BREAKING: Supreme Court Upholds Mandate of Health Insurance

Live Stream from DemocracyNow.org: "Democracy Now! Live Coverage of U.S. Supreme Court Healthcare Ruling: Tune in Thursday 10-11am EDT"
Democracy Now: "Supreme Court Upholds Affordable Care Act"

A one-hour Democracy Now! special broadcast hosted by Amy Goodman, covering the U.S. Supreme Court’s landmark decision on the Patient Protection and Affordable Care Act. Chief Justice John Roberts was the swing vote in upholding the Act, joining Ruth Bader Ginsburg, Sonia Sotomayor, Elena Kagan and Stephen Breyer. From outside the Supreme Court in Washington DC, to New York and around the country we get reaction from: filmmaker Michael Moore, health insurance industry whistleblower Wendell Potter, Georgetown University law professor David Cole, Elisabeth Benjamin of the Community Service Society of New York, Congressmember Keith Ellison (D-MN), Dr. Margaret Flowers of Physicians for a National Health Program, Hilary Shelton of the NAACP, Russell Mokhiber of SinglePayerAction.org and Karen Higgins of National Nurses United.

Jeffrey Young, "Supreme Court Health Care Decision Preserves Biggest Expansion Of Coverage In 45 Years" --Huffington Post, June 28, 2012
Voting for upholding Barack Obama's individual health insurance mandate law: Justices John Roberts, Stephen Breyer, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan.
Chief Justice John Roberts' swing vote to the liberal direction saved bill: Mike Sacks, "Supreme Court Health Care Decision Preserves Biggest Expansion Of Coverage In 45 Years" --Huffington Post, June 28, 2012
Truth be told, this is a liberal sell-out to the private health insurance industry. It is ironic that Mitt Romney and conservative company decry it, as Heritage Foundation, a right-wing think tank proposed this individual mandate. As Cenk Uygur at Huffington Post points out in "The Mandate Is the Perfect Symbol of the Central Mistake of Obama Administration", June 25, 2012, the conservative Heritage Foundation originally proposed this.
From Alternet:
"Supreme Court Upholds Most of Obamacare"

The Supreme Court--with Chief Justice John Roberts leading the majority--has voted to uphold the heart of Obamacare, or the Affordable Care Act, according to reports on Scotusblog, in its first quick reading of the Supreme Court's historic health care reform decision.
The ACA's requirement that all Americans (except the very poor) have a health insurance plan by January 2014 or pay a tax penalty was upheld, giving the Obama administration a tremendous political victory.
However, the decision appeared to allow the coverage mandate to stand based on the Congress's ability to impose a tax, not under its constitutional authority to regulate interstate commerce. That interpretation is a victory for conservative ideologues, as it may constrain future congressional action on national economic issues.
Scotusblog said this was the Chief Justice's key quote, "Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it."
Another major element of the law, concerning the expansion of state-based Medicaid programs to help the working poor and elderly was largely upheld, but apparently with restrictions that may allow red states not to implement the ACA, according to early reports.
On the Medicaid expansion, this was Robert's key quote, "Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding."
In other words, it remains to be seen if red states will still be able to thumb their noses at the Obama administration and Congress and not implement the Medicaid expansion--such as opening clinics in underserved areas--without losing any funds for its other existing Medicaid programs.
Reading from the bench, Justice Anthony Kennedy made it clear that he--and presumably the other conservative judges would have thrown out the entire law.
Alternet will have more reports and update its analysis as the day proceeds. By Steven Rosenfeld | Sourced from 358 Posted at June 28, 2012, 7:34 am

Contrast this lame system with some of the best systems in the world, which do not have individual mandates to get private insurance. Sweden -government-run, costing approximately 9 percent of Sweden’s gross domestic product (GDP). Italy -government-run, costing 9.0% of GDP in 2006.
France, the top rated globally by the World Health Organization, is closer to the approaching American model than the above systems. BUT, with its private component, it is much costlier than most European systems: it cost 11.2% of GDP on health care in 2005, or US$3,926 per capita, a figure much higher than the average spent by countries in Europe.

T.R. Reid from Washington Post., debunking myths about health care around world

From Washington Post, Aug. 23, 2009 ... Never too late.
5 Myths About Health Care Around the World
As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

1. It's all socialized medicine out there.

Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.

In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

5. Health insurance has to be cruel. Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.

Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
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In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.

T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," [the NPR "Fresh Air" interview link] to be published Monday.

Hear stories of how European health care compares with American health care, from Americans living abroad

The commercial media, particularly FoxNews and poorly informed reporters, pump us with stories of the horrors of European public medical care.
Yet, Public Radio International (PRI)'s "The Takeaway" aired this morning (August 28, 2009) interviews with Americans living abroad, to hear how European health care compared with health care in the United States.

Read also the background on the medical systems of Germany and the United Kingdom. They have better rankings in terms of infant mortality rates and life expectancy than the United States has.

Interviews are by John Hockenberry and Femi Oke. Interviewed guests, living abroad, in Bavaria, Northern Ireland and Russia are Cynthia Geyer, Amanda Graham and Lynne Udoalov.
Click here for this and other The Takeaway segments this month on healthcare, or Healthcareroundtablesinternational.