Obama health care law upheld.

BlueDevil,DNP, DNP, RN · Jul 2, 2012

Well that's pretty black and white: contraceptives fall under preventive health care, abortions and joint replacements do not.

akulahawkRN, ADN, RN, EMT-P · Jul 2, 2012

There are many views floating around out there as to what CJR did or did not do, and why he voted the way he did, however the general opinon seems to be the court did not do any great harm to the power of Congress to use the Commerce Clause.
Roberts switched views to uphold health care law - CBS News

Don't be so sure that the Court didn't do great harm to the use of the Commerce Clause, indeed, it did... by limiting the ability of Congress to use that Clause to that of regulating interstate commerce rather than compelling it. To that end, Congress could have used the Commerce Clause to do pretty much nearly ALL of what it wanted to do with regard to the ACA. It still can. What it could not do is compel people to purchase a private product (because the public option does not exist). To have that kind of power would mean that Congress could have made a private person buy anything that Congress wanted that private person to. In effect, via the Commerce Clause, Congress is limited to regulating commerce between the States. Congress can still encourage a behavior via it's tax power though. The tax can not be any more expensive than (in this case) the insurance would be.

In any event, the writer of the article stated, "ut Roberts also would limit Congress' authority in future cases under the commerce power." That type of phrase shows up in a couple places in the article.

The 4 dissenting Justices did limit the Commerce clause in that regard, they just didn't join Roberts specifically. The 4 Justices that agreed with Roberts all thought the ACA was constitutional under the Commerce Clause. The fact remains that the IM was deemed unconstitutional, and is a holding of the Majority Opinion.

I have no crystal ball, but I just have a strong suspicion that there will be other lawsuits against the "penalty" portion of the Individual Mandate in the future. I also see States wanting to assert their 10th Amendment rights with regard to other parts of the ACA, particularly in those areas where the States are mandated to do things.

I just think we haven't seen the last of the lawsuits challenging this law.

tewdles, RN · Jul 3, 2012

I have no desire to limit access. But i dont think it should be free. But i wouldnt expect deserving elders to get their surgeries without paying the going rate of copay either. You, on the hand, say they dont deserve the surgeries, even if they have insurance.

I said that? Really?, cuz that certainly wouldn't fit with my personal and professional opinion of health care, so I cannot imagine that I posted anything remotely like that.

I, actually, don't think that any of our health care is free...whether we have insurance or not. There is a cost associated with all of it. In fact, when people refer to "free health care" I wonder what they are talking about because I am pretty sure that unless they are seeking care from a volunteer or mission based or free urban clinic there are charges associatied with the care (which may be written off if there is no payor). There is a reason that health care represents 17% of our GDP and it is not because it is "free".

In terms of elective surgeries, they are just that, elective. They have priority to the patient but not necessarily to the system other than for revenue. Elderly persons seeking elective surgical intervention need to decide with their families and physicians if the surgery is reasonable and if their risk/benefit is conducive to the procedure. Already, we have thousands of un-insured, under-insured, and insured folks who do not receive elective surgeries for knees and shoulders (etc) because the patient cannot afford the care. Too many people cannot afford the copays and deductibles to seek the needed care right now...and we are talking not about geriatric patients, but adult patients in general.

Esme12, ASN, BSN, RN · Jul 3, 2012

i said that? really?, cuz that certainly wouldn't fit with my personal and professional opinion of health care, so i cannot imagine that i posted anything remotely like that.
i, actually, don't think that any of our health care is free...whether we have insurance or not. there is a cost associated with all of it. in fact, when people refer to "free health care" i wonder what they are talking about because i am pretty sure that unless they are seeking care from a volunteer or mission based or free urban clinic there are charges associated with the care (which may be written off if there is no pay or). there is a reason that health care represents 17% of our gdp and it is not because it is "free".
in terms of elective surgeries, they are just that, elective. they have priority to the patient but not necessarily to the system other than for revenue. elderly persons seeking elective surgical intervention need to decide with their families and physicians if the surgery is reasonable and if their risk/benefit is conducive to the procedure. already, we have thousands of uninsured, under-insured, and insured folks who do not receive elective surgeries for knees and shoulders (etc) because the patient cannot afford the care. too many people cannot afford the co pays and deductibles to seek the needed care right now...and we are talking not about geriatric patients, but adult patients in general.

not for profit hospitals have "free care" or "partial free care" subsidized by the state (contributed to by the hospitals that use it) for a pool of money to subsidize/off set costs for the uninsured and under insured for not for profit institutions do not pay income tax.

here is an example of one for connecticut

http://www.cthealthpolicy.org/action/pdfs/200804_hospital.pdf

the state of massachuetts.....

free care pool[/b]
prior to the passage of chapter 58, the uninsured had a safety net for seeking medical care, commonly known as the “free care pool”. the uncompensated care pool was created in 1985 as a means of paying for medically needed service provided by hospitals and community clinics and health facilities to uninsured and underinsured low-income residents up to 200% of the poverty line. the free care pool also provided partial uncompensated care to individuals between 200% and 400% of poverty, and aided individuals of any income level in cases of extreme medical hardship or debt.
general info from mass.gov
“uncompensated care pool,” office of health and human services, 2008.]

mass-care » ma reform and the free care pool

[color=#1122cc]reforming and restructuring the hospital indigent care new york....

all states have one.....these exist before obama care.

tntrn, ASN, RN · Jul 3, 2012

.See your post #87. I cant copy and paste formsome reason, but you posted that 80 year are not "entitled" yada,myada, yada. And i question what entitlement has to do with it, if they are healthy and if their insurance will help pay. I personally dont feel that any of us are "entitled" to any of it, but if our plan covers it, so be it. And there should always be s co-pay.

allnurses Guide · Jul 3, 2012

.

See your post #87. I cant copy and paste formsome reason, but you posted that 80 year are not "entitled" yada,myada, yada. And i question what entitlement has to do with it, if they are healthy and if their insurance will help pay. I personally dont feel that any of us are "entitled" to any of it, but if our plan covers it, so be it. And there should always be s co-pay.A bit off the topic of the health care law that should help working people afford health insurance.

BUT, I pay a significant amount for a Medicare supplement. With it we have no copays.

It is a big help for my 85 year old husband to not have to deal with a copay when he goes in for his monthly visit with lab draw. The adjustments on meds and fluid intake keep him out of the hospital.

kayruhh · Jul 3, 2012

I don't agree with it.

I'm not insured and neither is my patents because we can't afford to fork out the extra money.

So now we are going to be required to have health insurance, or else we have to pay a fine.

That is ridiculous. We can't afford it and I'm sure other Americans can't too. Just taking more steps towards

Socialism.

allnurses Guide · Jul 3, 2012

I don't agree with it.
I'm not insured and neither is my patents because we can't afford to fork out the extra money.
So now we are going to be required to have health insurance, or else we have to pay a fine.
That is ridiculous. We can't afford it and I'm sure other Americans can't too. Just taking more steps towards
Socialism.

That is why the law has a way for you to have help.

Home | HealthCare.gov

It may depend on whether your state accepts the new federal options to help working people afford health insurance. -- http://www.cbsnews.com/8301-505245_162-57465101/ark-gov-weighing-medicaid-expansion-after-ruling/

I don't like the new law taking tax money and paying insurance companies.

I think Medicare for all is a better plan.

tewdles, RN · Jul 3, 2012

.

See your post #87. I cant copy and paste formsome reason, but you posted that 80 year are not "entitled" yada,myada, yada. And i question what entitlement has to do with it, if they are healthy and if their insurance will help pay. I personally dont feel that any of us are "entitled" to any of it, but if our plan covers it, so be it. And there should always be s co-pay.

So there's the problem...#87 is not my post.

tewdles, RN · Jul 3, 2012

not for profit hospitals have "free care" or "partial free care" subsidized by the state (contributed to by the hospitals that use it) for a pool of money to subsidize/off set costs for the uninsured and under insured for not for profit institutions do not pay income tax.
here is an example of one for connecticut
http://www.cthealthpolicy.org/action/pdfs/200804_hospital.pdf
the state of massachuetts.....
free care pool[/b]
prior to the passage of chapter 58, the uninsured had a safety net for seeking medical care, commonly known as the "free care pool". the uncompensated care pool was created in 1985 as a means of paying for medically needed service provided by hospitals and community clinics and health facilities to uninsured and underinsured low-income residents up to 200% of the poverty line. the free care pool also provided partial uncompensated care to individuals between 200% and 400% of poverty, and aided individuals of any income level in cases of extreme medical hardship or debt.
general info from mass.gov
"uncompensated care pool," office of health and human services, 2008.]
mass-care » ma reform and the free care pool
[color=#1122cc]reforming and restructuring the hospital indigent care new york....
all states have one.....these exist before obama care.

my point about "free care" is that although the patient and family may not pay and therefore the care is considered "free", it is in fact not "free" to the system. there is cost incurred each time a patient enters the health care arena, no matter how the bill is handled. this is why our health care costs (in part) account for such a large portion of our national gdp. sort of like fighting unbudgeted wars, they get paid for...but at a very high cost (as we are experiencing now).

DoGoodThenGo · Jul 3, 2012

mass-care » ma reform and the free care pool
[color=#1122cc]reforming and restructuring the hospital indigent care new york....
all states have one.....these exist before obama care.

my point about "free care" is that although the patient and family may not pay and therefore the care is considered "free", it is in fact not "free" to the system. there is cost incurred each time a patient enters the health care arena, no matter how the bill is handled. this is why our health care costs (in part) account for such a large portion of our national gdp. sort of like fighting unbudgeted wars, they get paid for...but at a very high cost (as we are experiencing now).

in theory all hospitals in nys are "not for profit" and there is a pool of funds to reimburse hospitals for unpaid/indigent care, and guess what? many hospitals in the state including quite a few in the nyc area are bleeding red ink from providing charity care.

saint vincent's hospital system literally went bankrupt and folded from providing unpaid charity care, and there are probably going to be a few more regardless of obamacare.

the dirty little secret is that many of the largest nyc hospital systems such as nyp receive quite a large portion of funds from the state indigent care fund. this as they often try to shift such populations to other facilities. however the joke is now on them as st. vinny's and north general are now gone those "charity" cases are moving onto the hospitals that remain.

allnurses Guide · Jul 3, 2012

I don't agree with it.
I'm not insured and neither is my patents because we can't afford to fork out the extra money.
So now we are going to be required to have health insurance, or else we have to pay a fine.
That is ridiculous. We can't afford it and I'm sure other Americans can't too. Just taking more steps towards
Socialism.

Do you get paid for caring for uninsured patients?

Are you a volunteer?