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The Best Science Writing Online 2012
Showcasing more than fifty of the most provocative, original, and significant online essays from 2011, The Best Science Writing Online 2012 will change the way...
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The U.S. Supreme Court is a busy place this time of year. So when the justices announced that, starting March 26, they would hear six hours of arguments on the health care reform law—the most time it has dedicated to any one case in decades—the gravitas of the issue became clear to all.
The Patient Protection and Affordable Care Act (PPACA) is perhaps the most profound change to health care since Medicaid was instituted in 1965. "This case deserves the hype it's getting," says Gregory Magarian, a law professor at Washington University in Saint Louis School of Law.
The case is not just a political lightning rod—and whatever decisions emerge from the Court in the early summer will likely do little to diffuse the partisan tensions around the issue. What's really at stake in the case is individuals' access to health care.
Signed into law March 23, 2010, PPACA is expected to expand access to health care to an additional 32 million uninsured people in the U.S.—unless all or part of it is struck down by the Supreme Court.
"If this law's thrown out, I think we're resigned to the status quo, which is a lot of people without access to health care for a long time," says Larry Levitt, an expert at the Kaiser Family Foundation, a nonprofit, nonpartisan policy analysis organization. "I don't think there's any question about what lack of access to health care means: people get treated later, and some people die earlier as a result."
That also means continued health care cost increases, an expenditure that already eats up some $2.6 trillion a year—about a fifth of all U.S. spending.
At issue are two major provisions: the requirement that everyone have health insurance—the so-called individual mandate—and an expansion of Medicaid benefits, which would help more people afford insurance in the first place. "If the Court rejects either or both of those, it would have far-reaching implications for how health care reform would work—or even if the law would work at all," Levitt says. With fewer people insured, premiums would become even more expensive.
One of the unusual things about the legal challenge is that most of the law's big changes have not yet gone into effect, which has muddied the debate about how it will likely affect people's lives in practice. The individual mandate, for example, is not slated to begin until 2014. As more provisions are rolled out, Magarian notes, the law's benefits for individuals will likely become clearer to many. "For a lot of people this law is going to be a desirable thing on a personal level." he says.
From a public health perspective, the only argument against the law is that it should be even more aggressive in ensuring that people have access to affordable health care, says John McDonough, a professor at Harvard University's School of Public Health.
The Court will be hearing arguments about four segments of the law over the course of three days. What is at stake for each of these issues?
Individual health
Much of the outcry about the PPACA has centered on a need to preserve individual rights—that is, no law should require that people get health coverage. But the case before the court, Magarian explains, "isn't about that at all." The question in front of the Court pertains to state rights. "I think that would surprise a lot of people." This confusion, he posits, might be behind some of the recent polls that show about two thirds of Americans favor repealing the whole law part and parcel. As Levitt points out, if the Court overturns the PPACA, the states are well within their constitutional bounds to require their residents to purchase health insurance (as they already do with auto insurance).
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91 Comments
Add CommentThe republicans should be ashamed of themselves by opposing the health care reform; they are denying millions of Americans, mostly children and our senior parents, affordable health coverage. If any part of the health care is repealed, the insurance companies are going to jack their premiums and deductibles, just like the credit card companies did, so high that no one but the 1% can afford it; the way it is now. Shame on you scum-bag republicans.
Reply | Report Abuse | Link to this"Magarian suggests that the recent poll numbers showing a majority of Americans favoring a complete elimination likely betrays confusion about what the end result of the law will be: affordable health care for millions more Americans."
Reply | Report Abuse | Link to thisThat's right ... the majority of Americans are just not smart enough to know what's good for them.
I'd say we should all be ashamed of our healthcare system.
Reply | Report Abuse | Link to thisWhile the Affordable Healthcare Act is better than nothing, we spend more as a nation on healthcare for worse results than pretty much any country in the developed world. The travesty isn't what the Republicans are doing, the real travesty is the failure of both parties to implement the healthcare systems that have provided hundreds of millions with good, affordable medical care.
Does ikt escape everyone's attention that there is no right to healthcare in the Constitution? I do not real reading any clauses regarding the right to free healthcare but I will have another read tonight.
Reply | Report Abuse | Link to thisOn another note: have any of you that have posted lived with national healthcare? I have and I can tell you one thing for certain: if you think that the quality of care is going to get better and cheaper you have another thing coming. What you will get is a grinding halt in medical research and sub standard personnel becoimg health care professionals. The quality of care will go down hill and then who will be to blame. Certainly not our elected officials that are keeping their top tier healthcare that they are 'entitled' to as elected officials. If that does not send up a red flag I do not know what does. We have to trust that the people regulating our care have our best interests at heart when they are not subjected to the same system? Wake up and understand that those same elected officials (both sides of the aisle) can legally inside trade and cast their votes with their eye on re-election and not what is best for the people who they allegedly represent.
What is going to happen is that those seniors that are going to be covered are not going to get better care. What they are going to get is subjected to a system that uses actuarial tables to determine if the care they need is cost effective given their life expectancy. Really, do you think that the federal government is going to do any better with your healthcare than they have done with the VA? I mean that is a shining example of how we treat people that actually deserve free healthcare and what they get is appalling.
What ultimately will happen is that the majority of the populace will end up with horrible socialized medicine and those that can afford it will go to private doctors and hospitals and get premium care (just like the politicians will be getting). Then we will have an even deeper divide in our society.
Try reading the first line of the constitution again "....promote the general welfare....". I don't believe you've ever studied any other healthcare system. Both the AMA and the WHO rank national healthcare systems and despite our overspending, we rank behind most of our European friends. In fact our only real successes have been breast cancer and prostate cancer - Americans have a higher survival rate in only those illnesses.
Reply | Report Abuse | Link to thisOkay, your comment is somewhat dumb (as in dumbed down by the republicans). I am a veteran of two branches of the military, and I loved every minute of it, and I can tell you, the VA has the best health care in America and I do not have to pay a penny for my service. I have a heart condition brought on by the gas that was use in training. I have had three major heart attacks - that they called "widow makers", and the VA has saved my life every time and I have not payed a penny for the service. America would be wise to follow in the foot steps of the Veterans Health Care system.
Reply | Report Abuse | Link to thisWe are believed to be the richest nation, of our size, on Earth. There is no excuse we cannot pay our doctors like the military does, a set wage. If we can pay our athletes a million dollars a year to play a game, there is no reason we cannot pay our our doctors equally to save our lives.
Obviously you have no arguement as you are going to say that I am biased by the fact that you think I am a republican. Also, how are you so sure that I did not serve? Another assumption on your part (and wrong).
Reply | Report Abuse | Link to thisWe can pay our doctor's a set wage and guess what you get? What you get is certainly not the best and brightest. I will give you a direct quote from one of my friends in the UK (that I met living there) who was speaking to another friend: 'Why would you want to be a doctor? You know that it does not pay very well'. Also, if other countires doctors are so good then why is it that they have to redo their residency in this country if they want to practice here.
I have lived in socialized medicine and it is a disaster. I am speaking from poersonal experience and therefore it is my observation.
I never said that I have studied another ... what I said is that I lived in a country that had one. I was thankful each and every day that I had private health insurance so that I did not have to go to the public hospital. As a matter of fact, I spent more time using their CT Scan machine for scanning rock cores than they did for scanning patients. I also learned something interesting: if you want a good CT scan of a 4" diameter core you use the setting used for a broken nose. Now I ask: what are the chances that a facility in the US would allow someone to bring in a core and scan it in their machine?
Reply | Report Abuse | Link to thisAs far as the rest of the world goes: where does most of the medical technology that they use come from? I think that you will find that it was developed right here in the good old USA. Strange that we have the best technology and everyone else is benefiting isn't it?
I've lived in ther USA twice and it was fine except for the abysmal health care system. I don't know about 'Obamacare' but the lack of universal healthcare is appaling.
Reply | Report Abuse | Link to thisAmericans speak of freedom yet some of my colleagues were indentured servants to their employers because of the need for a healthcare plan that a member of their family was dependent upon.
Well, good thing you didn't study any other system of medicine, because if you had you would know that this "horrible socialized healthcare" you're describing has produced a better standard of healthcare for pretty much every other developed country on the planet. Additionally, I know doctors in the UK, and if you think they don't make a good living, you're delusional.
Reply | Report Abuse | Link to thisBut why bother looking at pesky little things like facts and evidence when you have anecdotal observations and personal beliefs.
My particular complaint about Medicaid is Part B. I am a retiree who chooses to live outside the U.S. At age 65 I was involuntarily and against my expressed wishes, made to begin paying premiums (only $99 monthly, I admit)which are being deducted from my monthly social security pension. However, there are NO health organizations here in Thailnd (my reidence) who will allow me to use Part B medicaid benefits.
Reply | Report Abuse | Link to thisSo my question for the lawyers...under what law can NON-RESIDENTS of any state or country be forced to pay for "health care" which they are NOT allowed (by regulation) to use unless they return to the U.S. when they reside (and are so recognised by social security) as residing OUTSIDE the U.S.
I've been trying to "Opt out" of medicaid Part B for nearly 6 months now...and it's very very difficult to do.
ApparentlyI will have to travel myself back to the U.S. to physically appear before a social security officer to listen to a lecture about the value of Medicaid...and then sign a form in front of him/her to request "opt out" from Part B.
This will cost me approximately $2000 for the trip.
Apparently that's how the government is "taking care" of me.
I have private health insurance...but it is from a local Thai source...and the U.S. government won't acknowledge them.
All I want is to NOT be forced to pay for health benefits I am not allowed to recieve by social security rules.
Over forty years ago I would start looking a week early for SA on the magazine racks and read it cover to cover. Now it is at the bottom of my "science favorites" in my browser, occasionally clicked.
Reply | Report Abuse | Link to thisThis was a sad, gradual change as SA became a platform for pseudo-scientific support of social and political viewpoints and reached it's present point of not even pretending to use science to support some of it's articles advocating the socialization of America.
I'd bet my life that a truly scientific study would indicate that if those who didn't and did not want to contribute to the general good of America were denied the right to vote, all else being equal, the Democratic party could not win an election, health care costs wouldn't be what they are, and the present national debt wouldn't exist.
Be that as it may, (I'm not saying I CAN'T be wrong here), the real sadness is the hypocritical attitude that somehow, assuming I'm right, science can support a social viewpoint, and that a magazine supposedly "scientific" in nature and once a truly great platform to offer science to the public descends to fanatical support of a form of social tyranny, in the blind faith that if it's "socialist" in nature it must be correct.
Are you even remotely acquainted with US law?
Reply | Report Abuse | Link to thisWe are required to participate in numerous social welfare programs, including social security, medicare and unemployment insurance. All group schemes in which participation is compulsory, and all of which have been ruled as constitutional by the only body permitted by the US Constitution to make this determination; the Supreme Court.
I suppose the Supreme Court could nullify any previous decision, but at the moment (and for the last 70 years) these programs are Constitutional. So your point really isn't valid.
Reply | Report Abuse | Link to thisAs to what laws I would be ok with, we have these people called representatives who are elected by the people to decide laws. You might have heard of this thing called a representative democracy. Like nearly everyone, we have laws I like and laws I don't like, but your argument on hypothetical laws is irrelevant to the issue.
Finally, the mandate to purchase private healthcare is predicated on having the money to afford private healthcare, people will not be thrown in jail for being too poor to afford health insurance, so I would say social security, medicare and unemployment insurance are valid comparisons.
When you can exsplain how we can afford Obama Care. I will be 100% behind it. Untill then shame on you for not being able too.
Reply | Report Abuse | Link to thisJames Davis Im allso a veteran and I work for the VA. I will tell you that yes we do a great Job at taking care of veterans. Only because they deserve it. They are a special population group. If you try and exspand that entitlement to the entire population it wont work. You will no longer get your special entitlements. Because we simply can not AFFORD THIS !
Reply | Report Abuse | Link to thisAgain please tell me how we can afford Obama Care. How do we pay for this. In my exspericance as a veteran and a Health Care employee of the VA. I can tell you that when ever something free comes about everyone and thier mother will come out of the wood work demanding thier fare share. Just like we have veterans that not only do not deserve what they are recieving thier actual health does not justify the treatment they recieve. Why? Because it free. They shop around for a doctor that gives them the diagnosis that they are after. You shop around long enough you will find a quack, and the VA is fool of quacks that will agree on the diagnosis that you are looking for. We do not need this type of system for everybody. Not only can we not afford it. But it will deterate and destroy what we have. Name one person that is not on health care that was denied access to a hospital in the us.
Just one.
One of the problems we have is that DOCTORS can not be DOCTORS any longer. A Doctor can not diagnose and prognose a pt by simpy by his own physical assesment. No they have to have a MRI, CT SCAN, LABS, XRAYS. Not because they do not know what is wrong with the pt. But becuase they are afraid. Afraid of being sued. This is what drives up the health care cost. This is what we should be focusing on. Driving down the cost of health care by allowing doctors more freedom to diagnose on thier own medical schooled backed scientific opinion. A
Reply | Report Abuse | Link to this"laws passed by our legislature ideally should pass Constitutional muster"
Reply | Report Abuse | Link to thisAgain, what country are you referring to?
In the US, if a law is deemed unconstitutional by the Supreme Court, it cannot go into effect, nothing ideal about it. The fact that someone doesn't like a law does not determine its constitutionality, never has.
I don't need to justify the constitutionality of current or past laws; the Constitution itself does this every time the only body legally permitted to interpret this document, the Supreme Court, determines that a law is constitutional.
How is this difficult for you to understand?
Regarding your views on the quality of healthcare, you seem to be ignorant of both global healthcare programs as well as US law.
Reply | Report Abuse | Link to thisThe US is not even ranked in the top 25 countries for healthcare provided to its citizens. The countries with the best overall healthcare are the ones that have universal healthcare, like Germany, Japan... basically every Scandinavian country.
Not only do they provide a better standard of healthcare, it actually costs both the citizens and the state less (as a percentage of GDP).
Please at least have the decency to look at overall healthcare rankings and associated costs before making the absurd statement that government healthcare would result in higher costs and lower quality.
No, perhaps goes into effect was a poor word choice, but if a law is deemed unconstitutional, it cannot be enforced. It is that simple. I don't see what you find so complicated about it.
Reply | Report Abuse | Link to thisI feel politicians should propose and vote for laws that are in the best interests of their constituents, within the bounds of the constitution. You seem to believe politicians are voting for laws they believe to be unconstitutional, with no evidence other than your dislike of the laws in question.
Regarding polls, many of those favoring repeal are in favor of universal healthcare, myself among them. We have elected officials who can be voted out of office and replaced with others who we feel match our views more closely; which is perfectly in keeping with the Constitution, the ACA was put in place by a majority vote of elected officials, not some judicial end-run you seem to believe occurred. If you don't like that, feel free to move to a country that solves every issue by a majority vote.
The last major, "end runs around the Constitution in the form of tortured-logic rulings through a stacked judiciary" was during the Bush administration, when Bush II spat on the Constitution and the Supreme Court with his domestic spying program.
As for your final question, I will give an answer that feeds into your absurd paranoid fantasy, then the real one.
1) No, I will not abide by the Supreme Court decision, I will force all humanity to accept health care mandates regardless of the Supreme Courts decision.
2) Yes, I will abide by this ruling. What choice do you imagine I have about it?
The Canadian health care system is often slagged by American politicians hoping to make points. There really are only two numbers to be concerned with:
Reply | Report Abuse | Link to this1. The number of people in the U.S in 2009 filing bankruptcy in which medical costs were a major factor: about 900,000
2. The number of people in the Canada in 2009 filing bankruptcy in which medical costs were a major factor: about 0
The U.S. has something in it's health care system that the Canadians will never have: Fear
This fear is a major fiscal and economic drag on the country. People refuse to move or take other jobs purely because of health care insurance. Not good when we need talented people to fill or create jobs, but their fear of health care stops them dead in their tracks.
And you JamesDavis, thought I was a Republican.
I apologize "Shoshin". It's just sometimes you sound so much like those anti-everything republicans. The ones who think that a black president and an Oriental Secretary of Energy is not smart enough to do the job the greatest majority of Americans voted them into office to do. I know that SOE Chu was appointed, but he was appointed by the person we elected to office to speak and act in our behalf, and I think Obama is trying his best to do that and the republicans are trying everything they can to anti everything Obama is trying to do to better America, American health, American energy, and American jobs. If you are not a republican, then stop talking like one.
Reply | Report Abuse | Link to this"The law has yet to take full force, and key aspects, health experts argue, remain fundamentally misunderstood by the public."
Reply | Report Abuse | Link to this-----
This by far is the biggest problem, and I know that to be a fact simply because of those parroting the typical talking points and denying that there are definitely cost-saving attributes in the PPACA -- making health care more affordable than the current abysmal system.
"My particular complaint about Medicaid is Part B."
Reply | Report Abuse | Link to this-----
My particular complaint is people trying to discuss health care without realizing the difference between Medicare and Medicaid.
"When you can exsplain how we can afford Obama Care. I will be 100% behind it."
Reply | Report Abuse | Link to this-----
Unlike the GOP which loves BIG GOVERNMENT expansion by cutting taxes and borrowing to pay for everything like endless war, the PPACA has built-in tax increases that pay for its implementation and increased coverage, that will in fact reduce deficits by $170 billion over the first decade and reduce deficits by over $1 trillion during the second decade.
Your post proves without a doubt: "The law has yet to take full force, and key aspects, health experts argue, remain fundamentally misunderstood by the public."
Reply | Report Abuse | Link to thisThat we should have national health care is a no-brainer. All other industrialized economies have some form of national health care and have relieved their businesses of the health care burden, leaving American businesses that have to compete with them saddled with providing health care. We all pay for health care for everyone else anyway, except our cost are magnified because of the inefficiencies inherent in the hop-scotch patchwork of a health care system that we have now. What Obama passed was a republican's dream of a bill, with a democratic face. A boon for the health insurance industry at the expense of the American public. Now, if they don't repeal this bill, insurance companies will engorge themselves on the American public. The insurance industry is vehemently opposed to nationalized health care for one reason - it would put them out of business and the outrageous profits that they were making off of peoples fears would instead be used to provide better health care for the American people. Obama should have backed nationalized health care, or at least started out with it, instead of capitulating to the point of the monstrosity that was finally passed.
As far as panels that determine what health care is affordable and feasible, another republican scare tactic, we already have that in the insurance companies whose ONLY motivation is profit.
This recent bout of healthcare reform is a farce. It doesn't provide any more access to health care than what current laws provide since it's currently illegal to refuse treatment to patients who need it. Nobody is going without healthcare unless they don't want it. Nobody is showing up to emergency rooms and being rejected because they don't have insurance and nobody with cancer or any other illness is going to the hospital and being refused treatment. This also doesn't make health care any cheaper, even right now the law is increasing the cost of healthcare because of new regulations doctors and insurers have to deal with. What this law does is two things:
Reply | Report Abuse | Link to this1. It's requiring private citizens to purchase a product they may or may not want.
2. It's tying the hands of doctors who want to give treatments but can't because the person being treated isn't deemed worth the treatment.
Every time national healthcare it fails miserably. It always increases costs, it always denies people treatment and it always instills corruption through bribes for treatment.
It accomplishes the exact opposite of what the democrats say it will while at the same time limiting our freedoms.
Additionally, healthcare in america is so expensive for a few reasons:
Reply | Report Abuse | Link to this1. We front the bill for most medical research.
2. Our legal system favors lawyers and allows them to milk people, doctors, and insurers by not holding them responsible for frivolous lawsuits.
3. National regulations prevent fair trade among insurance providers. Unlike car insurance which you can buy from anyone, health insurance can only be purchased from insurance providers in your state.
4. Schooling is overpriced, making it very expensive to become a doctor.
In July of 1798, Congress passed – and President John Adams signed - “An Act for the Relief of Sick and Disabled Seamen.” The law authorized the creation of a government operated marine hospital service and mandated that privately employed sailors be required to purchase health care insurance.
Reply | Report Abuse | Link to thisKeep in mind that the 5th Congress did not really need to struggle over the intentions of the drafters of the Constitutions in creating this Act as many of its members were the drafters of the Constitution.
And when the Bill came to the desk of President John Adams for signature, I think it’s safe to assume that the man in that chair had a pretty good grasp on what the framers had in mind.
http://www.forbes.com/sites/rickungar/2011/01/17/congress-passes-socialized-medicine-and-mandates-health-insurance-in-1798/
Congress Passes Socialized Medicine and Mandates Health Insurance -- In 1798
Reply | Report Abuse | Link to this"An Act for The Relief of Sick and Disabled Seamen"
http://www.scribd.com/doc/29099806/Act-for-the-Relief-of-Sick-DisabledSeamen-July-1798
I didn't say I was a democrat either. I'm an independent in thought and action. I go with what makes sense.
Reply | Report Abuse | Link to thisTake off the ideological blinders and try exercising your right to vote. That means really vote, not just follow party lines and ideology.
It's quite refreshing not to have to twist yourself inside out justify to yourself somebody else's idiotic position that you know in your guts is wrong.
And I'll talk like republican if I want to, or a democrat or whatever.
BTW, I don't care for your racial focus. Obama's race is irrelevant to me. Only someone hung up on the "one drop of blood" issue views him as black. 19th Century thinking at it's best. His race means nothing, and it better mean nothing. Oops, there I go speaking like a democrat again.
See how easy it is? Things make sense.... go with them!
And AGW is still garbage whether you speak democrat or republican.
In what way was this article Science?
Reply | Report Abuse | Link to thisGood question!
Reply | Report Abuse | Link to thisThe subtitle states:
"The law has yet to take full force, and key aspects, health experts argue, remain fundamentally misunderstood by the public"
I certainly agree with that assessment as well - what did this article do to alleviate that misunderstanding? A clear and objective summary of key components and time lines would be most beneficial, but none is found here.
The law was sold as "affordable".
Reply | Report Abuse | Link to thisBased on a 10 year projection that included 10 years of revenue but 6 years of expenses.
In other words, if you published a scientific paper with such phony numbers you'd be laughed out of your profession.
No, anyone with functioning eyes views Obama as black. There you go, talking like a Republican again.
Reply | Report Abuse | Link to thisAnd pretty much the only people who have your views on AGW are Republicans.
At issue are two major provisions: the requirement that everyone have health insurance—the so-called individual mandate—and an expansion of Medicaid benefits, which would help more people afford insurance in the first place. "If the Court rejects either or both of those,<strong><a href="http://www.waytowholesales.com/product_show-2041-Low-Hyperdunk-Shoes-8-c_61509.html">2041 Low Hyperdunk Shoes</a></strong> it would have far-reaching implications for how health care reform would work—or even if the law would work at all," Levitt says. With fewer people insured, premiums would become even more expensive.
Reply | Report Abuse | Link to thisAbout:- "Does ikt escape everyone's attention that there is no right to healthcare in the Constitution? I do not real reading any clauses regarding the right to free healthcare but I will have another read tonight."
Reply | Report Abuse | Link to thisThere's also no right to healthcare in the Bible, the Quran, the Bhavagad-Gita, the sayings of Buddha, nor of Confucius. Albert Einstein, Mohammed, Leonardo da Vinci, Newton and Karl Marx also are mostly silent on the subject.
Congress, however, has not been silent, and it has been signed into law by the Constitutionally elected President of the United States. This is sufficient.
Where will the money be coming from to provide health care for the 32 million uninsured? Either from the wallets of We the People, or China had better get out the big check book again (and for all eternity).
Reply | Report Abuse | Link to this"The Preamble serves solely as an introduction, and does not assign powers to the federal government, nor does it provide specific limitations on government action. Due to the Preamble's limited nature, no court has ever used it as a decisive factor in case adjudication, except as regards frivolous litigation."
Reply | Report Abuse | Link to thisIf you are going to chide someone for having read it, perhaps you should first understand it.
"Canada’s health care system is in deep trouble financially. So it should come as no surprise that the British NHS is as well. It is again proving correct Margaret Thatcher, who said, “the trouble with socialism you eventually run out of other people’s money.”
Reply | Report Abuse | Link to thisThe Brits ran out of “other people’s money” quite some time ago (as is the US as debt and deficit figures show) and their social structures are existing on accumulating debt. The NHS, a celebrated “single-payer” government run system in place since right after WW II, is failing:
Jeff Taylor of the Economic Voice clarified the problem when he wrote last week that “the U.K. is broke.”
“Our whole society and way of life is now built on the shaky foundation of debt,” he writes in response to the NHS cuts. “Our hospitals, schools, armed forces, police, prisons and social services are founded on debt. In truth we have not yet paid for the operations that have already taken place.”
The NHS is planning on extensive rationing of surgery in order to meet budgetary needs. The service is looking at eliminating literally millions – with an “m” – of surgical procedures because it simply can no longer afford them. Representative of those procedures which will no longer be available to NHS members are hip replacements for obese patients, some operations for hernias and gallstones, and treatments for varicose veins, ear and nose problems, and cataract surgery.
The intent is to “save” 29 billion by telling patients in need of those procedures “no.”
from: http://washingtonexaminer.com/opinion/opinion-zone/2010/06/government-health-care%E2%80%99s-inevitable-fate-%E2%80%93-bankruptcy-or-denial-care
Seems like a politically motivated article. Highly slanted toward a single point of view and inappropriate for this magazine.
Reply | Report Abuse | Link to thisOk so you can force people to by car insurance, but not health insurance? Why? It doesn't make much sense to me. Oh right because if a poor person get's into an accident with a rich person, they need some sort of legal basis for making sure the poor person can pay up. Ok, ok, I'm at least half kidding on that one. In any case, don't americans realize that the quality and extent of healthcare coverage of everyone in the their country effects them? Maybe they do, and maybe they have a fancy for the kind of repressive government the U.S. is known for secretly supporting abroad, at home, rather than the kind of egalitarian governments they bash offhandedly under the blanket term 'socialism'.
Reply | Report Abuse | Link to this"I will tell you that yes we do a great Job at taking care of veterans. Only because they deserve it. They are a special population group. If you try and exspand that entitlement to the entire population it wont work. You will no longer get your special entitlements. Because we simply can not AFFORD THIS !"
Reply | Report Abuse | Link to thisExcept for the fact that it has been tried and worked succesfully in numerous countries for decades upon decades.
"Again please tell me how we can afford Obama Care."
What are it's actual costs? Please tell me what they are, because I can't actually find any!
"In my exspericance as a veteran and a Health Care employee of the VA. I can tell you that when ever something free comes about everyone and thier mother will come out of the wood work demanding thier fare share."
Of life saving care. Yeah, sick people tend to want to live. What an insightful comment.
"They shop around for a doctor that gives them the diagnosis that they are after. You shop around long enough you will find a quack, and the VA is fool of quacks that will agree on the diagnosis that you are looking for."
That happens in privatized care as well, it's an associated cost of healthcare in general. Get over it.
"Name one person that is not on health care that was denied access to a hospital in the us."
I don't think anybody can find a specific record like that, so asking for a specific name is kind of ridiculous, nor do I think hospitals keep a 'rejected list' or something of that sort. I can however point to the amount of people who simply don't even try to get care because they have no coverage and can't pay for anything. There's a difference between being turned away from a hospital and not being able to pay for their services. I don't think they generally turn people away, but there's only so much they'll give you before realizing you can't pay up. It's limited healthcare at best.
"Nobody is going without healthcare unless they don't want it."
Reply | Report Abuse | Link to thisWrong. People are avoiding care because they can't afford it.
"nobody with cancer or any other illness is going to the hospital and being refused treatment."
Wrong. Insurance companies deny coverage all the time. And if you can't pay for it another way you either don't get treatment, or go bankrupt like hundreds of thousands of americans do every year.
"This also doesn't make health care any cheaper"
Maybe this bill won't, but nationalized healthcare has in basically every country it's been tried in. The most efficient healthcare systems are in Japan and just about every scandinavian/nordic country.
"Every time national healthcare it fails miserably. It always increases costs, it always denies people treatment and it always instills corruption through bribes for treatment."
Could you give an example, or do you not care whether or not you say things that are patently false? What about Japan, denmark, norway, sweden, etc, that directly conflict with your above statement? They have lower costs, better access and treatment! As for corruption, social trust is the highest in those countries which is exactly the opposite of what you'd expect with corruption.
Canada's healthcare system isn't in financial trouble. Even given our severe and growing old age population issues, and even on a weaker less socialized form of healthcare our costs are lower, with better coverage, and equally good if not better quality of care then the states. Try again.
Reply | Report Abuse | Link to this"Healthcare" is not the issue. Freedom, Liberty, Pursuit of Happiness, and, the Constitution of the USA are the important issued involved.
Reply | Report Abuse | Link to thisObama wishes to hold a threat to our heads and force us to sign off on a contract clearly secured under duress. Such contract are illegal under current law, and have always been prohibited by our Constitution.
Rubbish
Reply | Report Abuse | Link to thisThat's Obama's argument, that he, and only he, ought to make decisions about life or death.
Reply | Report Abuse | Link to thisMove to Australia or Canada.....we have free Health care for ALL our citizens at a cost far less that the US.
Reply | Report Abuse | Link to thisenough said
Move to Australia or Canada.....we have free Health care for ALL our citizens at a cost far less that the US.
Reply | Report Abuse | Link to thisenough said
Are all democrats total morons or just those who post comments like this. Obamacare and other plans Obama is trying to ram through congress is a financial nightmare in the making and will lead us to become a third world bankrupt country owned by China and others with drastically diminished quality of health care(who wants to become a doctor when your income is dictated by some moron politician or bureaucrat who will drastically reduce it compared to the present system, which still needs fixing but not this way).
Reply | Report Abuse | Link to thisFree ? So who pays for this "Freebie" ? There is no such thing as "Free" anything on this planet.
Reply | Report Abuse | Link to thisThere is a bigger issue here than just healthcare. Are we going to change our system of rulership so that there are no longer any brakes on the power of the federal government? If the federal government can require one to buy a private product then there are no limits. Everything in your life is subject to the interstate commerce clause. Some of us don't really believe that is the best way to run a nation.
Reply | Report Abuse | Link to thisActually, your responses indicate that you are confused about a great many things.
Reply | Report Abuse | Link to this"They know full well that Obamacare is unconstitutional. Obama himself is on record as saying our Constitution is inadequate for today's society. Hence the tortured logic involved in finding constitutional justification for all Progressive schemes - past, present and future."
Like former Senator McCarthy, who defined communist as anyone who disagreed with him, you seem to think your dislike of a law makes it unconstitutional. The supreme court has yet to determine whether the ACA is constitutional, as for other progressive "schemes" like Medicare; they are fully constitutional and always have been.
Similarly:
"Can you not see that the justifications for the individual mandate presented by Obamacare supporters can be used to justify rules governing what food you would otherwise choose to eat?"
We already have laws governing what food we can eat. Perhaps you have heard of the FDA? Similarly, New York recently banned transfats. If you are under the impression the government cannot make rules governing our food supply, you are appallingly out of touch with reality.
"Where do Canadians go when they seek timely, technologically superior health care, paid for with their own money?"
Almost exclusively in Canada. A statistically insignificant minority go to the US. Probably because Canada, like nearly every other country in the developed world, has been demonstrated to have better healthcare on average than the US.
Do you think by repeating the same falsehoods a sufficient number of times they will magically become true?
"Can you not see that the justifications for the individual mandate presented by Obamacare supporters can be used to justify rules governing what food you would otherwise choose to eat? "
Reply | Report Abuse | Link to thisRight because if it wasn't difficult enough to pass a law that would give healthcare coverage to millions of americans who otherwise can't get any short of bankruptcy, they're going to decide what people can eat predicated on that? Can't you see that you're being paranoid? The government already does regulate to a certain extent what people eat, FDA, ever heard of it? It typically tries to keep heavy metals and biological contaminates out of food.
"Where do Canadians go when they seek timely, technologically superior health care, paid for with their own money?"
Canada by in large. A slim majority might go for experimental treatments that have yet to be approved. You see in Canada we have this weird habit of testing things to see if they're safe rather than treating consumers as guinea pigs. That's why Canadians will have to wait for things like the 'liberation therapy' for multiple sklerosis. You see, the U.S. is not a special country, it's just one of many places a minority of people from countries all over go for dangerous or otherwise untested treatments. And if we're going to talk about going to a neighbour country for treatment then let's talk about americans defrauding Canadian healthcare system. Yeah, there are more Americans going north then there are Canadians going south. Nice try.
"After Obamacare is fully enacted, certain Canadians will just stay home."
Could you elaborate on that on? Another paranoid theory perhaps?
What this topic has to do with science?
Reply | Report Abuse | Link to thisIs it Political American?
"Store shelves are usually not stocked with FDA banned foods."
Reply | Report Abuse | Link to thisBecause the government already has the legal right to inspect and regulate our food supply; regardless of whether the ACA is deemed constitutional.
If you want the freedom to die in a ditch of treatable illnesses and contaminated food, please feel free move to a country that guarantees you this "liberty", I believe Somalia would be a good choice.
Oh deary me. Just take what I wrote and add the word otherwise then, even though it doesn't really change the meaning. Way to avoid addressing the point I made through this meaningless semantic diversion. ;P
Reply | Report Abuse | Link to thisIf your argument against the collective good isn't the actual bill itself, but rather what it could lead to, a slippery slope, then I suggest you take a look at what kind of slope your on.
"As for those Americans gaming the Canadian system - isn't this a fault of that system?"
Isn't that entirely besides the point? Oh sorry that shouldn't be a question, yes, yes it is entirely besides the point.
As for those hackers gaming the internet system, isn't this a fault of that system?
All the citizens of the country pay taxs according to their ability to pay....when you need medical help it is 'free'. If you don't understand become an Australian
Reply | Report Abuse | Link to thisAmericans are not as ignorant as this author supposes, or wishes. The singlemost notion that a central government, a bureaucracy of state employees may somehow dictate to American citizens what and when and how to do something, like buy a certain brand of toaster, vehicle, insurance, book, hymn, or religious symbol, is somehow empowered by the Constitution to demand, threaten coerce, and punish the citizens who employ them is ludicrous; it is a notion designed to void our Constitution, eliminate our freedoms, and make us subservient to some sort of "Great Leader". No. We the People enumerated some items the central government is to accomplish; all other items belong to We the People, not some "Great Leader"
Reply | Report Abuse | Link to thisHalf of those working in the USA do not pay any taxes at all except sales tax at point of purchase.
Reply | Report Abuse | Link to thisNonsense.
Reply | Report Abuse | Link to thisWhat you say is predicated on the ridiculous notion that people who live unhealthy lives should have them extended by all means possible. People elsewhere are more responsible, more lively and they have more reasonable expectations of mortality.
Live better, die with dignity, not in pathetic hope of another day.
Your point being?? A lot of people in Oz also don't pay tax, generally this is the very rich (who pay accountants a lot of $$ to avoid tax) and the very poor. They still ALL get FREE (and for those who pay no tax it is FREE) health care. The very poor in this country also get FREE money to live so they can still have a half descent life and most of them try to get employment to better their lives. Please stop dispaying your ignorance by ranting dribble about FREEDOM, what FREE to sufferer unnecessarily cause you can't afford healthcare. You know the world can be quite a nice place if people stop fixating on MONEY....a government is there to provide services for the people.
Reply | Report Abuse | Link to thisGlad I live here where people still care, well most anyway.
"..a government is there to provide services for the people."
Reply | Report Abuse | Link to thisObviously you have not read the US Constitution. Our government is sworn to protect and defend "the constitution". The power is the People and the People retain the right to bear arms and to replace the government if it strays from this path. The present regime (both sides) is failing miserably and the citizenry is becoming restless. If the government does not reign in their push towards a socialist system, they may not retain power much longer.
"Those that fail to learn from history, are doomed to repeat it."
Winston Churchill
Nope I haven't read the US constitution, or ours for that matter. Maybe because I live in a country with 'socialised' medicine I don't have the need to worry about it. Nor do we feel we have the need to 'replace' our system...it is working very nicely and has many little bits of socialist policies here and there. Certainly it is working far better that the US system over the past few decades. You are correct that both sides of the US political system is failing. Maybe some 'socialism' is what you need....the fastest growing and soon to be most powerful country in the world is 'socialist' albeit with some tendency to try some capitalism. An interesting fact.
Reply | Report Abuse | Link to thisThe Chinese are living proof that neither capitalism nor socialism is perfect but a blend of the best from both sides is better than either one alone.
For the 900 million Chinese who are not in the privileged middle class, life isn't much different than it was 100 years ago, which is to say it is an oppressed, bare subsistence with few rights and little hope.
Reply | Report Abuse | Link to thisFor the 300 hundred million middle class (by Chinese standards) that live along the coast there are improved economic standards and rising expectations,
with few rights.
For the hundred million or so elite Chinese things are just dandy with a comprehensive security system in place to make sure it stays that way (they hope).
Woe betide anybody who isn't a member of the Han ethnic group who dominate China.
"Half of those working in the USA do not pay any taxes at all except sales tax at point of purchase."
Reply | Report Abuse | Link to this-----
Not true at all, but apparently you never heard of payroll taxes that all working Americans pay, along with gas taxes to get to work.
As a matter of fact, while income taxes are 42% of federal revenue, payroll taxes are 36% of federal revenue.
"the People retain the right to bear arms and to replace the government if it strays from this path."
Reply | Report Abuse | Link to this-----
Sounds like insurrection to me.
The Insurrection Act of 1807 is the set of laws that govern the US President's ability to deploy troops within the United States to put down lawlessness, insurrection and rebellion.
On September 30, 2006, the Congress modified the Insurrection Act as part of the 2007 Defense Authorization Bill. Section 1076 of the law changed Sec. 333 of the "Insurrection Act," and widened the President's ability to deploy troops within the United States to enforce the laws.
"The Act certainly did not order seamen to purchase any form of private insurance, nor did it order them to purchase any other type of private good."
Reply | Report Abuse | Link to this-----
"In 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves. In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm."
First was the 1790 law , passed by that first Congress, which applied to any U.S. ship that was at least 150 tons or with a crew of at least 10. It required the master or commander to either have a supply of on-board medicines (with instructions) or provide "all such advice, medicine, or attendance of physicians, as any of the crew shall stand in need of in case of sickness" and do it "without any deduction from the wages of such sick seaman or mariner."
Sounds like mandatory health care to us.
Then, in 1792 , a Congress that included 17 framers passed a law requiring nearly every "free able-bodied white male citizen" age 18 to 44, within six months, "provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch with a box therein to contain not less than twenty-four cartridges," along with balls and gunpowder. A rifle could be substituted. The purpose was to establish a uniform militia.
Again, that sounds like a mandated purchase to us.
Finally, in 1798, a Congress that included five framers expanded the health coverage mandate, requiring every ship owner or master coming into a port to pay 20 cents per seaman for every month each worker had been employed.
The funds, which could be withheld from the seamen, were used "to provide for the temporary relief and maintenance of sick or disabled seamen, in the hospitals or other proper institutions now established" in the port. Leftover funds were used to create hospitals for those mariners.
http://www.politifact.com/rhode-island/statements/2012/jan/13/einer-elhauge/harvard-law-professor-says-early-congress-mandated/
You guys are all soooo funny...the discussion is about health care reform....my comment was simply that from the perspective of someone who lives in a country with 'FREE' healthcare for 'EVERYONE' it is GREAT. Last time I saw a public poll on what Australians thought of the 'FREE' medicare system in Australia was 99%+ were in favour of it. Most thought it could do with some improvement but NONE wanted to get rid of it.
Reply | Report Abuse | Link to thisHowever the majority of the comments here from people in the US is all about 'freedom' and 'socialism' (whatever that is, as no one explains what it is just that it is evil) and constitutions and overthrowing the govenment. Pew, I don't know what else to say.
Yep lakota2012, Postman1 is kinda off the track.....most civilised countries have things called elections to change govenments.
Reply | Report Abuse | Link to thisIt would be fasinating (scarry too)to see a country drift into civil war over this issue, that incidently would see a huge increase in the need for a health care system for the wounded.
Do US soldiers have 'free' health care? They do, Oh no! America's biggest industry has 'socialised' medicine....Postman1 you better over throw the govenment!
Good Luck with that.
lakota and Crasher- I am not the one you have to worry about. I was only pointing out that there are 80 million gun owners in the USA and the majority of them believe in our constitution. By the way, the Soviets thought they were too strong to be overthrown. Now the USSR is long gone. The people hold the power, even there. Don't forget the Arab Spring, either. In those countries, USSR included, the people did not even have the right to own arms, yet they succeeded. My comment was not a warning from me, but an advisory that the possibility exists.
Reply | Report Abuse | Link to thisI suspect you are mis-informed. The people in Russia have little say, the arabs have little say and here is Oz the people have little say in how the country is run. Just as in the US the people who actually run the country and create the laws of the land are the mega rich. They rule because they have the ability to manipulate the common people thru the media etc to hold views and to cast votes for things they want. They rule because they line the pockets of the polititions and others in positions of power to do things their way. Democracy exists in name only in all our countries, be they capitalist or communist. Why else in the US would poor people who have NO health insurance vote down a policy to give health coverage to all!
Reply | Report Abuse | Link to thisLast time something like that was attempted was the Civil War, do you recall how that turned out?
Reply | Report Abuse | Link to thisJamesDavis,
Reply | Report Abuse | Link to thisFirst of all, I consider myself pretty moderate in the political spectrum. I had to post to point out how these quotes from your comments completely relegate your credibility.
”Shame on you scum-bag republicans.”
“Okay, your comment is somewhat dumb (as in dumbed down by the republicans).”
“It’s just sometimes you sound so much like those anti-everything republicans.”
Before you start going off on freedom of speech, I am not saying you can’t say these, I am only stating that it ruins your integrity in an educated and informed argument. Thank you for your service.
JamesDavis,
Reply | Report Abuse | Link to thisFirst of all, I consider myself pretty moderate in the political spectrum. I had to post to point out how these quotes from your comments completely relegate your credibility.
"Shame on you scum-bag republicans. "
" Okay, your comment is somewhat dumb (as in dumbed down by the republicans). "
"It's just sometimes you sound so much like those anti-everything republicans. "
Before you start going off on freedom of speech, I am not saying you can't say these, I am only stating that it ruins your integrity in an educated and informed argument. Thank you for your service.
Crasher- "Why else in the US would poor people who have NO health insurance vote down a policy to give health coverage to all!"
Reply | Report Abuse | Link to thisBecause under obamacare they will be required to pay for that insurance, and the bureaucrats will decide how much and what care they receive. At present, public hospitals can not turn away anyone and the uninsured receive the same level of care as the insured, free to them. Not sure how it works in oz, but my 19 year old stepdaughter was getting better care than me, for free, until obamacare caused her to be put on my policy. Resulting in raising my premiums and she now has to pay a copay. I don't mind her being on my policy, but she and her son were better off without, as are the rest of the poor here.
Nope, hospitals are only required to provide emergency medical care.
Reply | Report Abuse | Link to thisTranslation: they patch you up and ship you out.
Who told you the VA is "appalling"? I'm a vet, and damned if they haven't done a great job for me.
Reply | Report Abuse | Link to thisThe debate is not as much about the proposition, but how it is to be implemented. The PPACA is particularly vulnerable in re the Individual Mandate as the mandate relates to the limits placed upon the Federal Government by the Constitution.
Reply | Report Abuse | Link to thisIt is as inaccurate to characterize the U.S. as exclusively capitalistic as it is to characterize the PRC as exclusively socialistic.
I do wonder what aspect of Science is illuminated by SciAm's position piece on the PPACA.
"... Why else in the US would poor people who have NO health insurance vote down a policy to give health coverage to all!"
Reply | Report Abuse | Link to thisThe PPACA will not "to give health coverage to all".
http://en.wikipedia.org/wiki/Ppaca#Change_in_number_of_uninsured
Further, I was unaware that poor people in the U.S. who have no health insurance have voted down the policy. As I understand it a large minority of Americans, as reported by polling organizations, disapprove of the PPACA, but I had not read of those limited that were limited to reporting the views of "poor people". Would you post a url to them?
Marcher - Have you ever spent any time in an emergency room? Picture lines of people coming in with everything from gunshot wounds to colds to hemorrhoids, and they all get cared for, at least in the south. They do have to wait , but if they were all in your doctors waiting room, you would have to wait too. Also, obamacare will still not cover everyone if implemented as is.
Reply | Report Abuse | Link to thisI'm not saying doctors don't treat sick people without insurance, I'm saying they get the absolute bare minimum of care, and I don't mean waiting in line.
Reply | Report Abuse | Link to thisTranslation: someone comes in with a gunshot wound to the leg, if they have no insurance and cannot afford long-term care, the most cost effective measure might be amputation. If I can't afford anything, that's what they do, my leg simply would not be worth the cost of saving.
"Also, obamacare will still not cover everyone if implemented as is."
When did I claim it did?
Most comments have missed the point of the CONSTITUTIONAL challenge to Obama care. The point is unfettered federal power. If deemed constitutional the citizenry can and will be subjected to totalitarian dictates. Only time will tell when the "freedoms" that you cherish are threatened or ended. There are other way to achieve health coverage. If we could buy health insurance as we do auto there would be competition & lower prices.
Reply | Report Abuse | Link to thisAnd yes, the citizenry doesn't need the "Mandarins" to oversee the choices they make. Check out the cartoon version of "Animal Farm" for enlightenment. LL
The system I worked in as an MD in neuropsychiatry worked fine (Europe), it is based on solidarity between the members of society for several generations. People with low income pay less than others so do several groups like widows and people with disabilities. The problem that will kill of the social security system in most European countries is illegal migration and migration. They are sucking te blood out of the system that was build on generations of working people. With a great group of illegal migrants in the US, that seems to me a serious problem if they give individual insurance, a lot of people will pay for others that never contributed to the system (legally). I know it is a complex situation but beware before you commit to a new system. After two decades in health care I was fed up with all the paperwork and stupidities, so I went back to scientific research.
Reply | Report Abuse | Link to thisThe one issue it seems no one wants to have anything to
Reply | Report Abuse | Link to thisdo with is RESPONSIBILITY.
What sort of reasoning, or lack thereof, would make
an individual think they can just assume medical
care is free and the emergency room is the normal
method of care?
All this talk about 'rights' and not a peep about being
responsible to the society in which you live.
We are headed toward the most reasonable way of creating
a sustainable society that offers what is the most valuable
asset, equality.
(1) It is not in the constitution, but some people do consider it morally right to keep people from dying early. Perhaps some right-wingers want to restrict that to people with jobs, but even people with jobs often don't have health insurance.
Reply | Report Abuse | Link to this(2) Your experience is called an anecdote. Please explain the numerous surveys that indicate citizens in most countries with nationalized health care like their health care system--that is, they report higher satisfactin levels than do US citizens on average. For example: http://content.healthaffairs.org/content/26/6/w717.abstract?ijkey=btmwgHzAr9YPo&keytype=ref&siteid=healthaff. Perhaps you have health insurance? Even people who do have it pay higher premiums as a result of people who don't.
Also, this act is NOT national health care like most countries have, it is still run privately from the supplier side. Or don't you think some companies could stand a little competition?
Reply | Report Abuse | Link to thisAlso, this act is NOT national health care like most countries have, it is still run privately from the supplier side. Or don't you think some companies could stand a little competition?
Reply | Report Abuse | Link to thisWhat a dumb ignorant article. Not a hint of economic sense or a hint at the purpose of American Constitutional government, both the core controversies of ObamaCare opposition.
Reply | Report Abuse | Link to thisWhen thinking through the implications of ObamaCare, clearly providing medical services to the poor and needy of America is not the goal or purpose to the author’s advocacy of the law.
The article is so bizarre in its points; the only conclusion to draw is the author's personal financial and professional vested interest in implementation of the ObamaCare law, at the expense those most in need of quality healthcare.
If the Republicans take control of the the House and the Senate in November, they won’t actually repeal the ACA, they’ll just defund it, thereby achieving their objective without having to vote on repeal. If someone seeks accident lawyer can contact at <a href="http://www.caraccidentlawyers.net">Philadelphia Car Accident Lawyer</a> for better assistance.
Reply | Report Abuse | Link to this