Some questions I have for those interested in commenting, as I said over the
weekend, I'll be working on my proposal for healthcare.
Congress, through
Obamacare, injected itself in the business of healthcare, through the creation
of a tax, they call it a fee, Supreme Court Chief Justice called it a tax, which
was the only was it is Constitutional.
The Federal Government presently
manages directly or indirectly:
* healthcare for active duty and retired
military through DOD or Tricare;
* healthcare
for veterans with service-connected disabilities through the Veterans Administration;
*
healthcare for members of Federally-recognized Native American, Native Alaskan
and Native Hawaiian tribes, nations or clans, through the Indian Health Service;
* healthcare for those
collecting Social Security or Social Security Disabiilty, through Medicare; and
* healthcare for Federal Employees
through the Federal Employees Health
Benefits Program (FEHBP) and contracted with various insurance
companies.
Also, I'm pretty sure, there is a "federal-program" that
provides children of families on welfare, of Aid to Families with Dependent
Children, medical services for those children only through, I think they are,
contracted providers.
Here's the rub, I'm having with this issue
....
* Who licenses doctors and nurses? Each state.
* Who licenses
hospitals? Each state.
* Who licenses insurance companies? Each
state.
According to the U.S. Constitution, what are the limitations
placed upon Congress pertaining to Commerce?
The Commerce Clause,
Article I Section 8 Clause 3 of the Constitution of the United States, grants
Congress the power “To regulate Commerce with foreign Nations, and among the
several States, and with the Indian Tribes”. The commerce power is an enumerated
power of Congress and the Supreme Court has interpreted it as an express grant
of authority to Congress and an affirmative limitation on the rights of the
states to regulate commerce within their own borders. Commerce Clause – The
Commerce Power of Congress
While "the Supreme Court upheld the
Affordable Care Act. But in doing so, Chief Justice John Roberts’ majority
opinion appears to have placed new limits on Congress’s ability to regulate
interstate commerce. Will this make future federal legislation harder to enact?
Or does Congress still, in theory, have the power to make everyone buy broccoli?
That’s a key question legal scholars are now mulling as they pick through the
decision. by
Brad Plumer on June 28, 2012 at 12:58 pm
"In its decision
Thursday, five justices, including Roberts, ruled that the health reform law’s
requirement for all Americans to purchase health insurance runs afoul of the
Constitution’s Commerce Clause. Basically, the court ruled that Congress can
regulate existing interstate commercial activity, but it can’t directly force
people to enter into a market (by, say, requiring them to purchase health
insurance). “The power to regulate commerce,” Roberts wrote, “presupposes the
existence of commercial activity to be regulated.”"
"This subtle
distinction between regulating activity and inactivity is one that libertarian
legal scholar Randy Barnett had developed and pushed into the mainstream. It’s a
new concept. Yet for the purposes of the Affordable Care Act, it ended up not
mattering. Roberts ruled that the individual mandate was akin to a tax —
Americans can either purchase health insurance or pay a fine through the IRS.
And, since taxes are perfectly within Congress’ powers to levy, the law was
upheld."
Here is another perspective. Individual states issue
driver's licenses, based upon your residency within that state; however the
Federal Aviation Administration issues pilot's licenses, based upon the National
Airspace System is under Federal Jurisdiction. However the Federal Government
also I believe has some licensing authority when it pertains to long haul
trucking, which I assume falls under the "Interstate Commerce"
clause.
Now as I understand the Supreme Court's decision,
"if" the fine/tax provision were not in the bill, it would be
unconstitutional. Correct?
Further, I know at one time there was a major
issue pertaining to Congress attempting to direct or mandate a National Driver's
License, and establish minimum requirements for obtaining it; but I believe it
did not make even through or to a vote, because they realized it could not pass
the "Interstate Commerce" clause of Congress' Powers by the
Constitution.
So the first question, I guess, is Healthcare "by law" a
State-right issue or is it or can it be a Federal issue?
Second question
is "Wasn't Healthcare "de-regulated" in the past, like the telephone companies
monopoly, resulting in all the baby-bell's or Aetna of California, Blue Cross
and Blue Shield of Alabama, etc.?"
In light of the above two questions,
the Supreme Court's decision, "Can there be a true "Federal" Healthcare System,
beyond what is already provided, as I enumerated at the begining of this post,
and beyond the scope of Affordable Care Act?"
Or, "Can Congress, in
conjunction with the systems at the begining, create an 'Amercian Citizen Health
Benefits Program' sort of a "government-type insurance that is a mixture of the
programs, but available to all American Citizens? And then should it get into
the Healthcare business or leave it to the states?"
Now what I would like to see, but not certain how to accomplish it would be
to in some manner set a "pricing-cap" or regulatory process to control
costs.
I would think with all the data the Federal Government collects on
everything from paper-clip use to cow-fart-methane, they should have a set of
statistics pertaining to various healthcare costs; such as office visits, the
various procedures, xrays, etc.
Along those lines of statistical
information, the to create a "benchmark" of healthcare costs, that would then be
indexed by what I addressed in my post about income taxes, such as using the
Federal Employees Locality Pay variance from the basic General Scale pay rate.
In otherwords, taking here for example, we in this portion of Alabama would pay
say $25.00 (Example only) for a basic office visit. In Monterrey County,
California, where I believe the pay differential was 1.6, then in Monterrey
County, you would pay $40.00.
Further as with everything, there is no
one-size-fits-all when it comes to healthcare, only those services you use or
need. So I would think a system that provides a basic level of service, WHICH, I
believe should include Vision and Dental care, as part of the basic package.
Then you have the yearly option, like the federal employees open-season to
change plans, to add services, such as pre-natal and post-natal care, adding
mental health care (to include substance abuse and recovery), etc.
Now on
a rather "explosive" topic, I personally do not believe in abortion, except in
the cases of rape or incest; HOWEVER, I believe that coverage for birth-control,
contraception (including abortions) can be a part or should be a part of the
Opt-In services provided under pre-natal and post-natal care. I would also agree
with the inclusion of contraceptive measures, including abortion ONLY in the
cases of rape or incest to be a part of the basic coverage. That would be in my
opinion under emergency services; beyond that, i.e., "I don't like using
condoms, or spermacides, or my boyfriend/husband couldn't keep his pecker in his
pants" ... that's under the opt-in service of pre-natal/post-natal care. ... But
I am sincere, when I say in the case of rape or incest, that should be an
emergency service covered by all insurance.
Now I'm sure the
extreme-evangelical Christian Right will have a problem even with those caveats
in place, but by providing an "Alternative Insurance" such as the American
Citizen Health Benefits Program, it allows them to keep the basic provisions
they have for their members or employees who wish to "stay in line with church
teachings" while at the same time presenting an option for those who may be a
little more liberal in their beliefs.
In advance, please no flaming
barbs or remarks, as I am honestly really trying here to get some good input as
well as adopt a mid-of-the-road balance that more than that 47% percent Romney
couldn't reach, can be satisfied with.
Thanks.
Bill
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