how much anything costs once they meet their deductible. Why don't health care facilities ADVERTISE their prices like other business in America do to compete for business? Probably because they have such a captive audience of imbeciles who "trust their HCP" to know and do what is in THEIR best interest. There are no real incentives for reducing costs, they are merely shifted more and more to the govt.

 

Just wait and see how many large employers and small businesses start dropping health care coverage when the law goes into full effect. Walmart, largest employer in the country just announced cutbacks and dropping some part time employees (of which they try to make everyone so they don't have to provide benefits). Just look at the rate increases going on this year alone.

 

The math doesn't add up because the demographics don't add up, and you have an industry that is rife with massive amounts of fraud, a legal system that makes HCPs order 50% more procedures or tests than necessary due to "defensive medicine" (afraid of getting sued). Anytime you put such a huge amount of money in the hands of govt bureaucrats, you end up with a mess. HCPs don't want to compete as business professionals. In fact, many are terrible money managers and that is why more are turning to being hospital/HCS employees.

 

I don't think the average American is interested or motivated enough to take responsibility for their own health care. So they leave it in the hands of the govt, their "trusted" HCPs, and don't even get me started about how specialist doctors are compensated like Wall St. fat cats compared to PCPs.

 

Until people stop being ignorant of how they are getting totally ripped off, nothing will change. Not even this "health care reform" bill is going to do anything but drive up the cost of medicine even more. Bottom line, I don't care if people eat like pigs, sit on their butts all day and smoke and drink like fiends. It's their business. People should be free to live as they please, and if they don't want to pay for health insurance, fine... then don't. However, when you start having chest pain, don't expect a handout from the the govt by going through the ER and costing the rest of us a fortune.

 

Biggest mistake is forcing ERs to accept patients who cannot afford to pay or have insurance. People should be free to live the way they want, and die the way they live. We have the most screwed up sense of entitlement about life than any place on the planet. If a model of health care is forced upon us by the govt, then it should be rationed. I do not agree that health care is a basic human right.

Amen.

 

Obamacare didn't even attempt to address the things that make health care expensive.

 

I love the fact that liberals chirp about how health care in America is failing because it's "capitalist", when it's nothing of the sort.

[OCinBuffalo]

If only somebody had a way to apply activity based costing/workflow/business intelligence to health care, while making the necessary feasibility study based changes to these methodologies to suit health care, while making it act like custom software, have it be able to changed broadly or slightly and without consequence, and have it be designed from the ground up to integrate to anything. (yes, the cloud too...as if we haven't been doing "the cloud" since the 90s in Major League IT )

 

Boy, that somebody would be able to tell use the cost of doing business per patient per day, or minute, second, week, whatever, in real time, and give us a true determination of how well our care processes are doing. That somebody would be able to provide GG with everything he is asking for, and a whole bunch of other things he doesn't know about but are just as critical to cost reduction.

 

Wouldn't that be great!

 

(For the new guys, yeah, that's pretty much what the F I do)

[birdog1960]

Or don't give a crap about pesky things like the Constitution.

judge silberman (the guy that struck down the widely supported DC firearms ban) disagrees with you.

[birdog1960]

Please, enlighten me. I have not been in hospital administration for 12 years, so I will have little to no experience with this matter... Actually not true... I have been, but I am sure a will find your healthcare math lesson refreshing.

not to point a finger at you personally but the hospital conglomerates have done more to promote medicine as a business than any other entity. they are most responsible for making specialty and subspecialty care obligatory to allay the worried wells concerns that they are receiving adequate care. specialists and their procedures, tests and surgeries are their golden geese and they're not about to kill them but that's what is needed to bring down costs.... and fewer hospitals, mri's, surgical centers, cath labs etc. all but the poorest places have excess capacity.