Late-innings Hardball in Health Care Push

With time and tempers short, everyone's playing hardball in the drive to pass, or stop, President Barack Obama's massive health care legislation by the weekend. AP's Mark Smith reports. (March 16)

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News & Politics

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• health_care_overhaul

[BeantownJim]

Ron Paul 2012

[freakawill2000]

@cdog4100

Thank you for finding that for me. You were right. It did upset that sense. That means Congress has the power to do practically whatever they want then. I don't think that is what was originally intended, but I can see the logic and it is the law. But under the same logic, Congress can regulate commerce inside foreign nations. That doesn't seem very "nice". Hmmm....

[cdog4100]

@freakawill2000 cont t. This is the same reasoning that allows feds regulate minimum wage, United States v. Darby (1941), Equal Employment act. See Heart of Atlanta Motel., Inc. v. United States (1964), and even illicit drugs (sorry no cite for that one). The constitutional challenge to the health care law is a long shot . . . but it is likely that Thomas will agree, because he is an originalist and likely hates the decisions I just cited. But they are law, and stare decisis has some pull.

[cdog4100]

@freakawill2000 Well, as I understand the supreme courts interpretation of the interstate commerce clause, the Supreme court has interpreted that Fed Gov't can regulate any economic activity that, in aggregate, has an effect on interstate commerce. Wickard v. Filburn, 317 U.S. 111 (1942) is Supreme court case that everyone cites. Its a big one, can probably find it on wikipedia, and it will likely upset your sense of Federalism. (It does for me.)

[freakawill2000]

@cdog4100

But what about forcing people to buy health insurance? There is no federal grounds for allowing that. State by state, I am unsure. But federally, congress was not given that power except in cases of interstate commerce. If you choose not to engage in commerce, how can it be regulated? I know that is a talking point, but I want to see an argument against it.

[cdog4100]

@freakawill2000 Ok, that's if they negotiate. Let's move on to the bigger point, because the solution to the problem that you have with insurance companies having to raise premiums to cover defaulters is fixed if everyone has insurance, because then NO ONE defaults. And, they are likely to seek care at an earlier stage (and thus cheaper care). This is exactly what, in theory at least, this health care law does. Will see how it works, but that is at least the economic theory behind it. QED.

[freakawill2000]

@cdog4100

I know the difference between mine and yours. In yours, the cash payer doesn't pay everything. In mine, they do. So if they default, it costs more. If they pay everything up front, it is cheaper. That sounds reasonable.

[cdog4100]

@freakawill2000 I don't need anecdotes, I consulted for the industry for 2 years. They raise the rates for individual cash payers because they are non negotiated rates. HMO/PPO rates are significantly lower. When the individual defaults, those losses are allocated across the board. Most insurance plans are based of of HCPCS base rates, and hospitals will over charge by billing duplicate codes. Without medical bill review (services only Insurances comps can afford) the individual gets hosed.

[freakawill2000]

@cdog4100

And I can tell you that it is true because that is exactly what happened to my aunt. In fact, you can go through hundreds of doctor's testimonies saying they charge the insurance people more because they don't get as much money from cash payers.

[cdog4100]

@freakawill2000 That's just not true. I can tell you unequivocally that hospitals charge more for a single payers than insurance, because insurance companies have better negotiating power. Google "medical bill review" and look at the companies that make TONS of money working for insurance companies beating down hospitals on complex medical procedures. Single payers, however, don't realize that you can negotiate, and don't have time or the power to do it effectively.