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Posts Tagged ‘Supreme Court’

Bits and pieces 14: A Summary of the Affordable Care Act

Sun ,08/07/2012

 The goals of healthcare reform were to see that every citizen had adequate healthcare, ensure that healthcare was affordable, and protect citizens from insurance company abuses. Although many of the criticisms of the law were baseless, the law’s effect on the deficit and its constitutionality were serious questions. An analysis by the nonpartisan Congressional Budget Office predicted the Affordable Care Act would decrease the projected deficit by $138 billion over the first 10 years and by approximately $1.2 trillion over the next 10 years.  The Supreme Court , in National Federation of Independent Business v. Sebelius,  upheld the constitutionality of the Affordable Care Act. Below is a summary of the provisions the law that may affect you :

  • students and unemployed young adults may stay on their parents insurance until age 26
  • insurance companies may not limit the amount of care a person receives in their lifetime
  • insurance companies may not cancel coverage because a person is sick  
  • lowers the cost of care for Medicare recipients and closes the “doughnut hole” in prescription drugs, saving seniors $3.1 billion in prescription costs since 2010
  • insurance companies must cover preventive services like yearly checkups, mammograms, cancer screening, and inoculations
  • increases the penalties for Medicare fraud
  • insurance companies may not deny coverage to children with pre-existing conditions
  • insurance companies must provide justification for raising rates
  • insurance companies must spend 80% of their premiums on health care or refund the difference. Americans are scheduled to receive $1.4 billion and Oklahomans $21 million in refunds this August.
  • provides tax credits for small business owners so they can afford quality insurance for their employees
  • provides for the creation of hundreds of community health centers and incentives for new doctors to staff them

Beginning in 2014:

  • provides working Americans tax credits to help them afford quality insurance
  • ends discrimination against adults with pre-existing conditions
  • prevents insurance companies from charging women more than men or overcharging those in need of care
  • provides funds to create state based insurance exchanges where people can compare prices of insurance
  • provide states with funds to increase their Medicaid programs

       Source: healthcare.gov

 There are also hidden benefits: 

  • It would improve the competitiveness of American companies. Most working Americans obtain health insurance through their employers; however, this putsU.S.businesses at a disadvantage with foreign competitors. Small companies have the added disadvantage that they cannot negotiate rates as low as larger companies.
  •  It would cut down on the number of the uninsured using emergency services. Emergency room care is expensive and unpaid bills must be passed on to paying customers.
  • It would reduce bankruptcies. A Harvard study found that about 50% of all bankruptcies in theUnited Statesare caused by illness and medical bills. Health providers, banks, businesses, and credit card companies who lose money in bankruptcies pass the cost on to the rest of us.
  • It would improve everyone’s health. You and your family come into contact with many people each year. People without health insurance are less likely to receive immunizations and are much more likely to have untreated communicable diseases.

Research Credit: Barbara Moore

(C) 2012 J.C. Moore

Healthcare Reform: The Affordable Care Act

Mon ,02/07/2012

 “Your family’s health and prosperity depends on that of everyone.”

The United States has just been through a recession that has left many Americans without jobs, financial security, and adequate healthcare. What could be a better time to see that every American has adequate healthcare? President Obama promised during his campaign to reform healthcare. His goals were to protect citizens from insurance company abuses, see that every citizen had adequate healthcare, and ensure that healthcare was affordable. It was up to Congress to write the details of the law.

For those who claim making law is like making sausages, the Affordable Care Act is more than an apt example. In the 1990’s, Hillary Clinton tried to reform healthcare – but attempts at reform stalled when Republicans came up with an alternate bill and the opportunity passed with no decision being made. In 2010, Congress used many of the ideas of the Republican bill to create the Affordable Care Act. Many of those ideas formed the basis of the Massachusetts health care bill that Governor Romney signed into law in 2006. The Affordable Care Act is certainly not ideal, but it came about as a series of compromises necessary to get it through Congress and avoid a filibuster in the Senate.

Controversies: Much of the controversy over the Affordable Care Act was about things that didn’t really exist in the law. It did not create death panels, provide public funds for abortions, provide payments to undocumented immigrants, take away fundamental rights, or threaten to bankrupt the country. Although there were many claims that the affordable care act will greatly increase the deficit, the nonpartisan Congressional Budget Office predicted the affordable care act would decrease the projected deficit by $138 billion over the first 10 years and by approximately $1.2 trillion over the next 10 years. However, the laws constitutionality was a serious question – and several states filed suit claiming that the federal government could not require citizens to purchase health insurance. The lawsuits reached the Supreme Court and in  National Federation of Independent Business v. Sebelius, 6/28/2012, the Supreme Court upheld the constitutionality of the Affordable Care Act. It ruled that the penalty for not purchasing insurance was a tax, and that Congress had a right to impose taxes.

Benefits: Now that the Affordable Care Act has been declared constitutional and will become law , below is a checklist from Whitehouse.gov  that summarizes what the affordable care act might mean for you:

  

 

The Future: There is still concern that the Affordable Care Act does not do enough to control the insurance costs or reduce the cost of care. The healthcare exchanges should provide more competition, and the 80/20 rule means that at least 80% of the premiums must be paid out in healthcare services.  There are also some intangible benefits to health care reform that may materialize in the future: 

  • It would cut the unpaid bills for emergency services. Currently, emergency rooms are required by law to treat everyone, and those without medical insurance often use them for medical care when they cannot pay. Emergency room care is expensive and those costs must be passed on to paying customers.
  • It would improve the competitiveness of American companies. Most working Americans obtain health insurance through their employers; however, this puts U.S.businesses at a disadvantage with foreign competitors who do not provide health insurance for their workers. Small companies have the added disadvantage that they cannot negotiate as low rates as larger companies.
  • It would reduce bankruptcies. A Harvard study found that about 50% of all bankruptcies in the United States are caused by illness and unpaid medical bills. Bankruptcies affect everyone because the health providers, banks, businesses, and credit card companies who lose money in the bankruptcy pass the cost on to the rest of us.
  • It would improve everyone’s health. Your family’s health depends on the health of everyone. You and your family will likely come into contact with thousands of people during this next year. People without health insurance are less likely to receive immunizations and are much more likely to have untreated communicable diseases.

 More information:  Here is some additional information from Whitehouse.gov with links to the topic: ”

A major impact of the Court’s decision is the 129 million people with pre-existing conditions and millions of middle class families who will have the security of affordable health coverage. 

We should also remember that under today’s ruling, having health insurance is and will continue to be a choice. If you can’t afford insurance or you’re a small business that wants to provide affordable insurance to your employees, you’ll get tax credits that make coverage affordable. But if you can afford insurance and you choose not to purchase it, the taxpayers will no longer subsidize your care for free.” 

 

Research Credit: Barbara Moore

(C) 2012 J.C. Moore

 

Senator Coburn’s Town Hall Meeting ( Part 1)

Sun ,11/07/2010


Integrity in Politics:
It is the purpose of this site to apply observation and reason to current events. Good government depends upon our Legislators and our voters having up-to-date and accurate information. Senator Tom Coburn is considered to be the best informed of the Oklahoma Legislators. However, some things he presented at his town hall meeting, though they play well with his base, are not supported by research. We feel that Senator Coburn should thoroughly research the topics upon which he votes and speaks and that he should provide his constituency with accurate information.

Supreme Court: When asked about the recent court appointments, Senator Coburn disparaged the latest Supreme Court Justice, Sonia Sotomayor, by claiming she had lied, a very serious accusation to make against a Supreme Court Justice – especially when wrong. Coburn said that Sotomayor had reneged on a promise made during her confirmation hearing not to use foreign law to interpret the Constitution of the United State. He used as evidence the ruling of the Supreme Court on the case of Graham v Florida, in which a juvenile offender had been sentenced to life in prison for nonhomicidal crimes.

After reading the Supreme Court response which was actually presented by Justice J. Kennedy, not Justice S. Sotomayor, it appears that Senator Coburn was actually not being honest in his presentation of the information. As shown in the section of the Supreme Court brief below, the only reference to foreign anything is that the practice has been rejected the world over. This does not refer to any foreign laws but merely reflects on our standing in how humanly we treat juvenile offenders compared to the global community to which we belong and by whom we are scrutinized and in no way reflected that any foreign law was used to interpret the United States Constitution.

This misleading charge by  Senator Coburn raises a concern about any information he uses to support his views and whether he is just another typical politician trying to manipulate his constituents with “smoke and mirrors”.  Additional support for the Court’s conclusion lies in the fact that the sentencing practice at issue has been rejected the world over: The United States is the only Nation that imposes this type of sentence. While the judgments of other nations and the international community are not dispositive as to the meaning of the Eighth Amendment , the Court has looked abroad to support its independent conclusion that a particular punishment is cruel and unusual. (See, e.g., Roper, supra , at 575–578. Pp. 29–31, 982 So. 2d 43, reversed and remanded. )

Elena Kagan: Senator Coburn also said he could not support the appointment of Elena Kagan to the court because she considers the Constitution to be a living document. Senator Coburn believes that the Constitution should be interpreted as the Founding Fathers meant it. That, however,  has been as an excuse used by some politicians and judges to interpret the Constitution as they wish and claim it is what the Founding Fathers actually meant. The Founding Fathers were wise enough to give us a mechanism for amending the Constitution and there are now 27 Amendments. The Constitution is alive and better for it.

Recess Appointments: When asked about President Obama’s recess appointment of Dr. Berwick to head the Center for Medicare and Medicaid Services (CMS), Coburn emphatically declared that it was wrong and  illegal. Yikes! Coburn should polish up on his history of the much-used recess appointment. By this same point in his Presidential career, George W. Bush had used this technique to make 15 appointments and he used it 179 times during his career. Where were those Republicans then? The last group of appointments will bring Obama’s total to 18. It has been noted that Bush was not facing the same level of obstruction.Currently, Obama has 189 nominations pending before congress and 28 have been on the floor for more than three months. Bush only had six nominees that had been waiting that long. It might also be an interesting FYI to note that even George Washington used the practice to appoint the then controversial judge John Rutledge to the Supreme Court after he had failed to be confirmed by the Senate.

Reccess Appointments are a legal practice granted to the President of the United States by the Constitution of the United States in Article II, section 2.

“The President shall have Power to fill up all Vacancies that may happen during the Recess of the Senate, by granting Commissions which shall expire at the End of their next Session.”

Some have indicated that they feel this power should only be used when the position becomes vacant during a recess but this has been adjudicated by The Eleventh Circuit, in an en banc decision in Evans v. Stephens which held that the Constitution permitted both intrasession recess appointments and recess appointments to fill vacancies that existed prior to the congressional recess.( Evans v. Stephens, 387 F.3d 1220 (11th Cir. 2004). ) Since the position filled by Dr. Berwick has been vacant since 2006 it fulfills the courts requirements and is clearly legal.

Health Care: Senator Coburn said he  objected to the appointment of Dr. Don Berwick to head the CMS as Dr. Berwick  promotes medical rationing. Coburn’s basis for this premise uses “cherry-picking“, a technique which picks out a quotation and presents it out of context. A statement that Dr. Berwick made in 2008 in an interview with the respected publication, Biotechology Healthcare has been “cherry-picked” and this partial quote has been publicized many times by zealous Republican in order to create the specter of medical rationing. Here is the partial quote Senator Coburn refers to: “The decision is not whether or not we will ration care. The decision is whether we ration care with our eyes open.”  But, here is the actual quote in context, “We make these decisions all of the time. The decision is not whether or not we will ration care. The decision is whether we ration care with our eyes open. And right now, we are doing it blindly.”

Despite what Senator Coburn might claim, that statement isn’t particularly radical. Rationing currently occurs in our health-care system as resources are limited, and medicine and medical procedures are approved or disapproved by insurance companies regardless of whether that system is privately or publicly funded. “Blindly” as used by Dr. Berwick indicates we are currently doing it badly and not with an eye to the best practices to be used for the good of the patient; and not with an eye to which practices are unnecessary and therefore unnecessarily costly; and not with an eye to what medicines, tests and equipment are provided unnecessarily and sometimes even to the detriment of the patient.

“Ezra Klein, a blogger for the Washington Post, notes that Berwick’s statement is no different than a statement from Republican Rep. Paul Ryan of Wisconsin (seen as an up-and-coming leader within the GOP), who said with respect to health care, “Rationing happens today! The question is who will do it?” www.cbsnews.com/8301-504763_162-20009880-10391704.html.
Here is another more honest Republican’s statement on Berwick’s appointment. Tom Scully, who ran the CMS under President George W. Bush, noted, “You could nominate Gandhi to be head of CMS and that would be controversial right now.” http://www.newsweek.com/blogs/the-gaggle/2010/07/07/don-berwick-appointed-to-drive-health-care-changes-sidestepping-congress.html

With the use of the “cherry-picking” technique, some Republicans appear to be using medical rationing as a scare tactic to gain support in the up-coming elections without regard for what is actually good for the patient, I mean constituents. And to make matters even worse, Senator Coburn is a doctor. He also  said that other countries have national health care at lower cost because they ration health care. He says you and your family are responsible for paying for your own health care. Isn’t that just rationing health care by using money. If you, or your family can’t pay, would he just let you die?

By Guest Author: Barbara Moore