Opting out of nationalized health care

George_1950 · #1 Oct 28, 2009, 10:04 PM

I'm curious whether Congress, in its wisdom, will enhance federalism by allowing states to (somehow) opt out of mandatory health care. It sounds like a progressive paradox, a little sugar to help swallow a bitter pill. But might Congress unintentionally provide ammo to the 10th amendment believers who wish to construct a wall of separation between the federal and state governments? "I am in favor of the clear, bold step represented by HCR 50, introduced by Representative Creighton, and co-authored by Representative Guillen. It’s clear that this is not a partisan issue: it concerns all Americans, and all Texans.

"The Tenth Amendment was enacted by folks who remembered what it was like to be under the thumb of a distant, all-powerful government. Unfortunately, the protections it guarantees have melted away over time."
Office of the Governor Rick Perry - Speeches - Gov. Perry Speaks in Support of States' Rights

tomder55 · Oct 29, 2009, 03:58 AM

Here's a hint .If Chucky Schumer proposes something instinctively suspect the worse.

The opt out is a bogus trojan horse because the people not on the public option will still be taxed to support it. No Governor in their right mind will tell the people of the state that they should be taxed for a benefit without having the "right" to participate. It's a cute ploy .Tax the people of the state and then give them the option if they want their slice of the pie in return.

Reid said that a tax on "Cadillac" plans has been modified to include family plans worth more than $23,000 . Those taxes would be collected from all states, including those that opt out . Plus there are other across the board funding proposals in various bills that would be collected from all taxpayers.

Pressure from constituents demanding hand outs they are paying for would be too strong for most states. If you need any proof of this just remember the flack some Governors took for suggesting their states don't need porkulus .

Imagine the court challenges as citizens claim they are being denied the right to participate. Or citizens of the state could take it to court to compel their states to opt out. Now you'd have the courts overturning or supporting each states decisions.

Beyond that ;who in the state makes the choice ;the Governor ? the legislature ? a referendum ?It has not been specified to date . Since it is a Federal program each State should decide to opt out or not in the same fashion .

If a state has the right to opt out of a Federal Mandate then why is that not the case for all Federal Mandates ? Maybe they should ;but that isn't the way it works now.

Now ;what happens to us commuters who cross state lines to work ? It probably wouldn't happen here in the North East . But I can see the possibilty of bordering states making different decisions regarding this .

What would a business in a state that opts out do ? I see the possibilty of them migrating across the border and ending employer provided coverage... in effect compelling their workers to join the public option. Under the pressure of lost businesses it wouldn't take long for states to conclude they HAVE NO CHOICE but to allow the public option in their states.

This is a phony ploy by the Dems to make it appear they are compromising so they can lure some of the queasy jelly fish "moderate" blue dogs ,with a sleight of hand ,to vote for the radical restructuring of the health coverage system.

Edit ; the way this is going to be adopted most likely will mirror the way they conned people onto Medicare Part B . To lure people to participate the initial low ball price was $3 /month. Now it costs $96 /month . When the price goes up do you think the Dems will have added an opt out plan for those states that initially decided to opt in ? NO WAY !

excon · Oct 29, 2009, 05:46 AM

Quote:

Originally Posted by tomder55

This is a phony ploy by the Dems

Hello:

I don't care about opting out or in.. I wanna know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there???? Cause if they are, and you ain't talking about 'em, I guess you support 'em. And, if they're not, then we got your number...

Then after all that, you wonder why you're not taken seriously in this debate. You opted yourselves right out...

excon

George_1950 · Oct 29, 2009, 05:51 AM

The liberal/progressive/Dems are liars? I wonder if the preamble to the 'health care bill' declares access to affordable health care a 'right'; and then will allow states to deny its citizens that 'right'? Isn't this legislative 'Dred Scott-ism': the Congress deciding the citizens of the US are property and, as such, have no rights?

George_1950 · Oct 29, 2009, 05:57 AM

Quote:

Originally Posted by excon

Hello:

I don't care about opting out or in.. I wanna know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there???? Cause if they are, and you ain't talking about 'em, I guess you support 'em. ...

excon

Realistically, if Congress and the president can declare access to health care a right, they can just as easily modify that right. Haven't you read the bill, excon?

tomder55 · Oct 29, 2009, 06:26 AM

Excon you make an irrelevent strawman argument(and an ad hominum). We are talking here about the Senate op out proposal by Reid ....who btw has revealed little else about the details .

On the issue of the death panels ;unless the language of HR 2400 has been modified ,then essentially they have not been removed.

George . They know this whole enterprise is unconstitutional . This cover of States Rights is subterfuge ;some pretext they can argue when the whole thing goes before SCOTUS.

excon · Oct 29, 2009, 06:37 AM

Quote:

Originally Posted by George_1950

Realistically, if Congress and the president can declare access to health care a right, they can just as easily modify that right. Haven't you read the bill, excon?

Hello George:

Nahh. I haven't read it. I'm gonna wait until there's a final bill.

Congress and the president CAN'T declare a new right. All they can do is recognize a right that the founders assured us - and NO, they can't modify it.

excon

PS> Tom, if the death panels are STILL there are you AREN'T talking about them, then you are doing a dis service to your fellow citizens.. You don't think I'D stop talking about them if I were on your side and they were really there.

tomder55 · Oct 29, 2009, 06:43 AM

Quote:

PS> Tom, if the death panels are STILL there are you AREN'T talking about them, then you are doing a dis service to your fellow citizens.. You don't think I'D stop talking about them if I were on your side and they were really there.

I try to avoid redundancy . My position on the House bill has been debated here and I have not changed my position.

speechlesstx · Oct 29, 2009, 06:51 AM

Quote:

Originally Posted by excon

Hello:

I don't care about opting out or in.. I wanna know about those death panels.. Are they still in there? How come you don't talk about them anymore. Is it cause they're really AREN'T in there???? Cause if they are, and you ain't talking about 'em, I guess you support 'em. And, if they're not, then we got your number...

You be the judge...

Quote:

Treating seniors as 'clunkers'

By BETSY MCCAUGHEY

Everyone knows that if you don't pay to maintain and repair your car, you limit its life. The same is true as human beings age. We need medical care to avoid becoming clunkers -- disabled, worn out, parked in wheelchairs or nursing homes.

For nearly a half century, Medicare has enabled seniors to get that care. But ObamaCare is about to change that, by limiting what doctors can provide their aging patients.

The Senate Finance Committee health bill released last week controls doctors by cutting their pay if they give older patients more care than the government deems appropriate. Section 3003(b) (p. 683) punishes doctors who land in the 90th percentile or above on what they provide for seniors on Medicare by withholding 5 percent of their compensation.

This withhold provision forces doctors to choose between treating their patients and avoiding government penalties. HMOs used the same cost-cutting device in the early '90s until it was deemed dangerous to patients and outlawed. Now, lawmakers want to use it against the most vulnerable patients, the elderly. This bill and four others under negotiation also would slash about $500 billion from future Medicare funding.

President Obama and his budget director, Peter Orszag, have told seniors not to worry, claiming that Medicare spending could be cut by as much as 30 percent without doing harm. They cite the Dartmouth Atlas of Healthcare 2008, which tries to prove patients who get less care -- fewer hospital days, doctors' visits and imaging tests -- have the same medical "outcomes" as patients who get more care. But read the fine print.

The Dartmouth authors arrived at their dubious conclusion by restricting their study to patients who died. They examined what Medicare paid to care for these chronically ill patients in their last two years. By definition, the outcomes were all the same: death. The Dartmouth study didn't consider patients who recovered, left the hospital and even resumed active lives. It would be important to know whether these patients survived because they received more care.

The journal Circulation addresses that question in its latest issue (Oct. 16) and disputes the Dartmouth conclusion. Examining patients with heart failure at six California teaching hospitals, doctors found that hospitals giving more care saved more lives. In hospitals that spent less, patients had a smaller chance of survival. That's the opposite of what Obama is claiming and Congress is proposing. The Senate Finance bill establishes a formula that penalizes hospitals for high "Medicare spending per beneficiary" (Section 2001, p. 643). That may save money, but the California study suggests it will cost lives.

When Medicare started in 1965, the law forbade the federal government from interfering in treatment decisions. Doctors decided what patients needed, and Medicare paid for each treatment on a fee-for-service basis. Though this protection from government interference has been whittled away a bit, doctors and patients in Medicare still decide what state-of-the-art medical care they want.

The results are huge improvements in longevity and seniors' quality of life. Life expectancy at age 65 has jumped from 79 years to 84, while disability has steadily declined. Seniors enjoy more active lives than their parents owing to hip and knee replacements, angioplasty and bypass surgery, according to James Lubitz and Ellen Kramarow of the National Center for Health Statistics (Health Affairs, Sept./Oct. 2007). Obama adviser Dr. David Cutler reports that the heart medications and procedures Medicare patients have received over the last 20 years have been a "wise investment" resulting in "excellent value" (Health Affairs, Jan./Feb. 2007).

Cuts in future Medicare funding -- what Obama calls "savings" -- will mean less help in coping with aging and possibly shorter lives. Do we really want to treat our seniors like clunkers?

Betsy McCaughey is chairman of the Committee to Reduce Infection Deaths .

You can call it half assed death panels if you like. One way or another the outcome will be the same.