Monday, July 2, 2012

Reaction to the Supreme Court decision on the Affordable Care Act

In keeping with this month's theme, I'll give the funny animators over at Next Media Animation the honor of having the first say.*

The US Supreme Court has ruled in favor of Obama's health care reforms, the Affordable Care Act. Imagine the heart attacks the ruling is giving the Teabaggers right now. At least now they're covered!
There are other kinds of humor than the light-hearted take Next Media Animation has. Over at Clusterfuck Nation, James Howard Kunstler's snark on the decision ranges from jaundiced to downright morbid.
Not to put too fine a point on it, but didn't that cunning rogue Chief Justice John Roberts pour a jug of Karo syrup into the gas tank of America's twelve trillion cylinder engine? Or, put another way (forgive the metaphor juke), didn't he just give President Obama enough rope to hang himself? Out to dry, that is. Roberts must know exactly what he is doing: prompting x-million young and/or poor voters to an election year tea party tax revolt. The Obama health care reform will henceforth be defined as a tax against people too economically strapped to buy health insurance - in other words, a gross injustice, courtesy of Obama.

Or call it a poison pill. Obama gets to brag that the heart of his 2700-page reform package stands - at the expense of the very people it was designed to protect. Forget about the niceties regarding the interstate commerce clause and other chatter points. This was all about Chief Justice Roberts interfering in a presidential election in a most mischievous way. He might as well have just heated up a branding iron that spelled out T-A-X and applied it to Mr. Obama's forehead.
I don't particularly agree with any of what Kunstler said, especially the part about it inciting a revolt among the young and the poor, two of Obama's key constituencies. If anything, a young-person's revolt would be to the Left of Obama, not his Right, and would ask for single payer, e.g., "Medicare for All." That would screw up Kunstler's thesis, which is a de-evolution of the system to local control and delivery without the federal bureaucracy. I didn't say that, merely observing the following.
Wow, Jim, you've outdone yourself this week, connecting the Supreme Court's ruling on the Affordable Care Act to the flawed health care system, the critically ill (and possibly terminal) financial system, and your own health. You need to remember one thing--health insurance is part of the financial system. There are reasons why that sector of the economy is called "FIRE"--Finance, Insurance, and Real Estate. Add in real estate, and all of your major concerns are tied together. Isn't that convenient?
I did blog about the Supreme Court deliberating on the Affordable Care Act, but both of those were before the decision, not after. I have some quotes from three people at SUNY Buffalo and SUNY Upstate Medical Center in Syracuse to include in a post. How interesting that, added to you, all of them are from Upstate New York. I guess I know what I'm blogging about today.
Speaking of which, it's time for those comments from campuses on the campaign trail, which I originally posted in Overnight News Digest: Science Saturday (PPACA upheld! edition), over the jump.

UB Law School Health Care Expert Available to Discuss Supreme Court Ruling on Obama Health Care Plan
Release Date: June 28, 2012
BUFFALO, N.Y. -- The long-awaited Supreme Court ruling on President Obama's signature health care law upholds much of the act's intentions to expand coverage, with one major exception, says a University at Buffalo Law School professor who is an expert on health care.

"That exception has to do with the expansion of the Medicaid program," says Anthony H. Szczygiel, founder and director of the William and Mary Foster Elder Law Clinic at UB's Law School. "The president's health care act encouraged states to expand Medicaid, but the president's plan also went further and gave the secretary of Health and Human Services the authority to withhold all Medicaid funding -- not just that related to the expansion -- if states fail to expand the Medicaid programs."

Szczygiel says the bottom line is that the Supreme Court ruling will accomplish much of what the act intended, in terms of expanding health insurance.
That's the legal expert. Now the medical expert at SUNY Buffalo.

UB Family Medicine Expert Available to Discuss Supreme Court Decision
Release Date: June 28, 2012
BUFFALO, N.Y. -- The Supreme Court's decision to uphold much of the Affordable Care Act will not only provide as many as 30 million or more uninsured Americans with healthcare coverage, it may also help foster some important and long overdue changes in the healthcare system, says Tom Rosenthal, MD, chair of the Department of Family Medicine in the University at Buffalo School of Medicine and Biomedical Sciences.

"From a primary care perspective, the most common thing we see in an office setting is that we are now seeing more young people in their 20s than we did because they are covered by their parents' insurance to age 26," he says. That change is adding to health care costs because this is a new population that is now seeking medical care.

However, in the long run, this coverage will prove to be more economical, he says.
The effect so far is a short-run increase in costs but the act will yield a long-run decrease; that's good news and exactly what was intended.

Now for SUNY's Upstate Medical Center, coming from their Wordpress blog.

Health care leaders applaud Supreme Court decision on Affordable Care Act
By Amber Smith
June 29, 2012
The Supreme Court’s decision to uphold the Affordable Care Act Thursday was mostly good news for Syracuse’s academic medical center.

David Smith MD, president of Upstate Medical University, told The Post-Standard he was pleased with most aspects of the federal law, including provisions designed to help prevent obesity, diabetes and other chronic diseases. Smith said he is concerned about a provision that would reduce the federal payments hospitals like Upstate receive in acknowledgment of caring for a disproportionate share of low-income patients. Projected loss of funding will not be offset by the increased number of patients with insurance, Smith told the newspaper, explaining that Upstate relies on the federal money to maintain costly services like trauma care and its burn unit.

In addition, Upstate University Hospital CEO John McCabe MD expressed concern about New York State’s commitment to expand Medicaid coverage and said on his blog that “we remain concerned about the loss of dollars to help support our Graduate Medical Education programs. This is the training pipeline for the future healthcare workforce.”
There are still some bugs to work out. I'm not surprised. It took decades for Social Security to evolve into what it is today, and I'm sure that Medicare and Medicaid will expand more, too.

*I plan on posting a lot of Next Media Animation videos this month as an easy way to get humorous take on the news. They love to kid around. :-)


  1. In a surprise revelation this week, defense contractors around the country were found to support new defense spending in America.

    "This is the pipeline to defense preparedness in the 2012-2022 decade. Cutting spending now would spell un-preparedness for Americans," observed Warren Buchs, press spokesman for Dronecorp.

    "At a time when other nations competing with the USA are developing advanced drone technologies, an increased drone spending program will ensure America leads the world in drone defense preparedness," said Clement C. Izdette, lead engineer for Bot-Tech Aerodrone LLC.

    Of course there are bugs to be worked out. It took Oppenheimer longer than a week to develop America's first nuclear weapon.

    1. You're perfectly right to be snarky and cynical about this news. However, the positive response from M.D.s and others who follow healthcare is a positive sign. I recall the AMA was originally opposed to Medicare and Medicaid. That their opinion has turned around indicates that they think the ACA is good thing for the practice of medicine.

      As for the defense contractors, my reaction is more complex and deserves more than a mere comment. My father worked for defense contractors nearly all his adult life, so I have a very ambivalent relationship to the subject.