Obama: Healthcare reform by year's end

"The stars are aligned", isn't this the same man who joked about Nancy Regan and astronomy or something like that? Who did Obama consult on this stars thing - do we now have a "Stars Czar"?

In ObamaSpeak, "Healthcare reform" equals "less healthcare, more spending".

The government doesn't have the money for the Obama spending orgy that has already been passed, let alone the money for this new spending orgy.

How is this going to be paid for? By bringing down health care costs? Yea...right.
Open up your wallets people, the Obama socialist system is coming.

Paulo

Medicare is out of money, yet we now plan to cover everyone with the same style of unsustainable coverage.

At the same time we're going to cut trillions off the deficit. And run the banks, the car manufacturers, the newspapers and who knows what else.

But don't worry, your taxes won't go up.

Is there anyone who actually belives any of this?

"The stars are aligned, with the sound of universal healthcare"

Now where did we put that $90,000,000,000 to pay for it?

Oh yeah...taxing high-calorie soda ought to cover it!

The Republican party will do everything in their power to stop healthcare for everyone. They're in the back pocket of the big health insurance companies and they know that everyone will like it, thus making it even more repulsive to vote for the Republican party from now on.

So many people are lacking access to health care at the moment with unemployment, the Republican fearmongering (see above comments) about reduced access will be much tougher to sell...

In addition, this strategy is aimed at the wrong opponent. The attacks are classic Republicans attacks on socialized medicine, but it will be hard, even for them, to frame Obama's health reform plan as "government takeover"... Practically the whole thing is formulated on private insurance... they can use this to attack the public option (and they will), but that forces them to admit that people would choose government care over private insurers. That's a tough pill to swallow.

And we have the argument of "choice" that Republicans will have a hard time countering...

I also notice, as usual, the current health proposals from the Republican party are ridiculous on their face, even to the most uninformed of Americans. They will need to come up with something better......and they can't.

LOL! Now there's a picture with this piece. Take a close look at it. Every one of those guys has a knife in his pocket and just waiting to find out whose going to do the official back-stabbing.

'Cause someone's going down for the "we didn't know anything about torture" fiasco, and it's going to be dear Nancy.

By the look on her face, she knows it too. Bye bye Madame Speaker.

Why in the world should anyone trust REPUBLICAN Opinions on SOCIAL SECURTIY OR MEDICARE?

THEY have been trying their best to KILL Social Security and Medicare sense it began. Do they deny that the Republican Party is against both Social Security and Medicare? I don't think they can.

So the question is why are they failing? Because Republican Administrations have been dipping into the funds for years to fund other programs.

Republicans aren't credible on this issue. SO STOP ACTING LIKE WE CAN TRUST YOU AND YOUR FRIENDS. YOU ARE THE PROBLEM. What is your answer to fix it? You probably don't have one. Well, I do. STOP TAKING MONEY OUT OF IT. And if it needs money GIVE IT MORE MONEY! That is real simple. But of course that may mean that we have to raise taxes on the rich. So! I 'm not rich and most Americans aren't rich so it wouldn't affect us. But most Americans will need Medicare and Social Security at some point.

Another answer is to lower health care cost. Medicare is being DRAINED BY HIGH HEALTH CARE COST! You would think that the Republican party would acknowledge that. Instead of spreading the Republican Talking Points. We need to lower the Cost of Healthcare. That in and of itself would relieve the burden on Medicare. How do we do that? By increasing Competition. Right Now the Healthcare Insurance industry really as all of us by the stones. We can't live with out healthcare and you know it. They raise healthcare cost each year because they can. It is that simple.

Increasing Competition would lower cost. How do we increase competition? By allowing the public option. That is right we need Single Payer. It is the only way. I would gladly pay the Government what I am paying my Health Care provider each week if that meant that every American had Healthcare insurance. Would Republicans be willing to do the same? I don't think so. Because Republicans are only concerned about their own butt, they could care less about the working poor, and the middle class. And they know it. Republicans only care about the Big Insurance Companies and making sure that continue to make Record Profits even in a down economy. You Republicans are disgraceful. You should be ashamed of yourself. You need to look at your life and not just say and do what Eric Cantor and John Boehner tell you to say and do. Think for yourself and do what is in the best interest of YOU, NOT THE REPUBLICAN POLITICAL MACHINE!

Why is B.O. wanting this so quickly? Is he afraid that he wont have a friendly congress to do his grunt work for him come midterm elections Nov 2010 ala the gang of fools (look at the picture)?
Notice there is one fool missing, Harry Reid, why?
If transperancy is suppose to be key according to B.O. then why are there not any Republican leaders in this meeting so they heat the same thing?
What is B.O. telling the gang of fools that he doesn't want the Republicans to hear?
Will the gang of fools read the 1200 page plus bill before bringing it to the full house or senate? I doubt not.
Will the gang of fools allow more than 48 hours for their colleauges to read the bill n its entirety? I doubt not.
We will be hearing "Oh My God, I did not know that was in there before I voted on it".
A real bright bunch of law makers we have and aren't most of them Lawyers?
Don't most attorneys say "read the document before doing anything"?
Call your reps it does work if enough call and voice there opinion.
Remember, we do count. We vote and that scares the you know what out of them in most cases.

Did folks happen to see the ads in today's Chicago Obune with two car dealer associations asking how the Obama plan to shut thousands of car dealerships will help the auto industry while it puts even more people out of work? So, the Obama badministration is on its way to destroying the auto industry. It's trying to destroy the banking industry. It's destroyed the tourism and hospitality industry. And now it wants to destroy the health care industry. Wow, this is the change we can believe in??

Wonder if American will get as good healthcare as the politicians.

Several of you talk about it would be better for the Gov't to get into the Health Care Business. They are and have been since LBJs 1965 land mark bill for the Great Society (and by the way this is a history lesson for some of you) that started Social Security on the road to Ruin. We have a thing called Medicare and Medicaid both gov't run. If any of you can prove to me that they are complete and total successes, which they aren't, then I will be quiet. It is a proven fact that when it comes to running a business type operation, government fails miserably. $700 hammers, $2500 toilet seats, need more proof. Prisons that have been turned over to private enterprise reduced costs 30 to 50%.
If socialized medicine is suppose to be the best thing since sliced bread, then someone please explain to me why people who live in socialized medicine countries come to the U.S. for care.
I have a relative who lived in one of those countries who lost a leg because he was told he had to wait for the proper care. In the U.S. he would have received the immediate care and still had his leg. Another relative in Canada just had shoulder surgery, had to wait close to a year. Here in the U.S. he would have waited no more than a week after seeing the DR.
So what makes you or anyone else think that we can do it better? I guarantee you the GOV'T will screw it up. If it aint broke and the gov't gets involved it will be broke. People just look at history, history does not lie..

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Posted by: Teresa Kathy | May 13, 2009 2:14 PM
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Really? What plan does Obama have? What guarantees are there that he won’t opt for a single payer system inasmuch as nothing is graven in stone yet? Some of us would like to see the details. I haven’t seen any concrete plan because there really isn’t one. There have only been some musings about the general shape of health care reform. The details are for Congress to decide in the first instance, and they haven’t written anything that is available for public perusal.
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If Obama finally agreed to a single payer system, it wouldn’t be the first time he flip-flopped on an issue. That he might sign a plan based on a single payer system is better than speculative when one considers that many in Congress like the single payer model. If they hand Obama a bill with a single payer system, the pressure to get something done with regard to health care might get him to agree with it against his better judgment (assuming it’s against his judgment). Just look at what the Democrats in Congress did with the stimulus bill and the budget. Neither the expense nor foolishness of those legislative monstrosities were sufficient to get him to veto them.
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Furthermore, “the lack of access” argument applies regardless of whether one shifts to a single payer system or leaves insurance companies and HMOs in control. Just look at what is going on in Massachusetts right now. Insurance companies and HMOs are in control of the state’s compulsory health care system, yet delays and shortages are an everyday occurrence. That’s because the system lacks facilities, equipment, supplies, trained doctors and nurses to meet the needs of the increased demand. This is an aspect of the question that doesn’t seem to have gotten enough through. The outlay for “shovel ready” projects necessary to sustain the system isn’t being factored into the projected costs. This could be just another instance of a well-intended plan that goes off the rails and ends up spiraling out of control because nobody factored in the costs necessary to sustain it. Sure, everyone will get a ticket to come in. They may only get a flea circus, but they’ll be welcome in.
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Don’t worry yourself about Republicans and their plans. Dismissing their plans doesn’t make the ultimate resolution correct. The Democrats have the votes to decide what will be. It is entirely in their corner to decide whether to do the right thing or something foolish.

seeing the DR.
So what makes you or anyone else think that we can do it better? I guarantee you the GOV'T will screw it up. If it aint broke and the gov't gets involved it will be broke. People just look at history, history does not lie..
Posted by: skier1 | May 13, 2009 3:48 PM
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Does the GOP pay you by the word to shill for the corporate insurance industry, the richest 2%, big oil and big business at the expense of the middle class and poor? If not, they should.

The funds for healthcare are in jeopardy because of profligate spending followed by a revenue-draining economic crash. This problem has Bush's fingerprints on it.

Of course, the Republicans are chomping at the bit to say, "Oh! This is too hard! Let's just abandon it!" Kind of like Afghanistan.

Keep opposing healthcare, Wingnuts. Nothing you do could guarantee your insignificance as a party in the future more than what you're doing now with healthcare.

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Posted by: BigCheese | May 13, 2009 2:42 PM
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What a laugh. No one needs to kill Social Security or Medicare. Those programs have enough congenital defects from birth that they will die on their own without any outside effort. They were poorly constructed. Payroll taxes to fund these programs are a joke. Congress gets to spend all of the money earmarked for these programs anyway. That’s why those programs are going bust. Had someone actually heeded the calls to reform Social Security, and take away Congress’ access to the cookie jar, Social Security and Medicare might have been able to last indefinitely.
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Your idea for increasing competition by going to a single payer system had me rolling on the floor laughing. The competition necessary to lower costs will abruptly cease the moment the government goes to a single payer system. Just look at what goes on in Canada and France. Private medical institutions are few and far between in these countries, and exist only to provide extra coverage for what the governments don’t provide. In which case, everyone gets taxed through the nose for the governments’ plans but still have to pay for high end medical treatment the government won’t cover.
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If lowering the cost of health care is the object, the answer is to get government less involved in regulating the health care industry, and less generous toward insurance companies and HMOs with taxpayers’ money. Remove the anti-competition regulations that give insurance companies and HMOs the pretext to charge everyone rates that are appropriate only for high-risk patients. Enact consumer protection laws to prevent gouging. Get the government to set prices that it is willing to pay for goods and services, and demand competitive bidding instead of paying whatever the health care industry asks. After you’ve done all that, enact limitations on damage awards for malpractice actions. As of now, the highest single CODB for doctors and hospitals comes from malpractice insurance. Hundreds, if not thousands, of doctors can’t and don’t practice medicine anymore because malpractice insurance costs are prohibitive. This is also a cost that is spread to consumers in the form of higher health care premiums. Go to the source of the problem to solve it. Don’t accept the standard Democrat answer of throwing more money at it. We don’t have the money to throw.

“The funds for healthcare are in jeopardy because of profligate spending followed by a revenue-draining economic crash. This problem has Bush's fingerprints on it.”
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Posted by: DrainYou | May 13, 2009 4:30 PM
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You couldn’t be more ridiculous if you tried. The funds for health care are in jeopardy because those in Congress can’t keep their hand off of them. The economic crash, if that is what you choose to call it, was caused by bad business practices in the private sector. It was not caused by the government. If you wish to continue with the sob story that the lack of government regulation caused the crash, then you had better explain the violent resistance from Democrats to regulation despite multiple warnings from Duh’bya and his capos.
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Way to go JohnEEE-boy.

Don’t accept the standard Democrat answer of throwing more money at it. We don’t have the money to throw.

Posted by: John W. | May 13, 2009 5:16 PM
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Government doesn't work under Republican leadership (of which you are supportive of because you can't get a clown Libertarian elected) because you hate government, thus your party is purposely incompetent as you go about selling out the American people to the highest bidder and pocketing the kickbacks.

Your paranoid delusions about black helicopters from the government coming to take us away are hilarious. I would think a jobless loser like yourself would be thankful for any help they could get instead of spending all of their time writing page long anti-government screeds on a message board all day long. Timothy McVeigh? Is that you?
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http://www.youtube.com/watch?v=7QDv4sYwjO0

I'd like to see them try something. It is ridiculous to end up losing your home because you have a catastrophic illness and have to choose between paying medical bills including the enormous costs of drugs to make you healthy, your insurance, or your mortgage. Healthcare should be not-for-profit. The stress of losing your home and paying bills can delay your recovery. Anyone who does not think something should be done must never have gone through the ordeal of having to deal with this.

If I Didn't Have to Worry about Private Health Insurance, I'd see the doctor more often.

I'd have all the Dr. Recommended tests done, without worrying about not being able to get into a plan because of pre-existing conditions like high blood pressure or high cholesterol -- yes, yes, I held off on those because my wife's job was in jeopardy last year and I knew I'd have to buy private insurance some day.

I wouldn't worry about losing our house and becoming homeless if one of us got seriously sick.

I wouldn't put off medical concerns for fear that it would destroy my family financially...

...And I wouldn't feel stupid about going in about something that turned out to be nothing at all, while having to pay hundreds of dollars out of pocket just to have a doctor glance at me.

If I didn't have to worry about private health care...unemployment in the family would be a lot less stressful.

If I didn't have to worry about private health care, my wife's second pregnancy would have been more joyful and less stressful. And the new baby wouldn't come into my hands with my worrying how we're going to afford to pay for the delivery.

I wouldn't have to make call after call after call about why this or that wasn't covered or reimbursed, only to get half responses, put on hold for a half hour, and then just dismissed out of hand.

I wouldn't have to appeal and be denied my claim for coverage because the private insurance company pulled a bait and switch.

I wouldn't have to meet with a parade of health insurance agents who each reassure me that they're working for ME, and each confidently tell me that their insurance will follow through on its promises...despite the small print.

My talented friend with diabetes could quit her dead-end job where they pay her peanuts and offer an anemic medical plan, and she could start her own practice as a child therapist and hire her own office manager.

My friend who owns a software company could hire another programmer, and businesses around the country could do what they do best and be competitive, and not have to double as America's social safety net.

I wouldn't have to hear my friends' stories about how group insurance premiums skyrocketed so their positions were eliminated and they were hired back as "contractors" with no benefits.

Manufacturers' legacy costs would be much, much smaller, their products would be less expensive and globally more competitive, and potentially thousands of jobs could have been saved.

If I didn't have to worry about private insurance, the worry over my child's midnight illness and high fever wouldn't be compounded by the worry over a hundreds of dollars visit to the emergency room.

Maybe my take-home pay would be a bit less. But it's already less, and I could budget around it.

John W is right. The Healthcare industry is dying to lower prices, but the big bad government won't let them. Trust the corporations. They only want what's best for you. Get the democratically elected government , answerable to the people out of the picture, and the for-profit corporations that answer to no one other than their share holders will make everything perfect for you, the humble patient. Then unicorns will dance in the flowers and the sun will shine on the Chocolate sundae mountain every day in our deregulated corporate controlled utopia.

http://content.healthaffairs.org/cgi/reprint/22/2/230.pdf

http://blog.ritterim.com/2009/05/06/medicare-payments-to-hospital-will-remain-relatively-flat-in-2010/

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Posted by: The Republican Mother Goose | May 13, 2009 6:25 PM
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You have completely misrepresented my statements. Then again, I am not surprised. If you noticed, I suggested that consumer protection laws be put in place to counter unfair treatment. That is some government control.
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What you can’t seem to understand is that certain government regulations drive prices up because none of the insurance companies and HMOs can afford to allow prices to go any lower because of them. Without these regulations, the insurance companies would have no excuse or pretext not to offer better, more competitive prices. Natural market forces would drive prices down because some insurance companies and HMOs would take the opportunity to undercut their competitors’ prices to capture a larger market share. I suppose you wouldn’t know that because you spend more time with coloring books filled with dancing unicorns than you do watching GEICO, Progressive or Allstate commercials. Your susceptibility to fantasies filled with fairy-tale creatures is also why you actually think democratically elected government is a better answer to problems. It keeps you from the REALITY that existing federal medical programs are going the way of the Dodo Bird because of bungled legislation, mismanagement and greedy politicians.

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Posted by: unemployed lawyer | May 13, 2009 5:47 PM
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Your post is both inaccurate and non-responsive, Troll-Boy. You really should spend more time acquainting your two brain cells.

Posted by: The Republican Mother Goose | May 13, 2009 6:25 PM
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You have completely misrepresented my statements. Then again, I am not surprised. If you noticed, I suggested that consumer protection laws be put in place to counter unfair treatment. That is some government control.
Posted by: John W. | May 13, 2009 7:37 PM
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Dubya,
All of this anti-government bluster and bloviating from you and yet you still can't get anyone from your far rightwing fantasy team elected....I'm shocked!....not

Republican Mother Goose,
I couldn't agree with you more. If you listen to Johnny W long enough you'd think that his fringe anti-government/no insurance for anyone who can't afford it stance is a popular position.....because he says so.

It is refreshing to see that an otherwise intelligent blog site has degenerated into name calling.

It does not bode well for health care reform.

We have a system that costs 40% more than the next most expensive country.

We have a system that costs 60% more than the average for industrialized countries, even adjusting for everything that statisticians can think to adjust for.

We have people dying everyday for lack of health care insurance.

We have people dying every day from prescription drug errors.

Patient complaints in other countries don't hold a candle to patient and would be patient complaints in this country.

Yet people think there are no opportunities for cost savings in this country.

Yet people think that the complaints of people in other countries are reasons not to address the complaints of people in this country.

In what other arena do we listen to the complaints of people in other countries.

If we are honest, we will admit that there is no perfect solution.

We will also admit that we do have one near-perfect health care mess in this country.

Ideological blinders and name calling will not get us any closer to a solution.

“Dubya,
All of this anti-government bluster and bloviating from you and yet you still can't get anyone from your far rightwing fantasy team elected....I'm shocked!....not”
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Posted by: unemployed lawyer | May 13, 2009 8:40 PM
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If one precisely followed your mode of thinking (because I cannot call it reasoning), then one would have to conclude that getting someone elected == being right, and losing in an election == being wrong. Okay. If so, then you must admit that Bush was right for eight years and that you wrongly criticized him, inasmuch as he defeated Al Gore in 2000 and John Kerry in 2004. No? One would also have to conclude that Hitler was right and his political opponents were wrong because his Nazi Party received the largest number of votes in the plurality government. Yes? No?
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What you have done is invoke the fallacy of “Appeal to Popularity” (also known as “Ad Populum”). (See http://www.nizkor.org/features/fallacies/appeal-to-popularity.html ) The fallacy appears in the form: (1) most people approve of (or have favorable emotions toward) X, and (2) therefore X is true. It is not unlike the fallacy of “appeal to authority.” I commend the entire web page to you. (See http://www.nizkor.org/features/fallacies/ ) It explains your entire raison d’être.
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Oh, and BTW: My views do not represent in any material respect anything that can be correctly described as “right wing.” The kind of “right wingers” you keep talking about are those who favor a totalitarian or authoritarian government along the lines of fascism or Stalinism. To the contrary, those of you who favor big government intervention in all aspects of the economy and society are the ones walking the same path that took the German people from a nominal monarchy to Nazism. It is because of you, I fear, that the lessons of history will be ultimately lost, and the tragedies of the past will be repeated.

Listen Boys anjd Girl's, John W is getting to the best part of the story.Listen closely while he tells you about the monster. I know it's scary, but ther is a big monster in our story called "democratically elected government" John W going to tell you about what a scary, evil monster it is. But don't worry, our story has a whole group of heros called "corporations". The heros are nice and caring,. The Corporation Heros would never hurt you, no, not like the bad, bad "democratically elected government" monster. Ciorporate Heros are never greedy. Not at all, no only the evil democratically governemnet is greedy. Sometimes people will tell you Corporate Hero's are greedy, but they are wrong, which is the moral of John W's fairy tale, that he's telling us..Let's all cheer for the wonderful corporation hereos as John W tell us about how they will take care of you when you get sick, if they can just destroy the monster that is trying to stop them. What's that, little Jenny? You are already sick? Oh dear. Well, Jenny, this story isn''t for you. The Corporate Heros in John W's story only want to help the healthy people. So why don't you go sit in the corner, ok.
OK, healthy kids, before John W continues his story, let's all say together "Democratically elected government is bad! Booo! Corporations are good! Yay!"

I'm still searching for the Constitutional provision that allows for government-run or government-paid health care. I've been practicing law since 1998 and still haven't run across anything like that. Can someone be kind enough to point it out for me?

I am a retired, union transit worker and I receive a small pension, due to the fact that I had to retire early, after 17 years of service. Throughout those years, I worked physical labor, basically, even up until I retired, at age, 61 years. I had cancer and could not continue to work. After the cancer treatment, which left me with no strength and absolutely, no stamina. After two years, I still have difficulty walking 2-3 city blocks. My healthcare was being paid for, by the Transit Company and myself, according to our contract, which was already in place, when I was hired. I worked hard for The Company, sweeping 48-50 railcars, a night, through rain, wind, snow and ice. There were plenty of nights, I went out into the rail yard, trying to find the " third rail ", for the snow had buried it and I had a job to do !! Given all of the hazards, the cars were swept every night and the inspectors were lucky to find a spent match stick, on my rail cars !! In other words, I gave them my best, in terms of doing my job, for a decent wage.
I received in the mail, yesterday, an announcement, that the Transit Company will be holding meetings, this coming Monday and Tuesday, on the south-side of the city, to discuss the changes that will be put in place by July 1, 2009. Their consideration, to disseminate this vital information to its former employees, on such short notice, by mail, and two gathering places, for two meetings, on the same day, and at difficult places to get to, only told me one thing. They are ramming these changes, all in their favor, down our throats !!
The changes, I will be forced to pay, a monthly charge of $550, to retain the same healthcare company, with increased premiums and more co-payments. That is an increase of cost, from $25, every payday, when I was working, to $550 a month. The Transit company deflects criticism with; "the legislature ordered it" !! I took early retirement and early Social Security, a fixed income, and they just took a little over a quarter of my income away, in the dead of night, in a smoke-filled room, in the midst the politicians of our state !!
They have violated our contract, denied us benefits they promised. This, while they presently are receiving the most revenues in their history and the retirees bear the burden !! What will happen to me, concerning the follow-up therapy and treatment of my cancer ? I am weighing the choices. Do I give up more than a quarter of my income, for the healthcare insurance ? That will leave me strapped and given that, with my illness, I already do very little, and do not have the strength to do much more. Now, I have to worry about healthcare and all of my other bills, rent, phone, utilities and food. I am not on the street yet and I don't know how long I would survive, if I were. Maybe I will join my buddy, a Vietnam Vet, who is in a nursing home, after being on the streets, for years. It is shelter, it is company and it is all this nation is willing to offer, its Vets, its workers, because they chose to do their work and honor their part of the bargain, the contract. Yet, business can negate contracts, just by crying " no money " and we knowing, they have never had so much money !!
That is why we ask for change. Change from the mindless people, who consider all of these people, who are not in their clique, potential marks, victims. Just as long as they get theirs, in one form or another. They have stacked the ranks of the Transit Company with political operatives, hacks and just plain, non-workers, and non-union, at that, and then crack the whip, on those that are good workers. A great many people know that this is going on in most of the agencies of the city, from politicians, who claim to be independent of those old patronage ways, to city newspapers, who look the other way, for they want favors done, as well !!
Until we say no, to all of those in government, and out of government, that will not treat every person, the way they insist, upon being treated, we will continue to have a workforce that isn't doing its job and is not serving the nation, at all. From the CEO, to the Mayor, to the street sweeper, we are in this together, we must work together or we will not survive. If we do not start treating our citizens like human beings, in stead of beasts of burden, our streets will become even meaner. So what are you going to do, double the standing Army, we have, right now, in the streets and buildings of America, the law enforcement officers, sheriffs, deputies and all or are we going to be more considerate, more fair-minded and yes, more compassionate, than we have been, up to this point, in our history !!? That., America, is what we, and myself, are facing. I hope we act in the best interests of all the people, not in the best interests of an agenda, a political strategy !! May God bless, all of us ! Good luck, America.
SUPPORT OUR TROOPS, BRING THEM HOME, ALIVE AND WHOLE. NOW.

All very touching, Don, but where is the Constitutional authority for nationalized healthcare?

Where in the constitution is the authority for mass transit, for interstate highways, public education, Social Security, taxes, $5 a gallon of gasoline, $15-$150 million dollar, yearly payout to CEOs, unemployment compensation, minimum wage, 5 day work week, 8 hour work day, laws against child labor. Need I go on, or does that begin to answer your question, you, that hides behind a phony name !!? I wasn't looking to be " touching ", I was stating facts, facts that I hope, will open peoples' eyes, to a broken economic system in America, controlled, for the most part, by greedy, narrow-minded, little people, who are only interested in staying in power, or having their cake and denying everyone else theirs !! Is that the America, that you wish to champion ? I sure hope not, you that hides behind false names !!
SUPPORT OUR TROOPS, BRING THEM HOME, ALIVE AND WHOLE. NOW.

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Posted by: Don Fitzgerald, America | May 14, 2009 9:44 AM
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Your story is very compelling, Don. I wish I could help you or give you legal advice. Unfortunately, I can do neither because I doubt that you live in the jurisdiction in which I practice law. It doesn’t snow here on the left coast.
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My best, friendly, non-legal advice would be to find someone who can tell you if you have any practical, legal recourse against your former employer. You will never know unless you ask, and your situation won’t get worse by asking. Maybe someone at the union can point you in the right direction.

Don wrote: "Where in the constitution is the authority for mass transit, for interstate highways, public education, Social Security, taxes, $5 a gallon of gasoline, $15-$150 million dollar, yearly payout to CEOs, unemployment compensation, minimum wage, 5 day work week, 8 hour work day, laws against child labor."

I'm with you, brother. Most if not all of these programs (along with about 90% of what the federal government does) are constitutionally suspect and should be eliminated. The America I wish to champion is one that circumscribes the power of the federal government to confirm to its constitutional limitations.

Thanks for the reasonable comment," John W. ". As you know, when that steamroller starts moving, it is very difficult to stop. You are right, though, the legal avenue, is the logical, jumping off point. As for union advice. our union, is an in-house union, which more often than not, will give legal advice to the Transit Company, before it gives advice to us, its members. The Transit Company has co-opted the union executives, with promises of lucrative positions with the Transit company, after they leave the union. in spite of that disappointing flaw in our union, I am still a champion of the union, if for now other reason, it does protect us from the whims of political appointees and incompetent management !! That is another issue, though. Thanks, again, for at least a modicum of concern !!
SUPPORT OUR TROOPS, BRING THEM HOME, ALIVE AND WHOLE. NOW.

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Posted by: Republican Mother Goose | May 14, 2009 7:29 AM
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The only fairy tale here is the one you have concocted. I never suggested that corporations are all good or that government is all bad or evil. I suspect that both are a mixture of good and evil in some proportion. However, my point wasn’t to attempt a moral assessment of each. Your error is in suggesting that I have.
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The question is one of efficiency. Take a look at the headlines from a couple days ago. They told us that Medicare is going to run out of money in eight (8) years. We also know the government could run us trillions of dollars more into debt if it attempts to pay the Social Security benefits of all the baby boomers as their retire. How could any of this happen if the government had properly structured and funded these programs? Congress has not only poorly structured and funded these financial monstrosities, it has also resisted taking any corrective action. Again, how could any of this occur if the matters were entrusted to a vigilant and caring government? There can be little doubt that the economy would be dead and buried by tomorrow if all businesses in the private sector were run with the same level of incompetence and malfeasance that we see practiced in the federal government. So you see, it’s not that government should be necessarily hated as something evil. It’s that it should be mistrusted because of its incompetence.
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Love them or hate them, private businesses, unlike governments, don’t exist for long if they are run incompetently. Businesses can also be coerced and motivated by laws and market forces to function for the public good. For example, Obama’s proposed cap and trade regulations are based on market forces to motivate industries to pollute less. It is the bottom line desire of industries to make money that provides that motivation. Hence, the very selfishness and evil you deplore can be manipulated to enhance the condition of society as a whole.
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I simply suggest that we remove the stumbling blocks to being able to use existing health care businesses to improve the situation. The removal of certain regulations (rather than all regulations, as you implied), regulation of government pricing and payment, and implementing some reasonable tort reform could be used to motivate and manipulate insurance companies and HMOs to provide better health care at more affordable prices. If you don’t think that’s worth a try, then you really do live in a fantasy world.

Don wrote: "Where in the constitution is the authority for mass transit, for interstate highways, public education, Social Security, taxes, $5 a gallon of gasoline, $15-$150 million dollar, yearly payout to CEOs, unemployment compensation, minimum wage, 5 day work week, 8 hour work day, laws against child labor."

I'm with you, brother. We're absolutely awash in constitutionally suspect federal programs and laws. Probably 90% of what the federal government does is beyond the scope of the power granted to it by the several states, and should be subjected to appropriate scrutiny and either judicial challenge or repeal.

Glad to see we share so much common ground, including the lack of any Constitutional warrant for nationalized healthcare. I champion an America where we respect our founding document and force the federal government to comply with its limitations. Contrary to the popular misconception, the feds serve the people, and not the other way around.

I'm still searching for the Constitutional provision that allows for government-run or government-paid health care. I've been practicing law since 1998 and still haven't run across anything like that. Can someone be kind enough to point it out for me?

Posted by: Constitution reader | May 14, 2009 9:11 AM

Here you go:

Section 8. The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States;

To regulate commerce with foreign nations, and among the several states, and with the Indian tribes;

Nice try, Publius. This section has nothing to do with nationalized healthcare. The "general welfare of the United States" is not synonymous with the "specific welfare of individual citizens."

Next contestant.

" John W ", it is the government, the taxpayers that are bailing-out Big Business, from the Airlines Corps, to the Banks and Insurance Corps, not the other way around !! So much for market based actions. Thank God, the government was able to help, otherwise, chaos may have ben unleashed, across the land !!
SUPPORT OUR TROOPS, BRING THEM HOME, ALIVE AND WHOLE. NOW.

Real Healthcare Reform:
Changing Priorities, Incentives and the Rules of the Game; Creating an Electronic Health Record for Every Citizen Who Wants One

If you have the financial resources of Bill Gates or Warren Buffett you needn’t pay money to a health plan each month, since if you get sick or injured – even very seriously - you have more than enough money to pay all your medical bills yourself.

But those of us who have significantly less financial resources must find some other means of dealing with the thousands or even hundreds of thousands of dollars or more of medical expenses that we might incur should a serious illness or injury be our fate.

Enter the concept of “health insurance”.

Large numbers of individuals and/or their employers pay some money each month into one or another big pot called a “health plan”. Those individuals who remain essentially very healthy for many years and then suddenly die or perhaps leave a particular health plan for some other reason – if they have put more money into the pot than was taken out to pay all their medical expenses - wind up helping to pay the medical bills of those members of the health plan who become seriously ill or injured and incur a lot of medical expenses.

Many Americans covered by some form of health insurance don’t seem to fully understand or perhaps choose to ignore the fact that if they become seriously ill or injured, for the most part their medical bills will be paid by the members of their health plan who have remained healthy. Keeping members of a health plan healthy by preventing illness and injury is critically important, but is something not currently given the high priority and attention it deserves.

Some Americans believe that healthcare should become a “right” of every American citizen. If a nationalized single payer health plan were enacted, every American citizen who became ill or injured - for any reason whatsoever - and incurred significant medical expenses would for the most part have his or her medical bills paid by U.S. taxpayers. Many Americans oppose such a system for America recognizing that significant difficulties such as long waiting periods and rationing of care exist in such types of all inclusive government healthcare systems that currently operate in other countries such as Canada and the United Kingdom.

For any health plan to work which has a large number of people pooling their money to essentially pay the medical bills of whichever members of the plan become seriously ill or injured, rules must be established as to when and how much money may be taken out of the pot e.g. “legitimate” doctor bills and hospital bills. Equally important is keeping track of the amount of money that is being put into the pot each month in premiums paid by health plan members or their employers. If too much is being paid out in expenses as compared with the amount being received in premiums, the pot will soon become empty and the health plan will go broke.

As previously mentioned, the monthly premiums paid by individuals or their employers go into a health plan’s big pot from which “covered” healthcare expenses are paid. But also from this pot are paid all the health plan’s administrative expenses including what may be big salaries and golden parachutes for CEO’s and other “healthcare executives” – individuals who may be paid to find technicalities of one sort or another in the health plan’s agreements so the health plan can deny or reduce payments, raise premiums, cancel insurance, or in one way or another minimize or exclude “bad risks” from the health plan. All such questionable business practices are done to enable the health plan to make a profit and remain in business.

Currently we are experiencing continual increases in healthcare costs that are unsustainable and which, if unchecked, will soon seriously threaten the future of the entire American economy. Healthcare costs must be controlled, but how? If a healthcare system made up of health plans is going to have a chance of both meeting the needs of health plan members and simultaneously develop the ability to keep costs under control, priorities, incentives, and the rules by which the game is played all must be changed.

The good news is that a lot of illnesses and many injuries are actually preventable. But how will prevention ever become a top medical priority when doctors, hospitals, and other providers get paid largely for diagnosing and treating illness and injury, not for preventing it?

Although health promotion and disease and injury prevention receive fashionable and socially acceptable lip service, the fact is that most of the participants in what should be more appropriately called our “sickness and injury care system” actually have no significant financial incentive whatsoever to spend any significant time and energy in genuinely promoting health and helping to prevent disease and injury.

Much to the contrary. Other than the actual members of a health plan – patients and potential patients - and their employers and perhaps the employees of some health plans, most participants in our sickness and injury care system - because of the way they are paid - have an enormous (if unspoken) financial incentive for massive amounts of disease and injury – much of which is preventable – to continue to occur in America. Strictly from a financial point of view, for those whose incomes come solely from the treatment – not the prevention - of illness and injury, the more illness and injury that occurs, the better. And if the illness or injury is serious and requires perhaps many expensive tests, multiple surgical procedures, and other very complicated prolonged treatment in an intensive care unit, so much the better; just as long as those unfortunate individuals who happen to be ill or injured are “covered” by “good insurance”, i.e. health plans that are reliable bill payers.

This is not to say that there are not some excellent very dedicated and hardworking doctors and other health professionals - although they are paid on a fee for service basis to care for illness and injury – who nevertheless attempt to essentially work themselves out of a job by making health promotion and disease and injury prevention a top priority with their patients.

It should also be recognized that some existing health plans – e.g. Kaiser and Group Health - combine insurance, doctors, and hospitals into a single entity in such a way that provides everyone - including all the health plan’s doctors - a real incentive to spend time and effort with patients on health promotion and disease and injury prevention as well as on early diagnosis and treatment. But unfortunately the above examples represent only a small part of the sickness and injury care system that currently exists throughout America.

For the most part - because of the way they are compensated – the majority of doctors and other professional providers, acute care hospitals and long term care facilities, pharmaceutical manufactures and pharmacists, medical and surgical equipment manufacturers and personal injury and malpractice attorneys - among others - depend mightily on massive amounts of disease and injury occurring in America; and these participants in our sickness and injury care system would be significantly negatively impacted if a lot of the preventable illnesses and injuries were actually prevented. This must be changed.

Unless the incentives and rules are changed to give as many participants as possible a real financial stake in health promotion and disease and injury prevention, in early diagnosis and treatment, and in maximizing health and minimizing disease and injury, healthcare costs in America will never be brought under control. Making appropriate changes in the incentives and the rules of the game is the real task and challenge of “healthcare reform”.

What about financial incentives for individual health plan members? Should individuals receive a financial incentive to be healthy? It is well recognized that engaging in regular exercise, abstaining from tobacco, and eating moderately so as to maintain a reasonably normal body weight are all significant factors in helping to promote an individual’s health and wellness. These healthy behaviors can all be confirmed by simple tests performed or ordered in a doctor’s office. Why shouldn’t those individuals who practice these health promoting behaviors and comply with recommended immunization schedules and appropriate preventive screening examinations such as for colon cancer and breast cancer pay significantly less in premiums to their health plan each month than those who don’t?

To really reform healthcare we must find ways – through changes in incentives and the rules of the game - to actually prevent what is preventable, to maximize early diagnosis and treatment, and minimize disease and injury with all its associated cost. We must find ways for participants to be part of our “healthcare system” and not just a part of our “sickness and injury care system”.

Significant changes in the rules of the game for our legal system – tort reform – is also critically important so that the gaming of the system now being done by personal injury and malpractice attorneys and their clients can be ended and so that the exorbitant costs to physicians and other professionals for malpractice insurance can be dramatically reduced.

Truly transforming our “sickness and injury care system” into a “healthcare system” by making significant changes in the incentives and the rules of the game may seem to be a formidable task and one that probably has never really been done before on a large scale anywhere in the world. But it is a worthy task and a critically important task for the future of America and its people.

One significant part of this process is developing the capability of creating an electronic health record for every American citizen who wants one. We need a standardized framework that will allow every American citizen to have an individual electronic health record – a computerized medical record - that can be accessed by all the doctors who care for a particular individual, regardless of wherever on the planet the doctors or the patients happen to be. It would be like having your own personal online banking account that only you have the password to, but which you can share with the doctors who are caring for you, wherever you or they may be.

I applaud those who are using their energy and expertise to upgrade our deplorable current paper medical records system and bring medical records in America into the 21st century. Developing a standardized framework for an electronic health record - for every citizen who wants one – created by your doctor with your assistance, with proper security and safeguards - is something that our national government can and should do as a part of healthcare reform.

If done well, electronic health records will be transformational in helping doctors efficiently and effectively care for patients and will save an enormous amount of time, effort, and money which is currently wasted on needless and frequently inaccurate duplication. And having an accurate electronic health record for an individual will also facilitate appropriate health promotion and disease and injury prevention for that individual. Like the telephone and the computer, someday we will all wonder how we ever got along without individual electronic health records.

But all this requires action, not just words. Now is the time for Americans and their leaders and doctors and other health professionals to step up to the plate and begin the process of transforming our “American Sickness and Injury Care System” into an “American Healthcare System” that is worthy of our great country.

Robert Westafer M.D.

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Posted by: The guy who hides behind false names (so sayeth Don) | May 14, 2009 3:46 PM
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Bravo! That was a very witty turnaround on Don’s premise that constitutional authority need not exist. However, it is not correct to say that all of the matters Don mentioned are constitutionally suspect. They would only be constitutionally suspect if enacted by a government, and the federal government in particular.
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There is no constitutional impediment to $5 a gallon of gasoline or $15-$150 million dollar, yearly payouts to CEOs. Those exist largely due to private agreements and market prices rather than some state action. The power to tax is found in the federal Constitution as well as those of every state. (And taxes account for much of the now mythical $5 per gallon gasoline.) Just about everything else would be permissible if enacted by some state legislature (except for interstate highways.) The federal interstate highway system (contrary to popular belief) was enacted as a “necessary and proper” means of fulfilling the federal government’s constitutional duties of national defense. One has to be able to move soldiers and military resources from the center of a nation to its extremes, or from one extreme to another, to defend against invasion. That is arguably a legitimate exercise of federal power under Mcculloch v. Maryland, 17 U. S. 316 (1819), even if the civilian population reaps a windfall in peacetime.
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The problem occurs when, as here, the federal government tries to do any of the rest without a clear constitutional mandate. Unlike the states that are limited only by their own constitutions and the extent of their sovereign territories, the federal government’s powers are limited to those enumerated in the Constitution.

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Posted by: Publius | May 14, 2009 5:11 PM
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Of the two portions of the Constitution you cite to expand federal authority, the “commerce clause” power offers the least valid justification to control health care. In the first place, health care is largely a local phenomenon which consists mostly of personal services provided on site. In the second place, the health care industry cannot properly be described as engaging in commerce. To be involved in “interstate commerce” an activity must somehow relate to the manufacture, production, transfer, transportation, exchange or buying and selling of goods or commodities that have an interstate or international market. Personal services are not “goods” or “commodities.” Otherwise there could be no sensible semantic or rational limit to Congress’ commerce power. Furthermore, Congress’ ability to regulate non-economic activity under the Commerce Clause is limited to those situations where the failure to do so could undercut other legitimate regulation of interstate commerce. That, of course, is not the case regarding Congress’ wish to get involved in regulating the health care. The goal is to provide health care, rather than to remove some obstruction to the flow of medical goods in the stream of commerce. Therefore, regulating the medical industry under the rubric of the Commerce Clause is dubious at best. I might add that there are at least five conservatives on the U.S. Supreme Court who are hostile toward reading the Commerce Clause as expansively as would be required to sustain regulation of the medical industry under it.
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The so called “general welfare” clause doesn’t fare much better. Even if one assumes, as true, the dubious proposition that Article I, Section 8, Clause 1 of the Constitution confers on Congress the power to spend for the “general welfare” without reference to any of the other enumerated powers (as Publius, here, urges), it still breaks down on the limitations that have grown up around that view. In particular, the cases dealing with the “general welfare” or “spending” clause require that the spending be done pursuant to a national plan or purpose, rather than a local one. Likewise, the national plan or purpose cannot infringe upon the prerogatives of the individual states. The point of these limitations is to insure that the federal government with “limited powers” doesn’t morph into a general government through the pretext of spending money. Clearly, a national health care plan, in just about any form, can’t help but infringe upon the prerogatives of the states. In dividing the respective spheres of political power between the federal government and the States, the latter have always traditionally and historically wielded the power to regulate the health, welfare and safety of their citizens and residents. In equal proportion, the federal government has not. In any event, if a plan comes out that involves more regulation of insurance companies and HMOs, and spending only on a small percentage of the population, then one might genuinely question whether the spending makes up part of a national plan or purpose.
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In addition, good grounds exist to question the continued validity of the foregoing view of the so-called “general welfare” clause. If one looks at Article I, Section 8 in its entirety, one notices that the enumerated powers of Congress are separated by semi-colons. In which case, language related to “general welfare” in Clause 1 is not a power separate from the taxing power described therein. In that context, the “common defense and general welfare” language was meant to serve as a limitation on the purposes of taxation, rather than a separate power. It means that the federal government was not to use its taxation power for punitive or prohibitive reasons, or for any purpose other than to raise money to fund the legitimate goals of the federal government. There is nothing in the enumerated powers that can’t be summed up by the phrase “common defense and “general welfare.” Moreover, if the federal government has the power to re-define itself merely by spending money, then most of the enumerated powers in Section 8 are superfluous and surplusage. Most of them can be accomplished by spending money. If there are any doubts, one need only read Madison’s essay on the subject in The Federalist Papers, No. 41. What power might the federal government not exercise, he asked, if it could expand its powers by spending money?
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Those who framed the Constitution were painfully aware that they risked having the states reject the Constitution if it ceded too many powers to the federal government, or if they, by any artifice, made the federal government one with general powers. The entire New York delegation, save Alexander Hamilton, got up and walked out of the Constitutional Convention because they believed the proposed Constitution did just that. Indeed the record of the Constitutional Convention reflects no consciousness of creating anything other than a limited, national government with enumerated powers in order to assuage the fears of the states of overreaching. Much of the resistance to the Constitution from the states (aside from the lack of a bill of rights) still came from those who viewed the Constitution as making the federal government too powerful. Patrick Henry, in the Virginia Ratification Convention, argued against ratification because the taxation power in Article I, Section 8, Clause 1, made the federal government one of unlimited powers. James Madison and Edmund Randolph, both members of the Virginia Delegation to the Constitutional Convention of 1787, explicitly rebutted Henry’s argument, claiming that he and others had misconstrued the clause, and that it was merely descriptive of the overall taxation power (as I described above). (The nearly verbatim exchange in the Virginia Convention can be found in a multi-volume record of the Constitution’s creation and ratification called Elliot’s Debates.) I commend it to anyone who doubts what is being written here. The Virginia Convention voted to ratify the Constitution, but only by a very slim margin. It is questionable if the Constitution would have been ratified by the requisite number of states if the people had understood it to grant such expansive powers as have been granted in the last 73 years. Thus, not only was the original understanding of Article I, Section 8, Clause 1 much more limited, it was also sold to the states based on that limited construction. It is that understanding which controls, or ought to control, in the construction of the Constitution.
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Many other criticisms may be laid at the feet of those jurists who decided the cases in the ‘30s that gave the so called “general welfare” clause the expansive reading it now has. Some based it on the notion that the States could expand the federal government’s power by consent. That reasoning violates the rule laid down in Marbury v. Madison, that the Constitution’s language was intended to fix the powers of the federal government, and that they could not be enlarged by means extraneous to the Constitution itself. The Supreme Court has since disavowed the notion that federal powers could be expanded by the consent or estoppel of the states. (See New York v. United States et al., 505 U.S. 144, 182 (1992).) Other jurists voted to uphold legislation based on the “general welfare” clause on the ground that such legislation was necessary to meet the emergency circumstances caused by the Great Depression. This view was (and is) contradicted by those numerous cases that held, both before and after, that “[e]xtraordinary conditions do not create or enlarge constitutional power. . . . Those who act under ... [constitutional grants of power] ... are not at liberty to transcend the imposed limits because they believe that more or different power is necessary.” (See A.L.A. Schechter Poultry Co. v. United States, 295 U.S. 495, 528-29 (1935), Youngstown Sheet & Tube Co. v. Sawyer, 343 U.S. 579, 588-589, 629, (1952); and see Reid v. Covert, 354 U.S. 1, 5-6 (1957) [“The United States is entirely a creature of the Constitution. Its power and authority have no other source.”].) So, yes, there are plenty of grounds to revisit the issue again.
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I know what you are probably thinking. You are thinking, “This guy is heartless, too wound up in dead letters, and not concerned enough about real, breathing people.” That is not true. I don’t begrudge anyone the help they need. My grudge is with the way the issues have been handled at the expense of the honesty and integrity of our system of government. If we were honest, we would honor the original agreement - the Constitution - which places limits on the federal government. If we wanted to give the federal government a larger role, the honest thing to do would have been to initiate the process to amend the Constitution to transfer those powers to the federal government. That would have given rise to an honest and open national debate about exactly how the lines should be drawn. That hasn't happened. Yet we have a federal government that operates far in excess of its Constitutional powers - as exemplified by the current push for a national health care system. Operating in this manner kills the value of a constitutional system by removing any restraints other than those that are self-imposed. In such a system the Constitution's meaning depends on whatever some official wants it to mean at the moment. At that point, the power of the People to determine their own government is gone.

“‘John W ’, it is the government, the taxpayers that are bailing-out Big Business, from the Airlines Corps, to the Banks and Insurance Corps, not the other way around !!”
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The government should never have started bailing them out. And, in any event, I don’t see how that is really germane to the points I made. It is a fact that businesses in a market system behave with regard to incentives the way I described it. Even Obama seems to think so, which is why he’s planning on implementing a cap and trade system to limit toxic emissions.
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The government’s actions you cite with regard to big business are only temporary. At least, I hope they are. Our government cannot sustain itself and all the massive spending that it is engaged in. One might hope to revive the health care system in a manner that makes it last longer than Medicare. Medicare is scheduled to die from structural defects in eight (8) years. That, in itself, proves the folly of entrusting a health care system to federal control along with everything else it’s trying to do.