# Wouldn't striking down the health care reform bill effectively GUARANTEE a single-payer system? **URL:** \ **Category:** Politics & Elections\ **Created:** [May 18, 2012, 10:41pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371 "2012-05-18T22:41:39Z")\ **Posts on this page:** 20\ **Page:** 2
**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:** [May 20, 2012, 5:42pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/21 "2012-05-20T17:42:00Z")
Well, you could reframe the “mandate” so it really is a tax. You’d have trouble getting that through the House, too, but it would be easier than Single Payer. ---
**Author:** ![BrainGlutton](https://avatars.discourse-cdn.com/v4/letter/b/82dd89/32.png) [@BrainGlutton](https://boards.straightdope.com/u/BrainGlutton)\ **Post date:** [May 20, 2012, 9:26pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/22 "2012-05-20T21:26:12Z")
> [@Ravenman](#): > > Aren’t there some more substantive nits to pick rather than what forum this belongs in? That’s why I want it moved to GD, this topic would get a better debate there, from more Dopers, not quite so focused on elections as such. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [June 1, 2012, 3:46pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/23 "2012-06-01T15:46:12Z")
[So apparently, Obama is preparing for a redo if the SCOTUS rules against the overhaul.](http://thehill.com/blogs/healthwatch/health-reform-implementation/230411-report-obama-readying-for-health-fight-after-supreme-court-rules) Look, I still think that it’s unlikely that the law will be struck down, but in that event, as I said earlier, there is NO OTHER alternative to HC reform other than a single-payer system. So, if Obama is forced to revisit this issue, I can’t imagine that he won’t be more forceful in a push for single-payer. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 1, 2012, 7:08pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/24 "2012-06-01T19:08:06Z")
> [@2ManyTacos](#): > > [So apparently, Obama is preparing for a redo if the SCOTUS rules against the overhaul.](http://thehill.com/blogs/healthwatch/health-reform-implementation/230411-report-obama-readying-for-health-fight-after-supreme-court-rules) > > Look, I still think that it’s unlikely that the law will be struck down, but in that event, as I said earlier, there is NO OTHER alternative to HC reform other than a single-payer system. So, if Obama is forced to revisit this issue, I can’t imagine that he won’t be more forceful in a push for single-payer. Seriously, why on earth would Americans and their elected representatives follow a President’s call for an even more sweeping health care reform proposal after the first attempt failed? It makes no sense whatsoever. If Obamacare were up for a vote today, it wouldn’t pass. Whatever the merits of single payer, it is farcical to believe that the idea is going to get political support in the next decade if Obamacare is struck down. Unless of course there’s some kind of new disease spread only by golf shirts and khakis that wipe out most Republicans and centrists, leaving only t-shirt and shorts wearing liberals left in most of the country. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [June 3, 2012, 4:08pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/25 "2012-06-03T16:08:16Z")
> [@EddyTeddyFreddy](#): > > Hell, no; the political world will flee the whole topic as radioactive and Congress will gladly stand back while the all-seeing, all-knowing, all-benevolently wise Invisible Hand of the Market sorts it out, untrammeled by nanny-state big-government tyranny. Is this what you believe the current state of the U.S. healthcare system is? An unfettered free market? The single largest problem that we have is that it is a cruel bastardization of a market system and a socialist system. If we actually had a free market (or even UHC) we would be far better than the current system. We get the worst of both worlds. ---
**Author:** ![Lightnin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lightnin/32/180_2.png) [@Lightnin](https://boards.straightdope.com/u/Lightnin)\ **Post date:** [June 3, 2012, 4:45pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/26 "2012-06-03T16:45:22Z")
> [@jtgain](#): > > Is this what you believe the current state of the U.S. healthcare system is? An unfettered free market? > > The single largest problem that we have is that it is a cruel bastardization of a market system and a socialist system. If we actually had a free market (or even UHC) we would be far better than the current system. We get the worst of both worlds. In an “unfettered free market”, one unburdened by regulations imposed by the State, why would any insurance company be willing to throw money away by covering those customers who are _guaranteed to be non-profitable_? ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [June 3, 2012, 4:59pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/27 "2012-06-03T16:59:25Z")
> [@Lightnin](#): > > In an “unfettered free market”, one unburdened by regulations imposed by the State, why would any insurance company be willing to throw money away by covering those customers who are _guaranteed to be non-profitable_? No. No more than an insurance company will pay for your burned down house when you didn’t have the foresight to purchase insurance before the fire. Millions of people in this country get screwed because of their own poor decisions: they didn’t have adequate auto or homeowners insurance, they didn’t save for retirement, they drive drunk, etc. If you are 22 and decide to save a few hundred bucks a month by not buying health insurance, and then next year you get skin cancer and can never get health insurance again, well that was your own stupid choice. You knew (or should have known) the risks and you took them. I’m not sure how far we should go in a free society to protect people from their own stupid choices. ---
**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:** [June 3, 2012, 7:24pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/28 "2012-06-03T19:24:12Z")
> [@Ravenman](#): > > Unless of course there’s some kind of new disease spread only by golf shirts and khakis that wipe out most Republicans and centrists, leaving only t-shirt and shorts wearing liberals left in most of the country. Quick! To the lab! ---
**Author:** ![The\_Tao\_s\_Revenge](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@The\_Tao\_s\_Revenge](https://boards.straightdope.com/u/The_Tao_s_Revenge)\ **Post date:** [June 3, 2012, 8:32pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/29 "2012-06-03T20:32:43Z")
> [@jtgain](#): > > No. No more than an insurance company will pay for your burned down house when you didn’t have the foresight to purchase insurance before the fire. > > Millions of people in this country get screwed because of their own poor decisions: they didn’t have adequate auto or homeowners insurance, they didn’t save for retirement, they drive drunk, etc. > > If you are 22 and decide to save a few hundred bucks a month by not buying health insurance, and then next year you get skin cancer and can never get health insurance again, well that was your own stupid choice. You knew (or should have known) the risks and you took them. > > I’m not sure how far we should go in a free society to protect people from their own stupid choices. How about some born with a per-exisitng condition? How about someone who didn’t have health insurance due to poverty? How many innocents would your ideology needlessly murder? That’s the problem. Conservatives like you WANT AMERICANS TO SUFFER if they’re not perfect, or have bad luck. You personally want Americans to die, for not being the best accountants. What an evil place to be. ---
**Author:** ![Lightnin](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lightnin/32/180_2.png) [@Lightnin](https://boards.straightdope.com/u/Lightnin)\ **Post date:** [June 4, 2012, 12:10am UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/30 "2012-06-04T00:10:58Z")
> [@jtgain](#): > > No. No more than an insurance company will pay for your burned down house when you didn’t have the foresight to purchase insurance before the fire. > > Millions of people in this country get screwed because of their own poor decisions: they didn’t have adequate auto or homeowners insurance, they didn’t save for retirement, they drive drunk, etc. > > If you are 22 and decide to save a few hundred bucks a month by not buying health insurance, and then next year you get skin cancer and can never get health insurance again, well that was your own stupid choice. You knew (or should have known) the risks and you took them. > > I’m not sure how far we should go in a free society to protect people from their own stupid choices. What **Tao’s Revenge** said. I suggest you look up the heinous practice of “rescission”, and imagine how common it would be if insurance were unregulated. Hell, all they’d have to do is be slow in paying out to a drastically sick person in the hopes that the customer would die before they’d have to give him the money he needs to get treatment. The last thing anyone should worry about, when they’re fighting for their life, is how they’re going to finagle their insurance company into actually paying for the required medical care. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [June 4, 2012, 2:08am UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/31 "2012-06-04T02:08:48Z")
> [@jtgain](#): > > I’m not sure how far we should go in a free society to protect people from their own stupid choices. Basic health care doesn’t seem to be one of those things that we should distribute based on ability to pay. ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [June 4, 2012, 10:33am UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/32 "2012-06-04T10:33:46Z")
> [@jtgain](#): > > If you are 22 and decide to save a few hundred bucks a month by not buying health insurance, and then next year you get skin cancer and can never get health insurance again, well that was your own stupid choice. You knew (or should have known) the risks and you took them. The problem is, in an unfettered free market, you can be 22, have had health insurance for your whole life, get skin cancer, and get refused a renewal 2 months later, since you won’t be profitable anymore. What kind of health insurance company would willingly re-up you knowing full well that they’re going to lose their shirts paying for your ongoing cancer treatment? This is why the “insurance model” is complete shit for health care. Insurance works for big ticket, very infrequent events, you pay a small amount, and get coverage in the unusual case of a big ticket item hitting you. Health care is nothing like that, it’s preferably an ongoing maintenance item, with occasional big ticket one time hits, and occasional big ticket chronic problems, and more frequent small ticket items. The insurance company (like every other company) wants to make money on every customer, but many customers have significant ongoing chronic bills to pay, that make them unprofitable. The other customers are healthy and don’t want to pay a big insurance bill if they don’t need doctoring, especially if you can dump them on the street the instant their do need doctoring. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [June 4, 2012, 2:16pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/33 "2012-06-04T14:16:09Z")
> [@Ravenman](#): > > Seriously, why on earth would Americans and their elected representatives follow a President’s call for an even more sweeping health care reform proposal after the first attempt failed? Because according to the polls, that’s what most Americans wanted in the first place? Not that I think they will; I think Congress and the President are so bought-and-paid-for and so terrified of anything “socialistic” that they’d commit electoral suicide rather than pass single payer. They’ve already demonstrated their willingness to put their careers on the line defying their constituencies over this. ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [June 4, 2012, 3:45pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/34 "2012-06-04T15:45:57Z")
FWIW, my state has [moved legislation that would incorporate many of the ACA protections into California law.](http://www.californiahealthline.org/capitol-desk/2012/5/senate-passes-major-health-reform-bill.aspx) _"The Senate passed SB 961 yesterday on a 22-13 vote, largely a partisan split. One day earlier, the Assembly passed its version of the bill, AB 1461 by Bill Monning (D-Carmel) on a 50-27 vote. Both bills would require insurers to cover a minimum set of basic requirements and would forbid them from denying coverage based on pre-existing conditions. "_ Now, I’m not entirely sure how the legislative process works here in CA as opposed to other states, but I would hope that the states who have made similar strides in implementing the ACA will have taken similar strides at the state level. Still, by the time that CA is ready to actually make these protections its law, the SCOTUS will likely have issued its verdict and we’ll have to see what, if any, alterations will have to be made. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [June 4, 2012, 5:27pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/35 "2012-06-04T17:27:02Z")
> [@Der\_Trihs](#): > > They’ve already demonstrated their willingness to put their careers on the line defying their constituencies over this. I’m not quite following you here: do you mean that some members of Congress have lost (or might soon lose) re-election because they did not support a single-payer system? If I have that correctly, who are these members you are talking about? ---
**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\ **Post date:** [June 12, 2012, 7:59pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/36 "2012-06-12T19:59:36Z")
Alright, well, the SCOTUS is set to release its verdict in the next few days on the health care law. Is there any legitimate reason to believe that they will strike it or the mandate down? I mean, yeah, the oral arguments were rough, but in the months leading up to the case the conventional wisdom - between both liberal and conservative scholars - overwhelmingly pointed to the law being constitutional. Lately, if you were to read any prediction articles about the case they would point to the reverse actually taking place, with the most likely outcome now being that the mandate is doomed and that the entire law could fall with it. I just don’t see how months of conventional wisdom and decades of precedent can be overriden based on the oral arguments. But I’m not a lawyer. ---
**Author:** ![Leaper](https://avatars.discourse-cdn.com/v4/letter/l/4bbf92/32.png) [@Leaper](https://boards.straightdope.com/u/Leaper)\ **Post date:** [June 12, 2012, 10:15pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/37 "2012-06-12T22:15:47Z")
> [@2ManyTacos](#): > > FWIW, my state has [moved legislation that would incorporate many of the ACA protections into California law.](http://www.californiahealthline.org/capitol-desk/2012/5/senate-passes-major-health-reform-bill.aspx) So has United Healthcare (I believe that’s the one; it’s one of the really big ones, anyway). ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 13, 2012, 2:23am UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/38 "2012-06-13T02:23:16Z")
> [@Cheesesteak](#): > > The problem is, in an unfettered free market, you can be 22, have had health insurance for your whole life, get skin cancer, and get refused a renewal 2 months later, since you won’t be profitable anymore. What kind of health insurance company would willingly re-up you knowing full well that they’re going to lose their shirts paying for your ongoing cancer treatment? > > This is why the “insurance model” is complete shit for health care. Insurance works for big ticket, very infrequent events, you pay a small amount, and get coverage in the unusual case of a big ticket item hitting you. Health care is nothing like that, it’s preferably an ongoing maintenance item, with occasional big ticket one time hits, and occasional big ticket chronic problems, and more frequent small ticket items. > > The insurance company (like every other company) wants to make money on every customer, but many customers have significant ongoing chronic bills to pay, that make them unprofitable. The other customers are healthy and don’t want to pay a big insurance bill if they don’t need doctoring, especially if you can dump them on the street the instant their do need doctoring. Insurance can work if done properly. France and Switzerland have health care systems that are in part based on private insurance, they do not have single payer. But those countries are not plutocracies so they have that going for them. One part of Mitt Romney’s ‘reform’ of health care is to allow people to buy insurance across state lines. That will drive prices down but it will do so by letting insurance companies all set up in the state with the weakest consumer protections. Recissions and other horror stories will be a lot easier if that ever becomes law. ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [June 13, 2012, 2:30am UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/39 "2012-06-13T02:30:08Z")
> [@The\_Tao\_s\_Revenge](#): > > How about some born with a per-exisitng condition? How about someone who didn’t have health insurance due to poverty? > > How many innocents would your ideology needlessly murder? > > That’s the problem. Conservatives like you WANT AMERICANS TO SUFFER if they’re not perfect, or have bad luck. > > You personally want Americans to die, for not being the best accountants. What an evil place to be. :rolleyes: (Hey anyone know if there’s a way to enlarge this, to the size of the sun?) ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [June 13, 2012, 1:47pm UTC](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371/40 "2012-06-13T13:47:36Z")
It really depends on how SCOTUS rules. If they narrowly rule against the mandate, but leave the rest, it creates a situation where insurance companies are required to insure old, sick people without the requiring young, healthy people to subsidize them. This will bankrupt the insurance industry, leaving only the government to provide full on socialized health care insurance. [Previous page](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371.md?page=1) [Next page](https://boards.straightdope.com/t/wouldnt-striking-down-the-health-care-reform-bill-effectively-guarantee-a-single-payer-system/622371.md?page=3)