House Passes Massive Medical Insurance Bill, 219-212 2424
The votes are in: yesterday evening, after a last-minute compromise over abortion payments, the US House of Representatives narrowly passed a bill effecting major changes in American medical finance. From the BBC's coverage: "The president is expected to sign the House-passed Senate bill as early as Tuesday, after which it will be officially enacted into law. However, it will contain some very unpopular measures that Democratic senators have agreed to amend. The Senate will be able to make the required changes in a separate bill using a procedure known as reconciliation, which allows budget provisions to be approved with 51 votes - rather than the 60 needed to overcome blocking tactics." No Republican voted in favor of the bill; 34 Democrats voted against. As law, the system set forth would extend insurance coverage to an estimated 32 million Americans, impose new taxes on high-income earners as well as provide some tax breaks and subsidies for others, and considerably toughen the regulatory regime under which insurance companies operate. The anticipated insurance regime phases in (starting with children, and expanding to adults in 2014) a requirement that insurance providers accept those with preexisting conditions, and creates a system of fines, expected to be administered by the IRS, for those who fail or refuse to obtain health insurance.
Pro / cons (Score:4, Interesting)
Not being a USA citizen, I can't think of any reason why this bill is controversial.
What exactly are the pro's and cons?
H.R. 4789 introduced by Congressman Alan Grayson (Score:5, Interesting)
It's a 4 page bill that basically proposes to extend Medicare benefits to everyone from age 0 to age 64 with a simple 'buy-in.' You buy in at cost and you're covered.
That means no Cigna Corporation sitting around denying you a liver transplant - which cost at least one girl her life.
Spread the word. This bill got 50 sponsors in 2 days.
http://www.opencongress.org/bill/111-h4789/show [opencongress.org]
http://www.open.salon.com/blog/brinna_nanda/2010/03/10/a_public_option_we_can_all_love_hr_4789 [salon.com]
So the government is forcing me to buy something (Score:2, Interesting)
People like to harp on Massachusetts as Taxachusetts, especially after Mitt Romney(R) forced the people of his state to buy insurance whether they wanted it or not, thus creating a new expense people had to pay, but now the federal government has seen fit to follow the Republicans down the social/fascist rabbit hole.
The biggest problem is no one has ever given me an answer as to why my money has to go to pay the medical bills of my neighbor who smokes half a pack a day, or my neighbor on the other side who thinks it's funny to drink a case of beer each weekend by themselves.
What about my coworkers who refuse to walk up one flight of stairs or drink a liter of Pepsi every day? Why should I have to pay for their medical expenses when they can't be bothered to take care of themselves?
Further, why should I have to buy something I don't want? Are you next going to force me to go to a store and buy something to keep the store alive?
The ONLY winners in this whole fiasco are the insurance companies who will reap huge profits from the influx of money and still, despite the wording of the bill, will not cover everyone or every procedure.
While the Republicans can try to claim they stood their ground on this bill, they shouldn't be too smug as their party started this nonsense.
Unintended consequences? (Score:5, Interesting)
Re:Mixed feelings (Score:3, Interesting)
"stops insurance companies basically doing whatever they like"... it plugs a few gaps, I guess. More than anything it theoretically eliminates the "uninsured"; but now the rest of us officially pay for them when we were only unofficially paying for them before. How does that help?
On top of that, what happens when someone who has no health insurance and who hasn't paid any fines goes to the emergency room? Are they turned away now? Or given free insurance on the spot?
"not affect anyone who is currently happy with their insurance"
Who is happy with their insurance? Premiums have been skyrocketing because insurance companies, hospitals, and doctors practically collude to hide the massive amounts of money that they move into their pocketbooks. Now they still get to do that, but we have an extra trillion dollars (and do you think that's the total bil??) to pay for with taxes and other costs that will make it back to consumers.
You can decry the Fox news bogey man all you want, but this bill looks like a disaster from what I've read so far.
Re:Pro / cons (Score:4, Interesting)
Do enlighten us then.
Re:Hoorah! (Score:2, Interesting)
No, we are on our way to a health system that might work in other countries, but will not work here.
Unless you define "work" as "provide more ways for politicians to milk more from the people".
Change the name (Score:3, Interesting)
Re:Pro / cons (Score:3, Interesting)
ya... all those countries with a heavily socialist system like Norway and the United Kingdom are just falling apart compared to the debt free and stable totally capitalist US.
I'm not from the US (Score:2, Interesting)
I'm not from the US, but, imho, what is currently wrong with the US health care is:
1) It costs more than needed in the US, and most money goes to administration/lawyers/patents/... instead of going to the actual production of medicine and the actual work done by doctors. Health care of the same or better quality can be provided much cheaper.
2) In the insurance system, people are excluded based on the current status of their body. Nobody should be excluded based on that.
I'm not sure if the new system now voted for, improves the above points, but the old one scores very bad at least.
Re:health insurance is like auto insurance now (Score:3, Interesting)
When I was on unemployment I got $550 a week. That's equivalent to a $15/hour job, and I thought to myself: "This is a pretty sweet deal. I get paid the same amount as my brother, but while he's truck driving and delivering goods, I'm just sitting here watching TV and playing games."
I'm back to work again, because I'm honest and took the first job offered to me, but it got me to thinking:
According to various studies, the benefits paid for being jobless (free housing, free food, free healthcare, and a government check) are equivalent to $10-15 hour. I didn't used to believe those studies but now having experienced it myself, I can see how it would be true.
Non-American: questions (Score:5, Interesting)
1) What is in it to stop the premiums going up as the money from subsidies comes in? In other words, will the basic laws of supply and demand in a free market not still apply? This bill does not seem to limit the dynamics of the free market.
2) What will stop the insurance companies from making their own rules that slowly erode the value of coverage by limiting the treatments that they pay for?
3) How will someone who is poor be ensured the same treatments as someone who is wealthy?
From what I have been reading, these have been the biggest issues with US health care, does the bill do anything about this? Making sure 'everyone has something' seems to be a drop in the bucket to me; or am I missing something?
Please don't label me a troll for these questions.. I think they are important questions.
Re:Ironic (Score:2, Interesting)
So I guess that means the "right to choose" crowd supported the elimination of free choice when it comes to health care coverage for millions?
No wonder the insurance compaies were on-board with this Health Care Reform...
Tell me again how the anti-HCR crowd is in the pocket of "big insurance" when it was the pro-HCR crowd that just added 30 Million plus new customers to their client lists...
Re:It is surprising to me (Score:2, Interesting)
Nowhere in the US Constitution does it say "Congress shall NOT guarantee the citizens healthcare"
Re:what happens if you drive without car insurance (Score:2, Interesting)
FALSE
I (and no other members) of the public are under NO OBLIGATION to pay for your sickness. There is no constitutional right to health care of any kind. That the people now pay (for some) of these incidents is thanks to legislation passed in the 60s and 70s, ie MEDICARE.
The only relation to auto insurance would be a requirement to pay damages for any communicable disease which you passed on to somebody else without their consent, similar to an auto accident. The reason you have auto insurance is because the potential costs to the injured party are very large and the ability of you to pay are very low - compounded by the fact that a significant portion of the population is exposed to that risk.
If a certain segment of the population feels that strongly about providing medical coverage to those they deem "needy" then they should do so by setting up a charitable trust to provide that care. Not by forcing those who do not need or want coverage to buy it.
Not until 2014 (Score:5, Interesting)
Re:health insurance is like auto insurance now (Score:4, Interesting)
What are you talking about? This [blogspot.com] totally looks sustainable [blogspot.com].
Re:Yes it does change things (Score:3, Interesting)
It's still insurance if as *nominally* in the UK you are paying into the general pool for the whole country for everyone, not just your own sweet self.
So, even while your house is burning down you are nominally paying taxes to have the fire brigade paid for. That used to be a private insurance matter too, each insurer providing its own fire crews and only putting out fires for people paying its premiums. Seems that scheme didn't work very well.
Rgds
Damon
Re:health insurance is like auto insurance now (Score:4, Interesting)
I remember when I used to live in Holland and Mandatory Health Insurance came into effect: almost instantly my Health Insurance Premium went up by 30% (with no extra coverage being provided): checking with price-comparisson sites showed that the increase was all across the industry.
in my experience, Mandatory Insurance of any kind is just a form of tax payed directly to the Insurance companies.
That said, although I do believe the US desperatelly needs a big overhaul of it's Healthcare system [*], what ended up being passed only solves one of the problems (lack of Universal Coverage) without significantly improving the efficiency of the whole system [**] while introducing measures which, given the lack of restructuring of the way the Insurance Industry works in this area and the lack of Tort Reform, have the potential to make the Healthcare costs higher, not lower.
* The US spends twice as much as a percentage of GDP in Healthcare than everybody else and yet comes out very bad in things like child mortality rates
** Universal Coverage does help a bit on the efficiency front due to things like "Herd Immunity"
Re:Pro / cons (Score:1, Interesting)
My biggest problem with this (and most) legislation at the federal level is that The Constitution doesn't allow it. These matters were meant to be left up to the states. If each and every one of the 50 states passed this separately, I would have considerably less issue with it.
You're wrong: "We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."
And for those who say the Preamble doesn't have any legal authority, wrong again:
Ellis v. City of Grand Rapids
"Substantively, the case was about eminent domain. The City of Grand Rapids wanted to use eminent domain to force landowners to sell property in the city identified as "blighted", and convey the property to owners that would develop it in ostensibly beneficial ways: in this case, to St. Mary's Hospital, a Catholic organization. This area of substantive constitutional law is governed by the Fifth Amendment, which is understood to require that property acquired via eminent domain must be put to a "public use". In interpreting whether the proposed project constituted a "public use", the court pointed to the Preamble's reference to "promot[ing] the general Welfare" as evidence that "[t]he health of the people was in the minds of our forefathers". "[T]he concerted effort for renewal and expansion of hospital and medical care centers, as a part of our nation's system of hospitals, is as a public service and use within the highest meaning of such terms. Surely this is in accord with an objective of the United States Constitution: '* * * promote the general Welfare.'"
Re:Ironic (Score:3, Interesting)
I wouldn't call it irony, I'd call it hypocracy. Ever notice that most "right to life" people are also for the death penalty, and most "pro-choice" people are fine with drugs being illegal?
Re:health insurance is like auto insurance now (Score:4, Interesting)
Bankruptcy. U.S. is on the verge of it, especially with talk of it being downgraded from AAA to AA status, as if it were a second world nation.
That is particularly interesting as the "Three world" philosophy was not about wealth or who was superior to everybody else, but simply enumerating the three major worlds:
1) Western Democracies
2) Communist Bloc
3) Everybody else
If the USA is becoming a second world nation, that would imply that the USA "won" the cold war by becoming communist. Arguably, it could be said that the USA has moved into the communist bloc of countries with this legislation.
Somehow I don't think that is what you intended, but I think it fits too.
Re:Not gonna happen (Score:5, Interesting)
In the state of New York, I had to purchase health insurance for my mother at one point in time. She was 52 years old, and based solely on that fact, I had to pay about $9000 a year for Blue Cross/Blue Shield coverage for her. That was back in the early '90s.
Just looked up the current rates. As of mid-2009, the Direct Pay HMO rates are $1110 per month and the Direct Pay POS plan rates are $1400 per month. That is in the range of $13,000 to $17,000 per year, for an individual plan, if you live in New York City.
A family plan is $3500-$4500 per month.
Think this is crazy? See here [state.ny.us]. Individual health insurance plans have increased by an insane amount in the last 10-15 years. The cheapest, crappiest HMO plan where you have limited doctor choice, etc. is $750-$800 a month, more than $9,000 per year. And if you go with the cheapest possible option, you know it will suck.
So basically, you don't know what you are talking about.
Re:So the government is forcing me to buy somethin (Score:3, Interesting)
This is, in my opinion, the worst part of American conservative fiscal policy - it seems like we are deathly afraid of someone, somewhere, potentially getting something they don't "deserve". It's almost pathological; we have ridiculous amounts of bureaucracy centered around making sure that nobody gets a benefit they don't deserve, when it would be more effective to just remove a lot of the bureaucracy and use the savings to loosen the criteria.
Re:Beware, lawmakers: November is coming. (Score:2, Interesting)
Re:health insurance is like auto insurance now (Score:3, Interesting)
Even fully socialized medicine is less of a kick in the pants to the constitution. At least then, it's the government providing a service for taxes. Something well-established in our country for things like roads and such.
Re:health insurance is like auto insurance now (Score:4, Interesting)
Ummmm.... Have you ever dealt with a hospital's debt collection system? Going to a hospital and getting treated without insurance for something major will drive you into bankruptcy by the time the hospital is done with you. They will take you to court, then garnishee enough of your wages so that you can't pay for food and shelter, thus forcing you into bankruptcy which is a major negative.
I've had hospitals come after me when I wasn't even the one responsible for the bill. Once a hospital came after me for a niece's bill. It took months of fighting with them to get them to back off.
Another time an employer who was self-insured rather than pay for Workman's Comp sent me to a hospital for testing in a labor dispute over retraining after I became ill due to working conditions and had to change occupations. The employer went bankrupt two years later and never paid the hospital bill. The hospital came after me 5 years later and I finally had to hire a lawyer to stop them from collecting not only the original bill, but interest, fees, and penalties that more than doubled the bill. Even that didn't stop them. They came after me again 2 years later with an even larger bill and I had to go through all the same shit all over again.
This horseshit that anyone can just go to the hospital and get treated for free is ridiculous. If you don't pay there are major consequences in your life and hospitals will make sure you pay those consequences.
Re:The only thing missing... (Score:4, Interesting)
I'm not convinced the person/people who yelled that stuff and spat were actually real Tea Party members/protesters against health care. It seems *awfully* convenient that one of the people in with the protesters did probably the one thing that would most discredit the protest in the eyes of the nation and would be guaranteed to get a lot of news coverage. It would be an awfully effective tactic for somebody who actually supports the bill to go out there, pretend to be a protester, and then spit and yell racial slurs to discredit the protesters. It's not like that sort of thing hasn't happened before...
Re:Health insurance is a tax now (Score:3, Interesting)
4) The way billing works in hospitals is more or less fraudulent. It works by inflating prices by 4x, offering a 75% discount to insurance companies (who essentially pay the original price), thus screwing over people that don't have insurance in order to cover losses from people that don't pay.
Accurate, but what's really going on is tax fraud, not regular plain ole fraud. Someone with no insurance, assuming they are not wealthy, will have most of the bill forgiven or sent to collections or otherwise disposed of at considerable "loss" to the hospital. The relevant tax fraud, is the hospital will book a phantom "loss" of 75% or more of the hyper-inflated cost of care, therefore not having to pay income tax on that fraction of revenue, or if a non-profit they just cooked the books allowing more "real" income to come in to balance that "phantom" expense.
As long as the actual expense is less than the income tax on the "phantom" loss, the hospital comes out ahead.
You claim to be a small business owner. What would the IRS think, if you marked the price of a used worn out blank USB stick as $10M, sold it to me, and I never paid you, or we settled for 25 cents total? Then on your income tax you enter a "$10M" business loss, thus you don't have to pay income taxes this year because that "loss" cancels out all your revenue?
Re:H.R. 4789 introduced by Congressman Alan Grayso (Score:3, Interesting)
Re:health insurance is like auto insurance now (Score:1, Interesting)
Actually you can offer legal tender, and the hospital is required by law to take it. You could offer them $1 a month to pay off your bills if needed. They cannot garnish your wages, any more than any other debt collection service can. They could take you to court, but they can't just take your money right off your paycheck. Only the government can do that, and only where law allows.
As to free healthcare, I'm guessing you've never visited a county hospital? Where do you think these folks go when they don't have insurance? It's not ridiculous, it happens every day of every year. If you go to some hospitals, they may refer you to a county hospital, but you will get healthcare, all on the taxpayers tab.
Re:Not gonna happen (Score:2, Interesting)
You do realize that if insurance companies do not discriminate against pre-existing conditions, they cannot possibly stay in business.
Risk versus Reward? The democrats don't realize that this is what happened to the financial industry.
1. Build Regulation that encourages risky lending practices
2. Privatize profits (in this case, allow the insurers to charge ever-increasing premiums on more expensive plans).
3. Allow the industry to "consolidate" itself towards greater efficiencies (expect the big insurers to purchase the smaller companies).
4. Socialize the costs (once there are no more small insurers to leverage for buyouts, the large insurance companies's bankrupt balance sheets will implode, but as they will be "too big to fail", the government will bail them out, regulate them, and end up with a significant (majority) ownership percentage).
There is no way that this plan passed by the House/Senate will create a solvent insurance industry. Frankly, for the vast majority of people, there is a serious incentive to *not* buy insurance until you need it. The fees simply aren't that bad. The large companies that pour money into the "premium" insurers will feed a giant pyramid scheme.
Of course, if you are a conspiracy theorist, one might believe that was by design. Kill the industry, and nationalize it. *shrug*
Either way, that the passage of this bill changes politics forever. The next time there is a Republican President, with a Republican Congress, expect 51 votes in the Senate, and a slight majority in the House to gut Social Security, scrap the Department of Education, and dramatically cut both the government budget and taxes. The legislative bar has been set very, very low, the gang of 16 is dead, and "Parliamentary Rules" have gone by the way side.
Having Biden overrule the Senate Parliamentarian will be the final nail in the coffin, and open the door to total legislative warfare once the minority gains power. The democrats whined and moaned that Bush was the imperial president; they managed to derail significant portions of his legislative agenda based upon that war cry.
That's never going to work again.
Re:It is surprising to me (Score:2, Interesting)
Oh no! One of our founders was a socialist marxist pinko commie fascist! Run for your lives, I mean, money!
And that's why Texas has just written Jefferson out of the history books. [scienceblogs.com]
Re:Health insurance is a tax now (Score:5, Interesting)
I used to be just like you. Survival of the fittest, I'll fight whatever or whomever to pass my genes on. Dog eat dog...
And, while most of that is still very relevant today, it's fucking 2010. We have the means, we have the technology to at least start thinking differently.
Even as a liberal pussy, I will completely back up the assertion that socialism is at least some form of theft.
But we don't live in caves anymore, or shit ourselves when lightning strikes. Maybe there's some other things we should look a doing differently too.
Re:Health insurance is a tax now (Score:3, Interesting)
Tort reform is a meme pushed by Republicans/conservatives at the behest of insurance companies and hospitals. It's in vogue to blame everything on lawyers, but don't forget that insurance companies don't want to pay out no matter how clear cut the negligence. Not many understand that malpractice lawsuits are part of the free market. If a doctor keeps committing malpractice, he'll keep having to pay, and someone will teach him to stop doing that. If there were no malpractice lawsuits, the quality of medical care will definitely be worse because there will be no accountability. (Unless you trust doctors to self-regulate, but they aren't doing that now. What makes you think they'll start when you stop suing them?)
Re:Hoorah! (Score:3, Interesting)
The state-exchanges have the prospect of being awesome. I was fired last year, and once my COBRA supplement expired, I had to find new insurance. As a healthy twenty-something I had to pay an exorbitant amount for health insurance. However, I ended up buying insurance from Oxford via the Healthy NY program, which has insurance companies provide a basic package of health care services for $260 a month. I can see the doctor for checkups for a $20 copay. I twisted my shoulder but I can get the checked out if it doesn't get better after a week. It's great. It's provided by private companies, but is affordable.
Re:Stop calling it 'insurance' (or update Wikipedi (Score:3, Interesting)
Of course, this works great for healthy people. It absolutely sucks ass for people with chronic conditions. That's the problem with a health insurance that isn't mandatory: someone will game the system, regardless of the rules. Either healthy people make out like bandits, or insurance companies make out like bandits. The only solution to this is health care where everyone pays.
The choices are really rather simple:
* allow healthy people to save money by letting them sign up for insurance only when they need it.
* allow companies to guarantee profits by allowing them to cover only people who are profitable to them on a quarter-by-quarter basis.
* drop the notion that a society can function without common sacrifices and make everyone pay into a pot, all the time.
Re:what happens if you drive without car insurance (Score:2, Interesting)
Re:Any part in the constitution that (Score:3, Interesting)
It works in countless other countries. Why shouldn't it work in the U.S.?
Am I the only one that finds that financial implications shouldn't really matter when health and life are in danger?
You guys burn billions on weird wars because some thousand people died in a terrorist attack but you don't want to spend a few hundred million to make sure that 1/6 of your population doesn't die of everyday diseases?
That sounds pretty strange to me to put it polite.
Re:health insurance is like auto insurance now (Score:3, Interesting)
http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act [wikipedia.org]
"Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986. It requires hospitals and ambulance services to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions."
Now, you might say "Ah-ha!! It specifically says 'emergency healthcare'!". However, further down the wiki page, you will note some of the conditions required for it to no longer be an emergency:
The patient is able to care for themselves, with or without special equipment, which if needed, must be provided. The required abilities are:
* Breathing
* Feeding
* Mobility
* Dressing
* Personal hygiene
* Toileting
* Medicating
* Communication
Yes, if you can't go to the bathroom or put your shirt on, it's an 'emergency'. So the law effectively means that nearly any medical condition is an emergency. And furthermore, the ER has to take the time to diagnose the patient in the first place, which costs money and increases wait times.
"I don't think the federal government is forcing emergency room doctors to provide comprehensive care."
You can think that all you want, but it doesn't make it true.
Anecdotal evidence alert: My father in law had severe stomach and back pains in the middle of the night and went to the ER. After waiting several hours, my wife finally took him home so that he could more comfortably lay in bed rather than sit up in the hard ER chairs. Luckily the pain went away after a few more hours, but it was our first glimpse at how poor ER care has become.
Re:health insurance is like auto insurance now (Score:3, Interesting)
Re:So the government is forcing me to buy somethin (Score:3, Interesting)
Re:health insurance is like auto insurance now (Score:3, Interesting)
You're right about those "definitions", and I'm glad that people are corrected on slashdot when they use them incorrectly... but I can't help but feel that the common usage of these terms has changed.
Especially now that the cold war is quite over, "second world" doesn't really have a meaning. "Third world", whether it was originally intended to mean this or not, is used now to refer to under-developed countries - especially Africa and the like, but not necessarily *that* undeveloped.
We're in the position now where "first world" still refers to western democracies, and now more-or-less also refers to any developed nation, including Russia, and "third world" refers still to "everybody else." It's separated from its original cold war meaning, and it's a very shaky distinction at best.
Therefore, in popular usage "second world" is sometimes being used (as in the parent's post) to describe developed nations with "issues" - things that prevent them from really being considered progressive, democratic nations.
Just as describing someplace as a "third world" country carries a lot of meaning and is useful in describing places, "first world" and "second world" as terms can be just as useful, and I expect this type of usage to increase greatly over the next few years.
Not that things really need to be simplified that much, but it does help clear up ambiguities in descriptions of places one is unfamiliar with. For example, I would describe Thailand as a third-world country after spending a lot of time there, but at the same time it's far from African countries with starving babies and rampant disease - it's at the upper limit of being considered third-world, but it's definitely not first-world. Obviously, since "second world" is obsolete in its original meaning, it makes a lot of sense to re-purpose it to describe those kinds of countries.
Re:health insurance is like auto insurance now (Score:3, Interesting)
>>>Your life wasn't thrown into utter turmoil, you didn't have to short-sale your home or default on your mortgage, your family didn't go hungry
>>>
Even without unemployment that would not have happened. Unlike most Americans I sacrifice (slow internet, cheap $5 cellphone, no cable TV, seven-year-old computer) and save every dollar. I had half-a-million in my account on layoff day, and still do even now. So I could have survived just fine w/o government assistance.
I'll admit this isn't completely altruistic. I set a goal to retire when I'm 40, and even though that has now been pushed back to 45, I'm still keeping my eye on having enough money to quit working (unless I want to). I'm following Ben Franklin's example.
Re:It is surprising to me (Score:1, Interesting)
No it does not. James Madison wrote that provision and he clearly stated he meant it was the *general purpose* of the government being created and what follows are the *specific powers* that are being created to implement that purpose. You'd have to be crazy to think otherwise, because it would basically give congress a blank check, something they were obviously trying to stop. Direct info below:
"With respect to the words "general welfare," I have always regarded them as qualified by the detail of powers connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character, which there is a host of proofs, was not contemplated by its creators."
"I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents...." James Madison as he vetoed a bill.
"There is nothing more natural than to begin with a general statement and then qualify it with specifics. [In other words read the WHOLE sentence, not just the first clause.] If Congress can do whatever in their discretion can be done by money, and will promote the General Welfare, the Government is no longer a limited one, possessing enumerated powers, but an indefinite one." James Madison.
And if you still have doubt, just read the Constitution itself:
"The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." "The Tenth Amendment is the foundation of the Constitution." Thomas Jefferson
Re:Yes it does change things (Score:3, Interesting)
Yes, MY PRICE, MY COST, quadrupled. The money coming out of MY POCKET. As a young man raising a family, I did not have the money left over to put much (if anything) in the bank. Being laid off meant that I COULD NO LONGER afford insurance.
Lucky for us, the wife got herself a part time, temporary job about that time, which had pretty good insurance. She's still working that temporary job, while several of my "permanent position" jobs have been outsourced, moved to Mexico, or the company has been sold or gone out of business.
Go figure. The wife's "temorary job" has saved our asses, multiple times, with her insurance.
Re:Health insurance is a tax now (Score:3, Interesting)
Because the metric used included equal access to health care. Of course a system which provides health care to all its citizens will score higher than a system where some citizens are not covered because they choose not to or cannot afford to buy insurance. Citing that metric as a reason why the U.S. needs universal coverage is circular reasoning.
When I looked into this and added up the stillbirth and infant mortality rate [who.int] (PDF warning), the U.S. ends up in the middle of the pack of developed nations. Indicating there's still misreporting of infant deaths as stillbirths to try to lower your hospital/country's infant mortality rate, artificially lowering the U.S.' ranking in world infant mortality rate.
Has more to do with lifestyle. All those jokes about fat, lazy Americans have a degree of truth to it.
In terms of quality of health care, the U.S. is really no different than other developed nations. That's not what's broken. The problem is the U.S. spends a massively disproportionate amount of its GDP on health care [nationmaster.com] compared to those countries. 14% vs. about 8%.