Health Care

The Court Will Rule—and Then?

AP Photo/Alex Brandon
The Supreme Court’s decision today to take up the constitutionality of President Obama’s health-care reform in this session—they’ll hear oral arguments in March and rule by session’s end in June— means that the issue will be revived for voters just a few month before next November’s presidential election. This is probably good for Republicans no matter which way the justices rule. And, no matter which way the justices rule, I can’t see how this helps the Democrats. There are basically three ways the court could go. They could uphold the individual mandate; they could strike it down, which would essentially negate the rest of the law; or they could rule the issue can’t be litigated until 2015, when the federal government would levy the first penalties on persons who refuse to purchase insurance. Additionally, the court will rule on the important but still subsidiary issue of whether the feds can require the states to pick up additional Medicaid expenditures starting in 2016—but the...

Supreme Court to Hear Challenge to Affordable Care Act

Will the individual mandate survive?

It’s official; the Supreme Court will hear the a challenge to the Affordable Care Act, President Obama’s health care reform law. The Court’s decision is expected to come next June. Going by the tenor of conservative rhetoric and the decisions of lower courts, the key issue at hand is the “individual mandate,” which requires all Americans to purchase health insurance by 2014 or face financial penalties. Conservatives argue that the mandate is a gross overreach of federal power —by their lights, the Constitution doesn’t allow the government to tax “inaction.” Allowing the mandate to stand, they argue, would put the United States on a dangerous road toward unrestrained government. Indeed, in his ruling to uphold the individual mandate, Judge Lawrence Silberman of the DC Circuit Court of Appeals pointed out that while “the Government does stress that the health care market is factually unique,” it “concedes the novelty of the mandate and the lack of any doctrinal limiting principles.” As...

Health-Care Baloney from Mitt Romney

Massachusetts Gov. Mitt Romney, seated, smiles with, clockwise from top, Massachusetts Health and Human Services Secretary Timothy Murphy, Senate President Robert Travaglini, Sen. Edward Kennedy, D-Mass., and House Speaker Salvatore DiMasi as he signs into law at Faneuil Hall in Boston a landmark bill designed to guarantee virtually all state residents have health insurance, in this Wednesday, April 12, 2006, file photo. While Romney has received positive reviews of the sweeping health care initiative, it will be up to the state's next governor to sort through the details of the law. (AP Photo/Elise Amendola, File)
Let me do something weird and discuss a bit about the substance of last night's debate. (AP Photo/Elise Amendola) Massachusetts Gov. Mitt Romney in 2006, signing into law a landmark bill designed to guarantee virtually all state residents have health insurance There was some discussion of health care, and of course it was superficial and misleading. That was partly the fault of the candidates, and partly the fault of the moderators, who at one point gave the candidates 30 seconds each to solve America's health-care problems. Mitt Romney and Newt Gingrich both reasonably observed that this was kind of absurd. But here's something Romney said: I believe very deeply in the functioning of markets. The work I've done in health care, actually worked as a consultant to the health care industry, to hospitals and various health institutions. I had the occasion of actually acquiring and trying to build health care businesses. I know something about it, and I believe markets work. And what's...

Is There a "Bradley Effect" for Abortion?

Amendment 26 supporter Sandy Comer puts out a campaign sign at the polls at the Chamber of Commerce in Oxford, Mississippi, on Tuesday, November 8, 2011. Mississippians go to the polls today for state and local elections, as well as referendums including the so-called personhood amendment, a referendum on whether to define life as beginning at conception. (AP Photo/Oxford Eagle, Bruce Newman)
Yesterday, Mississippi voters soundly defeated Amendment 26, an anti-abortion ballot initiative that would have altered the state's constitution to define personhood as beginning at fertilization. Going into the election, a survey from Public Policy Polling showed 45 percent of voters in favor, 44 percent opposed, and 11 percent undecided—much closer than the vote turned out to be. A personhood amendment like the one in Mississippi has never been enacted and would have had radical implications, even in a strongly pro-life state like Mississippi. Not only would it have banned all abortions without exception, but popular forms of contraception like the morning after pill, IUDs, and even the pill would have been outlawed as well. In addition, miscarriages could be prosecuted as murder or manslaughter. But Mississippians won't have to deal with any of that, because Amendment 26 lost 58 percent to 42 percent. The discrepancy between what the polls said going in and the results means that...

DC Appeals Court Upholds ACA—With a Republican Taking the Lead

The influential Court of Appeals for the District of Columbia has issued an opinion affirming the Affordable Care Act (ACA) constitutional. In itself, this is not surprising, as several other courts have done so. What is surprising is that the Court's opinion was written by Republican favorite Laurence Silberman. The conservative Reagan appointee notes that the "activity/inactivity" distinction hatched to argue that the individual mandate violates the Constitution has no basis in the Court's precedents, and under those precedents the ACA is clearly constitutional: Today, the only recognized limitations are that (1) Congress may not regulate non-economic behavior based solely on an attenuated link to interstate commerce, and (2) Congress may not regulate intrastate economic behavior if its aggregate impact on interstate commerce is negligible. Those limitations are quite inapposite to the constitutionality of the individual mandate, which certainly is focused on economic behavior–if...

The Budget Prescription

Earlier this month, the European Commission launched a new round of investigations targeting the pharmaceutical industry for allegedly colluding to keep low-cost generic drugs off the market. As a result, regulators are looking into the 2005 contractual arrangements between U.S.-based pharmaceutical giant Johnson & Johnson and the generic branches of the Swiss-based company Novartis to see whether the agreements purposely delayed the introduction of a generic version of the painkiller Fentanyl to the Dutch market. The probe is the latest round in an ongoing battle between commission trade officials and Big Pharma over quasi-legal “pay to delay” deals—settlements forged between drug manufacturers and producers of generic alternatives with the goal of extending brand-name monopolies long after patents have expired. Four days after the Europeans moved against Johnson & Johnson, the Federal Trade Commission (FTC) Bureau of Competition issued its annual staff report on pay-to-delay...

A Model of Health

http://www.flickr.com/photos/59937401@N07/6127242068/sizes/l/
I n 2005, when Local 6 won its first union contract at the boutique Time Hotel on West 49th Street, Angel Aybar, then a 21-year-old room attendant responsible for checking, cleaning, and restocking minibars, not only got a raise from $10 to $16.50 an hour; he became a member of a uniquely effective health plan. The New York hotel workers’ plan provides comprehensive coverage at its own health centers, including full dental and optical care, with no deductibles or co-pays and a core philosophy that emphasizes primary care, wellness, and prevention. Aybar even credits the health plan for his marriage. “My wife and I had been sweethearts since junior high,” Aybar says. “She was working, and they were taking over $100 a month out of her paycheck for her health insurance. I guess it’s not very romantic of me to say this, but it was the union health plan that pushed us over the edge to get married. She was getting chronic headaches. They kept telling her it was just stress. Her first visit...

Good Night, Sweet Prince

The tooth fairy visited our house recently, which made me remember the time—many years ago, when tooth redemption brought only a quarter—that the tooth fairy kept forgetting to claim the tooth under my pillow. After a week, I put a sign on my bedroom door: TOOTH STOP! The next morning, I had my quarter, and a signed note. The tooth fairy explained that he had an extraordinarily large territory that included the Indian Ocean, and apologized for having been delayed by recent monsoons. The note was signed “Prince Oberon.” Of course I recognized the handwriting; I was eight, and by then I knew who the tooth fairy really was. But the note’s full delight didn’t really hit me until, in college, I read Midsummer Night’s Dream and laughed out loud. I loved that about my father: Playfulness that I would only fully appreciate years later. He was ordinary and extraordinary, like everyone: a Korean war vet who went to grad school on the GI bill, a mathematician who helped the Air Force's prime...

Mitt Romney's Public Option

If you want to be a serious presidential candidate, you have to offer just enough detail in your policy proposals that it appears that you're genuinely grappling with the issues, but not so much that you give people too much material with which to find fault. To that end, Mitt Romney has offered a plan that includes the following about Medicare: Medicare should not change for anyone in the program or soon to be in it. Nor should tax hikes be part of the solution. Reforms must honor commitments to our current seniors while giving the next generation an improved program that offers the freedom to choose what their coverage under Medicare should look like: • Give future seniors a choice between traditional Medicare and many other health-care plans offering at least the same benefits • Help seniors pay for the option they choose, with a level of support that ensures all can obtain the coverage they need; provide those with lower incomes with more generous assistance • Allow beneficiaries...

More on the Abortion Debates: What if Your Mother Had Aborted You?

Yesterday I posted "So what if I hadn't been born?" In reply, noted reproductive rights thinker Frances Kissling sent along her own very moving essay along these lines, published a few years ago in RH Reality Check: " What if your mother had aborted you? A daughter's perspective. " As she says, I feel a need to turn that question around and to ask instead: What if your mother's life would have been significantly happier and healthier if she had not had you? If you as a fetus had the capacity to make decisions, would you have given your life for your mother's life, health and happiness? My mother, Florence, the last of seven children in a harsh Polish immigrant family, left home at 17 and came to New York City. She got pregnant, chased the soldier who impregnated her and ended up with me. As you might imagine, she was an interesting and difficult person. Frankly, she never should have had children. She had her good qualities, but mothering wasn't one of them. And she had a miserable...

Moment of Conception

How a radical anti-abortion movement matured

O n April 17, 2007, the Supreme Court upheld a national ban on an abortion procedure known as intact dilation and extraction. Anti-abortion groups, which successfully branded it “partial-birth abortion,” had spent 15 years and more than a quarter-billion dollars getting Congress to pass the ban in 2003. The Court’s 2007 ruling was the movement’s greatest legal victory in decades, a significant step toward overturning Roe v. Wade . But not all abortion opponents were celebrating. Among the unenthused was Brian Rohrbough, president of Colorado Right to Life. Rohrbough belongs to an absolutist wing of the movement that believes in “personhood”—the idea that fetuses are people from the moment of conception. After losing his son in the Columbine High School shootings in 1999, Rohrbough concluded that the legalized “killing of innocent children in the womb” had set America on a path of moral decline that allowed such violence to occur. For Rohrbough, the ban on partial-birth abortion was...

Running Out the Clock on Government Regulations

House bill could hamstring important protections

Tuesday, the U.S. House Committee on the Judiciary passed, on a party-line vote, one of the most sweeping attacks in decades on government protections. The Rules from the Executive in Need of Scrutiny (REINS) bill would require that any major rule issued by a federal agency be affirmed by a majority vote in both the House and Senate. The vote would have to take place within 70 days. Proponents of the legislation claim that it would lead to improved regulations, but its real effect would be to hamstring government agencies so that rules that do not pass muster with the radical Republicans in the House—say, regulations from the Environmental Protection Agency or the Securities and Exchange Commission—would never be adopted. Leaving aside outright opposition to specific rules, many new regulations would fail simply because of time constraints. Over the past decade, under both Republican and Democratic presidents, the federal government has never issued fewer than 50 major rules in a...

Herman Cain: Yesterday, Totally Pro-Choice. Today, Totally Pro-Life

Yesterday morning, I looked into my crystal ball and boldly predicted that within 48 hours, Herman Cain would walk back his surprisingly pro-choice comments on abortion ("So what I'm saying is it ultimately gets down to a choice that that family or that mother has to make. Not me as president, not some politician, not a bureaucrat. It gets down to that family. And whatever they decide, they decide") and come out for full-on, abortion-should-be-illegal anti-choicism. Well here you go : FOX HOST MARTHA MACCALLUM: Do you believe that abortion should be legal in this country for families who want to make that decision [to abort]? CAIN: No. I do not believe abortion should be legal in this country, if that's the question. MACCALLUM: So then you're saying that if those circumstances come up and the family does make that decision, that they decide that that is the best thing for this young person or she decides that on her own, then if that's what they decided, then it would be an illegal...

Pink October

In case you missed it: Last Sunday The New York Times had a thoughtful examination of the pros and cons of the pinking of America —the Susan G. Komen foundation's marketing of breast cancer awareness and its work raising funds for breast cancer research. NPR took a look at the anti-pink backlash. So I thought it might be a good time to remind everyone of my favorite piece of all time on the pinkness, though, is Barbara Ehrenreich's " Welcome to Cancerland ," which she has since updated with the sharp-tongued "The Pink-Ribbon Breast Cancer Cult. "

Herman Cain is Pro-Choice!

The other day, I sorted through Herman Cain 's recent muddled comments on abortion and concluded that he was just unaware that this is an issue that involves laws, both current and potential, that affect what people can and can't do. Every time he got asked about abortion, he would answer as if he were advising a young woman not to get one. So he explained that he believes life begins at conception, and no one should get an abortion, even in cases of rape and incest. But he was far less clear on what he thinks the law ought to be. But now we may be getting some progress. Via Dan Amira , here's Cain explaining his pro-choice -- yes, pro-choice -- views on abortion: CAIN: No, it comes down to it's not the government's role or anybody else's role to make that decision. Secondly, if you look at the statistical incidents, you're not talking about that big a number. So what I'm saying is it ultimately gets down to a choice that that family or that mother has to make. Not me as president,...

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