Constitutional – Part 2

Remember in late March when political pundits, writers, and journalists, from across the ideological spectrum, lambasted Solicitor General, Don Verrilli, for what was thought at the time, an inadequate and weak defense of the Affordable Care Act.  Recordings from the hearing gave much political fodder, as Verrilli stumbled through his defense and gave a few lack luster answers to questions from the conservative Justices.  Grainy audio of the defense was even used in an ad attacking the Affordable Care Act. Well, after the events of this morning, Verrilli has been vindicated.

As I’m sure you’re aware, the Supreme Court made a 5-4 decision upholding the Constitutionality of the Affordable Care Act. Surprisingly, the swing vote came from, normally conservative, Chief Justice Roberts.

Now, back in March, when Verrilli was getting heat for his performance, critics attacked his use of the Commerce Clause to defend the individual mandate – that got all the headline news.  What got little coverage was the fact that this was not the only defense used by Verrilli to justify the individual mandate.

He also argued the penalty imposed by the Affordable Care Act for not purchasing healthcare was essentially a tax, which the United States government absolutely has the power to levy. This defense proved convincing enough for Chief Justice Roberts, and is the reason he decided to side with the 4 more liberal Justices on the issue. Basically, the government cannot force anyone to buy health insurance, but it can tax people who choose not to.

It should be noted that justifying the individual mandate using the Commerce Clause was deemed unconstitutional; this time Justice Roberts agreed with the 4 conservative judges.

Another issue resolved from the ruling deals with the expansion of Medicaid. Under the Affordable Care Act, Medicaid was expanded to cover more low-income Americans. This is going to be accomplished by increasing federal expenditures to the states’ Medicaid funds. (Medicaid is already state-run insurance funded by the federal government) The issue with the expansion of Medicaid was what to do with the states that did not want the money. Justices Ginsburg and Sotomayor held that it was Constitutional to strip states, which did not want the expansion, of all of their Medicaid funding. However, the other Justices felt this was an overreach in Congress’s power. What they settled on was states who did not want the expansion would be left alone. But states that did agree to the expansion must follow all the rules and regulations that come with the extra funding.

Overall, the vast majority of the law was deemed Constitutional with the one caveat about the Medicaid expansion. The ruling was a big win for Obama and the Democrats, but hopefully in the future this ruling will be seen as a win for everybody.

Constitutional!

It appears as though the individual mandate has survived. The SCOTUS blog has reported that the ACA is constitutional with Justice Roberts voting left.

While we wait for more information and details to come, I think this is a shining example of how the Unites States political system is supposed to work.  So much of the news this week was about how the Supreme Court has become politicized. It is refreshing to see something not fall on political lines. It is refreshing to see lawmakers do the right thing.

Let’s not forget, beyond all the heated political rhetoric that went along with the ACA, the law itself was not about politics. The heart of the law was to ensure the millions of uninsured Americans in this country have access to affordable health care. Thankfully we are now one step closer to achieving this goal.

More to come later.

One Chart Republicans Don’t Want You to See

With the Supreme Court decision on the Affordable Care Act not coming until Thursday now, I feel the need to post once more on the healthcare debate.

Republicans have done a phenomenal job of selling the Affordable Care Act as the single most destructive piece of legislation passed by the Obama Administration. Even though the idea for the law was thought up by Republicans over 2 decades ago, and is full of Republican ideals like personal accountability and getting rid of freeloaders; Republicans still say it’s evil.  They’ve linked it to death panels, deemed it a job killer, and argued it is an attack on personal freedoms – how dare the government ensure all people have healthcare.

However, the most frequent and overused attack against the Affordable Care Act is that the law will create soaring deficits and an unsustainable national debt; it will place a burden of debt on our children and grandchildren.

(Just a side note: Republicans have to stop claiming every Democratic policy will explode our debt while their idea to solve all our problems is cut taxes – which will in turn increase the debt.)

They have repeated this line so many times that it has just become common knowledge: Obamacare increases the debt – Fact. Now, the reason I said Republicans have done such a phenomenal job selling Obamacare as destructive is that it is all a big lie. The Affordable Care Act will actually reduce deficits. The Affordable Care Act will actually save money. As the chart below shows, over time, Obamacare will actually work to reduce deficits.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Yes, contrary to Republican talking points, Obamacare is actually fiscally responsible healthcare reform. So the Affordable Care Act is centered on personal accountability, and it cuts the deficit – tell me again, why aren’t Republicans on board?

If ACA is Struck Down… What’s Next?

Any day now the Supreme Court will give its ruling on the  Constitutionality of the Affordable Care Act, a.k.a. Obamacare.   When the hearings were taking place, back in March, the media buzz did not spell a favorable outcome for the President and his healthcare law.  With signs pointing towards a 5-4 decision against the bill it only begs the question as to what’s next? Few believe that our healthcare system is perfect.  There are millions of uninsured people, costs are ever-increasing, and ideas to fix those problems are scarce at best.  Whether you like the President’s healthcare plan or not at least it was an attempt to fix those issues.  So again, if the bill is struck down – what’s next?

Assuming the ACA is deemed unconstitutional we’ll have to start over and figure out a solution to the two main problems: Americans without healthcare, and the skyrocketing costs of healthcare.  Here are some ideas.

First, there needs to be competition and transparency in the insurance market.  The current insurance market creates a system where insurance companies are rewarded for covering healthy people while denying insurance to the sick. How do we fix this problem? Get rid of denying healthcare due to pre-existing conditions. Which by the way is part of the ACA that is bipartisan supported. Then, set a minimum level of coverage that all insurance plans must provide.  This creates transparency in the system by guaranteeing some type of standard coverage on which all people can rely, and prevents insurance companies from charging high premiums for plans that cover little.  It also creates a competitive market where insurance companies will work to offer less expensive coverage in order to attain more customers. Just like the free market is supposed to work.

Second, programs already in place need to be more accessible to more people.  Allowing more people to enroll in Medicaid potentially drives down costs in the long-run and insures more people at the same time.  A recent study was done where researchers enrolled uninsured people into Medicaid and the result was substantially lower costs (almost half as expensive).   By giving people, who tend to use emergency rooms for their primary care, actual primary care, it dramatically reduced costs.  In doing so, no longer will minor illnesses or nagging injuries turn into much more serious and much more expensive emergency room visits.  This means more people being covered with fewer government dollars being spent.

Third, we have to keep Washington out of it. The inefficiencies of Washington are becoming more and more evident, and those inefficiencies cannot be carried into the healthcare market.  An independent board or committee, outside of Congress, needs to be implemented to control things like Medicare costs.  Too often is Congress paralyzed by the fear of voters and campaign contributors to even mention changing Medicare.  Well that needs to be changed.  This is why an independent board works well.  It’s main concern will be ensuring the solvency of Medicare and not catering to special interest groups.

Finally, we need to start paying doctors based on quality not quantity.  Our current system rewards doctors for performing unnecessary tests.  Rather than paying on a per procedure basis, we should be paying for treatment of the patient. In this system, doctors will be paid for treating someone’s illness as whole rather than all the individual tests.   This should work to reduce overall costs.

These are measures that should have bipartisan support. Republicans should like them because it lets the free market dictate costs and it lowers costs, which means lower deficits. Democrats should like them because they provide insurance to more Americans.

One last note: If you added an individual mandate to this list you would have the foundation for Obamacare. Sadly I didn’t come up with these ideas myself, no, these are all reforms created by the President’s healthcare law.  And as I said, most of these ideas should have bipartisan support. The problem; however, in the current political climate anything the President does is immediately wrong.  Even though much of the law is based on the Republican’s plan from the 90’s, the right now views it as a march towards a socialist takeover of healthcare.

The Affordable Care Act is not a perfect plan by any means, but it does have a lot of good ideas and possible solutions to the problem of healthcare.  Which arguably is the biggest problem the country faces.  It’s a shame Republicans have completely rejected it because it was implement by a President they don’t like.

Waiting For Washington

After a couple consecutive jobs reports filled with not-so-great news, May’s jobs report only worsened that trend. 69,000 jobs were created (way less than expected) and unemployment ticked up to 8.2 % from 8.1%.  A pattern is developing. In both 2010 and 2011 the beginning of the year was marked with the hope of economic recovery; however, come April and May those hopes were stunted by a slumping economy – exactly what we are seeing now.  So the question I’m asking is how long is Washington going to continue to do nothing?

The Republican’s fix to our economic woes is to reduce the national debt by decreasing government spending and cutting taxes – somehow this will get the economy back on track. It seems the right forgot Europe already tried spurring on economic growth through spending cuts and it only made their economies worse off.  Also, counter to their goal, the austerity measures implemented have increased the debt of many of the Euro countries.

Phase 2 of the Republican plan is tax cuts, which have proven to be incredibly ineffective especially when compared to actual government consumption. Not to mention tax cuts only add to the national debt.  Republicans need to stop laboring under the delusion that tax cuts pay for themselves – (cough) the Bush tax cuts (cough).

So if we follow the Republican plan, not only will the national debt increase, but it simply will not help with economic growth.  What we need for a robust recovery is an increase in actual government consumption. Government needs to invest in things like  public works projects and infrastructure rebuilding. The key to recovery right now is not to drastically cut spending but to increase spending where it can make a difference. (I will admit; I’m upset few Democrats are willing to take this stance, but it is due in large part to an uncompromising right who views any government spending as a socialist policy)

I know Republicans reading this will be fuming at the thought of more government spending. I can hear their arguments now; ‘we’ve already spent trillions of dollars and what do we have to show for it – unemployment above 8%.’   The flaw in their argument though is government consumption is relatively low given the magnitude of the recession. The explosion in government expenditures came mostly from increased safety net expenditures (unemployment benefits, food stamps etc.), ever-increasing health care costs, and tax cuts, not from government consumption and investment.  We need government spending that works toward putting people back to work, only then can we expect our economy to return to normal.

One last note: I’m not asking for extreme left-wing policies.  All I’m asking for is government consumption and investment to be at the same levels as when President Reagan faced a recession.

The Fracking Problem: People are Human

If you talk to proponents of fracking they like to spout the line that hydraulic fracturing is actually completely safe and all the negatives associated with it are simply misplaced. You might be thinking, but what about the multiple cases of aquifer contamination, or the earthquakes in Ohio, or methane leaks that could possibly make fracking a greater contributor to global warming than coal – none of those are caused by fracking? Well technically no. Technically, the pro-frackers are correct.

Aquifer contamination and methane leaks are caused by poor or faulty well construction, and the earthquakes were caused by the improper disposal of fracking liquids. So it’s not the actual hydraulic fracturing that causes the problems; the problems are caused by errors in the fracking process not the fracking itself.  Kind of like saying guns don’t kill people it’s the bullets. The result is we get those in the industry crying out that fracking unfairly gets a bad reputation, and it is neither a threat to our communities nor our environment.  They claim we just have to prevent those mistake and errors from happening, and then we will finally have ‘safe, clean’ energy. So basically all we have to do is make sure people aren’t human.

And there lies the problem. The consequences of fracking are essentially unavoidable; people are always going to make mistakes. The one obvious solution to minimize this problem (still not end it though) is more regulation, which most industries fight tooth and nail to avoid.  So the actual act of fracking may not be harmful to the environment, but the same cannot be said for the process as a whole. The process will always be subject to human error that can lead to devastating effects for both people and the environment.