Thursday, June 28, 2012

Supreme Court Rulz/Open Thread

Check the SCOTUSblog on Blogroll to your right for live updates and the link to the opinion. Chief Justice Roberts apparently cares about his legacy and the well-being of the private insurance cabal and has thus ruled with the "libs" in upholding the Affordable Care Act.

Here is the continuing New York Times coverage.

Here is the full opinion.

Weigh in, if and when are you able.

29 comments:

John in Lafayette said...

Mattered not to me how this came out. While the ACA is a step in the right direction for some reasons, it exists primarily to further enrich the for-profit insurance companies. That's why there was no public option.

When we get to the day when everyone in America is on Medicare, then we will have something to talk about.

Zee said...

@All—

As we have discussed ad nauseum, I had been hoping that the Patient Protection and Affordable Care Act would be found unconstitutional. Well, it now appears that PPACA has been found constitutional, if the “mandate” is re-interpreted as a “tax.”

(It is some small comfort, at least, that the PPACA could not be upheld under the Commerce Clause, which would have expanded immeasurably Congress’s power over the individual.)

Mildly surprising—though not shocking—to me, is that it was conservative Chief Justice John Roberts who sided with the liberal wing of the Court, not Justice Kennedy. (Is this 5-4 decision once again reflective of a "sharply divided court," or a victory of bipartisanship, I wonder?)

Now, I suppose that I could gnash my teeth and cry out to the universe that Roberts is a traitor to the conservative cause, or speculate that he’s just a tool of the health care insurance industry, or whatever. Certainly, the right-wing chattering class will castigate him no end.

But I’m going to give the man the benefit of the doubt and conclude that he made a reasoned decision based on his deep understanding of the law, and get on with my life.

He sided with me on Washington, D.C. v. Heller and MacDonald v. Chicago. Though the Left howled “judicial activism,” I thought these were sound decisions based on my understanding of American history and the Constitution. How can I now turn around and call the man an idiot because he reached a conclusion different from mine on PPACA?

It’s the law now, and I need to live by it whether or not I agree with it.

Some wag once said that a legal education was merely a special form of brain damage, so nothing that comes out of the courts should ever come as a complete surprise to anyone. That’s why we call court decisions “opinions,” and not “truth.”

I just wish more people on the Left could learn to live with court opinions too, instead of, for example, endlessly re-litigating Bush v. Gore.

Well, back to my vacation. I think we are going to try to ride Independence Pass today.

Anne Lavoie said...

I liked this comment from reader Diana/New York in response to the NYT article:

"This 'victory' was no surprise at all. The health care law was written by corporations, proposed by a corporate president, passed by a corporate congress, and made permanent by a corporate supreme court."

NYT, June 28, 2012 at 7:50 a.m.

Pearl said...

I would only approve a Supreme Court ruling that announced that the well being of the people can only be accomplished by a single payer, government regulated health care system, paid for by a fair and just taxation of the American people.

One can only dream, unfortunately.

Kat said...

So, the 11th Circuit Court of Appeals said the mandate was unconstitutional but had no problems with the expansion of Medicaid.
The Supreme Court came to the opposite conclusion.
Big surprise.

Denis Neville said...

Kansas is stunned by the “Obamacare” ruling.

Our Republican government put all their eggs in the wrong basket. Kansas bet the farm on SCOTUS ruling ACA unconstitutional and lost. Last year Republican Governor Sam Brownback returned a $31.5 million federal grant that would have helped Kansas develop a health insurance exchange, which the ACA law calls for having in place by Jan. 1, 2014. Kansas now faces a Nov. 16 deadline to submit plans to HHS. Brownback today said no action would be taken by his administration to formulate the insurance exchange until after the November election.

Brownback on today’s ruling, "Stopping ObamaCare is now in the hands of the American people.It begins with electing a new president this fall.”

Republican Senator Pat Roberts, “It’s now up to the Congress to repeal and replace this law with step by step, common-sense, cost-cutting solutions that work for Kansans and all Americans, and that’s what I will work to do in the Senate.”

130,000 more Kansans will now become eligible for Medicaid under the ACA law. 350,000 Kansans don’t have health insurance coverage (13% of the population). 53,000 are children.

Anne Lavoie said...

Ok, so we are going to have an automatic and mandatory 'Obama Tax' on every man, women, and child in our country starting in 2014. We can only escape it by agreeing to a contract with one of the private health insurance Sharks. Not much of a choice except for which Shark you want to associate with.

Those contracts will cost us even more than the Obama Tax, although we are at least promised something in exchange, after our million dollar deductible is paid.
If we can't afford the premiums, Uncle Sugar will pay generous subsidies to the Sharks on our behalf, paid for by all of us just like before, only now the government has steered a huge pool of guppies and minnows their way also. 'That's a big fucking deal!' as Biden said. They're all thrilled that they now have the certainty of knowing where their next meal is coming from, guaranteed by Uncle Sugar.

So what happens if WE can't afford the contract (even with subsidies it isn't going to be cheap), or the tax, or just don't want to comply? Do we go to jail for tax evasion, or have our credit rating ruined?

This reminds me of a Protection Racket where criminals shake down the neighborhood to make regular payments to stay safe/healthy/alive (wink, wink). It's a regular source of income for the criminals. This sick twist of a shakedown props up a huge private enterprise sector with coerced payments, support by subsidies, and under threat of tax to force us into the Shark Pool. Sounds like a model for other similar private-public partnerships to come.

Someone is going to get nourished and healthy, but it won't be the general public. It will be the corporate health care sector, and their partners in crime - politicians.

Denis Neville said...

The ACA seems nothing more than a regressive tax on the working poor. The money spent buying the insurance will make actual routine health care unaffordable.

Don McCanne, MD, http://www.pnhp.org/news/2012/june/what-about-the-insurance-subsidies:

Example: 45 year old policyholder, family of four, no employer coverage; the predicted premium for the silver plan (70% actuarial value) is $14,245. By changing only the income level:

Income: $31,155 (133% of poverty)
Premium payment: None - covered by Medicaid
Maximum out-of-pocket costs: None - covered by Medicaid

Income: $31,156 (133% of poverty plus $1)
Premium payment: $935
Maximum out-of-pocket costs: $4,167

“One additional dollar of income results in the family losing the more comprehensive benefits of the Medicaid program, and mandates that they pay a premium of $935 plus potential out-of-pocket expenses of $4,167, for a total exposure of $5,202. That's a staggering amount at this income level. Compliance surely would be a problem, not by lack of will, but simply by inability to pay.”

Income: $93,700 (400% of poverty)
Premium payment: $8,901
Maximum out-of-pocket costs: $8,333

Income: $93,701 (400% of poverty plus $1)
Premium payment: $14,245
Maximum out-of-pocket costs: $12,500

“So at an income of $93,700, the premium would be $8,901 and the potential out-of-pocket costs would be $8,333, for a total exposure of $17,234. That is quite a dent for a family that is trying to save for two college educations, a retirement fund, and maybe for replacement of the broken-down family automobile. But add just one more dollar of income and the premium shoots up to $14,245 and potential out-of-pocket expenses to $12,500, for a total of $26,745. Then what are you going to cut out of the family budget? And isn't the $9,511 increase quite a "tax" to pay on that one dollar of additional income?”

“Just the premium increase alone might cause this family to downgrade their coverage from silver (70% actuarial value) to bronze (60%) in order to save on the premium. If so, this family literally would be placing a bet that none of them would develop a serious medical problem, and it would lose the bet if any of them did so. Should we really be forcing a family to gamble on its health care coverage?”

So Obama and the Democrats are now going to use the IRS to tax poor people, who are unwilling to buy or unable to afford insurance, so as to collect profits for private-for-profit insurance companies?

Single payer, improved Medicare for all!

Neil Gillespie said...

@Zee - "I just wish more people on the Left could learn to live with court opinions too, instead of, for example, endlessly re-litigating Bush v. Gore."

Bush v. Gore was a coup d'état by five justice of the U.S. Supreme Court. We became a banana republic with that so-called decision. The decision stunk so bad that it can never be cited as precedent under stare decisis, the legal principle by which judges are obliged to respect the precedents established by prior decisions.

No one is "endlessly re-litigating Bush v. Gore". The time for rehearing long expired, and there is no appeal beyond the SCOTUS anyway. We have all learned to live with that awful decision, and more importantly, what followed, such as:

The War in Afghanistan, the War in Iraq, all the other wars, coups, and detentions we hardly hear about, and cutting taxes on the rich during a time of multiple wars.

The 2008 Financial Crash, setting aside the rules of capitalism to bailout Too Big To Fail banks, fraudclosure and the mortgage crisis, and the end of the Middle Class as we know it.

Setting aside the rule of law for indefinite detention under NDAA.
Setting aside the rule of law to allow a presidential kill list, including American citizens.
Granting personhood to corporations in Citizens United.
Operation Fast and Furious, the ATF gunwalking scandal
And this gift to the health insurance industry, Obamacare

Bush v. Gore is a legitimate, ongoing subject, see these two recent stories, and one from Nov-2010

NYT May 22, 2012 - Justice Stevens Talks Bush v. Gore

http://takingnote.blogs.nytimes.com/2012/05/22/justice-stevens-talks-bush-v-gore/

"And on Monday at the annual meeting of the American Law Institute, Justice Stevens sounded off on Bush v. Gore—the decision that turned the White House over to George W. Bush. Naturally he didn’t put it that way, but he did call the majority decision "misleading" and criticized the "absence of any coherent rationale supporting the opinion’s reliance on the equal protection clause.""

ABA Journal May 23, 2012 - Retired Justice Stevens Hits ‘Misleading’ Parts of Bush v. Gore, Suggests Extension of Rationale

http://www.abajournal.com/news/article/retired_justice_stevens_hits_misleading_parts_of_bush_v._gore_suggests_exte/

"The principal point I want to make," Stevens said, "concerns the absence of any coherent rationale supporting the opinion’s reliance on the equal protection clause." In Stevens' view, the rationale could be used and extended in voting rights cases—to prevent political gerrymandering.

"My principal purpose in calling your attention to the court’s reliance on the equal protection clause in Bush against Gore is to emphasize how that provision of our Constitution, properly construed, would invalidate an invidious form of political behavior that remains popular today," he said. "If a mere defect in the standards governing voting recount practices can violate the state’s duty to govern impartially, surely it must follow that the intentional practice of drawing bizarre boundaries of electoral districts in order to enhance the political power of the dominant party is unconstitutional."

National Journal Nov-30-2010 - Just How Bad Was Bush v. Gore?

http://www.nationaljournal.com/dailyfray/just-how-bad-was-bush-v-gore--20101129

"It's been ten years since the Supreme Court decided Bush v. Gore, and everyone involved--especially the justices themselves--would like it to slip out of our collective memories."

Some of us believe we have a duty NOT to let it slip out of our collective memories.

Jay - Ottawa said...

“Whatever the politics, today’s decision was a victory for people all over this country whose lives are more secure because of this law.”
-- President Obama

Huh? So far I, as a non-lawyer, have only skimmed over and skipped through the decision’s 193 pages, thanks to the link provided by Karen. Here’s my first and admittedly hasty impression as to who is and who is not more secure with regard to the two major provisions of the ACA: (1) the individual mandate; and (2) Congressional demands upon states for a proposed expansion of Medicaid.

N.B.: Since Justice Roberts in his decision devoted many a snide aside to the "wisdom" or not of ACA, perhaps I should also preface my remarks by stating how near or far we are positioned from wisdom today. The following discussion and my tallies are laid down within the odd boundaries of an absurdity, that is, the ACA itself seen as a solution. Nevertheless, the corporatists have decreed -- and the majority must abide by their decree -- that Medicare for all is an absurdity for the USA, although everywhere else in the advanced world some form of Medicare for all is considered reasonable, doable and, in fact, since you ask, long done quite nicely with much less grinding of gears. Anyway, on the strange matter of how many judges can dance on the head of a pinhead law:

For the individual mandate:
Corporatists + Ginsberg – 5 yes
Tea Baggers – 4 no

For the new Medicaid requirements upon states:
Tea Baggers and Corporatists – 8 no
Ginsberg – 1 yes

As for the scores of “lesser” provisions within ACA, some of which are helpful:
Tea Baggers – 4 absolutely not
Roberts + the 3-4 corporatists -- ??

Many of these individual initiatives get their own paragraphs in the decision. I just haven’t read that deeply into the Roberts decision and the Ginsberg dissent yet, but I suspect he and she and they allow most of those innovations to fly.

Here’s what it probably boils down to, as predicted by many critics, like me, who always wanted single payer -- and still do. (We were once a majority.)

If you’re poor or not very well-to-do, you’re still skating on thin ice. You’re not likely to get the care you need as you need it; and whether or not you do get it, or try to get it, bankruptcy is as near as ever for most tough diagnoses for which you usually do incur overwhelming medical expenses. The prospect of financial ruin remains even after a lifetime of forking over ever larger premiums to the extortionist private health insurance industry, which remains in the driver's seat.

On the other hand, if you’re super lucky rich or almost that rich or really truly comfortable, not to worry. You may continue with your vacation plans, as usual averting your eyes from the sight of millions who, from cradle to grave, are not so lucky as you.

June 28, 2012 4:05 PM

Will said...

@Neil,

Excellent response to Zee's comment. As soon as I read the blood-boiling Bush v. Gore portion of his post, I knew it was only a matter of time before you, Denis or Jay would respond in an appropriate, content-rich fashion. You guys are great, and every now & then it's just gotta be said. Thanks again.

Denis Neville said...

Zee wishes “more people on the Left could learn to live with court opinions too, instead of, for example, endlessly re-litigating Bush v. Gore.”

I’m with Neil, “we have a duty NOT to let it slip out of our collective memories.”

Read Vincent Bugliosi, “None Dare Call It Treason,” The Nation:

“Scalia, Thomas et al. are criminals in the very truest sense of the word…No technical true crime was committed here by the five conservative Justices only because no Congress ever dreamed of enacting a statute making it a crime to steal a presidential election. It is so far-out and unbelievable that there was no law, then, for these five Justices to have violated by their theft of the election. But if what these Justices did was not "morally reprehensible" and a "wrong against society," what would be?”

http://www.thenation.com/article/none-dare-call-it-treason?page=0,0

“Why, one may ask, have I written this article? I'll tell you why. I'd like to think, like most people, that I have a sense of justice. In my mind's eye, these five Justices have gotten away with murder, and I want to do whatever I can to make sure that they pay dearly for their crime. Though they can't be prosecuted, I want them to know that there's at least one American out there (and hopefully many more because of this article) who knows (not thinks, but knows) precisely who they are. I want these five Justices to know that because of this article, which I intend to send to each one of them by registered mail, there's the exponential possibility that when many Americans look at them in the future, they'll be saying, "Why are these people in robes seated above me? They all belong behind bars." I want these five Justices to know that this is America, not a banana republic, and in the United States of America, you simply cannot get away with things like this.”

“At a minimum, I believe that the Court's inexcusable ruling will severely stain its reputation for years to come, perhaps decades. This is very unfortunate. As Justice Stevens wrote in his dissent: "Although we may never know with complete certainty the identity of the winner of this year's presidential election, the identity of the loser is perfectly clear. It is the nation's confidence in [this Court] as an impartial guardian of the rule of law." Considering the criminal intention behind the decision, legal scholars and historians should place this ruling above the Dred Scott case (Scott v. Sandford) and Plessy v. Ferguson in egregious sins of the Court. The right of every American citizen to have his or her vote counted, and for Americans (not five unelected Justices) to choose their President was callously and I say criminally jettisoned by the Court's majority to further its own political ideology. If there is such a thing as a judicial hell, these five Justices won't have to worry about heating bills in their future. Scalia and Thomas in particular are not only a disgrace to the judiciary but to the legal profession, for years being nothing more than transparent shills for the right wing of the Republican Party. If the softest pillow is a clear conscience, these five Justices are in for some hard nights. But if they aren't troubled by what they did, then we're dealing with judicial sociopaths, people even more frightening than they already appear to be.”

“That an election for an American President can be stolen by the highest court in the land under the deliberate pretext of an inapplicable constitutional provision has got to be one of the most frightening and dangerous events ever to have occurred in this country. Until this act--which is treasonous, though again not technically, in its sweeping implications--is somehow rectified (and I do not know how this can be done), can we be serene about continuing to place the adjective "great" before the name of this country?”

Pearl said...

Thank you Valerie and Zee for welcoming me into Karen's blog. It is a pleasure and a real shot in the arm to read all your opinions, filled with factual information, validating my gut feelings about what is really going on behind the scenes. I told Karen she is like a breath of much needed
oxygen amid the political pollution of my birth country.
Her comments to the N.Y.Times when I can find them are gems of wit,
intelligence and honesty. She should be a columnist in a major newspaper but alas, they don't have the guts to print the truth despite the claim, "All
the news that's fit to print" by the N.Y.Times.

As to the question about what happened with U.S. health organizations that set up shop some years ago in Toronto and elsewhere in Ontario where I live, I don't remember the exact details of whether or not this was an attempt by right wing Canadian officials to create a two tier system or allow forprofit groups to fill in some weaknesses. At any rate I do remember that it involved some financial flim flam, inadequate care for what they charged and anger by citizens which probably ended any more attempts of this kind. Canada does allow patients to have the use of machines and medical care over the boarders (such as Buffalo) which is paid for by the Province in order to fill in some gaps for the needs of patients. There are improvements to be made which would be more forthcoming if we ever got rid of the Conservative party but the basic foundation is irrevocably in place. I would like to see doctors put on salary according to their abilities and experience such as in academia, since individual charges for care can become complicated and lead to malfeasance - this is the set up in many of the countries that have our kind of medical system. At least we have a number of watchdog groups that keep tabs on things and recommend improvements like covering dental and optical needs.

But until the basic problems in the U.S. are changed, I don't feel a decent health care system has a chance of developing with the quality of lawmakers currently in office. And to think that attempts to have decent health care for U.S. citizens date back to Harry Truman ( and possibly earlier according to some of your comments), and to Nixon as well, shows the tremendous resistance to change by the corporate and wealthy upper % for a long while.

We are celebrating Canada Day this weekend and I send greetings to all of you for the Fourth of July festivities.

Denis Neville said...

Scott Horton, “Our Politicized Judiciary,” Harper’s Magazine, comments on the “remarkably intemperate and partisan language—evidence of an increase in the political temperature within the high court.”

http://harpers.org/archive/2012/06/hbc-90008692

He directs us to James Fallows’ comments on the potential repercussions of this partisanship for American political process:

“When you look at the sequence from Bush v. Gore, through Citizens United, to what seems to be coming on the health-care front; and you combine it with ongoing efforts in Florida and elsewhere to prevent voting from presumably Democratic blocs; and add that to the simply unprecedented abuse of the filibuster in the years since the Democrats won control of the Senate and then took the White House, you have what we'd identify as a kind of long-term coup if we saw it happening anywhere else.”

“Liberal democracies like ours depend on rules but also on norms -- on the assumption that you'll go so far, but no further, to advance your political ends. The norms imply some loyalty to the system as a whole that outweighs your immediate partisan interest. Not red states, nor blue states, but the United States of America. It was out of loyalty to the system that Al Gore stepped aside after Bush v. Gore. Norms have given the Supreme Court its unquestioned legitimacy. The Roberts majority is barreling ahead without regard for the norms, and it is taking the court's legitimacy with it.”

http://www.theatlantic.com/politics/archive/2012/06/scotus-update-la-loi-cest-moi/258900/

Horton concludes, “As the only branch now in the hands of the G.O.P., the Roberts Court has used its power to give its party an advantage on the electoral battleground, thanks to the Citizens United and Montana rulings, which together ensure Mitt Romney an enormous funding advantage in the coming battle. That’s hardly the way the Founders conceived the federal judiciary, but it is what the system they created permits.”

Neil Gillespie said...

@Will and Denis

Thanks guys, its nice to know that I’m not howling at the moon alone.

Chris Hedges said it best in his address to Occupy Harvard November 28 2011 (part 2)

"Since they won’t name those crimes, you must"

http://youtu.be/ugU6ELwbi_o

Hedges’ video is part of a piece on critical thinking on Zero Hedge that begins with this quote by Thoreau:

"Disobedience is the true foundation of liberty. The obedient must be slaves." - Henry David Thoreau

http://www.zerohedge.com/contributed/lack-critical-thinking-key-corrupt-status-quo-maintaining-their-power

This may come as a shock to some, but judges can decide a case based on their personal bias, and then look for a justification in the law. Given the complexity of law, that is not difficult. And judicial immunity removes accountability, especially for U.S. Supreme Court justices with a life tenure. State court judges can loose an election, or loose a retention vote, and federal judges can be impeached by the Senate, but that is very rare.

"Historically, judicial immunity was associated with the English common law idea that "the King can do no wrong."" - Wikipedia

http://en.wikipedia.org/wiki/Judicial_immunity

Neil Gillespie said...

@Pearl

Thanks for your comments in the previous thread about your experience in the emergency room in Florida. FRONTLINE has an excellent film, Dollars and Dentists,

http://www.pbs.org/wgbh/pages/frontline/dollars-and-dentists/

with a segment "When the Dentist Won’t See You" that states "Millions of Americans are ending up in the emergency room instead of the dentist’s chair when they have problems with their teeth — sometimes even when they have insurance."

http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/when-the-dentist-wont-see-you/

In another segment, "More Americans Visiting ER for Dental Care", FRONTLINE claims

"It is also expensive: A routine teeth cleaning that could prevent future dental problems can cost up to $100, as compared to $1,000 for ER treatment for untreated cavities and infections. And in states like Florida, where dental-related ER visits cost more than $88 million in 2010, taxpayers pay a brunt of the costs for Medicaid patients."

http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/more-americans-visiting-er-for-dental-care/

Then there is the case of Aspen Dental, a chain of nearly 350 offices in 22 states managed by a company owned by a private-equity firm. FRONTLINE told the story of 87-year-old Theresa Ferritto who needed two teeth pulled. "Aspen Dental wouldn’t just pull the teeth but insisted on a complete exam. She was bewildered when they finally handed her a treatment plan four pages long. Total price: $7,835. Ferritto could not afford it, but Aspen Dental signed her up for a special credit card, with monthly payments of $186 for five years." Ferritto lives on a fixed income of $1,300 a month.

http://www.pbs.org/wgbh/pages/frontline/health-science-technology/dollars-and-dentists/patients-pressure-and-profits-at-aspen-dental/

""I made a big mistake going there," she says. "I should have known better.""

"After a day of cleanings and two fillings, Ferritto asked her son for help. He called Aspen Dental to complain but said he got nowhere. So they turned to the state attorney general."

"Aspen Dental took all charges off her credit card for treatments she hadn’t yet received. But the company said the $2,540 she was charged for two fillings and cleanings was appropriate."

"Aspen Dental charged Ferritto $350 for an antibiotic put next to teeth the dentist was going to pull, a charge other dentists say makes no sense. There were four separate charges for an antibacterial rinse, similar to Listerine, for $129. There was even a $149 charge for an electric toothbrush that Ferritto didn’t even know she had, until she recently retrieved an Aspen Dental bag from her garage and found it inside."

There is a bright spot, the Sarell Dental non-profit model in Alabama.

http://www.sarrelldental.org/frontline-and-the-center-for-public-integrity-investigate-americas-dental-care-crisis

"Dental care can be a matter of life or death. Yet more than 100 million Americans either don’t have dental insurance or simply can’t afford to see a dentist. The result? Severe pain, preventable disease, humiliation, bankruptcy and sometimes even death…."

"Solutions to repair the dental care crisis are elusive. Efforts to reform the system often face fierce opposition from dentists themselves. But in Alabama, a new model is showing hope. It’s a nonprofit dental center led not by a dentist, but by a former corporate CEO. "The need that I saw when I got here was tremendous. There were more children needing care than there were dentists able to see them," says Jeff Parker, CEO of Sarrell Dental, where low-income kids are treated at reasonable costs. Alabama’s dental lobby worked aggressively to shut Sarrell down. It was unsuccessful."

Denis Neville said...

@ Neil – FRONTLINE’s “Dollars and Dentists” about our also broken dental care system was excellent.

http://www.pbs.org/wgbh/pages/frontline/dollars-and-dentists/

When I volunteered at the free health clinic, people with dental problems were common.

More than 130 million Americans do not have dental insurance. One quarter of adults ages 65 or older have lost all of their teeth. About 17 million low-income children do not see a dentist each year. Only 45 percent of Americans age 2 and older saw a dental provider in the past 12 months. Although most oral health conditions are preventable, 60 percent of kids age 5 to 17 have cavities. Tooth decay, is five times more common among children than asthma, according to the Senate Dental Crisis report:

http://www.sanders.senate.gov/imo/media/doc/DENTALCRISIS.REPORT.pdf

The ACA requires insurers to offer dental care for children, but not adults. Kaiser Family Foundation’s Commission on Medicaid and the Uninsured:
http://www.kff.org/medicaid/upload/7798-02.pdf

Medicare does not provide coverage for routine dental care. Nearly half of all Medicare beneficiaries did not see a dentist last year; 22% have not seen a dentist in the last five years; 33% low income have not seen a dentist in the last five years. Those who did see a dentist incurred an average of $672 out-of-pocket expenses for dental care.

Sen. Bernie Sanders and Rep. Elijah E. Cummings, legislation to expand comprehensive dental coverage to millions of Americans through Medicare, Medicaid, and the Department of Veterans Affairs:

http://www.sanders.senate.gov/newsroom/news/?id=c289e5cb-e429-439f-827c-d30fd250eb48

Anonymous said...

Hi, Zee,

I was looking to see if Janet Camp still posts here and found you instead. How is your back?

richard@john-locke.net

Denis Neville said...

@ Pearl

The ER chaos you experienced, unfortunately, is typical. Having worked in an urban ER, as well as my family’s and my own personal experiences as a patient in the ER, it can be a harrowing time.

In addition to traumas and true medical emergencies, the urban ER is often a refuge for the homeless, drunks, drug overdoses, mentally ill, knife and gun clubbers, little old ladies in no apparent distress, who following a minor fall or illness, would be better served by staying at home with good social support, rather than being admitted through the ER into a hospital with all its iatrogenic risks, people with minor medical problems with no primary care provider, etc., etc.

The pissing matches between physicians (ER doctors, primary care internists, specialists), patients and families, and hospital administrators over whether patients need to be admitted in today’s fractured health care system is pretty frightening.

There is a gallows humor in the ER. Under stressful, traumatic, or life-threatening situations and extraordinary amounts of pressure, where human lives hang in the balance, physicians and nurses say things that would horrify the lay public, sometimes even ourselves in any other context.

Also, welcome to Sardonicky! I enjoy your Canadian perspective.

Jay - Ottawa said...

“Who whom?”
--Lenin

Or, if you prefer,
“You’re so vain, you probably think this song is about you.”
Carly Simon

Despite the spin of Democratic operatives and their stenographers, the Court’s polyvalent decision on ACA is not about whether President Obama “won” or “lost.” Obama is not the patient for whom the ACA was crafted by the Congress then modified by the Court. As many hospital clinicians wisely remind each other whenever they start to distract themselves on the job with whining self-pity, “The patient is the patient.”

In the case of the ACA “The Patient” is the tens of millions who control the least money and who therefore stand the greatest chance of being sick in the first place and getting sicker as a follow-on when they forgo proper attention in the great big money game of American healthcare. To repeat, Obama is not the patient. At best, his legacy is the patient – and a sick legacy it is already. It’s people not politicians on whom humane citizens should be focused.

Yesterday, the Court decided 7-2 (not 8-1, as I previously wrote) that Medicaid expansion under ACA amounted to an entirely new program, not an expansion of the existing program. It took 17 years for all the states to opt into the “old” Medicaid. The country is a great deal more polarized this time around for opting in -- or out -- of the so-called “new” Medicaid. There are philosophies and special interests and single-minded true believers in high places who do not want Medicaid expanded to cover people too poor to pay insurance premiums. What will become of them?

You can begin to find more detail on the Medicaid angle here:
http://news.firedoglake.com/2012/06/28/non-trivial-number-of-poor-people-would-be-ineligible-for-insurance-subsidies-if-their-state-denies-medicaid-expansion/

Recall that the governors of 26 states petitioned the Roberts Court to overturn ACA in its entirety. Those governors and the interests that back them are still around the morning after. In other words, the most vulnerable people, those on Medicaid, just became more vulnerable to the whims of Red State governors.

The good Dominican friars of the Inquisition put no one to death over issues of belief or unbelief. Their auto da fé simply turned the guilty over to the secular authorities to exact a harsh penance or to light a match beneath the guilty. Something like that happened yesterday. The Roberts court did not directly push any poor kids or handicapped off Medicaid with their 7-2 Medicaid decision. They simply turned tens of millions of Medicaid recipients over to state governors, 26 of whom are on record as being hostile to Medicaid.

A great victory for Obama! But what about Lazarus?

Zee said...

@Jay—

“ …if you’re super lucky rich or almost that rich or really truly comfortable, not to worry. You may continue with your vacation plans, as usual averting your eyes from the sight of millions who, from cradle to grave, are not so lucky as you.” --Jay, Ottawa

Yes, I suppose that I am “comfortable”—at least for the moment—unless or until the banksters decide to crash the economy once again. I have no sense that I “deserve” to be this comfortable, but neither do I feel guilty about, or ashamed of, that fact. If I don’t “deserve” it, I still worked hard and took advantage of every opportunity offered to me to attain it.

I know, I know: I had opportunities that billions and billions of people around the globe never had or will have. Progressive dogma seems to indicate that I should, therefore, spend my entire life apologizing and atoning for the newly-created “original sin” of the accident of my birth. Sorry, but I just won’t do it.

This does not, however, mean that I have “[averted my] eyes from the sight of millions who, from cradle to grave, are not so lucky as [me].” I help out where I can with both my time and my money. The extent to which I offer each is my business.

And when I’m dead, well, Mrs. Zee and I were unable to have children, so whatever wealth remains goes to several carefully selected charities and research institutions rather than nieces and nephews who have never expressed any interest in either of us. I will probably be a greater contributor to society in death than in life, which, I hope, won't have anyone out there secretly hoping for me to run my motorbike off a cliff in the near future.

While Christ tells us that “it is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God,” (Matthew 19:23-24) it has been my observation that even my most progressive friends—and I’m not talking about Obamabots here—like a nice roof over their heads and vacations that are much more elaborate than my current Colorado motorcycling trip.

When push comes to shove, we all have a life that we have to live, and few of us--Progressive or otherwise--do so by taking truly Christian vows of poverty and charity.

Zee said...

@Richard--

Good to hear from you! Thanks for asking, my back is doing tremendously better since I started hanging upside-down from my ankles using an "inversion table:"

https://www.teetertv.com/?x=baa

A physician friend suggested it to me when none of my own doctors did. I checked with my PCP and opthamologist to make sure it was OK and then tried it out. 3-4 minutes a day has kept my herniated discs and sciatica under control.

More later, when I get home.

Best wishes!

Jay - Ottawa said...

@ - ?? - (Carly will never tell)

Thanks for giving me the opportunity to repeat, of necessity, the line quoted earlier.

"You're so vain. You maybe think this song is about you."

It is not about endless self-revelation. Here's what it's about. It's about politics and popular culture.

Anonymous said...

No, Jay,

"Your so vain" isn't about politics. Not even the N.D.P. it's abou one of Carly's Ex-Boyfrends from before James Taylor.

Richard@john-locke.net

Zee said...

@Neil, @Will and @Denis—

“The image of a pusillanimous Supreme Court making its decisions on the basis of political sentiment was expressed in 1901 by humorist and newspaper columnist Finley P. Dunne through the Irish-American voice of his favorite character, Chicago bartender Martin T. Dooley: ‘That is,’ said Mr. Dooley, ‘no matter whether th’ constitution follows th’ flag or not, th’ supreme coort follows th’ iliction returns.’ “

-- Finley P. Dunne. 1901. Mr. Dooley’s Opinions. New York: R.H. Russell. p. 26.

http://www.wikinfo.org/index.php/Insular_Cases

Well, Mr. Dooley was right in 1901, and he has been right almost since the Founding, when nine politically-nominated and politically-approved personages started deciding what the Constitution meant in 1803 with Marbury v. Madison.

The complicated legal system has been created by politicians, and, whether judges are elected or appointed, political beliefs and biases will always play a role in their decisions. They are not computers. This will be true of even the most honest and conscientious judges, and it is completely and utterly naïve to think otherwise.

(And as an aside, it is also hopelessly naïve to think that even the finest of political office-holders won’t blatantly try to influence the courts when it suits their political purposes. In 1937 Franklin Delano Roosevelt, hero of Progressivism and a man I generally respect, tried to pack the Supreme Court with Justices who were politically agreeable to him and his legislative (read: political) agenda.

http://en.wikipedia.org/wiki/
Judicial_Procedures_Reform_Bill_of_1937

Many of you out there doubtless think this was a legitimate tactic to further a noble cause, but I’m quite sure that at the time many others of a more conservative bent thought this was at the very least shameful, possibly illegal, and maybe even a betrayal of the Constitution. Me, I think that it was at least shameful.)

Whether a particular Supreme Court decision is a triumph of conscientious jurisprudence or an act of treason is simply a matter of whose particular ox is being gored at that particular instant in time.

For every distinguished legal scholar or shade-tree lawyer that you can find who believes that the decision in Bush v. Gore was criminal or treasonous, I can almost certainly find an equally respectable one who believes quite the opposite, and can muster legal facts and precedents to convincingly support that position. Such is the nature of the law.

I personally believe that Kelo v. City of New London (2005), in which the Supreme Court held by a narrow majority that it was right and proper to take the private property of one individual and give it to another to further an imagined public good, was an absolute and utter betrayal of the Constitution’s Fifth Amendment Takings Clause.

http://en.wikipedia.org/wiki/Kelo_v._City_of_New_London

But I’m sure that you would get as tired of me hearing me call Justices Stevens, Kennedy, Souter, Ginsburg and Breyer “traitors” or “criminals” as I am tired of hearing you call Chief Justice Rehnquist and Justices Kennedy, O’Connor, Scalia and Thomas the same.

If I’m not howling for the heads of Stevens, Kennedy, Souter, Ginsburg and Breyer, it’s because at the end of the day I want to believe they just happened to be the five people to whom the decision fell, and they did so to the best of their abilities based on their knowledge of the law and precedent, and, yes, their political beliefs and biases. And so it was with Rehnquist, Kennedy, O’Connor, Scalia and Thomas in 2000.

If we are have truly become a “banana republic,” it has little to do with Bush v. Gore, and everything to do with the Permanent Political Class that we, ourselves, have put and kept in power for the past 40-50 years, giving us the government we deserve.

I'm not asking you to forget Bush v. Gore, but try to get past the venom and work to change things.

Zee said...

@Jay or @???--

“It is not about endless self-revelation. Here's what it's about. It's about politics and popular culture.” --Jay, Ottawa

Since you (or @???) decline to speak directly—which I really can tolerate, as long as it’s done semi-respectfully—I can only assume that your “circuitous” remarks are directed at me. Hey, I'm paranoid.

After all, there are only two mentions of the word “vacation” on the current thread—mine, and then yours, plus, of course, the follow-ups—so why should I not feel perhaps “singled out” as being allegedly blind to the millions—nay, billions—who don’t have life as good as I do, indeed, vacationing while Rome burns?

If I have read too much into your “general” remarks, well, I apologize. I am a scientist, and I tend to over-analyze, and then, in painstaking detail.

Call a hypothetical someone “vain” if you like, @Jay or @???, but perhaps that person may merely be “insecure,” “defensive,” and maybe even “suspicious.” Why on earth would someone feel that way, just because that person is perhaps the only “contra” opinion on some hypothetical blog?

But @Jay and @???, guess what? I’m as much a part of politics and popular culture as you are, maybe even more so, as your political posture comprises maybe 20% of the American public. I may be in the minority on this blog, but I am more representative of the herd than you are.

I’m not saying that I deserve to be heard here, but you might care to listen as long as I’m not offensive. And especially since I share some of you political objectives.

And believe it or not, I’m interested in learning more about you, even if you are not interested in my “endless self-revelation[s].”

So brace yourself for more self-revelations on my part, because I really am interested in yours. Without “self-revelation,” how can one expect to truly understand one’s fellow man/woman?

Much of what I see in this blog is routine, self-confirming cross-references to talking heads who echo the feelings/beliefs of the blog participants.

Many of those links and cross-references have been real eye-openers to me, but what has interested and influenced me most have been the occasional, risky, self-revelations by—dare I call them friends?— @Valerie, @The Doktor, @Kat and @Denis, among others. And yes, even participants like @Anne Lavoie and @Neil Gillespie, who have dared to more-or-less-politely call me out directly on various topics.

@Karen—I apologize to you as well, if I have overstepped my bounds today with my speculations and suspicions. I hope that I will continue to be welcome here as long as I am respectful, which I think that I have been thus far.

But it is difficult to try to respond calmly to what I perceive to be indirect innuendo.

Please feel free to correct me if I have over-reacted.

Neil Gillespie said...

@Zee

Agreed that Kelo v. City of New London (2005) was just one more bad Supreme Court decision. You are free to express your opinion about the case. Where did you get the idea that anyone would be opposed to that?

As I wrote before, "Bush v. Gore was a coup d'état by five justice of the U.S. Supreme Court." I did not name any particular justices as you suggested, or call them "traitors" or "criminals", nor was I "howling for the heads" of any justice. There is nothing in the Constitutional that gives the U.S. Supreme Court jurisdiction to decide a presidential election. It was a power grab to award the presidency to Bush who received less popular votes than Gore, and further illustrates the undemocratic nature of Constitution/electoral college.

My opinion about Bush v. Gore is protected First Amendment speech, yet you repeatedly complain. Why? Because it makes you uncomfortable? Somehow you take my criticism of Bush v. Gore as personal insult. Why? This is not about you.

And this is lazy intellectual reasoning Zee: "Whether a particular Supreme Court decision is a triumph of conscientious jurisprudence or an act of treason is simply a matter of whose particular ox is being gored at that particular instant in time."

I am not a liberal or a progressive, and I did not vote for Al Gore. I’m a radical who voted for Ralph Nader because I believed in the candidate. My ox was not being gored. There is no "venom" to get past. This is what working for change looks like. Step one, call them out on wrongdoing. Bush v. Gore was a coup d'état by five justice of the U.S. Supreme Court. No further embellishment is needed.

My position has been pretty clear all along: The U.S. Constitution was written by the one percent for the one percent. The legal system is just a tool of the one percent to achieve its goals. That too is protected First Amendment speech.

As I wrote in a previous thread, Bradley Manning, Julian Assange, and Mohamed Bouazizi, are exemplars of freedom. They took action that brought change and set the Arab Spring dominos falling. And they paid a terrible price: Bouazizi is dead, Manning is in prison, likely for a long time under brutal conditions, and Assange is on the run. This is what working for change looks like.

Zee, from what you write, you seem to get your information indirectly, either from the Internet or TV. I encourage you to take the next step: Find a cause in which you believe, hit the streets, and learn firsthand. Since you believe in the courts, file a lawsuit on behalf of your cause. Go to court. See firsthand what actually happens.

Anne Lavoie said...

@Zee

I agree about enjoying reading people's personal opinions and relevant backgrounds or experiences. At some point, it becomes boring when all I read are quotes or references from others rather than a condensation and commentary from the wise people who visit this blog. I almost give up visiting this site when everything is impersonal and academic. I can get that anywhere and everywhere else.

I particularly appreciate when others paraphrase, summarize, and opine on something read, saving me the time and effort of re-reading a lot of information that others have already spent time and effort digesting themselves. This isn't an academic contest where we out-source each other with references, although sometimes it seems that way.

I realize some people prefer to shield themselves from criticism by hiding their own beliefs and opinions behind others' words rather than their own; however, that level of courage is not going to sustain or advance a movement such as Occupy, no matter how many times 'Occupy!' is shouted only on safe blogs.

When we value protecting our own group acceptance and ego over supporting a worthy cause, that does nothing to help us get through these troubles times.

Anyway, to each his own, and according to his/her own sense of personal comfort and safety, but I DO enjoy personal, honest, and original opinions, and I think now it is the time to work up some courage, announcing one's beliefs proudly, and standing behind them too. Our country needs us doing just that.

Jay - Ottawa said...

One’s upbringing, background, geography, experience, pressures of the moment and notions of good taste regulate what we say here. After all, we are not bloodless Platonic essences hammering away at keyboards. I do indeed find it interesting to learn what others from other backgrounds and other places think at the moment, or have learned over the years or sense might coming down the road – and why -- on a given topic. That’s what makes Sardonicky such a rich site: first, Karen’s good-sense take on a topic of politics or popular culture; then, our reactions -- to include the import of new material and new angles for a wider perspective on the given topic.

“…ON THE GIVEN TOPIC.” That’s the key. That’s what it (our commentary) should be centered on in the last analysis: the topic chosen by Karen. Not the topic chosen by me, or X, or Y or Z.

Sure, we can appreciate the asides that tell us where a person is from or how their experience, or reading, colors the subject for them. But a sense of proportion must be maintained between the “me” and the given topic itself.

For example, I find it curious -- maybe even suspicious -- when a commentator repeatedly switches the topic from the thread begun by Karen to something totally unrelated. I hope no one takes offense if I confess that I come back here time and again mainly to read Karen’s posts. The commentaries are secondary. And, have no doubt, a comment drops swiftly to the tertiary level when it strays far, far from the original post, especially when it is simply to go on and on about the commenter's CV or his favorite hobby.

Is there no difference between dropping an occasional personal note, for the sake of context, in commenting on politics and, on the other hand, persisting with an everlastingly narcissistic self-justification as a rationale for one’s politics? Is there no good reason for basing one’s views, at least some of the time, on reason and accepted principle, and with as much objectivity as one can muster, instead of endlessly making one’s self the measure of all things?

It is sweetly aggressive, not to mention boring, to take up space here on Sardonicky to report to a personal acquaintance (whose email is in hand) just how one hangs three minutes per day to correct a physical affliction. Why don’t we all post our private email messages here today, especially those about our ailments, instead of sharing exchanges about the Court’s ACA decision?

There is another angle to be entertained when a commenter always – well, nine times out of ten -- pulls the comment threat wholly off topic, either by talking long about one’s self (yet again!), or by opening up a completely off-topic bag of worms or, as recently happened, throwing red meat before our resident lions -- God bless them -- on the well-chewed topic of Gore v Bush. These tactics always serve to diminish Karen’s agenda, don’t they? Hmm…. I’ve begun keeping statistics on this occurrence –- really -- but that’s an off-topic issue for a future off-topic point of order.

At the top I began with an enumeration of the qualities that might govern the commentariat. The most important element of all was left out: the SETTING. Sardonicky is a salon where politics and popular culture are dissected, not the matter of how one prefers one's grapefruit sliced for breakfast. The hostess names the topic and sets the tone. Furthermore, at Sardonicky we catch more flies with vinegar than with honey.

I don’t mean to talk down good fellowship. There are ways of engaging in private side conversations. But isn’t the place for such exchanges over at PenPal and hotmail and FaceBook? Here, it’s Karen's salon, to quote the masthead, on politics and popular culture.