Tag Archives: Obamacare

Health Care Mandates and Shopping Lists

Well, the legal debate over Obamacare before the Supreme Court is getting interesting. Concerning the individual mandate that would require nearly everyone to buy medical insurance, Justice Scalia sees a day when the federal government could force everyone to buy broccoli. Ouch. That sounds like a scenario right out of The Hunger Games.

No wonder the individual mandate is hard for conservative justices — and most conservatives, I guess — to swallow.

Yet I’ll admit that I find the whole matter somewhat hard to understand. Let’s see. The federal government can compel me to pay taxes, register for the draft, and pay into Medicare and Social Security. But if I don’t want health insurance, even knowing that at some point I will need the services of a doctor or will most likely spend some quality time in a hospital or emergency room, then so be it. My bad, if something happens. And pass the bill to someone else. [Note to self: Couldn't we figure out an affordable universal health care system so everyone would have some level of protection? A lot of people only a few months older than me seem to like Medicare.]

Anyway, since I can’t sort this out, I’ll turn to an article in WaPo, “Why the health-care law might stand at the Supreme Court“:

This much is clear after two hours of Supreme Court arguments over the constitutionality of the individual mandate, which I was in the room to hear: The president’s health-care bill won’t rise or fall on a question of law, but on how the majority of justices define the health-care market.

The mandate requires all individuals above a certain income level to obtain health-care coverage. The National Federation of Independent Business and 26 states challenged the mandate as unconstitutional, arguing that Congress does not have the power to force individuals to buy private products. The government, for example, has the power to regulate the kind of muffler your car has, but it cannot force you to buy a car in the first place. Health-care should be no different — a point made forcefully at various times by Justices Antonin Scalia and Samuel A. Alito. If the government can mandate the purchase of health care, Scalia said, “what else can’t it do?”

Well, good thing the government has a legal expert to explain all this. Or maybe not. Appears that Solicitor General Donald Verrilli Jr. had a tough day yesterday as he met with the Supremes. Here’s from Mother Jones, “Obamacare’s Supreme Court Disaster“:

Solicitor General Donald B. Verrilli Jr. should be grateful to the Supreme Court for refusing to allow cameras in the courtroom, because his defense of Obamacare on Tuesday may go down as one of the most spectacular flameouts in the history of the court.

Stepping up to the podium, Verrilli stammered as he began his argument. He coughed, he cleared his throat, he took a drink of water. And that was before he even finished the first part of his argument. Sounding less like a world-class lawyer and more like a teenager giving an oral presentation for the first time, Verrilli delivered a rambling, apprehensive legal defense of liberalism’s biggest domestic accomplishment since the 1960s—and one that may well have doubled as its eulogy.

Wow. And you thought you had a bad day at the office yesterday.

And the Mother Jones article raises a good point. Why not televise these important oral arguments before the court? It would be great reality TV. If we as a nation are able to sit through weeks of The Bachelor waiting to see who will get a rose, shouldn’t we have the opportunity to watch three days of legal debate to see who is going to get the shaft?

As it stands now, all we can do is join in the navel-gazing, trying to figure out what Justices Roberts and Kennedy are thinking. [Fortunately for those who have to bring clarity to the navel-gazing, Justice Thomas doesn't appear to think about anything.]

OK. I have other fish in the skillet today.

And since I joined the ranks of the quasi-retired, I find that a part of most days is now spent grocery shopping. Here my wife gives me a list filled with mandates: milk, butter, eggs and so on.

Today I’m checking the list for broccoli.

Even in my dotage, I can only be pushed so far.

ObamaCare and the Reality of Medical Costs

Ah, I thought ObamaCare was going to reduce medical costs. Well, it’s only been a year, and most of the provisions don’t take hold until 2014, but if my recent experience inside the medical gulag is any indication, guard your purses and wallets.

OK. Here’s the backstory.

Last month I managed to end up first in the emergency room and then as an overnight guest at Akron General Medical Center. Diagnosis: vertigo caused by a virus, most likely intestinal. And no question I was sick, flopping on the floor as though I just anchored a month-long fraternity kegger.

In fact, I am still a little nauseous from the experience, particularly as I open the medical bills that somehow find their way now to my snail mailbox every afternoon.

First a disclaimer. The treatment I received as best I can tell was comprehensive and excellent and the staff was professional and yada, yada and yada. And my primary care physician — remember when they were just doctors? — said that anytime someone at my age pulls a stunt like that they have to check for a heart attack or stroke. Wait a minute. At my age? Sigh.

Anyway, here’s the rub. Total cost: nearly $10,000.

The visit to the emergency room and overnight hospital stay topped $7,000. The fees for the doctors — and they assembled like lawyers at the site of a traffic accident — came to another $1,000 or so. Then you add a host of tests and lab work and so on — and pretty soon, just like the federal deficit, you’re talking about real money.

And then get this. I had to make my way via ambulance from the emergency room to the hospital — a distance of about 15 miles. Cost: $783. And they didn’t even offer a double Jameson during the trip. Woot.

Fortunately, I have insurance that will cover most of these costs. A lot of people in this country don’t. I’ve seen some estimates that put the number at 25 million or so. And what happens if you don’t have insurance? Or if you are really sick over an extended period of time and didn’t have enough — or good enough — insurance?

And the point of all this.

Like most, I have no clue whether ObamaCare will reduce escalating health care costs — or not.

But I know that something has to be done — and soon. There is no way that this country — whether you are talking about government, employers, insurers or private individuals — and support the continual escalation in medical costs.

Just sayin’.

 

In 2011: It’s About Jobs and Education

Well, Happy New Year. We made it to 2011. And I managed to spend a restful New Year’s Day without watching a single minute of a college bowl game. No interest. I also don’t have much interest in reading — or writing — about what happened in 2010. You know — “The Top Ten Things Congress Should Have Done But Didn’t” — and so on.

That’s all part of history now. What happens this year matters much more so than what did or didn’t happen in 2010.

And here are some issues we will be wrestling with in the weeks and months ahead: a more conservative Congress will be battling with the Prez and the Inside the Beltway crowd to reduce federal government spending and limit Obamacare; concerns about spending, taxes, jobs — and the influence of public-sector unions — will dominate the legislative and policy making agenda in most states; the first wave of the Baby Boomers hits the magical age of 65, with implications for health care services and costs, Social Security and jobs; and the Cleveland Browns will name their sixth head coach in the last 13 years. The Pittsburgh Steelers have had three head coaches since 1970. Oops. I digress on the Browns issue.

Here’s what should be at the top of the list: jobs and education. We’re failing miserably in both these critical areas — with huge implications for our nation today and in the years ahead.

We’re now well into a jobless economic recovery. Here’s from an NYT editorial:

When people say that the recovery does not feel like a recovery, they are describing reality. The economy is growing, but for many Americans life is not getting better. Unemployment remains high. Home values are depressed. And state budgets are in deep trouble, presaging more layoffs, service cuts and tax increases.

The question for 2011 is whether growth will ever translate into broad prosperity.

For that to happen, the federal government must ensure that the recovery does not falter for lack of adequate stimulus, while fostering job-creating industries and committing itself to long-term deficit reduction.

With corporate profits robust and a one-year payroll tax cut set to start this month, there are reasons to hope for continued growth in 2011. Yet, growth is not expected to be strong enough to make a real dent in unemployment, which at 9.8 percent remains close to the recession’s peak of 10.2 percent in October 2009.

Rising corporate profits should spur hiring, but recent history is not encouraging. Part of the problem is that companies are more apt to spend their cash on stock buy-backs and acquisitions that increase share prices but not hiring. Many companies that are hiring are doing it in fast-growing markets like China and India.

And I still wonder if those Inside the Beltway really understand how difficult it is for people in the real world to find and keep a decent, well-paying job these days? I sat through several meetings and presentations last year with administration officials who talked about how they were creating or saving millions of jobs. Uh, where? DC maybe — but certainly not in the numbers that make any real difference.

Here’s Tim Kaine, head of the Democratic National Committee, saying on one of the TV Talking Head shows Sunday that Obama “had a lot of things he had to do before focusing on jobs“:

Henry: The president also said his singular focus in the next two years is going to be focusing on creating jobs. Does that suggest that maybe he did not fully focus on creating jobs in the first two years?

Kaine: Well, Ed, he had a lot of things he had to do. You know, when he started as President we were in the midst of two wars, he stopped one of them. And we were also in the midst of the worst economic collapse since the Great Depression and he had to spend an awful lot of time stabilizing the financial system of the country so that it wouldn’t put us into a deeper tailspin. With that work done he now can focus specifically on increasing job production.

From Mediate article: It seems Kaine was not prepared with the previously familiar talking point that Obama’s stimulus plan “saved or created” many jobs, and that the jobs issue was on the President’s radar all along. Regardless, with unemployment still at unacceptably high levels and with Obama supporters like Kaine strangely suggesting that a lot of other things in the past two years were more important, concerns over the President’s priorities are likely to persist.

Sigh. Anyway, back to reality. No matter what the administration and Congress do now, it’s going to be difficult to create enough quality jobs for a workforce that continues to grow — and at the same time when Baby Boomers have no intention of retiring en masse.

And here’s from Paul Krugman’s NYT Op-Ed “Deep Hole Economics“:

So, about that good news: various economic indicators, ranging from relatively good holiday sales to new claims for unemployment insurance (which have finally fallen below 400,000 a week), suggest that the great post-bubble retrenchment may finally be ending.

We’re not talking Morning in America here. Construction shows no sign of returning to bubble-era levels, nor are there any indications that debt-burdened families are going back to their old habits of spending all they earned. But all we needed for a modest economic rebound was for construction to stop falling and saving to stop rising — and that seems to be happening. Forecasters have been marking up their predictions; growth as high as 4 percent this year now looks possible.

Hooray! But then again, not so much. Jobs, not G.D.P. numbers, are what matter to American families. And when you start from an unemployment rate of almost 10 percent, the arithmetic of job creation — the amount of growth you need to get back to a tolerable jobs picture — is daunting.

First of all, we have to grow around 2.5 percent a year just to keep up with rising productivity and population, and hence keep unemployment from rising. That’s why the past year and a half was technically a recovery but felt like a recession: G.D.P. was growing, but not fast enough to bring unemployment down.

Growth at a rate above 2.5 percent will bring unemployment down over time. But the gains aren’t one for one: for a variety of reasons, it has historically taken about two extra points of growth over the course of a year to shave one point off the unemployment rate.

Now do the math. Suppose that the U.S. economy were to grow at 4 percent a year, starting now and continuing for the next several years. Most people would regard this as excellent performance, even as an economic boom; it’s certainly higher than almost all the forecasts I’ve seen.

Yet the math says that even with that kind of growth the unemployment rate would be close to 9 percent at the end of this year, and still above 8 percent at the end of 2012. We wouldn’t get to anything resembling full employment until late in Sarah Palin’s first presidential term.

And then there is the crisis in education — which is directly linked to jobs, both the lack of same in the U.S. and the move by U.S. companies to invest in the economies and workforces of other nations.

Here’s the case in a nutshell, from a WaPo article by Arne Duncan:

The urgency for reform has never been greater. Today, American students trail many other nations in reading, math and science, and a quarter of them do not graduate high school on time. Many college students do not finish, despite the clear national need for more college-educated workers who can successfully compete in the global economy.

President Obama in 2009 set a national goal that America will once again lead the world in college completion by 2020. With our economic and national security at risk, this is a goal Republicans, Democrats and all Americans can unite behind.

We’ll see.

But in any event, it looks like there are plenty of issues to keep this pajama-clad citizen journalist engaged in the months ahead.

And I didn’t even get to opine as yet about MLB’s designated hitter rule.

Go figure.