NPR: A Ruling Against Obamacare Would Have Broad Implications

NPR.org ^ | 03/04/2015 | John Ydstie

[depressed in 06]

The consequences are not any greater than what zerOcare now incurs.

[familyop]

I scored a “picket fence” on my ASVAB, but I became a combat engineer (light, no construction, infantry-related type). So the ASVAB lied. I wasn’t so smart after all!

;-)

[Moonman62]

Somehow despite Republican control of the House and Senate, NPR continues to be funded.

...

That’s because the Uniparty is in control. See my tagline.

[bert]

NPR is defended by layers of barb wire, sandbags and machine guns

The way to disrupt NPR is to have republican governors retake their state funded and operated public radio stations. rather than attempt a frontal attack on an extreme strongly defended position, a flank attack on public radio can be successful by governors

[Oldeconomybuyer]

NPR: A Ruling Against Obamacare Would Have Broad Implications

It's that pesky Constitution again.

[1010RD]

Note bene the camera angle. There are probably 20-40 people protesting tops and they got in their cars and drove to warmth right after the cameras left.

[1010RD]

You stopped too soon. Wickard v. Filburn threw all that jurisprudence out. Stare decisis is so 19th century.

https://supreme.justia.com/cases/federal/us/317/111/case.html

[Amendment10]

"Wickard v. Filburn threw all that jurisprudence out."

Using terms like “some concept” and “implicit,” here is what was left of the 10th Amendment after FDR’s activist justices got finished with it in Wickard v. Filburn.

“In discussion and decision, the point of reference, instead of being what was “necessary and proper” to the exercise by Congress of its granted power, was often some concept of sovereignty thought to be implicit [emphases added] in the status of statehood. Certain activities such as “production,” “manufacturing,” and “mining” were occasionally said to be within the province of state governments and beyond the power of Congress under the Commerce Clause.”—Wickard v. Filburn, 1942.

FDR’s thug justices had essentially reduced the 10th Amendment to a wives’ tale imo.

[1010RD]

Totally agree, but now imagine the CC in the hands of a conservative AG and POTUS. I think you could undo a lot of state laws that interfere with interstate commerce.

[DannyTN]

No I've worked for corporations that owned hospitals, clinics and other medical services. After reading that AG opinion, it seems that there are some restrictions on ownership, especially sole proprietorships. But the medical practice itself always really relies with the individual licensed doctor.

So the revolutionaries fought to over through a national tyranny only to invoke a state tyranny?

If licensing physicians is so tyrannical, why haven't any of the 50 states done it differently? Maybe you're advocating chaos. Just because you don't like it doesn't make it tyrannical.

Why not a hospital across the street from another hospital?

Baptist, St. Thomas, Centennial(HCA), Vanderbilt and VA are all within a 5 block radius in Nashville. There is actually 25 hospitals in Nashville. 10 in the downtown area.

There are indeed boards that regulate it. But if you know your economics, you know that in any industry with sufficient profits, that profit is eventually driven to zero and probably negative, before industry rationalization kicks in and some competitors drop out. You don't want that with hospitals. You don't want to go to a hospital on the verge of bankruptcy.

So to attract the kind of intense capital investment that hospitals require, they do limit the competition some. But that's a state thing, not a federal thing. All you need to do is find a state that doesn't do that.

It probably stems from when Medicare reimbursed hospitals on a cost basis.

[1010RD]

OK, Danny. You’re right. Free market competition in medicine would lead to a disaster.

Think man, think.

[DannyTN]

There are things we should do to promote free market competition.

1. We need to enforce the old anti-trust laws that says you can't charge one person different for a service than you charged another person. That would undo some of the mess that the insurance companies have created.
2. We need to publish rates. People have no clue when they go to a doctor what they are likely to get charged. And it's usually the last thing on your mind when you need a doctor. The Feds put together a list of what hospitals charge for each procedure, but they charge a lot of money for it, so it's not available to the public. Things we don't need to do includes stop requiring doctors to be licensed. That would cause people who have little or no education to start promoting themselves as doctors.

[1010RD]

Which anti-trust laws would you apply and how did they make things better historically?

Also, what if a medical caregiver had to, by law (because fraud must always be illegal) (fraud defined here: http://definitions.uslegal.com/f/fraud/ so that we are discussing using like terms) had to declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state, would that be a good law?

[DannyTN]

I'd apply the law that said you couldn't price your service differently to different people. They made the HMO's and insurance companies immune to pricing related lawsuits. So the HMOs started sending out 70% off of normal pricing contracts. Providers in turn, raised their prices by 4x so that they could get a reasonable reimbursement rate and still participate in the insurance networks. Get rid of the provider's ability to charge the insurance company one thing and an uninsured person another. Then make the rates public.

Also, what if a medical caregiver had to, by law (because fraud must always be illegal) (fraud defined here: http://definitions.uslegal.com/f/fraud/ so that we are discussing using like terms) had to declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state, would that be a good law?

No. You didn't get rid of the licensing, so by implication you're proposing that they make that information available because they will now be competing against people who didn't go to school. That's not a good law because it allows people who are not qualified to hold themselves out as doctors. People who aren't qualified shouldn't be practicing medicine, period.

[1010RD]

Let’s hold off on the first part with all the new laws you’d like to see put in place and just focus on the second.

Under a free market the consumer is king. Your issues, along with most of the country’s, are that lack of free market competition and transparency.

So under my scenario a medical caregiver had to, by law, declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state.

Isn’t that just consumer choice?

You and I both have a back ache, that won’t go away. We both go look for a person to treat it.

Under my law we find two doctors: Dr. A and Dr. B.

Dr. A declares that he attended NW Medical and was duly licensed by the state. He presents the proof. He states that he’ll treat your back ache for $500.00.

Dr. B declares that he too attended NW Medical, but is not licensed by the state. He presents the proof. He states that he will treat your back ache for $150.00.

They’re equal in all other ways.

Which doctor do you choose and why?

[DannyTN]

Licenses do more than just show they attended school. They still have to pass the boards indicating that they actually know what was taught. And licenses can be revoked for incompetence or misbehavior.

Unlicensed people should not be practicing medicine.

And the rates should be public, in most cases people don’t have a clue until they get the bill.

[dragnet2]

A Ruling Against Obamacare Would Have Broad Implications”

To sum up;

In other words the fix was in, it's a done deal, and government is going to do what the hell it wants.

The pattern repeats itself over and over.

[1010RD]

I understand your position. It’s that no one should practice medicine (and perhaps any other trade) without government testing and licensing, correct?

Here’s my example and I’m genuinely interested in your answer:

You and I both have a very bad and persistent back ache.

We both go look for a person to treat it.

Under my law we find two doctors: Dr. A and Dr. B.

Dr. A declares that he attended NW Medical College, passed all the necessary classes and was duly licensed by the state. He presents the proof and it’s the truth. He states that he’ll treat your back ache for $500.00.

Dr. B declares that he too attended NW Medical College and passed all the necessary classes, but is not licensed by the state. He presents the proof of all the foregoing. He states that he will treat your back ache for $150.00.

They’re equal in all other ways.

Which doctor do you choose and why?