Yes, George, it dies to the sound of the thunderous applause of teabaggers and the extreme right.

Yes, having the freedom not to carry health insurance and thereby obligating your fellow citizens to pay for your care after you've incurred an impossible debt and taken a bankruptcy is SO important. There's nothing I like better than having to watch my tax dollars go to compensate hospitals and other health care providers left holding the bag on the uninsured and underinsured while the health insurance companies get to keep their huge profits because they used to be allowed to get rid of all the sick people and anyone else deemed likely to, you know, actually USE their insurance.

I really empathize with our Republican tea-bagger neighbors, many of whom prefer to leave the US because of this action. Therefore, I've compiled a list of all first-world countries they can emigrate to that don't have such a burdensome universal health care system...here's your list. [empty]

The Supremes have voted that the AHCA was constitutional. That is what their vote was about. That is what the Supremes do.

Gerry Connolly said: "This health care act will help bring down the cost curve of health care." Google it to find out what he means... another deception. It took the Supreme Court to tell us that this is a trillion dollar tax on working Americans.

Jean, where's the trillion dollar tax? You pay a few hundred dollars fine on you income tax if you choose (for some reason) not to have health insurance. Health insurance, that will now be affordable. So where's the tax? 99% of the people will pay nothing. SO, WHERE IS THIS TRILLION DOLLAR TAX????

Why would James Madison be rolling over in his grave? Are you implying that as a slave owner he would be upset that affordable healthcare could now be available to all, including minorities?
I bet he would also have his knickers in a knot over the fact that we allow women to vote, work and wear short pants.
I think that as a country we would all be better off if we did not worry so much over what a bunch of narrow minded slave owners would of thought about our increasingly complex and evolving world that they would be unable to comprehend.

As you can see George, the Patch is loaded with self-righteous leftists who believe they have the right to seize other people's money using proxies in government to make themselves feel better. I've already been attacked repeatedly with the usual name calling and epithets like "racist" all because I resent them thinking the rest of us are nothing more than servants to serve up whatever part of our incomes these progressives decide them want to have. They claim we're "selfish" for not sharing. Yet these morons have no clue how much some of us give to charity, including organizations which provide healthcare to those truly in need, like those very will but without insurance.

I resent having government forcing me to pay hard earned money to programs which do nothing but give welfare to no loads. Obama's own aunt is just such a person. She came here from Kenya and stayed illegally and has lived for more than 20 years on the dole. Never worked a day in her life here in the States. Obama doesn't pay a penny to support her. He ensured she and his uncle, also here illegally and who has been arrested numerous times for drunk driving, were not deported. But he doesn't lift a finger to support them. They're both on welfare living off the taxpayers in Massachussets. The thing is, if the morons in Massachussets want to pay through the nose for that and keep electing politicians in their state who continue such programs, that's their business. If they wanted Romney care, that's their business. Anyone who doesn't like it can leave. But they now want it at the federal level because they don't want anyone to be able to escape their control. The liberals have bankrupted their states with this nonsense. They resent anyone escaping, and want to mandate it everywhere so we're forced to pay for their socialist society. That's what socialism is all about. Tyranny. It's a dictatorship. In their case, it's a dictatorship of the voting left. Instead of sticking a pistol to you head and demanding your wallet, they simply elect politicians to do it for them.

More simply put: it's socialized healthcare.

What does the Supreme Court have to do with that? Your case defines the pre-Obamacare situation.

p.s. in 2009 Obama said that this wasn't a tax: http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/

The penalty provision that the SCOTUS interpreted as a tax is the same as the penalty provision in Romney's health care law in Massachusetts. Romney also denied raising any taxes. So he is in the same boat as Obama here.

“The notion that the state somehow bears responsibility for the indigence of the aged is not far removed from that demoralizing supposition that the state is somehow responsible for the criminality of the criminal. I will not deny that the dislocations of capitalism afford some ground for the former….The point here is that no society is healthful which tells its members to take no thought of the morrow because the state underwrites their future. The ability to cultivate providence, which I would interpret literally as foresight, is an opportunity to develop personal worth. A conviction that those who perform the prayer of labor may store up a compensation which cannot be appropriated by the improvident is the soundest incentive to virtuous industry.”
-Richard Weaver, Ideas Have Consequences

While I wouldn't call myself a "conservative" as today's world knows it, I see the other side of the coin. What some call "selfishness" I see as a desire to allow, nay, require, others to stand on their own two feet WHEN THEY CAN.

Unless I see emergency rooms able to turn away every sniffle and hangnail as non-emergency, all we've done is shift the burden of payment...that is what is socialistic about it.

"At this festive season of the year, Mr. Scrooge", said the gentleman, taking up a pen, "it is more than usually desirable that we should make some slight provision for the poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir."
"Are there no prisons?", asked Scrooge.
"Plenty of prisons", said the gentleman, laying down the pen again.
"And the Union workhouses?", demanded Scrooge. "Are they still in operation?"
"They are. Still", returned the gentleman, "I wish I could say they were not."
"The Treadmill and the Poor Law are in full vigour, then?", said Scrooge.
"Both very busy, sir."
"Oh! I was afraid, from what you said at first, that something had occurred to stop them in their useful course", said Scrooge. "I'm very glad to hear it."
"Under the impression that they scarcely furnish Christian cheer of mind or body to the multitude", returned the gentleman, "a few of us are endeavouring to raise a fund to buy the poor some meat and drink, and means of warmth. What shall I put you down for?"
"Nothing! I help to support the establishments I have mentioned—they cost enough; and those who are badly off must go there."
"Many can't go there; and many would rather die."
"If they would rather die", said Scrooge, "they had better do it, and decrease the surplus population."

Wonderful and insightful quote!

Herein lies the problem that I do not think will ever, ever be solved: "The Affordable Care Act requires responsibility from all citizens. ERs are not intended to treat sore throats."

We as humans are selfish. When this all goes into effect our ERs and Dr.'s offices will be full of people with runny noses and other ailments that as of today most of us would self-treat with a day of rest and trip to the pharmacy.

This is where I think a lot of proponents of the plan are not considering all the effects this law will have. When they are put on a waiting list for something they feel they deserve ("Hey. I never had to wait 2 weeks for an appointment before!") there will be a whole new set of complainers about this law.

The positives of this act FAR outweigh the negatives, if there are any. Most people who are against this seem to have no real knowledge of the details and have relied more on fear-inducing or hysterical propaganda. Everyone wins with this law. Everyone. How can anyone object to not being turned down for pre-existing conditions, allowing children to remain on a parents' policy through age 26, that the majority of the money made by insurance companies goes towards healthcare and not to pure excessive profit for a few managing CEOs, credits for businesses providing health care services, not allowing an insurance company to drop a client when they actually become sick, assistance for the elderly with prescription costs, no lifetime limits for use of insurance. No one is invincible. TEveryone will need health insurance at some point whether it is through aging, preventative care, or an accident. It really is common sense. We were already paying for uninsured patients through higher costs (created by the companies themselves, NOT Obama), so this is simply a more transparent way of doing the exact same thing. Those who cannot afford to pay will be able to get the help and healthcare they need without discrimination. I am more than happy to have some of my tax money go towards helping others, as charities cannot possible keep up with all of them.

Never mind that, if you guarantee coverage of pre-existing conditions, nobody will buy health insurance UNTIL they get sick, ACA is a disaster. More than 85 percent of Americans are just fine with their health insurance. Now, to take care of part of the rest, we will go trillions and trillions of dollars into debt. Government will attempt to save by micromanaging every penny it/we spend(s) on healthcare. But the money will never add up. Think of it this way: Everyone eats too much at a buffet. Why? Because there is no cost consideration to getting that second main course or third dessert. It is catastrophic public policy. It will expand government, drive up costs, reduce innovation, curtail freedom, destroy the patient-doctor relationship, force rationing and lay ruin the world's best healthcare system. Other than that, it's cool.

Oh, you must be one of those people who's decided that he's never going to be in serious need of very expensive medical care. Got it all worked out, have you? Never going to get cancer or a heart attack or a stroke? Never going to develop diabetes or congestive heart failure? Never going to need that insurance, are you? What you're REALLY saying is you should have the "freedom" to go without insurance so when one of those things happens to you and you've run up a humongous bill at the hospital you should be able to walk away with your bankruptcy while the taxpayer absorbs the costs of your care. Hmm, sounds like freeloading, not freedom, to me.

Southarljd: 7-11 called your late for work, AGAIN...

Dusty, your 5th grade English teacher called. She wants you to take remedial classes so you can learn the difference between "your" and "you're".

Haven't been shopping for health insurance lately, have you? Bet you've never been turned down, as so many have, nor have you used your insurance only to find yourself without coverage after the company penalizes you by rescinding or terminating your contract. You speak with the complacency of someone who thinks all is well in his world, so why worry about anyone else, and in the smug self-assurance that what you have will be yours for as long as you want it. Guess what, George? If it hadn't been for Obamacare there would have been no reason for your company to keep you as a customer as soon as you started using your coverage. It's childish to declare wrong requiring people to get coverage so they won't become a public burden and requiring those providing the coverage to keep providing it even when those who paid for it actually use it. That's the way a little kid thinks, not a thinking, educated adult citizen of a society who understands when people get sick someone must pay for their care.

Then why is OBAMA hiding behind his privilage to uphold the documents you believe will find him free of all blame? The NANNY STATE is always placing blame. I guess The AK-47 walked to Mexico by itself, and just for your information Palin was 4 years ago. If it wasn't for the Three Stooges we would have never known about it. It just amazes me that when you dont abide by the liberal mindset we have to attack what you are unwilling to understand, ie. a different oppinion.

Let's also not forget Romneycare was a state-level reform and not a multi-trillion-dollar federal boondoggle. You can escape Romneycare by moving to Vermont.

Well said. Now they get to take care of you from birth to grave. Oh but they will deside how , when, and if they will treat you if you are to old. No thanks. It DOSEN'T WORK IN EUROPE, THEIR BROKE.

The "fat lady" example that you gave does not apply. Congress, the states and localities apply a variety of taxes on tobacco, snack foods, alcohol, etc. those are user-based taxes. The health insurance "tax" is for a failure to have coverage.

Quality-based payments are already becoming a reality in private insurance and Medicare/Medicaid.

100% government health care has not been a Dem strategy. Since I began working in health policy 20 years ago, the Dems and Republicans produced a number of options to health care reform. In fact, my first job, working in Congress, was to assess Pres. G.H.W. Bush's proposed health reform plan.

Decisions for elective surgery are already being made by private insurance. Medicare does not have a pre-authorization program. If no coverage policy exists, it is up to the physician to provide the service and then wait to see if s/he gets paid or if s/he needs to appeal to receive payment.

In fact, universal health care does work in Europe -- at half the price and with better results.

KM.. and the "fat lady' tax will have to be paid if she does not comply if the bureaucracy deides she should skinny up by law. Taxes are levied on tobacco, etc., but the govenment has not yet decided to dictate thier use one way or the other.. just wait.

Stix,

I think that you are reaching. Physicians are not being removed from the process. Physicians will advise if a person needs to lose weight. Taxing fatty foods or sugared soads, right now, are local issues (a la NYC).

Getting covered so that you can see a physician is the "tax". Do you honestly think that being a part of our health care system--17% of the federal budget--is that big of a deal?

Virginia drivers have to prove that they have insurance or kick into the uninsured driver fund. That rule applies in many states. How does that differ from having health insurance or kicking into the fund via what the SCOTUS calls a tax?

When you become of Medicare-age and need to be hospitalized, will you argue against that? You've paid into the Medicare Part A and some of the Part B funds via taxes for years. I am not seeing the difference.

For disclosure, I am a type 1, insulin-dependent diabetic. Got it at 10 years old. I am now 45. My lifestyle had nothing to do with my illness. While planning my wedding in 1992, my COBRA coverage, which I paid out-of-pocket for each month because my new employer would not cover me, was running out. My fiancé and I married 5 months early in a civil ceremony so that I could get on his health insurance.

When his company's insurance changd, it decided to apply pre-existing exclusions to my coverage.. Having diabetes would have prevented their covering anything as simple as strep throat. "You've got strep? Must be due to you diabetes."

I now receive care for a variety of side-effects of my diabetes. No amount of exercise will eliminate my diabetes. Removing pre-existing conditions and lifetime coverage caps are huge for me and many like me. There is a huge difference between choosing poorly (eating poorly, never exercising) and doing what everything that you can yet still not getting covered.

Should gainfully-employed persons with chronic conditions be denied coverage? Thankfully, the ACA said no, and the SCOTUS agreed.

The responsible should not have to endure the costs of the irresponsible. With that, Health Insurance Exchanges will reduce the cost of coverage for families who earn too much for Medicaid eligibility.

KM: Diet? Nah,

Let's make that the "four stooges."

Nein, Lee. Germany indeed has private non-profit or for profit insurers that are tightly regulated but according to German doctors and other health care professionals that I know, there still is a basic national insurance safety net that precludes the travesties of the pre-ACA system, such as KM describes. There are millions of hard-working Americans such as KM who are going to be liberated from fear of bankruptcy or worse due to our current profit-motivated insurance system. As for Europe - Germany, Denmark, Norway, Sweden, Finland, Austria, and the Netherlands all have so-called "socialized" medicine and are far from imploding . I've had to use it in Germany, Sweden and Finland and it is exactly as my German friends describe it. On being treated for an injury in the ER of a Swedish hospital the doctor told me when I asked about the bill - (the hospital was actually an associated provider of my then insurance) - "You know, you Americans have an uncivilized and bureaucratic health insurance system - it is going to cost us more in time, arguing, and money to get them to repay us and you than it is worth - we're treating you for free under Swedish national health care rather than deal with your bureaucracy." The European economies are imploding largely from demographics - shrinking tax base - and a wide range of things other than health insurance...and despite that several of them, such as France have a higher standard of living than the US.

@Lee -

Look around you. OUR country's economy is imploding under the weight of health care - and ineffective health care at that.

The countries you cite are actually far better off than the USA in regard to health care spending, and results too. As a percentage of US per-capita health care, they pay 42% (Greece), 41% (Spain), 45% (UK) and 53% (France).

The average life expectency in these countries exceeds that of the USA by 1.3 (Greece) to 2.7 (Spain) years.

So, no, I don't back down from my statement that the European universal health care model works, at least as far as affordability and effectiveness, but aren't those the two most important aspects?

Actually, the healthcare in France is very low. Very low. The country pays for medical schooling, and places limits on lawsuits. I haven't looked into Greece and Spain so I can't comment on that. There's a huge market medical tourism. Surely you know this.

France does NOT have FREE UNIVERSAL health care. I know because I am married to a Frenchman. You are using an fallacious argument.

The "new" SCOTUS? I am trying to understand the adjective used.

You are not trying hard enough.. does 'new SCOTUS-invented right' help you? Or perhaps you just want to rebut without understanding?

I hope you don't mind paying the new penalty tax should you decide not to buy the Chevy Volt (or anything else) the bureaucracy could now mandate with this new constitutional precedent. Heaven knows we need to save the planet at all costs and 'green' is the new liberal mantra!

Yes, the guy requiring unnecessary medical procedures is now unhappy that he has to participate in necessary medical procedures.

+1

Wrong. Health Insurance Exchanges are for those who do not qualify for Mediciad and have no other access to insurance. Adding healthy and not-healthy people to the exchanges will spread the cost and reduce the number of people who either choose to their local emergency room as a primary point of care or who otherwise would go bankrupt from health costs. It is spreading the cost of care across all participants,

Think of life insurance--something I pay dearly to have--you pay into it at a young age, hoping never to have to use, yet some in your pool will die and their benefits will be paid. Your premiums cover that person's death. No one ever said that insurance would have a financial reward.

If you never have a car accident, does that make your car insurance less valuable? If you pay life insurance for 20 years so that your kids' college tuition is covered, and you out-live the policy, does that make it worthless?

The fact is there are 50 state exchanges, none yet fully defined and no HSS definition of required minimum policy provisions.. and no idea what those policies will cost.

In the meantime, the SCOTOUS ruling today was that individual state participation in ACA Medicade coverage was not binding and therefore may not be available. The CBO says 20 million workers will lose employer insurance, so whatever employers were paying (less the fine aka tax) will fall either to new policy holders or to the taxpayers.

I predict in the end it is taxpayers and federal borrowing that will be making up any net losses. CBO seems to agree as they say deficits in the long run will increase under the ACA as written.

The ACA is a typical liberal solution to social issues,, the intent is all that counts and blinders are on as to the future implementation and cost.

Mostly they are interested in vaginas, but once in a while they are coerced into doing the right thing.

April - you rock.

"Vagina"? Aww, you wrote a naughty! No more testifying before legislative bodies for you. Words like that make uptight, "conservative" males very squirmy and squeamish.

The government should stay out of healthcare, unless it has to do with vaginas, then the government should interfere in literally the most invasive way possible. Or something like that, Republican talking points often confuse me.

Wishing you well in your upcoming surgery.

Once it was possible to obtain some treatment at the student dental clinic at Virginia Commonwealth, though it was mostly ordinary preventative care. Still, perhaps worth looking into. Best wishes for a fully resolved situation soon.

Agreed.

I so agree. I am English and grew up with "socialized medicine". I've lived in Germany too and believe me, it works - there's no fear of losing your house just because you got sick. What about that isn't a good thing?!!!!

Tom, it sounds like you are anti-American, which I don't appreciate. We are a government of rules and since the early 1800's the Supreme Court decides what laws are constitutional: anyone applying for citizenship knows this, as well as my four year old daughter. If you don't like our democracy, I suggest that you leave.

Tom.. I would not call the Constitution “dead”. I would say that we have a Constitution in order to protect the people from an oppressive Congress and President, and we have a Supreme Court which should also be interpreting the Constitution to ensure the people are protected.

We still have the Constitution, but the Chief Justice has just demonstrated that the Court is willing to ignore the unconstitutional ACA as written under the Commerce clause, and in effect rewrite it to make it constitutional and therefore declare it the law of the land.

Obama said the mandate penalty was not a tax, the case was argued before the court by the DOJ as not a tax, but yet Roberts called it a tax to in effect legislate a new ACA version from the bench.

A sad day for us all, even for those doing the victory dance, many of whom probably do not care about the Constitution anyway.

"Dead"? How come with you tea party types every time the Supreme Court or government does something you don't like you declare the Constitution dead? I'm sick to death of you people pretending to know something about it when most of the time you misrepresent it and you've had such as Glenn Beck, a guy who never completed two semesters at a community college, "teaching" you what's in it. Well, you know what? I have multiple degrees in history and government and a law degree, and I took courses in Constitutional Law (my favorite) in law school, and have had a lifetime of studying it, and I have to tell you that you are wrong, wrong, wrong, and all the other people whining about how unconstitutional it all is are wrong, too.

Here's what the Constitution says about Congressional authority: "Art. I, Sec. 8, [1] "The Congress shall have the Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States ..." Sounds pretty sweeping to me. What part of the Constitution can you point to which says otherwise? BTW, the 10th Amendment only works for powers NOT reserved to the Federal Government, so that's not available to you. Go ahead, read the document and tell me where it says the Congress had no authority to pass this law or the Supremes to affirm it.

Congress has the constitutional authority to tax, but this SCOTUS decision opens the door to an entirely new form of taxation.. to mandate by law that a citizen purchase a commercial product or behave in a prescribed way under penalty of being individually taxed if he does not comply.

It is the first in history and certain to be exploited by bureaucrats that are more than willing to substitute their will on issues that heretofore were strictly personal acts of individual freedom.

This new congressional “right” sounds too close for comfort, to the punitive China one-child policy that is also based on the noble idea of universal benefit. Laugh now if you wish, but no one ever envisioned the Commerce Clause being stretched as far as it has either. The door is open!

Unfortunately, too many people do not consider the scenario you describe. The ill and the poor are a minority that do not deserve consideration.

I have never been without medical insurance, but in my job, I have seen too many bankruptcies because of medical bills. Sure the poor can get medical care, but the only way to get rid of the debt is to write it off in bankruptcy. This medical debt just gets passed on to other customers.

The Supreme Court has voted that the ACA is constitutional.

Yeah, um, you might take a look at Article 1, Section 8, paragraph [1] before parading your ignorance about the Constitution for all the world to see. It clearly reserves the power to tax to the United States Congress, just as paragraph [3] gives the Congress authority to regulate Commerce (aka, the Commerce clause), which at least 4 of the Justices also found valid reason for upholding the law. Since the Constitution CLEARLY relegates power over taxes AND interstate commerce (which health care is) to the Congress, your argument using the 10th Amendment is unfounded. IT only comes into play for "powers not delegated to the United States by the Constitution". Therefore, it does NOT apply.

As for the population saying no, let's talk about those numbers. First, MOST Americans have no idea what's REALLY in the ACA because they've been lied to in a steady stream of deliberate misstatements from Fox News and every right wing radio and TV host in the country and there's been a well-funded campaign by extremely rich right wing astro-turf organizations to inculcate fear and trepidation over this modest improvement to health care access.

Second, even people who THINK they're against the law immediately reverse themselves when they're told what's in it. In fact, polls which have asked for reactions to specific provisions reveal the more people know, the more they like it. EVEN the mandate when its purpose is explained to them.

Sorry. You lose, and America wins.

"Rationing"? What in blazes are you talking about? Do you have ANY idea how many people have had their health care rationed to the point of their death or permanent injury by a health care industry invested in profit instead of patients' welfare? Are you aware that the Harvard Medical School concluded in a major study a couple of years ago that TENS OF THOUSANDS of Americans DIE every year from lack of health insurance, which in turn means they cannot get the care they need? Do some research, Tom. You sound like you get all your news from Fox, which isn't actually a news organization.

It has to lead to rationing. The ACA adds tens of millions, dismisses pre-exisitng conditions (which is not insurance bu a social safety net), and adds 5 years to children on their parents policies. All noble goals, all very expensive. THe truth remains that it will be cheaper for businesses and individuals to renounce their current policies and pay the "tax." If you need emergent health services, you can simply buy one then at the same price as when you did not need it. THe only possible way to keep this under control is to ration medicine. That will be done through regulations determining which health care is cost effective and which is not.

The truth is no one really knows what exactly the ACA will do, which is one reason why businesses have been reluctant to hire and why they have been reluctant to expand.

Gosh, the next thing we know the US will allow funding from other countries to buy elections. Opps - I guess that already happens with supper PACs.

Yum! I love supper PACs!

Supper PACs - soooo tasty!

That will not be hard. There will be Boards assessing cost effectiveness of medical practices. Those it deems to be cost ineffective will be denied.

And while you say it wth sarcasm (at least I hope you do), it is an extraordinary power that is dangerous in the wrong hands. What is to stop a government officials form using it as a club against (real or perceived) enemies? Nothing.

We already have those boards. Currently the insurance companies do that.

One can sue an insurance company now that denies coverage. You can't sue the federal government. People will have no recourse for denied coverage.

Your problem sounds like one of erroneous coding, in that the bill sent to Medicare, for whatever reason, was not correctly coded by whoever in the doctor's office is tasked with filing claims. It's one of the little known problems of our system that the entire system IS built upon coding for particular services instead of upon paying for treatment no matter what it is. Being a fee for service system, if the service provided is not properly coded, then the coverage doesn't kick in and the patient gets a bill. Contact your doctor's office and speak to the office manager and try to get them to adjust the coding and refile the claim. Be firm with them.

Finding a doctor willing to accept MediCare is a growing challenge. It's just not worth it.

In the UK, doctors hold private appointments 2 afternoons a week. Those are beyond coveted. NHS is great if you are healthy or have an obvious injury. But if you are sick, forget it. Medicine is practiced in UK by regulation -- there really is no need for a medical license (which explains why fewer than half their doctors are native born -- the smart Brits come here is they want to practice medicine).

Of course Mr. Analyst, the Government and Democrats are never “incompetent”.

Suggest you take your blinders off as start to appreciate what is good about this nation (like everyone together), and not dwell on the negative and on who you perceive to be your only enemies. You are drinking too much Dem Party cool aid in my view.

The Analyst must have sympathy for the out of control federal spending resulting in a debt nearing $16T. Talk about leading this country down a path of disaster.

@SP, yeah, I'll bet you were REALLY concerned about all that federal spending when Bush was in charge, leading us into two unfunded wars, an unfunded Medicare Part D, and a completely unnecessary and catastrophic series of tax cuts for the wealthy. For your information the rate of federal spending under President Obama has shrunk to the rate it was at the end of the Korean War. He has actually done quite a bit to rein in spending, but the problem is that once commitments have been made then years later their effects are still being felt and he can't simply willy-nilly stop spending on stuff for which funding has already been allocated. But, why bother yourself with the very real complexities of the day-to-day operations of the government when you can fall back on poster-sized slogans which don't tax anyone's brain to repeat?

Yep. And I recall numerous companies doing just that during 2000, and most gave huge donations to the DNC. In fact, the guy who trashed Global Crossing, which eventually sold for pennies on the dollar and was bought up by a Chinese Billionnaire -- the same one whose holding company now owns the Panama Canal (thanks a lot Jimmy Carter!) -- walked with $175 million, after ruining the company, and one year later, while playing a game of Golf with non other than Bill "I feel your pain" Clinton and Terry McCauliff (Clinton buddy and head of the DNC at the time), handed bill Clinton a $1 million check for his "presidential library." He had also given a sizable donation for Hillary for her senatorial campaign.

If you look at the collapse of the stock market, which started before Bush was ever elected by the way, the majority of those companies whose values were falsely inflated and allowed their CEOs to walk with investor's money leaving everyone holding the bad on worthless stock were big DNC donators, not GOP donators. I know, because I lost my ass on several of them thanks to the utter idiots at Morgan-Stanley Dean-Witter. They had no idea what they were talking about when they made their recommedations, and then paid Bill Clinton $100K for a one-hour speech in the middle of the crash. I'd already fired them and pulled what was left of my money by then. But many wealthy investors threatened to pull all their money after that little stunt.

Tom - come out of your little fantasy world. Sure it will be unpleasant for you, but in the end you will be better off than the place you cower in now. There's much to see besides blaming everything on the democrats. I guarantee that if you look, and if you pay attention, you will find that the crooks on Wall Street are also Republicans and maybe even more than Democrats.

+1000

Excellent points Jody. I too feel fed up with the GOP for not making changes when they had control but some say they were thwarted. I don't have the time to go tit for tat with the politics of this oncoming mess. Any time the federal government gets involved things get worse and massive layers of government to fight through. Why do people feel the federalization of our medical system will be any different from other government agencies?

KM - the world is certainly changing, particularly employers. Businesses are giving all profit to their CEO's and show zero support for their retirees. It's more like a trickle-up plan.

That's "eminent domain," counselor.

Thank you Tom for the awesome idea! I just changed the signature page on my work emails to "E = hv where h is Planck's Constant" and now I totally understand quantum mechanics.

I am wishing your friend better days. It's amazing to me that everyone does not realize we may all fight cancer some day. We certainly all will have health challenges and ultimately die.

First of all, anyone who drives doesn't have to drive. It's a privilege. You don't want to pay for car insurance? Don't drive. But it's all a farse anyways. I've been hit twice by uninsurance motorists, once in California, and once here in Virginia, both of which have such laws. NOTHING WAS DONE to the uninsured parties. The police refused to write a report or any tickets, even though I was hit and the other drivers were clearlhy in the wrong.

This healthcare law is an abdomination. It will be the same thing. The way its written leaves it wide open for freeloaders getting free healthcare insurance paid for by the government (read, the taxpayer). Most of us were for reforms which would resolve the issues you mention. But THIS monstrocity will not do so. It will only result in trashing what system we have. People have NO idea what's coming on 1 January 2013.

I keep hearing about people "loosing their homes" over a lack of healthcare insurance. Who has ever lost their home? I have several friends who have no insurance and have had catastrophic health issues. NONE of them has ever lost their home or faced loosing it. In fact, my best friend had triple bypass surgery a little over two months ago. The total bill was over $400K. They knew he couldn't pay up front, yet he got into a good hospital and was operated on by a leader in the field. The State of Mississippi has solved its problem of good working folks like my friend who drives a truck and who can't get healthcare coverage due to preexisting conditions -- he had bladder cancer twice and other things, which made the rates available to him way beyond his ability to pay. Mississippi uses funds from the State Lottery program to provide coverage for people like him. You NEVER hear about such things from the left. NEVER! I would really like someone herein who has actually honestly known someone first hand who "lost their home" or was turned away from life-saving care because they couldn't afford it. I've never seen it happen. I've heard a lot about it, but never had an actual case presented to see.

We've had a number of hospitals in Texas and other border states with Mexico driven out of business because of the federal unfunded mandate they not turn anyone away. One particularly outrageous case was the Mexican family from Nogales that snuck their father, who was suffering from heart disease, across the border, dropped him off at a local hospital emergency room, and ran off. They found him needing a triple bypass. Because he was deemed as likely to die if transported a long distance, they had to do surgery there. They did so, and this guy's surgery and aftercare cost nearly $1 million! A few weeks later he got up, walked out of the hospital, and crossed back over the border into Mexico, as good as new. Not a dime paid for by the socialized medical system of Mexico. The Texas hospital was stuck with the bill, which it had to pass on in higher costs to everyone else.

The point is this sick system we have which REQUIRES treatment to even illegals, and then allows them to walk away leaving others with the bill is driving costs up. And none of this will be resolved with Obamacare. In fact, it will encourage more. This time they'll be lining up at the doctor's offices. Anyone who the government decides cannot afford healthcare will get it paid for by the taxpayers. All it was meant to do is be a massive transfer of wealth to buy votes.

Tom - you do quite a lot of mouthing but without much thought or research.

"Even after the Patient Protection and Affordable Care Act is fully implemented in 2019, about 23 million Americans will remain uninsured. About one-third of these will be undocumented immigrants, according to estimates by the Congressional Budget Office.

This is by design. Illegal immigrants will not be permitted to buy insurance through government-run exchanges even if they pay with their own money. They will not get federal subsidies to buy insurance and will remain ineligible for Medicaid and Medicare; and even legal immigrants will have to endure a five-year waiting period before they can sign up for Medicaid."

Tom, when a person received medical care, that person is billed for that work. Without insurance, a hospitalization bill may be a hundred thousand. So perhaps the person will not or cannot pay it, but that bill will remain on their credit report and will affect most future financial transactions. Even if the bill is only 1,000, the medical judgement will affect whether or not the person can get a car loan, car insurance, or a home. The judgement remains on your credit report forever, and for 10 years after it is paid. I guarantee that.

Tom, the fact that you would deny health care to a dying man, regardless of his immigration status, says the world about you. I'm with Olivia in thanking President Obama and the U.S. Congress for passing this health care legislation, but I don't think it has anything to do with your complaint. With or without this new legislation, it's the obligation of hospitals to treat any critically ill people regardless of their immigration status or ability to pay. Fortunately, most Americans are compassionate and share this view.

One thing that's great about the new legislation is that 30 million people will become insured and will be more likely to treat illness before it gets to a critical stage, saving the patient from the agony and saving the taxpayer or other insured the costs of those expensive bills.

I wonder how much racism plays a part in Tom's thoughts. Would Tom feel the same about denying treatment to a dying undocumented person if she were the white child of a British university student who had overstayed her visa?

I am in favor of the national insurance plan, but I also feel we should do better to stop the free loaders who take advantage of the system. This happens on the federal, state and local levels.

Bah, humbug! Let the children starve! Good grief, are you serious? If somebody you know is taking advantage of the system, turn her in, but don't deny food to hungry children.

1% uninsured? Sure about that. Only 12 MRI machines in all of Canada? Sure about that one too?? Well, I'm sure you are, but it sure does show your ignorance and how patheticlly uninformed most people who object to health care reform actually are on the facts. A damn stubbron thing when you really have no legitimate point.

THere is no chance illegal immigrants will be excluded from Obamacare. We will hear terribly tragic stories and government will respond. That is what government does -- it responds to loud constituencies. Normally, that is how our government works but it is also why government stinks at business.

Calling someone what they are is not name calling. You seem to ignore the facts that don't support your point of view. That is ignorant. Better yet, you make up "facts" that do support your point of view. That is also ignorant. Then your rational is that you "believe" others do the same. You seem to have confused actually trying to quantify a difficult and ever changing statistic with not blindly repeating talking points someone tells you. People like you always have "firm" numberss because you just make them up. As for politics, you're repeating party talking points and you're not trying to bring up politics? Wow, have you now convinced yourself that you're just not right with your made up facts, but that you're morally superior too? And let me get this straight: there's no starving children anywhere in the US because YOU haven't seen a picture of them lately??? Wow. You know, if you want a real discussion, you shouldn't start with insulting our intelligence.

I have recently worked with underprivileged children who depend on the free or reduced-cost breakfasts and lunches at school. Most are not over-weight, although the food their parents can afford to buy for them is usually higher in calories and lower in nutritional value. Although I haven't checked into the requirements for reduced-price meals, I know that getting other services in the county requires proof of need, having helped a family through that maze.

Interesting and insightful article Haunches. Another friend had a kidney stone attack on a Monday and had to leave for a cruise to Sweden/St. Petersburg on Friday. US doctor did a laser stone break-up so he could pass the stones and my friend made his trip. Once on the cruise he met several passengers from Europe who all told him that if he had lived in their countries he would never have made the cruise as their systems aren't as responsive as the US. I can only go on what I have been told from honest people I know and what I read from reliable sites. I also read that in the last year or so the Medicare program finally purchased the same software that the private insurers use to find fraudulent/deplicate claims. I was shocked after hearing for decades about Medicare fraud the federal government had never upgrade their system with software that they must have known that private insureres used. Also, Chairman and CEO of IBM, Samuel J. Palmisano, approached President Obama and members of his administration before the healthcare bill debates with a plan that would reduce healthcare expenditures by $900 billion. His offer was rejected twice to get our health care costs under control. Our healthcare system is costly and that is what needs reform not the entire system. But cost reforms were rejected (tort reform, selling across state lines, etc) and therefore, one can only gather cost wasn't the concern but further control of the American people's lives is.

Haunches, you make this out like it's the worst thing in the world. In my mind, it indicates some financial responsibility in health care. The Canadians choose to sacrifice some convenience for a massive reduction in health care costs. If I have the choice to pick health care that's 50% less expensive at the cost of delaying some non-emergency treatment, so be it, especially if the health care system provides better overall results, as it does in Canada. You will find that most of those multi-million dollar MRI machines sit unused much of the time in the USA so that you can have that spur-of-the-moment & often unnecessary MRI.

If you can figure out a way to have the best of both worlds, good for you, but there's not a single person in the political world today who's suggesting a system that cuts costs by 50%, yet improves quality and keeps all the so-called convenience of the current system.

Mandy, nice to hear that your friend was able to make his cruise. I rest my case.

Richard, how do you rest your case? My friend was a US citizen and received US medical care under a private insurer provider by an employer that covered premium costs partially. The point is tht if he was under socialized medicine, he would not have received the laser surgery in time to be on the boat on Friday.

Mandy -- Tort reform is a key issue on controlling costs. Other countries that have reformed health care successfully instituted tort reform as part of the process (like Germany). The trial lawyer lobby in the U.S. is too powerful to permit any tort reform, so we pay for an insane amount of defensive medicine.

The U.S. medical system is so strong that it is able to deliver timely and high quality medical services despite the built in disadvantages. If we were ever serious about tort reform, we would see health costs (including premiums) drop like a rock.

One of the reasons your friend's cruise-mates pay less than half as he does for health care is because they sacrifice medically-unnecessary expediency for tremendous cost savings. Ensuring that a spoiled rich guy makes his next cruise on time shouldn't be the baseline goal of our health care system unless that guy is kicking in a pile of extra money to cover the extra costs of managing such a system. Would I always like to be treated at the drop of a hat for my convenience? Yes, of course. If someone can design an affordable health care system that can do so, great. Tort reform doesn't get us anywhere close. I would much rather sacrifice some convenience for a 50% cost reduction, saving our country from bankruptcy and ensuring that every American has quality health care instead of just the wealthiest.

By the way, this discussion has little to do with the new health care law. The types of cost savings measures that you decry and I support are not part of the new law, nor are they likely under the competitive system of private insurance companies.

Mr. Holmquist -- That's the rub. Putting tort reform to the side for the moment, the only other way to reduce costs is to reduce the demand for medical services. The 2010 scandal in Canada was that wait times for a simply MRI was 12-18 months, so Canadians who needed the service found it privately or traveled to the U.S. The need did not just go away because supplies were unavailable.

Obamacare will necessarily involve rationing of this type. That is the only way to control costs if there is no tort reform at all. If there is no rationing, premiums and taxes will explode to pay for things like adding tens of millions to the insured rolls, increasing children to 26, etc. That has been the experience of every nation that has gone down this road, and we are not special.

Now that I think about it, Mr. Holmquist, you may have a point. Proponents told us not to worry our pretty little heads off about what the law would do. After all, we needed to pass it to find out what's in it. We still have no real grasp of whats in it. Somehow, I think if proponents sold it like you are, i.e. what the big deal about non-emergency medical services, that costs too much, go to the back of the line and wait your turn while we asses whether you are worth the cost of treating, I suspect not to many people would have supported the law. And not many supported it to begin with.