If Supreme Court strikes down health care law, then what?

By most accounts, the U.S. Supreme Court is likely to strike down President Obama’s health care law tomorrow, either in whole or in part. If the court’s ruling goes against the law, inquiring minds will want to know: Now what?

Contrary to some opinions, the federal health care takeover – including a vast expansion of influence over the personal health choices of Americans – is not only a suboptimal solution to the nation’s health care problems, it’s not a solution at all. Good intentions notwithstanding, it exacerbates many existing problems and creates new ones.

So what’s the alternative?

Utah in the driver’s seat

If the Supreme Court strikes down the federal health care takeover, it will be a recognition of the reality that the federal road to health care policy solutions is a dead end. This will mean that the only available source for genuine health care policy solutions will be the states and local communities. 

In other words, the only alternative path forward is agreements such as the Health Care Compact – a locally driven, state-by-state approach to solving health care issues – which return full control over health care policy to Utahns who know what is actually happening in the state, rather than federal bureaucrats in Washington. Unlike federal attempts to take over the health care system, the Health Care Compact actually holds promise as a way to provide genuine solutions to health care problems.

Affordable access for all

Within a compact approach to health care policy, the state can pursue truly innovative ways for helping Utahns gain access to affordable, high-quality health care. For instance, the state could abandon insurance as the way to pay for any and all health care services (whether cheap or expensive) while limiting choices of doctors and hospitals. Instead, state policy could encourage Utahns toward tools that give them control and responsibility over their own health care, such as Health Savings Accounts (HSAs) (which would not be limited by nonsensical federal regulations, thanks to the compact).

To make such a patient-centered health care system work, policy could require doctors and hospitals to make pricing information available and transparent (in person and online), so that patients can look for the most affordable option that meets their health care needs. The less that people have someone else cutting a check to pay for their health care, the more responsible people will be with their health care decisions, and the more they will look for less expensive options. In other words, doctors and hospitals will face increasing pressure to find innovative ways to cut the cost of their services, which will help make health care more affordable for everyone.

Just as importantly, when doctors and hospitals are forced to look patients in the eye and tell them (instead of faceless insurance companies) that they are charging them tens or hundreds of thousands of dollars, they will likely be quite motivated to think outside the box for ways to make their services less expensive.

HSAs could also provide substantial support for people with pre-existing conditions. Currently, health insurers will either not cover these conditions or will charge an exorbitant premium to do so. An HSA would be free from federal regulations that control coverage and could be structured to assist with the costs of pre-existing conditions. Additionally, the individual’s high-deductible plan would kick in to cover the high costs of treatment for pre-existing conditions such as cancer. With HSAs, individuals are treated equally and not singled out because of a pre-existing condition.

With time, these and other patient-centered health care policies will help decrease health care costs and increase access to quality care.

Help for the poor

The health compact approach would also allow Utahto provide innovative solutions to the problem of making health care accessible to the poor, through policies such as authentic charity care, as an alternative to the current Medicaid system. Many medical professionals in Utah are willing to volunteer their time and resources to help those in need; indeed, many private, volunteer clinics already operate in the state.

Sutherland has proposed that Utah establish a state-chartered Community Health Foundation, which would coordinate a statewide network of free health care clinics funded through private donations and staffed by volunteer professionals.

As you can see, sound alternatives to the federal takeover of health care are far from lacking. You can read more at the following links:

 

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17 Responses to If Supreme Court strikes down health care law, then what?

  1. Don Ruzicka says:

    I want to keep this short and conceptual because I could literally go on for days about this subject. Please take no offense, but the entire premise of your proposition is flawed because delegating the “solution” from the federal government to the states and the communities, while certainly an admirable proposition fpr many issues, still suggests that the solution rests in the hands of government entities. Just because it is closer to the local level doesn’t mean that it is a better solution than the feds offer. You suggest that if the SCOTUS strikes down PPACA then “the only available source for genuine health care policy solutions will be the states and local communities”. Frankly, that is ridiculous! Have we gotten to the point where we are so dependent on government and so conditioned to “quick fixes” that we truly believe that everything can and should be corrected through government edict? When looking for solutions why do never seem to think about the free market solutions of competition, supply and demand, profit motive and self-regulation and adjustments? That’s how a free market works and how the greatest health care system on the planet got to be the greatest health care system on the planet along with every other economic system that made this nation the most successful, powerful, charitable, innovative and inspirational in the history of the world. All of a sudden we need the government to re-create the free market for us. That is an oxymoron!

    There is much talk about repeal and replace with reference to PPACA. Replace with what? You are suggesting basically “new and improved government solutions”. If repeal is such a great idea for PPACA, why not for the rest of the legislation that got us here in the first place such as; CHIP; HIPAA; EMTALA and MEDICARE/MEDICAID? Without getting rid of or dramatically revising all those massive government mandates and regulations it is literally impossible to restore a free market. You can tweak it, compel it or try to “reform” it through government directives but you will never restore a free market and you will be forced to continue to “reform” it when your previous “reforms” don’t work (sound familiar?). Please understand that “reform” has nothing to do with honestly fixing our health care/insurance system, it has everything to do with politics. Government has a legitimate regulatory role in any free market but it is limited to keeping the playing field level. You can’t mandate a free market and avoid the extended and painful but necessary process of allowing free markets to adjust and heal themselves after government road blocks are removed.

    Don Ruzicka

    • Derek Monson says:

       Don,

      First let me say thank you for commenting.  I know that you have a lot of personal background and experience in these issues and I appreciate your perspective.  I also appreciate how strait forward and honest you are in your comment.  As someone that I respect, I will attempt to return your candor in my response, and I hope that you also will not take offense at my honesty.

      I don’t think you understood my much of my blog post.  For example, you suggest that when I say the only alternative for health care policy solutions are the states and local communities, I am only talking about government.  I don’t know what “local community” means to you – presumably government in some form based on your response – but for a conservative like myself community means myself, family, friends & neighbors, businesses in the area, churches and religious groups, charities, local community organizations, etc….none of which is government.  In other words, local communities include most, if not all, of the players in the free market that you rightly look to for health care solutions.

      As another example, you think I’m calling for “new and improved government solutions.”  Here, again, you are incorrect.  My explanation of what community means already makes this clear, but you go on with this point into the areas of CHIP, HIPAA, EMTALA, and Medicare/Medicaid.  I can only assume that you aren’t familiar with the Health Care Compact, which I suggest as the alternative way forward to PPACA, because the Compact is meant to directly address all federal health regulations and programs, including all of those that you mention.  I would suggest that you read the Compact and about what it is meant to do, and I think it will clarify a lot for you about what I am suggesting.

      Derek Monson

    • Thomasfritz says:

       Don – see my rather long comment above.  Read the last paragraph.  What do you suggest who should pay?  You want CHIP and such programs out, incl. Medicare.  OK.  Who pays for grandma/pa if they are sick at age 80.  NO private insurer will give cover them, unless you have a mandate since ins. companies need a large base of healthy people to cover the huge costs of the few that get really sick.  That’s how private insurance works. 
      Grandma worked as a caregiver for decades, raised a family and saved nothing since she never made much.  her two kids barely get buy as some lost jobs and have their own kids and problems.  Cost fo the procedure is $500,000, which is very normal.
      Who pays for the kid (see above) and grandma and how.  if you want them to die without care, please say so.  otherwise, provide a solution and into just rail against this or that program.  These are realistic numbers and tens of millions of people are in that situation.
      maybe you are on medicare?  If that didn’t exist, how would you cover your $500,000 cost?  What if your wife has the same problem for $500,000.  Do you just write a check?
      I am not attacking you and respect your belief in a small govt.  I have it too, but health care is not an industry that is suited for the private sector like TV making or the cell phone industry. But all I hear form conservatives is to get the govt. out and the free market in.  OK, but who pays if a kid is sick with cancer that can costs potentially millions and the parents and family has no money.

  2. Don Ruzicka says:

    I want to keep this short and conceptual because I could literally go on for days about this subject. Please take no offense, but the entire premise of your proposition is flawed because delegating the “solution” from the federal government to the states and the communities, while certainly an admirable proposition fpr many issues, still suggests that the solution rests in the hands of government entities. Just because it is closer to the local level doesn’t mean that it is a better solution than the feds offer. You suggest that if the SCOTUS strikes down PPACA then “the only available source for genuine health care policy solutions will be the states and local communities”. Frankly, that is ridiculous! Have we gotten to the point where we are so dependent on government and so conditioned to “quick fixes” that we truly believe that everything can and should be corrected through government edict? When looking for solutions why do never seem to think about the free market solutions of competition, supply and demand, profit motive and self-regulation and adjustments? That’s how a free market works and how the greatest health care system on the planet got to be the greatest health care system on the planet along with every other economic system that made this nation the most successful, powerful, charitable, innovative and inspirational in the history of the world. All of a sudden we need the government to re-create the free market for us. That is an oxymoron!

    There is much talk about repeal and replace with reference to PPACA. Replace with what? You are suggesting basically “new and improved government solutions”. If repeal is such a great idea for PPACA, why not for the rest of the legislation that got us here in the first place such as; CHIP; HIPAA; EMTALA and MEDICARE/MEDICAID? Without getting rid of or dramatically revising all those massive government mandates and regulations it is literally impossible to restore a free market. You can tweak it, compel it or try to “reform” it through government directives but you will never restore a free market and you will be forced to continue to “reform” it when your previous “reforms” don’t work (sound familiar?). Please understand that “reform” has nothing to do with honestly fixing our health care/insurance system, it has everything to do with politics. Government has a legitimate regulatory role in any free market but it is limited to keeping the playing field level. You can’t mandate a free market and avoid the extended and painful but necessary process of allowing free markets to adjust and heal themselves after government road blocks are removed.

    Don Ruzicka

    • Derek Monson says:

       Don,

      First let me say thank you for commenting.  I know that you have a lot of personal background and experience in these issues and I appreciate your perspective.  I also appreciate how strait forward and honest you are in your comment.  As someone that I respect, I will attempt to return your candor in my response, and I hope that you also will not take offense at my honesty.

      I don’t think you understood my much of my blog post.  For example, you suggest that when I say the only alternative for health care policy solutions are the states and local communities, I am only talking about government.  I don’t know what “local community” means to you – presumably government in some form based on your response – but for a conservative like myself community means myself, family, friends & neighbors, businesses in the area, churches and religious groups, charities, local community organizations, etc….none of which is government.  In other words, local communities include most, if not all, of the players in the free market that you rightly look to for health care solutions.

      As another example, you think I’m calling for “new and improved government solutions.”  Here, again, you are incorrect.  My explanation of what community means already makes this clear, but you go on with this point into the areas of CHIP, HIPAA, EMTALA, and Medicare/Medicaid.  I can only assume that you aren’t familiar with the Health Care Compact, which I suggest as the alternative way forward to PPACA, because the Compact is meant to directly address all federal health regulations and programs, including all of those that you mention.  I would suggest that you read the Compact and about what it is meant to do, and I think it will clarify a lot for you about what I am suggesting.

      Derek Monson

    • Thomasfritz says:

       Don – see my rather long comment above.  Read the last paragraph.  What do you suggest who should pay?  You want CHIP and such programs out, incl. Medicare.  OK.  Who pays for grandma/pa if they are sick at age 80.  NO private insurer will give cover them, unless you have a mandate since ins. companies need a large base of healthy people to cover the huge costs of the few that get really sick.  That’s how private insurance works. 
      Grandma worked as a caregiver for decades, raised a family and saved nothing since she never made much.  her two kids barely get buy as some lost jobs and have their own kids and problems.  Cost fo the procedure is $500,000, which is very normal.
      Who pays for the kid (see above) and grandma and how.  if you want them to die without care, please say so.  otherwise, provide a solution and into just rail against this or that program.  These are realistic numbers and tens of millions of people are in that situation.
      maybe you are on medicare?  If that didn’t exist, how would you cover your $500,000 cost?  What if your wife has the same problem for $500,000.  Do you just write a check?
      I am not attacking you and respect your belief in a small govt.  I have it too, but health care is not an industry that is suited for the private sector like TV making or the cell phone industry. But all I hear form conservatives is to get the govt. out and the free market in.  OK, but who pays if a kid is sick with cancer that can costs potentially millions and the parents and family has no money.

  3. A_frightened_American says:

    While people may decry the “evilness” of “forcing” everyone to buy health insurance, the fact remains that ALL of us are now paying a very large tax already if we are among those who are “responsible” enough to buy our coverage.

    At least 20% to 30% of all the health expenses of all of us are now being diverted to pay for medical care for others who do not have insurance.  On top of that, in most cases at least 30% of our health insurance premiums are being skimmed off by the insurance companies as their profit margin.

    Many, including the AMA, CBO, OMB and others estimate that if universal, single-payer coverage could be adopted, medical bills for every American would be reduced by about 40%. 

    Don Ruzika — a relative of Gayle perhaps — suggests below that the “free market” is the real solution.  He ignores the fact that there is no “free market” in health care now.  It is a heavy handed corporate monopoly ruled by large insurance companies.  We are continually warned of how terrible it is to have those awful “government bureaucrats” making our health care decisions for us.  Yet people like him completely ignore the fact that our health care decisions are now being made by bureaucrats within the insurance companies.

    He is right in only one part of his posting:  “Reform” has everything to do with politics.  It has everything to do with a political system in which huge sums of corporate money are allowed to purchase our legislators and whatever political decisions they may thereby be induced to produce that will please their corporate owners.

    We have already sold America to the wealthiest among us.  How much more harm will people like Don Ruzika, the Sutherland Institute, ALEC and all the other “conservatives” be allowed to do to common people like me and my family?

    • Derek Monson says:

       Most of your post illustrates quite well how we need a free market in health care.  You are largely correct in saying that “there is no ‘free market’ in health care now”…that is exactly why the free market is the solution to many of our health care problems. 

      For instance, if there were truly free market competition in the health care sector, what we paid for health care wouldn’t be going to pay for everyone else’s health care.  This is because in a free market, people needing health care services would be paying for most of their health care services directly and by themselves, rather than having a third party (insurance or government) do it for them.  The exceptions to this, of course, would be health care services for unpredictable and disastrously expensive health care problems, which is what genuine insurance is meant for.

      Free market competition is also really the only way in a free society to do anything about excessive profit margins for insurance companies.  If those profits are too big, in a free market other insurance companies would start up, or other current insurance companies market would notice an opportunity, and they would provide the same product for less money, thus lowering the profit margins you denounce.

      And as a side note, if you think insurance company profits are such a bad thing, than mandating everyone buy insurance should be the worst idea in the world.  After all, what the mandate is going to do is FORCE everyone to give their money to the very companies that you don’t like, driving their profits even higher.

      Derek Monson

      • Thomasfritz says:

         I agree that a third party between patients and providers adds costs, complexity and, with insurance companies, an adversarial relationship.  Insurance plans that pay practically for the first dollar of whatever service you get are essentially prepaid insurance plans since ins. cos. know that on average, you will use say $2,000 of services in a year.  They encourage waste.
        I disagree that high profits attract competition in the ins. market.  The financial and regulatory barriers to entry in this market are huge.  That’s why we only have a few giants out there.  It’s the same with high end microchips that power computers.  Essentially, Intel owns most of that market since a plant to make them (a fab) costs several billions.  In fact, the big players get bigger every year and squeeze out the smaller ones or buy them up.
        The essential argument about health care (HC) in this country is this:  maybe 50% or so (just rough guesses) of the population in this country gets excellent HC because they have good ins. plans.  Very few people can pay out of pocket for anything serious. They can also afford the co-pays, deductibles and other costs.  That’s the part of the population that’s to the right of the income distribution curve.  The other 50% is simply too poor to even pay for an office visit and doesn’t generate enough revenues for their employers to justify that the employer buys insurance.  These people depend on a patchwork of govt., charity and other HC plans or go without until they have to go to an ER.  No matter how much you write about free market, that people should pay their own basic HC and then get catastrophic ins., the numbers don’t add up.  if you make $40,000 or less for a family of four, which almost half the country makes (many maker far less than that) , you can barley pay your other bills.  You need housing, a car to get to work, some food, clothes, expenses for kids, etc.  There is NOTHING left for an HSA account or anything else.  This is all wishful thinking.  In other countries, they found that out a long time ago and the top 50% simply said that we pay for the bottom 50% since sick and uninsured people are too costly in the long run.  The top 50% of the country pays for almost all public education since illiterate people are costly too (prisons, lost productivity, etc.).  Our Founding Fathers figured that out already. In the US, the top 50% has to extend this mindset to healthcare too.  We barely tax the bottom 50% since there is nothing to tax, and there is even less to extract to pay for expensive HC.  It’s simple math and you can talk all you want about solutions.  If we didn’t have that division, many solutions would work.  But we have had  this discussion for decades and it gets worse every year.  if you throw out the govt. from HC and leave it all in the private sector, soon the top 50% would scream for the govt. to take care of all the sick people because charity cannot handle them. That’s an illusion and there is no free charity.  Somebody has to pay for the bandaid and the expensive MRI.  I prefer everybody than just those with insurance.  Conservatives complain about the tax in Obamacare, but not about the hiden tax in my premium to support the uninsured. 
        You may say – the bottom 50% just needs to work harder and make more money.  No matter what, without some redistribution of wealth, there will always be lots of people who do the dirty work and not earn much.  if the fruit picker makes $100K, then soon the engineer demands $1 million (why study so long if you can pick fruit) and prices move up accordingly (that’s free market too).
        So the solution is to find the fairest way for the top 50% to come up with the money to pay for the HC of the bottom 50%, just as we do with education and many other social expenses. if not, the problem gets only worse.  The bottom 50% with no or little health care and no money to pay for even basic care will not go away.  They vote too and the social costs will become so great that a solution will be found.  The ACA did just that, imperfect as it is. 
        You and Don below can talk about free market in HC until the day you go to the doctor and ask for a price list for all services, like a restaurant menu.  Until then, HC is a dark cave.  The patients don’t know what they need, how much it costs and how to pay for it.  Today you are healthy and tomorrow you have a $1 million problem on your hand.  Unless we resort to every man/woman on his/her own, we will need some form of solution whereby everybody pays into the pot in case you become one of the 5% of the population that consumes half of all HC costs.
        I am open for non-ideological solutions.  Let’s start by telling me how a family of four with an income of $25,000 or less a year (I think that applies to a quarter of the population) should get HC if they have cancer.  No charity, since it’s not free and nobody can supply HC for “free” to a quarter of the population. Who should pay or shall they just die.  if so, be honest to say.  if not, what do you suggest.  Obviously, they cannot pay a dime and if the main earner is sick, they have zero income.  Don rails against CHIP below, s what if the kid has cancer ($500K say). You are for families, pro-life, etc.  who pays for her care? thomasfritz@yahoo.com

    • Jbo says:

      what most Americans have forgotten or never knew is that we used to have the #1 and most affordable healthcare system in the world before government decided to regulate it in all extremes. Also, you have clearly not read the bill. Anybody who does knows it is not about healthcare, but it is a collection of evils such as government controlled euthenasia. The feds decide who lives and who dies. They decide who gets treatment and who doesn’t. They have permission to electronically tag you from birth with a microchip. The elderly will be too ‘costly’ to keep alive. An emergency reserve pseudo-army support team, part of Obama’s domestic national security force. Over 150 new government agencies. Regular visits to your home to tell you if you’re a good parent or not, and sometimes take them if the healthcare worker is in a bad mood that day and doesn’t like the way you told your kid to behave during the visit. Obama are supporters have simply not read any of the bill, or they have only been fed tiny pieces of it.

      • Thomasfritz says:

         Did you look under your bed today to see if one of those agents from Obama is lurking there? I saw one the other day behind my tree in the back yard.  Dangerous times indeed….

  4. A_frightened_American says:

    While people may decry the “evilness” of “forcing” everyone to buy health insurance, the fact remains that ALL of us are now paying a very large tax already if we are among those who are “responsible” enough to buy our coverage.

    At least 20% to 30% of all the health expenses of all of us are now being diverted to pay for medical care for others who do not have insurance.  On top of that, in most cases at least 30% of our health insurance premiums are being skimmed off by the insurance companies as their profit margin.

    Many, including the AMA, CBO, OMB and others estimate that if universal, single-payer coverage could be adopted, medical bills for every American would be reduced by about 40%. 

    Don Ruzika — a relative of Gayle perhaps — suggests below that the “free market” is the real solution.  He ignores the fact that there is no “free market” in health care now.  It is a heavy handed corporate monopoly ruled by large insurance companies.  We are continually warned of how terrible it is to have those awful “government bureaucrats” making our health care decisions for us.  Yet people like him completely ignore the fact that our health care decisions are now being made by bureaucrats within the insurance companies.

    He is right in only one part of his posting:  “Reform” has everything to do with politics.  It has everything to do with a political system in which huge sums of corporate money are allowed to purchase our legislators and whatever political decisions they may thereby be induced to produce that will please their corporate owners.

    We have already sold America to the wealthiest among us.  How much more harm will people like Don Ruzika, the Sutherland Institute, ALEC and all the other “conservatives” be allowed to do to common people like me and my family?

    • Derek Monson says:

       Most of your post illustrates quite well how we need a free market in health care.  You are largely correct in saying that “there is no ‘free market’ in health care now”…that is exactly why the free market is the solution to many of our health care problems. 

      For instance, if there were truly free market competition in the health care sector, what we paid for health care wouldn’t be going to pay for everyone else’s health care.  This is because in a free market, people needing health care services would be paying for most of their health care services directly and by themselves, rather than having a third party (insurance or government) do it for them.  The exceptions to this, of course, would be health care services for unpredictable and disastrously expensive health care problems, which is what genuine insurance is meant for.

      Free market competition is also really the only way in a free society to do anything about excessive profit margins for insurance companies.  If those profits are too big, in a free market other insurance companies would start up, or other current insurance companies market would notice an opportunity, and they would provide the same product for less money, thus lowering the profit margins you denounce.

      And as a side note, if you think insurance company profits are such a bad thing, than mandating everyone buy insurance should be the worst idea in the world.  After all, what the mandate is going to do is FORCE everyone to give their money to the very companies that you don’t like, driving their profits even higher.

      Derek Monson

      • Thomasfritz says:

         I agree that a third party between patients and providers adds costs, complexity and, with insurance companies, an adversarial relationship.  Insurance plans that pay practically for the first dollar of whatever service you get are essentially prepaid insurance plans since ins. cos. know that on average, you will use say $2,000 of services in a year.  They encourage waste.
        I disagree that high profits attract competition in the ins. market.  The financial and regulatory barriers to entry in this market are huge.  That’s why we only have a few giants out there.  It’s the same with high end microchips that power computers.  Essentially, Intel owns most of that market since a plant to make them (a fab) costs several billions.  In fact, the big players get bigger every year and squeeze out the smaller ones or buy them up.
        The essential argument about health care (HC) in this country is this:  maybe 50% or so (just rough guesses) of the population in this country gets excellent HC because they have good ins. plans.  Very few people can pay out of pocket for anything serious. They can also afford the co-pays, deductibles and other costs.  That’s the part of the population that’s to the right of the income distribution curve.  The other 50% is simply too poor to even pay for an office visit and doesn’t generate enough revenues for their employers to justify that the employer buys insurance.  These people depend on a patchwork of govt., charity and other HC plans or go without until they have to go to an ER.  No matter how much you write about free market, that people should pay their own basic HC and then get catastrophic ins., the numbers don’t add up.  if you make $40,000 or less for a family of four, which almost half the country makes (many maker far less than that) , you can barley pay your other bills.  You need housing, a car to get to work, some food, clothes, expenses for kids, etc.  There is NOTHING left for an HSA account or anything else.  This is all wishful thinking.  In other countries, they found that out a long time ago and the top 50% simply said that we pay for the bottom 50% since sick and uninsured people are too costly in the long run.  The top 50% of the country pays for almost all public education since illiterate people are costly too (prisons, lost productivity, etc.).  Our Founding Fathers figured that out already. In the US, the top 50% has to extend this mindset to healthcare too.  We barely tax the bottom 50% since there is nothing to tax, and there is even less to extract to pay for expensive HC.  It’s simple math and you can talk all you want about solutions.  If we didn’t have that division, many solutions would work.  But we have had  this discussion for decades and it gets worse every year.  if you throw out the govt. from HC and leave it all in the private sector, soon the top 50% would scream for the govt. to take care of all the sick people because charity cannot handle them. That’s an illusion and there is no free charity.  Somebody has to pay for the bandaid and the expensive MRI.  I prefer everybody than just those with insurance.  Conservatives complain about the tax in Obamacare, but not about the hiden tax in my premium to support the uninsured. 
        You may say – the bottom 50% just needs to work harder and make more money.  No matter what, without some redistribution of wealth, there will always be lots of people who do the dirty work and not earn much.  if the fruit picker makes $100K, then soon the engineer demands $1 million (why study so long if you can pick fruit) and prices move up accordingly (that’s free market too).
        So the solution is to find the fairest way for the top 50% to come up with the money to pay for the HC of the bottom 50%, just as we do with education and many other social expenses. if not, the problem gets only worse.  The bottom 50% with no or little health care and no money to pay for even basic care will not go away.  They vote too and the social costs will become so great that a solution will be found.  The ACA did just that, imperfect as it is. 
        You and Don below can talk about free market in HC until the day you go to the doctor and ask for a price list for all services, like a restaurant menu.  Until then, HC is a dark cave.  The patients don’t know what they need, how much it costs and how to pay for it.  Today you are healthy and tomorrow you have a $1 million problem on your hand.  Unless we resort to every man/woman on his/her own, we will need some form of solution whereby everybody pays into the pot in case you become one of the 5% of the population that consumes half of all HC costs.
        I am open for non-ideological solutions.  Let’s start by telling me how a family of four with an income of $25,000 or less a year (I think that applies to a quarter of the population) should get HC if they have cancer.  No charity, since it’s not free and nobody can supply HC for “free” to a quarter of the population. Who should pay or shall they just die.  if so, be honest to say.  if not, what do you suggest.  Obviously, they cannot pay a dime and if the main earner is sick, they have zero income.  Don rails against CHIP below, s what if the kid has cancer ($500K say). You are for families, pro-life, etc.  who pays for her care? thomasfritz@yahoo.com

    • Jbo says:

      what most Americans have forgotten or never knew is that we used to have the #1 and most affordable healthcare system in the world before government decided to regulate it in all extremes. Also, you have clearly not read the bill. Anybody who does knows it is not about healthcare, but it is a collection of evils such as government controlled euthenasia. The feds decide who lives and who dies. They decide who gets treatment and who doesn’t. They have permission to electronically tag you from birth with a microchip. The elderly will be too ‘costly’ to keep alive. An emergency reserve pseudo-army support team, part of Obama’s domestic national security force. Over 150 new government agencies. Regular visits to your home to tell you if you’re a good parent or not, and sometimes take them if the healthcare worker is in a bad mood that day and doesn’t like the way you told your kid to behave during the visit. Obama are supporters have simply not read any of the bill, or they have only been fed tiny pieces of it.

      • Thomasfritz says:

         Did you look under your bed today to see if one of those agents from Obama is lurking there? I saw one the other day behind my tree in the back yard.  Dangerous times indeed….

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