Live data from Hacker News

I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

merricklozano.com

11–20 of 29 posts

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#11
post #9

IANAL and I have not read the complete unabridged text of the bill but so far as I can tell the only piece that is likely unconstitutional is the individual mandate, correct? The commerce clause can be very powerful provided commerce is already taking place but I am not aware of precedent allowing it to coerce one into commerce in the first place. Is there such a precedent? Would the existence of such a precedent be…

That's an open question. The legal term is "severability". Sometimes an entire law (or contract) will be struck down if one part is found to be illegal or invalid. Other times just the invalid part will be cut out, and the rest will still be enforced. It can go either way, depending on very specific details of the law (or contract), drafting history, previous precedents, etc.

Often, a law (or contract) will contain a severability clause specifically saying what will happen. (Contracts almost always say that the contract should stand if any clause is found invalid.) The problem here is that the ACA's drafters (perhaps foolishly) did not consider the possibility of a constitutional challenge, and did not include a severability clause into the law.

If the mandate is found unconstitutional, the court will also need to rule on the severability question; it's very uncertain at this point which way they'll rule (if they have to rule at all).

(Bonus question: Do we want the ACA struck down if the mandate is struck down or not? The law does a lot of things, some of which are quite good, and would still work just fine without the mandate clause. On the other hand, guaranteed issue and community ratings without a mandate might completely destroy the health insurance market, without replacing it with anything else, which would be a disaster. The Court is highly unlikely to rule that it's partially severable, so we'll probably see the whole ACA struck down, or only the mandate. In theory, Congress could fix it either way the next day...but in practice it's likely to be terrible deadlocked. Messy.)

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#12

Some people aren't in a position to take on the risk of entrepreneurship. Counting those with significant medical conditions among them doesn't strike me as abnormal. If society is geared to reward risk takers who succeed, it seems that if society were then to eliminate a good deal of that risk, something in the arrangement would be lost. How is universal healthcare any different to start ups than a government funded…

Seriously? You can't compare a luxury item like a sports car, or a magical "government startup insurance" with medicine. Neither of those other two items realistically reduce actual pain and suffering, while providing health care universally can definitely be shown to.

I'm a Canadian and quite happy with our socialized health care. It's one of the reasons that I've been able to make the leap into entrepreneurship - I'm on my third product now. I have no pre-existing conditions, but I know that I'll receive no life-ruining bills from the government if something does change in my health situation.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#13
post #3

Healthcare isn't a right. End of story.

Assuming this is not a blatant troll, but someone severely ignorant on why we have healthcare. If you're a troll, please excuse me for wasting my time.

So?

You think it's good for the society to operate as a lottery? Those who get sick die or endure lifelong misery, and those who don't get to enjoy a productive life. You think the sick will just disappear and stop bothering you with their constant wheezing?

Maybe you should learn from the history of humankind and what access to healthcare has done to benefit us all (and not just those who get sick).

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#14

What are the chances that if the Affordable Health Care act is found unconstitutional that America gets universal health care in the next decade?

I realize that universal health care is not on the table today, but I do hope we can change that over time.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#15

Some people aren't in a position to take on the risk of entrepreneurship. Counting those with significant medical conditions among them doesn't strike me as abnormal. If society is geared to reward risk takers who succeed, it seems that if society were then to eliminate a good deal of that risk, something in the arrangement would be lost. How is universal healthcare any different to start ups than a government funded…

The average age of a tech startup founder is 39, and a % of those have families. They should not have to risk financial ruin as a tradeoff for starting a company that could provide jobs.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#16
post #6

Your friend is doing it wrong. Instead of shelling out 17k/year, get a 5k deductible policy, and pay for the doctor visits yourself. put the 5-10k you save per year in some sort of investment you can get at when you really have to. Something like an index fund if you're young, or bonds if you're older.

Those 5k deductible policies still cost $500 a month for family in a small group and leave you really exposed to 15k per person (max out of pocket) and max 45k out of pocket for the family. That's not inline with what healthcare should cost. An individual may pay $75 for that same policy but still have exposure of around 15k per year max out of pocket.

The HSA plans are just as expensive as middle of the road plans as well and are geared towards people who save a lot to begin with.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#17
post #15

Some people aren't in a position to take on the risk of entrepreneurship. Counting those with significant medical conditions among them doesn't strike me as abnormal. If society is geared to reward risk takers who succeed, it seems that if society were then to eliminate a good deal of that risk, something in the arrangement would be lost. How is universal healthcare any different to start ups than a government funded…

The average age of a tech startup founder is 39, and a % of those have families. They should not have to risk financial ruin as a tradeoff for starting a company that could provide jobs.

Exactly. I'm in this position now: a single breadwinner with a child. As a Canadian, I don't risk financial ruin for any health-related issues (unless I travel to the US without health insurance, of course).

This was a big factor in me making the jump to founding a company from up here in Canada. Hiring folks with families in the USA was a huge pain for us, specifically because of the health care issues. We were paying a lot for them to extend their current health care from their previous employers, and one had the added stress of having a pregnant wife at the time we brought him over, with all the complications that brings to the health insurance story.

Hiring a fellow Canadian was basically a cakewalk.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#18
post #9

IANAL and I have not read the complete unabridged text of the bill but so far as I can tell the only piece that is likely unconstitutional is the individual mandate, correct? The commerce clause can be very powerful provided commerce is already taking place but I am not aware of precedent allowing it to coerce one into commerce in the first place. Is there such a precedent? Would the existence of such a precedent be…

There are such precedents. Right wing lawyers and bloggers tend to deny that such precedents exist, and left wing lawyers and bloggers tend to say that they have more meaning than they probably do—but there are precedents.

Probably the best example in Linda Greenhouse's essay for the NYT (http://opinionator.blogs.nytimes.com/2012/03/21/never-before...) is the Emergency Medical Treatment and Labor Act (it prevents hospitals from refusing care to uninsured patients; this coerces hospitals into commerce. (That a law had to be passed to make this the standard is IMO disgusting. Obviously the Hippocratic oath applies only to doctors and not to hospital bean counters.)

It's worth noting (a few paragraphs later) that EMTLA has a knock-on effect, too: you or your employer pays for all of this uninsured/underinsured treatment through higher premiums. Greenhouse: "The uninsured don’t exist apart from commerce. To the contrary, their medical care results in some $43 billion of uncovered health care costs annually and, through cost-shifting, adds $1,000 a year to the average cost of a family insurance policy. People who don’t want to buy broccoli or a new car can eat brussels sprouts or take the bus, but those without health insurance are in commerce whether they like it or not." This 1986 law actually makes your insurance more expensive, forcing you into commerce that you may not be interested in.

The flaw with Obamacare—and the only way it could have been passed because of the complete and total insanity of American politics today—is that it doesn't actually establish universal healthcare. If the individual mandate had been instead cast as a tax which is then used by the individual to select their insurer (IIRC a key feature of the Clinton healthcare plan that was scuttled), then it would have been no different than Social Security (which has whiners saying "but I will have a better retirement plan, so why should I be paying this?"—tell that to the people living large on their Enron 401(k)) or school taxes (which has childless and empty-nest whiners saying that they don't get benefit from schools) or anything else where there's a mandate that you pay something for a benefit that you may or may not use in a particular year.

Better yet, look at the houses that burned uncontrolled in the Tennessee county for want of a $75 annual fee (http://streeteasy.com/nyc/talk/discussion/22973-free-market-...).

Sorry. I'm completely baffled by what's happened to American politics in the last decade. I was disgusted enough with what was going on during the Clinton years that it was an easy choice for me to emigrate to Canada (not perfect, and some of our politicians are emulating American belligerence a little too much, especially the local moronic mayor), but now I don't even recognize the country in which I was born. It saddens me.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#19

What are the chances that if the Affordable Health Care act is found unconstitutional that America gets universal health care in the next decade?

Zero, seeing has AHCA doesn't provide universal health care either (but it's a baby step in the right direction).

According to what I understand, the U.S. has had three chances at something approaching universal healthcare—in the late 60s/early 70s around the same time that Canada was dancing around the same question; in the 90s under Clinton; and under Obama. Given that it took about fifty years after Canada[1] to even get this passed…it will likely be a long time before anything rational gets passed.

[1] Per Wikipedia, the Federal framework for jointly-funded universal healthcare in Canada was passed in 1966 under Pearson, and it was strengthened in 1984. OHIP was first created (as OMSIP) in 1966, reinvented in 1969 (as OHSIP), and finally renamed in 1972 to OHIP.

Re: I Hope the Supreme Court finds the Affordable Care Act Unconstitutional

#20
post #3

Healthcare isn't a right. End of story.

Most citizens of civilized countries—and a number of countries that certain folks in the U.S. consider 'uncivilized'—would disagree with you.

In fact, they would largely say that healthcare is not a free market and shouldn't be treated as such under any circumstance.

I happen to agree with them, which makes me happy I live in Canada, where most citizens and doctors agree with me on that matter.

Post reply on HN