Rob St. Amant

Rob St. Amant
Birthday
December 31
Bio
My roots are in San Francisco and later Baltimore, where I went to high school and college. I stayed on the move, living for a while in Texas, several years in a small town in Germany, and then several more in Massachusetts, working on a Ph.D. in computer science. I'm now a professor at North Carolina State University, in Raleigh. My book, Computing for Ordinary Mortals, will appear this fall from Oxford University Press. http://goo.gl/hQBHy

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JUNE 29, 2012 8:23AM

Obamacare and its detractors

Rate: 12 Flag

I've been reading some of the unhappy reactions from Republicans about the Supreme Court's decision on Obamacare. There's a silver lining for  John Boehner at least; no one on his side is in danger of spiking the ball in celebration.

Here are a few of the reactions. The Supreme Court will find Obamacare unconstitutional didn't work out very well as a prediction, but still...

Obamacare is unconstitutional anyway. Or in the words of Rand Paul, "Just because a couple people on the Supreme Court declare something to be 'constitutional' does not make it so." Paul doesn't explain why he thinks the U.S. government has been under this misconception since 1803, when Marbury v. Madison established the principle of judicial review. Thomas Jefferson, at that time President, didn't seem to have much to say about it, even though the decision wasn't in his best interest. So much for the Tea Party's favorite founding father.

Obamacare is socialism. For example, "One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project, most people are a little reluctant to oppose anything that suggests medical care for people who possibly can’t afford it." Oops, my mistake. That's Ronald Reagan, in 1961, talking about Medicare. Louie Gohmert says something similar, though: "How much more socialist can you get than a government telling everybody what they can do, what they can't do, how they can live?" Good luck convincing the 50 million older Americans on Medicare that they're socialists.

Obamacare is too expensive. Jim Sensenbrenner: "The health care law's taxes and mandates are making it harder to create jobs. Its budgeting gimmicks will bankrupt our country." For complex social and political reasons, as above, the U.S. has resisted universal health care, despite examples elsewhere in the world that go back to the late 1800s. Expense is part of it, but it occurs to me that this argument involves a failure of imagination. Some 40 European countries seem to manage universal health care without difficulty. Or maybe we could just start fewer wars in the Middle East. That should cover it.

The Republicans have their work cut out for them. (Democrats, too, to improve the system.) A bit of advice: "armed rebellion" is probably not the best solution.

 

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Hey...Insurance should be hiring!

But you know if this isn't constitutional, I want all my car insurance premiums back for the years my vehicles were paid off and I was forced by government to carry coverage anyway...
Excellent idea! Also, I'd want to have my income tax returns over the past couple of decades revised, because I didn't get a child credit. Why should I be paying an implicit penalty for not taking action to raise a family?
Or my favorite: "The Supreme Court ruling on the president’s health care plan resulted in a sad day for freedom, liberty and the American people." -- Michele Bachmann

Sadly, a lot of people will fall for the rhetoric despite the fact that they still, apparently, enjoy the same freedom that they enjoyed two days ago.
Obamacare is not even close to my first choice for universal health care, and to me represents the worst of both worlds.

The first step should have been the dissolution of all Health Insurance companies.

If we left it that way, prices would eventually fall making it somewhat more affordable to some.

Of course a fully paid for, 100% government based insurance would be even better.

Or have all healthcare be run as non-profit collectives.

But this crap?! Sucks.
Speaking of the ACA being too expensive, here's another study (latest OECD report published 2 days ago) about health care cost:

U.S. Health Care Costs More Than ‘Socialized’ European Medicine
Hi, Steve! I'd forgotten about Bachman. Leave it to her to escalate the rhetoric.

Doug, I'm not satisfied with Obamacare in its current state either, and I'd be happier with the alternatives you suggest. But think of it this way--how many votes in the House and the Senate do you think a bill for "the dissolution of all Health Insurance companies" would get? Zero would be a reasonable estimate. The CBO estimates that 30 million more non-elderly people will have health insurance by 2017; Obamacare outlaws rescission and rejection of applicants based on pre-existing conditions; parents can keep their kids on their health insurance plan until age 26. So when you say that Obamacare is the worst of both worlds, I can only think you'd favor rolling these things back? Even if Obamacare isn't the best of all worlds, it seems to be better than the status quo.

Hey, Dom, thanks for the link. I don't think I've seen the breakdown between public and private spending.
"The health care law's taxes and mandates are making it harder to create jobs."

This is the worst and ugliest argument of them all. Mister Senselessbrenner, you boys have had it your way since 1980 -- so where are all the jobs?
One more thing -- it was Republican Teddy Roosevelt who first proposed some form of universal healthcare. Imagine where we'd be today if the Republican Party had remained progressive rather than becoming the New American Independent Party it has become.
A lot of the rhetoric from the opponents of ACA is revealing--and disturbing. There are way too many people in prominent positions in the Republican Party today who are willing to say anything, no matter how disconnected it is from reality, in order to inflame the anger of their supporters.

I would really like to see any remaining sane Republicans stand up and say, "Have you no sense of decency, sir? At long last, have you no sense of decency?" Because this is the new McCarthyism, except that the extremists are no longer bothering to try and claim people are Communists (well, most of them aren't). They are trying to turn "liberal" and "Democrat" into the modern version of a damning smear.
I need you to go paste this into the comments in my local conservative rag, whose Op Ed today is agitating for Mitt and repeal because of all the bullet points you've so thoroughly debunked here.
Also: "He said it wasn't a tax and now it comes out it's a tax! Obama lies, freedom dies." -Sarah Palin
Gotta love Louie Gohmert - he proves that Tommy Franks was wrong about Douglas Feith every time he opens his mouth.

I'll confess, I'm not a fan of the ACA, it's not health care reform, it's health insurance reform and it does nothing to control the costs of either health care or health insurance. But it *is* better than the present system and I can live with it while we're getting to Medicare for all.
I personally support those conservatives crying out that they will move to Canada. Let them enjoy the benefits of actual national health insurance.
Thanks for the comments!

Tom, I agree with your first point--Republicans have had a lot of chances to do something about health care, but they didn't seem to think it was a priority. Until now, of course, when the preferred solution is Ryan's privatization plan. Oh, wait--that's always been the plan.

And I wasn't aware of Roosevelt's proposal; it's good to have friends who know some history.

Hi, Susan! It's like old times here. I read on a blog somewhere or other (not here) that President Obama finally said the right words in justifying the ACA: "It's the right thing to do." A lot of Republicans will find themselves on the wrong side of history, I think.

Hey, Verbal, Sarah Palin's another one I forgot. Her sentiments are everywhere, though she does express herself... in a unique way, let's say.
But it *is* better than the present system and I can live with it while we're getting to Medicare for all.

John, this is my view exactly. It's incremental progress, and I hope we can continue. It's not perfect by a long shot, but I can't see it as anything but an improvement on what we have now.

Funny, Stim. I've heard the same thing; I guess Canada is just the go-to destination for dissatisfied Americans, even if it's even more of a socialist hell-hole with respect to health care than here. :-)

Thanks, skypixie.
I agree that the healthcare bill is imperfect in it's present form. After waiting a century to get anything that reformed our present system in anyway, I say hold on to it--we worked too hard to get it to just throw it away out of pique. Take whatever you can get, and keep fighting for more, even as you consolidate any and all gains.

If for no other reasons, this bill is important in that you can't have your plan cancelled out from under you for specious reasons just when you need it most. Being a woman, it's also nice to know I can't be charged more because being a woman is a"pre-existing condition." (In that context, I'd say being a man is just as MUCH a pre-existing condition given that gender is outside human control.)

Rated.
Well said, Shiral. And I'd neglected to include women's health care issues as a reason to support Obamacare as a change from the status quo. That's just as important as the other things I mentioned.
Quick comments:

On your first point:
The Supreme Court's decision on Dred Scott is likely a historical reference in Rand Paul's favor. In this case, Robert's reasoning is easy to critique. Plus, there is an easy case to be made that Kagan should have recused herself. Or, what if a liberal had not been in the tank for the law and crossed to side with Scalia, et al. Would he or she be viewed as statesmanlike as some observers have comments on Roberts?

On your point two:
Reagan's point is valid and defensible then and now.

On point three:
The idea the the European welfare states are "managing without difficulty" seems inconsistent with a continent-wide government debt crisis that has a good chance to break the Euro.
Thanks for the comment, McGarrett.

Rand Paul gave an extended account of his views in an editorial in the National Review, but he managed to mention nothing of the role of the Supreme Court in the U.S. government, incuding the concept of judicial review. I agree that in the abstract Supreme Court decisions can be critiqued, but as a practical matter we have 200 years of history to think about. Roberts's reasoning may be easy to critique, but of course so is the dissent. And Kagan's recusal? Scalia and Thomas have set a high bar for recusing themselves in past cases.

Reagan's point is valid and defensible then and now.

Defensible by whom? Has any national politician who's spoken out against the ACA brought Reagan's past views on Medicare into the picture? If so, I haven't noticed.

The idea the the European welfare states are "managing without difficulty" seems inconsistent with a continent-wide government debt crisis that has a good chance to break the Euro.

If you want to attribute a global recession to European health care policies, good luck. There are obvious, more proximal causes.
Rand Paul probably has his dad's understanding of the Constitution on healthcare, which is something between zero and nil.
What they have is an absurd theory that claims Congress' first enumerated power is a preamble, with no power other than its relation with the powers that follow on the list. That first clause is the tax and spend for the general welfare one the Court used to rule the ACA constitutional.

Rand's theory, which he and daddy borrow from Rwing neo-Confederate revisionist/negationists, is so easily proven untrue we can justifiably call Rand a liar. The story is interesting, but the conclusion is when the Court affirmed the obvious in US v. Butler, 1936:

"The clause confers a power separate and distinct from those later enumerated [,] is not restricted in meaning by the grant of them, and Congress consequently has a substantive power to tax and to appropriate, limited only by the requirement that it shall be exercised to provide for the general welfare of the United States. … It results that the power of Congress to authorize expenditure of public moneys for public purposes is not limited by the direct grants of legislative power found in the Constitution."

It was Madison who, while selling ratification, made the claim it was a preamble. Nobody but Madison said that, as the proof it isn't is obvious -- down the the Con Convention records and proper English grammar. Even Madison, eventually, disagreed with Madison.

The probable reason it took the Court until '36 to affirm it is because it was so very obvious.

Speaking of flaming reactions...
Dred Scott, McG?

The only connection I see is that Rand has 3/5ths of a brain.
Rob, I responded to your post with a level of content that it contained. You provide examples of reactions that you feel are off-target but provide little content. I reply that cases can be made that support all the claims. I didn't see much need to make the cases since you had not made a case either.

Now, your response to my counterpoint #1 is that past decisions and recusals and what-not can call into question other decisions. So, it sounds like you yourself can posit reasons that the court deciding something doesn't mean that it is inherently correct. Sounds like what Rand Paul said (I have not read his article).

Regarding Reagan, I have seen people play highlights of Reagan's speeches in the early 60's. And, they get played on talk radio sometimes. A theory might be that the media you get info from does not cover the full scope of criticisms. Mine likely does not either. But, absence of evidence is not... oh you know the cliche.

Regarding Europe, as government finances collapse for many reasons, the odds that people's healthcare will be preserved as is are low. However, if healthcare were privatized, the odds that it will adapt quickly and remain are high. So, rich people in Europe who buy private insurance or self-insure will be fine and the rest maybe not so much. I would rather take my chances with private businesses than a U.S. government that is trillions in debt.
KC: car premiums are State's rights; has nothing to do with the Federal government telling you the tax payer you must buy something or be fined and penalized for it. This is the first time we as a people have to buy something just because our Federal government tells us to. But keep up the good work there.

It is unconstitutional, it is socialism and it is too expensive; just ask our friends in Europe. They are admitting it and going down the financial tubes now as we speak.
Thanks for the background, Paul.

As a general comment, I'm still surprised that an idea produced by the Heritage Foundation and put into place by the current Republican candidate for President is somehow considered anathema by... Republicans.

Hi, McGarrett. I'm not sure what to make of your meta-commentary--we're just having light conversation about politics, by my view. Let me try to be a bit more precise.

So, it sounds like you yourself can posit reasons that the court deciding something doesn't mean that it is inherently correct.

I wasn't talking about "correctness", though what that might mean I'm not sure; I was talking about how something is determined to be constitutional or not. My understanding is that this is what the Supreme Court does. As for Dred Scott specifically, I think that the decision was incorrect--but as a practical matter it was overridden by changes to the Constitution. I think arguments about the unconstitutionality of the ACA are in practice vacuous, unless the hope is that the decision will be reversed by a future Supreme Court.

Let's take Reagan seriously, then. Which definition of socialism was he using? Where's the collective ownership of the means of production? I think that he was using "socialism" as a scare word, with all of the overtones of the Cold War giving it weight. I think the same thing is true today when most people talk about socialism. That is, when the average conservative talks about something (like Obamacare) being socialist, it's likely to be something that's general enough to encompass other stuff (like Medicare) that almost no one except a tiny minority of libertarians opposes. I'm just looking for consistency here. If a politician--notice that all of the people I quoted are politicians--is going to label something as socialist, that politician should at least show some consistency.

As for expense... We'll have to disagree about the risks, as well as the overall goals.

Thanks for commenting, Deborah. I think my response to McGarrett gives my views on your position as well.
Rob,
I wrote an article about how Ron Paul saying Soc Sec and Medicare were unconstitutional conflicted with the Founder's views. A hysterical history negationist that Paul endorses took me on, and also joined a conservative shock jock in trying to make me famous. I am very familiar with their pitiful arguments.

The difference between saying something is unconstitutional because of a false interpretation isn't any better than not giving any reason at all, but our conservative friends must have been trained to say it out of reflex (same as when they cry Socialism!). It would be interesting to see them, at least once, put a foundation under their statements and a definition to their buzzwords. Mainly so we'll know in what way they are wrong.

Deb....Car insurance can be a federal issue if Congress made a law under the Commerce Clause. There's no problem with it, so don't expect it anytime soon.

The 14th amendment deleted the Dred Scott ruling, which was largely the reason the 14th was passed.
It's like a fountain of joy that just keeps on giving. My fear is the backlash will boot Obama out of office and we'll be back to the beginning. But how about this: Romney keeps it! If you appreciate it as theatre, you won't be disappointed.
lol, Ben Sen... Romney won't keep it (even if elected)... he's made it his mission to do away with Obamacare.

Also, I want all my car insurance premiums back too!
- James from http://www.4autoinsurancequote.com
I was outraged, at the time, by all the concessions that were made to insurance companies. Single payer, for me, was the only way to go. However, what I didn't see then, was the concessions that the insurance companies were making, which they are now lobbying to escape. These concessions, happily, are already taking effect: insurance companies have to return excess profits, and they may no longer refuse coverage. This is a revolutionary change. Just the limits on profits, I am told, may cause many healthcare providers to pull out of the business. Some of them have been raking 40 percent of the healthcare dollar for their investors. Good riddance.