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Lincoln Mitchell

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One-Sided Passion Over Health Care Case

Posted: 04/ 4/2012 8:35 am

The Supreme Court case of Department of Health and Human Services v. Florida which is seeking to overturn the health care bill passed by President Obama in 2010 is creating an interesting and telling political dynamic. Efforts to repeal the bill, particularly the individual mandate which requires uninsured Americans to buy health care or else face a fine, may seem extremely polarizing at first glance, but it is not that simple.

The polarization and passion around this case is largely one-sided. Conservatives, for a number of reasons, some having to do with wanting to limit the reach of the federal government, others more due to extreme and irrational hatred for President Obama, want to repeal the bill. Progressives, on the other hand, do not feel a similar passion. Very few people on the left believe that a mandate requiring people to buy health insurance is the kind of thing that is truly worth fighting for. Many progressives, and conservatives, seem happy with parts of the bill, such as requiring insurance companies to cover pre-existing conditions, but there is little excitement on the left for the individual mandate, or even the bill in its entirety.

The discussion and the debate around the health care bill, even following its passage, illustrates the disconnect between the Obama White House and the activist wing of the Democratic Party. The bill itself was viewed as a tremendous, even defining, accomplishment by the White House, but many progressives saw the bill as a badly put together compromise which cost the country its best chance at a genuine single payer universal health care program for at least a generation. Similarly, while the Obama administration, and its right wing activist opponents, the two sides represented in current case, see this bill as a major piece of legislation which will meaningfully, for better or for worse, change the country, many ordinary Americans have already forgotten about the bill, partially because it has not yet had time to make an impact, but also partially because it not the major piece of legislation that the White House and its opponents seem to think it is.

It is in this context, as well as that of a presidential election, in which the court's decision will be made. The court could uphold the law, overturn the individual mandate or overturn the entire bill. Regardless of the decision, the right will be able to use the case and its outcome as a way to mobilize the base. If the bill, or any part of it is overturned, they will argue that the courts agree that Obama is trying to unlawfully expand the government and needs to be stopped. If the bill is not overturned, the right will fall back into its now familiar, and tiresome, narrative of victimhood and mobilize its base by arguing that they now have to fight even harder to defeat big government.

For Obama and the Democrats, the decision will have a very different impact. If the law is upheld, it will be a big victory for the White House, but not for the progressive movement. On balance, many on the left will be pleased by this verdict but it will fall short of being the kind of decision that will mobilize progressive activists or that is viewed as a meaningful triumph. If the law is overturned, it will be a reminder of the import of the Supreme Court for presidential elections, but in the context of the now accelerated right wing attacks on women's rights few progressives need any reminder of this.

Currently, it seems as if health care reform is one of the major accomplishments which the Obama campaign will cite in their efforts to secure a second term for the President. If the bill is overturned by the Supreme Court, it is likely that the Obama campaign will focus on other accomplishments, such as the gradual economic recovery or the killing of Osama bin Laden. These issues are more likely to resonate with voters than the health care bill which is mostly remembered by Obama swing voters as a polarizing and ugly fight.

Therefore, losing this case would be a defeat for the Obama administration, but it does not have to be a devastating one. If the bill, or part of it is overturned, the right wing will, rightfully, present this as a major accomplishment, but it is an accomplishment that does little more than excite an already mobilized base. The Obama administration must find a way to take this defeat in stride if it occurs. Passing the bill was never the huge victory the administration thought it was, so seeing it overturned does not have to be experienced as a huge defeat. The administration would be best served by minimizing not just the defeat, but the bill itself by not talking about it much and moving on to things, like the recovering economy or the extremist social policies of the Republican Party.

 
 
 

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Craig Casey
Nobamacare! Entitlements & taxes must be cut.
04:01 AM on 04/05/2012
The health care bill passed by President Obama in 2010? Really? I thought Congress shall pass all laws. Which is why the socialist don't like the term "obamacare."

Extremist social policies of the Republican Party? Obamacare looked to expand Medicaid by 20 million, that is an Extremist social policy. Get your facts straight!
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LeftCoastEng
Obsessed with failed trade
07:22 PM on 04/04/2012
How could you not mention that there are about 50 million people that don't have health care? Yeah, no biggie.
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HUFFPOST SUPER USER
Nomccain
05:29 PM on 04/04/2012
If this health care bill is overturned, the Republicans and the American people are going to be the losers. The Republicans are going to be held accountable for the reversals of the good points of the plan such as doing away with pre-existing conditions and allowing teenagers to stay on their parents policies longer. Moreover, when this system becomes unaffordable for many more people, as it will, the democrats can hang the Republicans for increased costs and less coverage as more and more Americans suffer. Their failure to address this critical issue and seek a solution will come back to haunt them. They may feel smug now, but the snake is going to turn on them down the road and it's not too far off either.
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Craig Casey
Nobamacare! Entitlements & taxes must be cut.
04:05 AM on 04/05/2012
Based on the additional $5 trillion we are now, are you sure you don't want to change your username, "Nomccain?" Maybe you will after your currency is worthless and Obama's work is complete, the destruction of our credit rating.
justobserve
Not left nor right or center. Just a free thinker!
03:39 PM on 04/04/2012
If the Supreme Court is not unanimous in deciding the HCR's mandate constitutional or not then why is it that its constitutionality depends on the interpretation of a few judges, as in even all the SC judges can't agree on it? What a weak system! It should be uninamous or it's off!
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HUFFPOST SUPER USER
rigmoten
RELEASE THE TAXES
03:32 PM on 04/04/2012
Weird that the progressives aren't as invested in protecting a heritage "solution" to our health care system as conservatives are in hurting Obama.
07:35 PM on 04/04/2012
Just to let you know, the conservatives wanting to hurt Obama aren't all that passionate about overturning the individual mandate. They think losing that issue could make it harder to win the election, so they're mixed about it. They still bring it up for the cheap political points with the base, but it's pure lip service. They can't even explain any of the logic behind why people care or anything, and a lot of Republicans (just like I'm sure most Democrats) are very frustrated with those politically-driven Republicans for putting politics ahead of actually fixing our long-term problems.

But most of the in-depth articles you see (like ones from Avik Roy, Rivken, Ilya Shapiro, etc.) are from people that really believe the individual mandate will permanently grant the federal government the power to require purchases of arbitrary things just as easily as they pass regulations. And we're just as scared of someone like Bush Jr. having that power as we are of someone like Obama having that power, and we're definitely scared to death of Romney getting that power since he's used it before. Considering it looks like it will be Obama v Romney in the fall, we're scared to death because either one is completely untrustworthy with such a powerful legislative weapon.
12:54 PM on 04/04/2012
Chiding the SCOTUS doesn't seem "one-sided" to me. "Duly constituted", as the President called AHCA does not mean Constitutional--unless you're not a fan of "word of the day".

You can't be the champion of the underclass unless you have a majority of underclass people. Simply put you must make more voters by promising more of the things they want whether they can afford it or not. You're not really improving their means just making them feel better and beholding to their benefactor.

Social Democracy is like Halloween. The problem with handing our free candy is sooner or later you'll run out. When that happens you get your house TP'd or egged.

It's more like Liver than Broccoli. You either HATE it or LOVE it.

Whether you like it or not, SCOTUS decides, as a CO-EQUAL branch of the Federal Government, the CONSTITUTIONALITY of LAWS and NOT the POPULARITY of LAWS.


"Don't interfere with anything in the Constitution. That must be maintained, for it is the only safeguard of our liberties." A. Lincoln
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Craig Casey
Nobamacare! Entitlements & taxes must be cut.
04:07 AM on 04/05/2012
But he's the anointed race baiter. Obama made a career out of being the token underdog. He's elevated class warfare to an art form. No wonder Obamacare is such a mess! http://www.slideshare.net/CraigJCasey/reasons-why-i-hate-obamacare/
frankiebarbella
hell hath no fury, like a bureucrat scorned!
12:46 PM on 04/04/2012
Lincoln makes and interesting argument regarding the passion of the leftwing activist who want a single payer medicare for all type system. I am a believer that this type of system exceeds federal authority, but it does not exceed state authority. This argument has been waged for more than 6 decades at the federal level. Instead of making this a federal issue and running into constitutional challenges, why not attack it at the state level. Which brings me to a question, why hasn't it been attacked at the state level? There are 50 dual sovereign entities that could experiment with such a system and not one of these entities in either blue or red states have tried a universal medical services approach. Why? I suspect that many of the more progressive states could possiblly advance such legislation with electoral ease, yet they have not. Why?
01:18 PM on 04/04/2012
Because the states did try this almost 100 years ago and it failed. New York made the main effort, the state attempted to enact a health insurance program in 1919 and it went down to defeat. State health insurance programs were defeated in every state they were introduced. Doctors opposed state plans because they feared capitation payments would reduce doctors' incomes, while states rejected these insurance plans because they feared sick people from other states would attempt to take advantage of the health insurance policies enacted by a single state.
frankiebarbella
hell hath no fury, like a bureucrat scorned!
01:47 PM on 04/04/2012
So if states cannot do it, why should the fed?
HUFFPOST SUPER USER
mjclear
12:07 PM on 04/04/2012
There is passion on the Progressive side supporting the Affordable Care Act, but it is tempered with the realization that the bill did not go far enough in establishing a system in which all citizens are assured care when needed.

We are happy with the parts, but the parts do not make a whole; as long as anyone is not able to access the health care system, it will not be a system that we can be fully supportive of.

As for the individual mandate: the argument that it is not the task of the Federal Government to require all of us to have insurance is laughably obtuse. We are mandated to pay into Social Security retirement, and we are happy to do so. We are mandated to pay into Medicare and receive its benefits, and we are happy to do so. Obamacare is no different.

The only real solution to the broken health care system will be universal care. Alas, it will be a while before most conservatives see that the solution is right in front of them.
12:22 PM on 04/04/2012
When you start with a flawed premise, you end with a false conclusion. SS is not a mandate. It is a free exercise of the governments taxing authority which rest in Article 1 section 8. This article, while broad is still subject to specific limitations i.e. if a direct tax, must be apportioned, if an excise tax (SS / Medicare), must be uniform, BUT an excise tax is NOT compulsory. A mandate is, which is why they did not put it under the taxing authority, i.e. why they called it a penalty.

The fact that you are so willing to be controlled cause you feel you get goodies is very scary. Cant wait until an imaginative politician creates a mandate on a topic you disagree with. lets see you argue then.

"when you trade freedom for security, you will find you have neither".......
DanBest
My micro bio is empty
01:08 PM on 04/04/2012
Mandates were cooked up by conservatives as an alternative to a singlepayer system. The parents of this child want to strangle it in the crib and it looks like thier partisans on the supreme court will allow them. I don't even understand what you cons mean by freedom anymore. SCOTUS just ruled that you can be strip searched even if you haven't committed a crime. You would think that would be considered unreasonable search and seizure, but not according to the same justices that think that isn't an assault on a person's freedom. But making someone buy health insurance so that they don't end up making us all pay when they land in an ER. Somehow that's an assualt on freedom? Dana, are you a woman? Is a transvaginal ultrasound just another name for a freedom wand? Come back when you can expand freedom to mean something other than a company's freedom to make a profit and a deadbeat's freedom to game the medical system. Neither deserve to be defended.
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cintirich
Support the Constitution, not talking points.
01:13 PM on 04/04/2012
Brilliant! F&F
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Craig Casey
Nobamacare! Entitlements & taxes must be cut.
04:20 AM on 04/05/2012
I don't remember allowing you to speak for me. Please define who "we" is. "I" am not happy paying into a bankrupt system.
11:53 AM on 04/04/2012
Never before in recent history has our nation faced the diverse calamities that has affected us. Our economic restraints has limited our ability to assist all disaster victims. Under the Republicans' plan it is a possibility that FEMA funds and other aid will be diminished. Mitt Romney who is the Republican leading presidential hopeful front runner has stated in an open speech " I care nothing about poor people." The Middle Class has limited resources to recover from a disaster rather by nature or man made. The poor has no resources at their disposal. If this nation elect any Republican with the Tea Party backing will find themselves worse off. This is not a kinder or compassionate Republican party. It is an open divisive and contentions party. Moderate Republicans are not speaking out against those who are determined to promote the current party plans. They fear for their own political future. Politics, economic concerns, and religion has converge to the extent that all three is undermining the basic premises of our nation. It will be disgrace to extend economic concerns above human concerns. Romney has stated "corporations are human." His ideological conclusions leave little room for doubt,that people of the lower end of the economic spectrum does not matter. It is this thinking that is sending signals to specific subcultures that this nation is opened for class warfare. Disasters, sickness, human suffering, and all human frailties will no longer be under consideration from a political perspective.
11:38 AM on 04/04/2012
Sums it up nicely for me: The National Association for the Self-Employed (NASE) continues to oppose the individual mandate. The lack of cost controlling mechanisms in the law along with the mandate put America’s smallest businesses in the difficult position of being required by law to purchase more expensive health coverage. In this difficult economic time, forcing small business to pay for costly health insurance without providing them with an affordable coverage option is too great a burden. The association, however, is supportive of the market reforms included in the law, but believes that Congress failed to address underlying issues of affordability when crafting the health care law.
justobserve
Not left nor right or center. Just a free thinker!
03:59 PM on 04/04/2012
That's why a universal system that has been tried and true all over the first world countries should have been the one we got to have. The HCR is piecemeal and that's why it has problems for its opponents to attack, but whose fault is that? The GOP must be laughing: they never intended to have the 50 million uninsured people to get insurance and the mandate was their own idea! They knew how to protect their rich insurers and pharmaceutical friends. Their mantra is "We don't need reform, we have the best health care system in the world". For rich people that is! Of course, money can buy anything for the rich.
nelthroppesq
Attorney in allentown,pa
11:31 AM on 04/04/2012
The right of which I am a part does not have an obsession with Obama. We do not like the way he plays fast and loose with the Constitution. We are opposed to the socialist agenda he seeks to impose. We have vewen adamantly apposed to the socialist Health Care system he seeks to impose with the goal being to create a single payer system in the end with a government bureaucracy in charge of providing and contolling this critical aspect of our lives. This idea of forcing people to buy Health insurance or be penalized clearly goes against the Constitution and to brush it off as a minior matter is typical of the Left. Justice Kennedy himself said that this changes dramati cally the relations;hip of the citizen with the state, Conservatives arte concerned and rightly so with this tampering with our Constitution. The Left should study the Constitution. There is more there than the 4th Amendment. This concerns more than just the electyion of Obama. It seems, hjowever that he has no deference to the Constitution as evidenced by his veiled threats at the Justices over the last few days.
03:27 PM on 04/04/2012
I fail to see how President Obama is playing "fast and loose" with our Constitution. Nor is there any reference in the Constitution to healthcare whatsoever. As for the structure of our government, as explained in the Constitution, the executive branch is only 1/3 of the government, while the Legislative and Judicial make up the remaining 2/3. Each branch has the power to check and balance each other, as so, no one group is allowed to become tyrannical over the populace. So while it may be called Obamacare in the media, it was not strictly his doing to pass these measures. Further, the 4th amendment talks about warrants, searches and seizures. I don't understand how that plays into your argument at all. Perhaps instead of charging people with their knowledge of the Constitution, you should take time to brush up on it yourself, or at least research better prior to posting.
11:24 AM on 04/04/2012
All persons should be concerned that the Mandate is an application of fairness and accountable justice. The Solicitor General and Administration made the wrong argument before SCOTUS. “Can Young Adults be force to engage in Health Care Commerce?”, is not the strong (correct) argument. The real issue is, Can Young Adults formerly engaged in Health Care Commerce drop out and stick society with the bill after taking all the benefits of achieving good health and education?

Through good parents or Medicaid, health care is provided. I was born in a hospital, received a Polio vaccine at 3 for day care, Multiple vaccines by 7 to attend school, yearly glasses at 12, dental treatments till 15, and treated for gym injury at 17. Now at 19 and healthy, I choose to drop out of health care system and stick society with the bills.

The IRS can send you a Tax Bill and ask you to prove Taxes are not owed. The IRS could also send you a Health Care Tax and ask you to prove one was not previously engaged in Health Care Commerce. But in America's entitlement society, it is my right to freedom that allows me to stick society with my health care costs and back stop me in case of catastrophe.
frankiebarbella
hell hath no fury, like a bureucrat scorned!
12:57 PM on 04/04/2012
What if you choose to self insure? As a grown healthy adult in my 20s I consumed approximately 1000$ in medical services in 10 years. Mostly in yearly check ups and routine services. However my insurance costs (which are really prepaid medical services) were approximately $50,000 in that same period. Should have I or my employer have to pay for services I do not consume? Should I be required to buy such insurance for services I will most likely not need? Should I have to be put into risk pools where I do not belong in order to lower the cost for complete strangers? Should the federal government be the entity to decide on the services, regulate the prices and be the bill collector as well? And most importantly, why are we not looking to the real issue, the cost of medical services and not the method by which they are financed?
HUFFPOST SUPER USER
Anne Rutherford
02:57 PM on 04/04/2012
Fine, if there is a provision for that. Most companies that self-insure must have sufficient savings and accounts to prove that. So, let's have you place $500,000 up front in a frozen account to prove that you can self-insure. I pay for other women to have OB services as part of my employer's health plan and that's what gives our group a community rating. As a women, I pay part of the cost of men's prostrate examinations - part of the group rating and pool. If you want to contain health costs, the rating pool needs to be broader, not smaller. Let's say you win, and then have an accident that costs more than the mythical amount you put away up front to be self-insured - who pays then, or do we let you die because you can't pay for your care and rehabilitation? In fact, a good portion of the cost of health care services is related to health care insurance practices and how services are paid. I'd be interested in hearing what you know about these issues and how you would resolve them.
03:34 PM on 04/04/2012
Do you want that hospital you plan on going to within a 1000 miles of you?
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11:08 AM on 04/04/2012
This article says, "it not the major piece of legislation that the White House and its opponents seem to think it is". That statement is immature nonsense, like someone stood up for a Middle-School dance. In the adult world, the perfect is the enemy of the possible.

Progressives for decades have been trying to do something to correct what passes for a health-care system in the U.S.

Before Obamacare, our system was 90% corrupt. Compared to every other industrialized country, it had worse outcomes for patients and was more expensive. However, federal law and policy guaranteed it to be very profitable for companies. For example, Medicaid can not by law negotiate prescription-drug prices. Taxpayers must pay the price the pharmaceutical industry demands.

Obamacare's Initial changes improve things to perhaps 80% messed up. That percentage lowers significantly as provisions phase in. The law will need tweaks. It will need some major extensions to really reign in costs.

If upheld, Obamacare provides a workable starting point. If not upheld, then for sure we need to elect both Obama and genuinely progressive folks to Congress and go with single payer.

Remember the so-called "Democrat" Senator, who actually represented Mutual of Omaha when health-care reform was making its way through Congress? Bribing him to go along was so obvious, that bribe had to be watered down in order for the bill to be passed.

That incident is exhibit 1 for the perfect being the enemy of the possible.
10:54 AM on 04/04/2012
I'm not enthusiastic about the individual mandate. What bothers me is that the Supreme Court, which I thought was supposed to be judicial as opposed to political, will render a 5-4 decision, split perfectly across Republican / Democratic party lines. Then, the two candidates for President in the fall, Romney and Obama, will be the two people who have actually signed an individual health-care mandate into law. And a big part of their race will be arguing about health care, and what to do about the 30 - 40 million uninsured Americans. Way to go, America.
10:41 AM on 04/04/2012
Florida -

- The state that keeps on giving