There's more than a little racketeering involved. Google this phrase: "as-hospital-costs-soar-single-stitch-tops-500" and read the accompanying story. I happen to live near the hospital that is described in the news story and can tell you it's not an exaggeration.
A few weeks ago on a Friday afternoon, I momentarily blacked out after a particularly vigorous hour in my local gym. My wife, concerned that I might have had a stroke, took me to the local ER where I spent the next 4 hours. After a brief neurological exam, an EKG and a CAT scan, the ER doc ruled out a stroke or other serious problem, and gave me a diagnosis: it was an anomalous reaction to strenuous exercise and probably would not recur. At that point I went home. Two days ago, the bill arrived. $7.000. This was, of course, the phony bill that the hospital never expected to be paid. After the insurance company's write down and co-pay I was left with a balance of $1400.
However, to pay this little I had to leave the hospital AMA--"against medical advice"--because the neurologist wanted to admit me for the week-end and do further (and completely unnecessary) tests on Monday that would have run the bill up to something more like $50,000 and my share somewhere north of $5,000.
Hospitals--including so-called "non-profit" hospitals--increasingly look to their bottom line when making patient care choices. If they can admit you and start administering care 24/7--even if "care" consists of a nurse walking into your room in the middle of the night to wake you up to ask if you're asleep--you become a profit center and the Affordable Care Act does nothing to stop this racket. These ludicrous charges are not the result of government "red tape" or rapacious trial lawyers: they are the result of greed.
The article quoted by Spring leaves the impression that residents of those 515 counties had multiple high-quality insurers competing for their business prior to the advent of Obamacare and that, somehow, Obamacare scared off all but one of them. There might a a grain of truth in there somewhere but it is hard to find. Because Obamacare effectively puts an end to "junk" policies by requiring all health insurers to offer a modest but decent basic benefit package, junk insurance sellers have left the marketplace. Their departure accounts for most of the reduction in competition that has the WSJ editors' knickers in a twist. An honest appraisal of that change would read: "Hey Junkman, don't bang you butt on the door on the way out!"
HI Lan, glad to hear you aren't freezing your butt off in the UP.
You make a good point and one that the President's lawyers would press on the judges who hear a challenge. But the tradition of statutory construction that Jonathan Adler refers to is pretty well established and I don't think any court will ignore it just to give the President a pass in this matter.
The big difference between Bush's assertion of expansive Presidential authority and Obama's is that Bush tied his unilateral actions to his powers are commander in chief whereas Obama is asserting his authority as the head of the Executive branch. Historically speaking,the courts have been much more receptive to arguments based on the commander in chief power (which, incidentally, is why Bush made everything he did somehow part of the "war on terror"0.
It's not that simple, alas. You recall George W. Bush wold issue "signing statements' when he signed a law passed by Congress. In those statements, Bush would announce which parts of the law he was going to enforce and which parts he was gong to ignore. The signing statements amounted to unilateral Presidential amendment of a law passed by Congress. But because Bush was a Republican, conservatives looked the other way and didn't challenge his unilateral power grab. That suited Barack Obama just fine and he has continued the Bush tradition of using signing statements to effectively amend laws passed by Congress. His delay of the implementation date for the employer mandate is just the next logical step on that road. As Professor Adler points out, under existing conventions of statutory interpretation, his action is clearly illegal. However, if it is challenged, Obama will argue that the President has inherent powers to delay the implementation if delay is essential to realizing the intention of Congress when it passed the ACA. And he will be able to point to the precedents established by his predecessor as support for his position. The Supreme Court will then have to decide whether to clip his wings, even though doing so would also clip the wings of any future Republican President.
From AP: The South Carolina Education Oversight Committee approved most of the state's new science standards on Monday but blocked a clause featuring the phrase "natural selection.” According to Republican state Sen. Mike Fair, "To teach that natural selection is the answer to origins is wrong."
"I don't have a problem with teaching theories. I don't think it should be taught as fact," Fair said after Monday’s review, according to the Post and Courier. "Natural selection is a direct reference to Darwinism. And the implication of Darwinism is that it is start to finish."
The clause in question, from page 78 of the South Carolina Academic Standards and Performance Indicators for Science, reads as follows:
Conceptual Understanding: Biological evolution occurs primarily when natural selection acts on the genetic variation in a population and changes the distribution of traits in that population over multiple generations.
Trofim Lysenko is smiling in his pit in Hell.
The ACA is not going to be repealed though it will almost certainly be amended as experience accumulates and we seek what changes are necessary to make it work as well as possible. Non-repeal is just one many things that won't happen: Obama won't be impeached and removed from office; Chris Christie won't be our next Preside etc.
The other day I challenged one of the local trolls to tell me specifically what law President Obama was violating by granting an extension of time for compliance with the employer mandate. Of course he didn't answer because he was just repeating something he heard somewhere. But there is an answer and it is pretty clear, as law professor Jonathan Adler explains:
"Whatever the stated reason for the new delay, it is illegal. The text of the ACA is quite clear. It provides that the employer mandate provisions “shall apply” after December 31, 2013. The Treasury Department claims that it has broad authority to offer “transition relief” in implementing the law. That may often be true, but not here. The language of the statute is clear, and it is well established that when Congress enacts explicit deadlines into federal statutes, without also providing authority to waive or delay such deadlines, federal agencies are obligated to stay on schedule. So, for instance, federal courts routinely force the EPA to act when it misses deadlines and environmentalist groups file suit.
Were the express command that the employer mandate take effect in 2014 not enough, other provisions of the ACA reinforce the requirement. For instance, the ACA expressly provides for the amount of the employer penalty to be assessed in 2014, and then provides for the penalties to be adjusted for inflation in subsequent years. Further, the imposition of the employer mandate in 2014 is essential for the proper implementation of other parts of the law. Most importantly, the employer mandate reporting provisions are essential to determining eligibility for tax credits and cost-sharing subsidies in state health insurance exchanges, and the tax credits are to be available beginning January 1, 2014. The tax credits and employer penalties were supposed to take effect together, and no one’s suggested delaying the credits."
As usual, the Supreme Court will have the last word.
News Bulletin: Hell has just frozen. I agree with you. Everybody should play by the same rules regardless of their political aims.
While the private sector has added jobs to the economy in every month since March 2010, a total increase of approximately 8.2 million jobs through January 2014, the public sector has contracted. To put this in perspective, federal, state, and local governments added jobs in only twelve of the forty-seven months between March 2010 and January 2014 and lost more than 700,000 jobs over this period. The ratio of public sector employees to total population is now about 8.5%, its lowest level in more than half a century, down from a high of just over 10% in 2007. The 2008-9 recession differed dramatically from earlier post-WW II recessions in that public sector employment did not recover together with private sector employment but kept on declining. Had this recovery followed the path of previous recoveries of the past 70 years, the USA would have about 2.5 million more jobs today than it has.
Grover Norquist is famous for saying he wants to shrink government to the point that you can drown it in a bathtub. He's getting his wish, and the ironic thing is that he 's getting it during the Obama administration, regularly depicted in conservative media as presiding over a vast expansion of government. As these numbers demonstrate, quite the opposite is true. As Milton Friedman might have observed, while Obama might wish to enlarge the public sector, it is a mistake to take the wish for the deed.
Whether you think fewer school teachers, policemen, firemen, EMTs, judges, prosecutors, public defenders, etc. is a good thing or a bad thing depends on your politics. But one thing is for sure; the United States is scaling back its public sector to levels not seen for decades and we will live with the consequences, good or ill, for decades to come..
If there is a more irrelevant response to a post on this board, I'm hard pressed to find it.
You: Gates wasn't financially secure.
Fact: Gates' family was very well off.
Now that's what I call real debating skill.....NOT!
You write: "Gate was NOT financially secure". Really? This is from an on line biography:
Bill Gates grew up in an upper middle-class family with two sisters: Kristianne, who is older, and Libby, who is younger. Their father, William H. Gates Sr., was a promising, if somewhat shy, law student when he met his future wife, Mary Maxwell....Bill had a very close relationship with his mother, Mary, who after a brief career as a teacher devoted her time to helping raise the children and working on civic affairs and with charities. She also served on several corporate boards, including those of the First Interstate Bank in Seattle (founded by her grandfather), the United Way and International Business Machines (IBM)....Bill's' father was a named partner in the Seattle law firm of Preston, Gates & Ellis...Bill attended the Lakeside School, a prestigious private school in Seattle.
His maternal grandfather founded First Interstate Bank. His mother was on the board of IBM. His father was a founding partner of one of Seattle's most prominent law firms. And you think he wasn't financially secure? What's your idea of financial security?
The point is, in Gregory Clark's terms, Gates is a stellar example of the persistence of birth advantages. Gates' tremendous head start in life, coupled with his obvious talent, combined to help him become an outsize financial success. A kid with Gates' natural abilities born into a ghetto household or a West Virginia coal miner's family would have an incredibly difficult time succeeding at all, much less becoming one of the world's richest people.
Actually, not obvious at all. We in the United States have believed, pretty much across the political spectrum, that the end of hereditary titles and the rise of democratizing institutions like free public schools and libraries have substantially reduced the built-in advantages/disadvantages of birth. Clark's research shows that this hopeful belief just isn't true. Birth matters much more than anything else in terms of social mobility. And the effects are incredibly persistent, lasting for hundreds of years, whether you're talking about the modern USA or medieval China.
Even the great business success stories of the present day (Bill Gates, Steve Jobs, Larry Ellison, Mark Zuckerberg etc) all begin with people who were well-off and educated and converted those advantages into great wealth. Gates and Zuckerberg were Harvard undergrads, Jobs was at Reed, I don't know about Ellison. The fact that Gates and Jobs left college to pursue their business visions is testament to their basic financial security and fundamentally excellent education. Gates' father was a named partner at one of Seattle's premier law firms, for instance, so you might credibly say that Bill Gates worked his way up from the top. Of course there are exceptions: Jay-Z, for instance, might be one.
Because birth attributes are so resistant to change, it's hard to create social institutions that will meaningfully alter the pre-determined outcomes. If you are one of the fortunate top dogs, you will almost certainly resist changes that benefit the unfortunate bottom dogs at your expense. Perhaps the best way to level the playing field is a very steep inheritance tax. Good luck on passing that one.
What law do you think the President has violated? Be specific.
The economic historian Gregory Clark has a new book ("The Son Also Rises") that is a major contribution to our understanding of social mobility. Here's a summary of the argument from an early review:
How much of our fate is tied to the status of our parents and grandparents? How much does this influence our children? More than we wish to believe. While it has been argued that rigid class structures have eroded in favor of greater social equality, The Son Also Rises proves that movement on the social ladder has changed little over eight centuries. Using a novel technique--tracking family names over generations to measure social mobility across countries and periods--renowned economic historian Gregory Clark reveals that mobility rates are lower than conventionally estimated, do not vary across societies, and are resistant to social policies. The good news is that these patterns are driven by strong inheritance of abilities and lineage does not beget unwarranted advantage. The bad news is that much of our fate is predictable from lineage. Clark argues that since a greater part of our place in the world is predetermined, we must avoid creating winner-take-all societies.
Clark examines and compares surnames in such diverse cases as modern Sweden, fourteenth-century England, and Qing Dynasty China. He demonstrates how fate is determined by ancestry and that almost all societies--as different as the modern United States, Communist China, and modern Japan--have similarly low social mobility rates. These figures are impervious to institutions, and it takes hundreds of years for descendants to shake off the advantages and disadvantages of their ancestors. For these reasons, Clark
contends that societies should act to limit the disparities in rewards between those of high and low social rank.
If people who are only working to keep health care quit because they can now purchase comparable health care on their own, then so long as there is a supply of unemployed people to take their place, the net effect on the number of jobs is zero. So there isn't "less work" or "less income". Indeed, to the extent that people quit in order to form their own businesses, there will be MORE work and MORE income.
Just because I quit my job doesn't mean I qualify for a subsidy. My spouse, for example, might be a self-employed professional who hasn't been able to get health insurance on her own because of a pre-existing condition. Now with the new law, she can get coverage and I don't have to work to provide it for her.
I am completely baffled by the argument that says the ACA saps individual initiative etc. It's just the opposite. With the new law, individuals become responsible for their own decisions about what insurance to buy rather than passively accepting whatever plan their employer has to offer.
As for creating a ruling class and thrusting the rest of the population into serfdom, your party has been doing a bang-up job of that for some time now. The economy is getting more and more top-heavy, not because of Obama but in spite of him.
Billy's right. Read the CBO report. Obamacare will reduce the labor force as people who are currently working only to hold on to the medical insurance no longer have to do so. But the jobs will still exist and other people, most of them unemployed, will fill the vacant slots..
There is an interesting philosophical argument here and it isn't obvious to me which side is right. Reducing incentives to work, however one does it, is viewed as a negative by many economists. Reducing the need to work simply to hold on to healthcare is viewed as a positive, sometimes by the same economists .Is the net good or bad? I don't know.
From a broader historical perspective, there's nothing sacred about the 40 hour work week. If increasing automation and computerization reduce the need for labor, perhaps the work week should get shorter, as it has in the past. You could translate Obamacare's reduction of the need to work into a shorter work week although, by itself, it isn't enough to justify moving to a much shorter week (32 hours, for example)
"Conservative" has many meanings. Dubya was certainly not a fiscal conservative but he was what people like Bill Kristol call a "national greatness" conservative. He (obviously) preferred exerting military strength to employing diplomacy and got our collective mammary glands in a washing machine as a result, not to mention running up a trillion or so in off-the-budget costs.
More to the point, I am just wondering what Spring would do if he were Emperor of the United States (perish the thought). It's easy to take pot shots and we all like to do it, but coming up with real solutions is another matter altogether.
You and Billy are both right. On a current basis, receipts exceed disbursements in Social Security. (I don't know about Medicare.) However, going forward, that situation will change sometime in the 2030's unless changes are made to the level of benefits or to the level of taxes imposed to pay for the benefits and probably to both. Put another way, the liabilities of the Social Security system would cease to be unfunded if we reduced the benefits paid to future retirees and increased the taxes on current workers. As far as reducing benefits goes, raising the retirement age to 68 and reducing the FICA COLA would have significant impacts. On the tax side, removing the income ceiling on FICA and imposing FICA taxes on capital gains would go a long way to eliminating the unfunded liability. In the current state of politics in Washington, it's hard to see a bipartisan agreement to fix Social Security, although the elements of a deal are obvious: some benefit cuts to satisfy Republicans, some tax increases to satisfy Democrats.
I'd be interested to know what you would do to "fix the economy" as you put it. The last conservative President we had, George W. Bush, "fixed" the economy right into the worst recession since the Great Depression. (OK, that's unfair; he was more like a flea on the economic dog.) But seriously: what would you do? and why do you think that your solutions would fix things?