# Healthcare Reform Down In Flames? **URL:** \ **Category:** Great Debates\ **Created:** [December 13, 2010, 5:45pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004 "2010-12-13T17:45:34Z")\ **Posts on this page:** 20\ **Page:** 11
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [December 15, 2010, 4:59pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/201 "2010-12-15T16:59:05Z")
> [@GIGObuster](#): > > On that specific point I agree, not cut and dry, but seeing how other recent rulings came, is still a long shot; and I have to agree with others that what the odd judge ruled will most likely be thrown out. There are two other rulings negative rulings, with more (including a multi-state lawsuit with multiple AGs participating against the bill) with ruling not yet made. What exactly are you relying on to reach your conclusion? ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [December 15, 2010, 5:05pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/202 "2010-12-15T17:05:44Z")
> [@Bricker](#): > > I’m not so sure how long a shot it is. > > First, I think the Fourth Circuit will be receptive to the idea. So I’m willing to bet it will be upheld at the Circuit level. > > The Supreme Court has scaled back the sixty-year precedent in two relatively recent cases: the Violence Against Women Act (United States v. Morrison, 529 U.S. 598 (2000); holding that federal law that gave victims of gender-based violence a civil cause of action exceed Congress’ Commerce Clause powers) and the Gun Free School Zones Act (United States v. Alfonso Lopez, Jr., 514 U.S. 549 (1995); holding that prohibiting guns within 1000 feet of a school exceeded Congress’ Commerce Clause powers). > > What’s at issue now is whether refusal to buy something can be penalized. This decision doesn’t say it’s unconstitutional for the government to offer healthcare… it says the federal government cannot require a person to buy healthcare. > > Under the sixty year old Wickard v. Filburn decision, it can. But if Wickard didn’t exist, a fair reading of Morrison and Lopez would make it questionable at best. > > So I’m not so sure now that the Supreme Court won’t be interested in continuing the trend of Lopez and Morrison. > > In any event, you can see (hopefully) that it’s not a cut-and-dry issue. I did not say it was. I pointed out there is dispute over whether it is as definitive as the thread or you implied. There are legal questions. Hopefully you can see that. ---
**Author:** ![flickster](https://avatars.discourse-cdn.com/v4/letter/f/7bcc69/32.png) [@flickster](https://boards.straightdope.com/u/flickster)\ **Post date:** [December 15, 2010, 5:06pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/203 "2010-12-15T17:06:18Z")
> [@sh1bu1](#): > > Not could, would. > > There are lots of places in the US that would gladly pitch public education so they could teach creationism, the real history of the War of Northern Aggression, have Bible study, and provide marksmanship classes with targets of abortion providers. and the problem would be?..well, except for the abortion provider targets. I have no problem with states and regions establishing curriculum that reflect the local culture, as long as reading, writing and arithmetic are the focal point. As with employment, if you don’t like what is offered there you are free to take your kids elsewhere, utilize a private school, or home school ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [December 15, 2010, 5:14pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/204 "2010-12-15T17:14:18Z")
> [@Bricker](#): > > There are two other rulings negative rulings, with more (including a multi-state lawsuit with multiple AGs participating against the bill) with ruling not yet made. > > What exactly are you relying on to reach your conclusion? [http://news.yahoo.com/s/yblog\_thelookout/20101213/ts\_yblog\_thelookout/judge-rules-against-health-care-law-what-does-it-mean](http://news.yahoo.com/s/yblog_thelookout/20101213/ts_yblog_thelookout/judge-rules-against-health-care-law-what-does-it-mean) > [@](#): > > What happens now in the legal process? > > A federal appellate court will hear the government’s appeal of Hudson’s ruling. If that court, too, rules in favor of Virginia, then the Obama administration would appeal to the Supreme Court, which would almost certainly take the case. > > Meanwhile, other legal challenges to the law are making their way through the court system. On Thursday, a Florida district court will hear a lawsuit brought by a group of state attorneys general. If this case, too, goes in favor of the law’s opponents, then the Supreme Court would probably merge it with the Virginia case, and rule on both challenges together. > > So, how is the Supreme Court likely to rule, assuming things get that far? > > That’s the $64,000 question. Orin Kerr, a professor of constitutional law at George Washington Law School, told The Lookout that despite Monday’s ruling, he expects the Supreme Court “will uphold the statute fairly easily.” But Barnett, not surprisingly, sees things differently. Last year, he noted, the law’s supporters derided the legal challenge as frivolous. “It’s not frivolous anymore,” he said. So, of course one can grant that it is not frivolous anymore, but it is still wishful thinking that the rulings against reform will prevail. ---
**Author:** ![jayjay](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jayjay/32/6765_2.png) [@jayjay](https://boards.straightdope.com/u/jayjay)\ **Post date:** [December 15, 2010, 5:25pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/205 "2010-12-15T17:25:29Z")
> [@flickster](#): > > and the problem would be? That none of what he cited is actually accurate, maybe? You may be fine with children (anywhere) being taught that everything was created in six days, but I’m not. Because it’s WRONG. Of course, if the entire southeast and southcentral regions of the US _want_ to become international laughingstocks as they watch their children continually denied admission to actual accredited universities for lack of real education, that should be no skin off my nose. Except for what it does to those children. ETA: I’m sorry, I have to revisit, mostly because I’m incredulous that someone who, IIRC, is a conservative but not one of the biblethumpers actually worships the idea of local control so much that he would gleefully watch science education in any particular region completely evaporate in favor of ancient myths. It boggles my mind. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [December 15, 2010, 6:11pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/206 "2010-12-15T18:11:46Z")
Considering that the educational systems of the Deep South are _already_ the nation’s worst, one can hardly imagine how bad they’d be without federal oversight. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [December 15, 2010, 6:29pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/207 "2010-12-15T18:29:47Z")
> [@Bricker](#): > > There are two other rulings negative rulings, with more (including a multi-state lawsuit with multiple AGs participating against the bill) with ruling not yet made. Can you re-write that with the grammar mistakes corrected? I can’t understand what you’re trying to say. Thanks. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [December 15, 2010, 6:33pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/208 "2010-12-15T18:33:18Z")
I bet it’s something to do with rulings. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [December 15, 2010, 8:01pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/209 "2010-12-15T20:01:08Z")
> [@GIGObuster](#): > > So, of course one can grant that it is not frivolous anymore, but it is still wishful thinking that the rulings against reform will prevail. I agree with this statement, and further say that a district judge should not take it on himself to reverse Supreme Court precedent. He may dislike it, but it is the (case)law of the land. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [December 15, 2010, 8:04pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/210 "2010-12-15T20:04:36Z")
> [@John\_Mace](#): > > Can you re-write that with the grammar mistakes corrected? I can’t understand what you’re trying to say. Thanks. Yeah, that sentence wasn’t my finest hour, was it? _There are two other rulings negative rulings, with more (including a multi-state lawsuit with multiple AGs participating against the bill) with ruling not yet made._ That means: Arrayed against the one ruling we’re discussing here, there are two courts that have ruled in the opposite way, and other lawsuits – including a multi-state plaintiff suit – as yet undecided. So characterizing the one case here as against the manifest weight of the rulings is not correct… there are only two that cut the other way, with more undecided. And besides that: rulings rulings rulings rulings. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [December 15, 2010, 8:21pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/211 "2010-12-15T20:21:05Z")
> [@Bricker](#): > > I agree with this statement, and further say that a district judge should not take it on himself to reverse Supreme Court precedent. He may dislike it, but it is the (case)law of the land. That seems rather puzzling to me. Does this happen very often, that is having a district judge reverse SCOTUS precedent? Is that a way for a lower level judge to essentially force the hand of the SCOTUS to revisit that precedent? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [December 15, 2010, 8:33pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/212 "2010-12-15T20:33:45Z")
> [@John\_Mace](#): > > That seems rather puzzling to me. Does this happen very often, that is having a district judge reverse SCOTUS precedent? Is that a way for a lower level judge to essentially force the hand of the SCOTUS to revisit that precedent? Heh. In Perry v. Schwarzenegger, the binding Supreme Court precedent is straightforward. That’s exactly what it is, then: a way for the lower level judge to kick the issue up and see if the mood has changed. At worst, they get a rebuke in the opinion that overturns them. ---
**Author:** ![Spectre\_of\_Pithecanthropus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spectre_of_pithecanthropus/32/12343_2.png) [@Spectre\_of\_Pithecanthropus](https://boards.straightdope.com/u/Spectre_of_Pithecanthropus)\ **Post date:** [December 15, 2010, 9:18pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/213 "2010-12-15T21:18:36Z")
> [@Mighty\_Mouse](#): > > No really, the ultimate issue is that medical providers are seeking some kind of abnormally high compensation, relative to the rest of the poplulation, by taking advantage of the fact that most consumers aren’t the payors, and that politicians are happy to mandate coverage for this and that. That is the problem you have to fix. Providers do charge excessively high “list prices”, but they almost never get those fees, because they’ve agreed to accept far less from their contracted insurers. This doesn’t help the person who can’t get approved for insurance at all, or who can’t afford premiums that are half or all of their income. > [@](#): > > You can’t get to where Canada, UK, Japan etc are without breaking some eggs. It is just not honest to pretend as if it can all come out of insurance company profits. People don’t believe that line, because they are not quite that stupid. Insurance company profits are generally wafer thin, but that doesn’t mean we can’t still ask if they should exist at all (with respect to health insurance). Those notorious CEO payouts aren’t necessarily counted as profit, nor are the much more modest wages of the armies of administrative staff, together with the cost of rent, utilities, and so on. How can all this not represent a huge layer of cost in the system? This was the particular egg that needed breaking. ---
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [December 15, 2010, 9:38pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/214 "2010-12-15T21:38:53Z")
> [@Spectre\_of\_Pithecanthropus](#): > > Providers do charge excessively high “list prices”, but they almost never get those fees, because they’ve agreed to accept far less from their contracted insurers. Insurers set the prices in individual situations, but these prices are in turn driven by the average prices for the region as a whole, which are largely beyond the control of the insurers. (There was some scandal recently relating to the fact that UHC owned the main outfit that calculated R&C pricing, and thus had a conflict of interest.) Even beyond prices, utlization is also impacted by this issue. Bottom line is that the decision as to whether or not to seek a given medical treatment/procedure/checkup is made by someone who is not going to bear the financial brunt of that decision. On an aggregate level this tends to inflate the cost of medical care. One way around this is rationed healthcare, where the decisions are made - or at least heavily influenced - by bureaucrats. Another approach is to have high deductible “catastrophic” health care plans, where the costs below a certain level are paid by the individual and the insurance kicks in at a higher level. This way, the decisions about whether to see a doctor for a cold or whether to have an MRI for something that seems-OK-but-you-never-can-tell-so-why-not-rule-it-out will be made by someone with skin in the game, but if the guy gets cancer or something they’ll be covered. The Bush administration tried this approach in pushing CDHPs, but the Obama people have backed off on this, IIRC. ---
**Author:** ![HRoark43](https://avatars.discourse-cdn.com/v4/letter/h/bc8723/32.png) [@HRoark43](https://boards.straightdope.com/u/HRoark43)\ **Post date:** [December 15, 2010, 9:48pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/215 "2010-12-15T21:48:14Z")
> [@sh1bu1](#): > > Really? It wasn’t a problem that insurance costs are increasing faster than wages? It’s not a problem that insurance is not portable when you lose/change jobs or start a business? It’s not a problem that American companies have to pay more for workers’ insurance than other countries do, making our labor costs higher? It’s not a problem that a major reason for bankruptcy is health care costs? Insurance is not portable? I thought there was COBRA, right? As for rising health care expenses, so what? You can go overseas to get cheaper health care nowadays. It’s called medical tourism. In some cases even health insurance companies support that. And if you can’t do that, why not turn to your community for help? Oh yeah that would require being an active citizen of your community, right? Why do we always turn to the Government instead of our community? Whatever happened to “can do”? ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [December 15, 2010, 9:48pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/216 "2010-12-15T21:48:59Z")
> [@Bricker](#): > > The problem in the judge’s decision is not a “logical flaw.” It’s that the decision rolls back precedent to the 1940s. The decision is perfectly logical. It just uses a view of the Commerce Clause that the Supreme Court rejected sixty years ago. I wish they hadn’t, and I’d love them to take this chance to rethink their idea. I disagree with this. I assume you are referring to _Wickard_. That ruling said nothing about economic inactivity. I think that the individual mandate is akin to making a farmer grow wheat against his will. This seems like the exact opposite of _Wickard_. ---
**Author:** ![Buck\_Godot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/buck_godot/32/6573_2.png) [@Buck\_Godot](https://boards.straightdope.com/u/Buck_Godot)\ **Post date:** [December 15, 2010, 10:24pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/217 "2010-12-15T22:24:33Z")
> [@HRoark43](#): > > Insurance is not portable? I thought there was COBRA, right? As for rising health care expenses, so what? You can go overseas to get cheaper health care nowadays. It’s called medical tourism. In some cases even health insurance companies support that. And if you can’t do that, why not turn to your community for help? Oh yeah that would require being an active citizen of your community, right? > > Why do we always turn to the Government instead of our community? Whatever happened to “can do”? That’s right, get your church to fund a [spaghetti dinner](http://boards.straightdope.com/sdmb/showthread.php?t=538568) for your sons chemo therapy. At $10.00 a head you only need 5,000 diners to cover this years bills. ---
**Author:** ![Mighty\_Mouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mighty_mouse/32/7776_2.png) [@Mighty\_Mouse](https://boards.straightdope.com/u/Mighty_Mouse)\ **Post date:** [December 15, 2010, 10:27pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/218 "2010-12-15T22:27:42Z")
> [@Spectre\_of\_Pithecanthropus](#): > > Providers do charge excessively high “list prices”, but they almost never get those fees, because they’ve agreed to accept far less from their contracted insurers. This doesn’t help the person who can’t get approved for insurance at all, or who can’t afford premiums that are half or all of their income. > Insurance company profits are generally wafer thin, but that doesn’t mean we can’t still ask if they should exist at all (with respect to health insurance). Those notorious CEO payouts aren’t necessarily counted as profit, nor are the much more modest wages of the armies of administrative staff, together with the cost of rent, utilities, and so on. How can all this not represent a huge layer of cost in the system? This was the particular egg that needed breaking. I know a self employed person who have a catastrophic policy, $10,000 annual deductible, $15,000 max out of pocket. She actually hit that limit, but would have had double or triple the expense if the rates she had to pay the doctors and hospitals weren’t regulated by the contract they had with the insurer. I am not arguing about your point of health insurance costs. A health economist once described this the American system to me as follows. We have a doctor who wants to make $500k per year for seeing 5000 patients (about three an hour, $100 per patient). The insurance companies (and Medicare/Medicaid) think this is too much, and he should only get $350k. They then play a huge game involving administrative workers, both in the medical practice and at the insurer (and the software companies, consultants, regulators etc). In the end the doctor makes $250k and society ends up paying four other people $500k, for a total cost of $750k per doctor, who ends up seeing only 4000 patients. I asked how he knew that in the absence of all this game, the doctor wouldn’t make off with $1M for seeing 2000 patients and spend the rest of his time playing golf. Part of the reason he works hard to see 4000 patients is that we REDUCED his rate per patient. ---
**Author:** ![HRoark43](https://avatars.discourse-cdn.com/v4/letter/h/bc8723/32.png) [@HRoark43](https://boards.straightdope.com/u/HRoark43)\ **Post date:** [December 15, 2010, 10:32pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/219 "2010-12-15T22:32:41Z")
> [@Buck\_Godot](#): > > That’s right, get your church to fund a [spaghetti dinner](http://boards.straightdope.com/sdmb/showthread.php?t=538568) for your sons chemo therapy. At $10.00 a head you only need 5,000 diners to cover this years bills. I can afford my son’s chemotherapy if he were to ever need it. I’m not trying to be callous or flamebaitish here, but I have an honest question… if it’s his time to go it’s his time to go. If you can’t find the money to save his life why bring everyone else down in the process? Again, I’m not trying to troll, there is the whole natural selection thing. Seriously, if liberals disagree with that then why don’t they contribute more donations to such things? I don’t see Angelina Jolie (or name your other supposedly liberal icon) rushing out to help every time there’s a kid who needs chemotherapy. I visit dailykos and [moveon.org](http://moveon.org) and I rarely if ever see them headlining a charity drive for these kids. What gives? ---
**Author:** ![GIGObuster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gigobuster/32/421_2.png) [@GIGObuster](https://boards.straightdope.com/u/GIGObuster)\ **Post date:** [December 15, 2010, 11:09pm UTC](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004/220 "2010-12-15T23:09:11Z")
> [@HRoark43](#): > > I can afford my son’s chemotherapy if he were to ever need it. > > I’m not trying to be callous or flamebaitish here, but I have an honest question… if it’s his time to go it’s his time to go. If you can’t find the money to save his life why bring everyone else down in the process? Again, I’m not trying to troll, there is the whole natural selection thing. > > Seriously, if liberals disagree with that then why don’t they contribute more donations to such things? I don’t see Angelina Jolie (or name your other supposedly liberal icon) rushing out to help every time there’s a kid who needs chemotherapy. I visit dailykos and [moveon.org](http://moveon.org) and I rarely if ever see them headlining a charity drive for these kids. What gives? > **[Angelina Jolie: Charity Work & Causes](https://www.looktothestars.org/celebrity/angelina-jolie)** > > Profile of Angelina Jolie's support for charities including UNICEF, ONE Campaign, and UNHCR. We have 217 articles about Angelina Jolie's philanthropy. > [@](#): > > The Jolie-Pitt Foundation, dedicated to eradicating extreme rural poverty, protecting natural resources and conserving wildlife, donated $1 million to Doctors Without Borders, an international medical humanitarian organization created by doctors and journalists in France in 1971. The organization provides aid in nearly 60 countries to people whose survival is threatened by violence, neglect, or catastrophe, primarily due to armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters, for emergency medical assistance to help victims of the Haiti earthquake. [![](https://img.youtube.com/vi/OpIYz8tfGjY/hqdefault.jpg "Annie Hall") ](https://www.youtube.com/watch?v=OpIYz8tfGjY) “Boy, If Life Were Only Like This!” - Woody Allen in Annie Hall after producing Marshall McLuhan out of nowhere to show some loud critic that he was wrong abut McLuhan. So it is now, I love this internet era. [Previous page](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004.md?page=10) [Next page](https://boards.straightdope.com/t/healthcare-reform-down-in-flames/564004.md?page=12)