“The Patient Protection and Affordable Care Act of 2010 (PPACA) – regardless of the view one has of the legislation – has created enormous disruption. And with disruption comes enormous opportunity, as well as risk. Many provider organizations (e.g. hospitals and physician groups) have responded to the changing healthcare delivery environment by safety in size through merger and acquisition. Payers are also buying or creating partnerships with hospitals, and hospitals are acquiring other hospitals and physician practices to become gigantic systems.”
“The main argument for a mandate before the Supreme Court was that people of modest means can fail to buy insurance, and then rely on charity care in emergency rooms, shifting the cost to the rest of us. But the expenses of emergency room treatment for indigent uninsured people are not health-care’s central cost problem. Costs are rising because people who do have insurance, and their doctors, overuse health services and don’t shop on price, and because regulations have salted insurance with ever more coverage for them to overuse.”
“Tuesday, March 23 marked the two-year anniversary of the passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) and the largest transfer of power from Congress to the Administration in the history of this nation. As the Supreme Court hears arguments about PPACA on Constitutional grounds – the individual mandate, in particular – let’s not be lulled into thinking its broader assumptions and provisions are otherwise innocuous or valid. Setting aside the need to address legitimate reform, including egregious problems with pre-existing condition rules on the insurance side, there’s the bigger problem of healthcare delivery and the fundamental safety of this sector of the industry.”
“Hitherto, most attention has been given to whether Congress, under its constitutional power to regulate interstate commerce, may coerce individuals into engaging in commerce by buying health insurance. Now the Institute for Justice (IJ), a libertarian public interest law firm, has focused on this fact: The individual mandate is incompatible with centuries of contract law. This is so because a compulsory contract is an oxymoron.”
“While the Supreme Court weighs the constitutionality of the Affordable Care Act, Congress is holding hearings on the federal regulatory process. The two topics are more closely related than you might think. The healthcare law required many regulations, and thus far, the major regulations issued to implement the Affordable Care Act serve as ugly poster children for the regulatory reform movement.”
“Republican lawmakers leaving oral arguments before the Supreme Court on Tuesday agreed that the government will have a tough time finding a fifth justice to uphold the health law’s individual mandate. Democrats for their part found solace in pointed questioning of lawyers on both sides of the argument by Justices Anthony Kennedy and Chief Justice John Roberts. Their outlook coming out of the court, however, was visibly less sunny than the Republicans’.”
“Rarely has one law so exemplified the worst of the Leviathan state — grotesque cost, questionable constitutionality and arbitrary bureaucratic coerciveness. Little wonder the president barely mentioned it in his latest State of the Union address. He wants to be reelected. He’d rather talk about other things.”
“The IPAB puts rationing of health care on autopilot. The IPAB is to be composed of 15 unelected, unaccountable officials who will have the authority to make cuts in Medicare payments if per capita spending exceeds defined target rates. The IPAB epitomizes Obamacare’s command-and-control approach, and passing a targeted repeal bill is an excellent way to help people understand that.”
“The Senate is under increasing pressure to bring up legislation repealing a key part of President Obama’s healthcare law. A House subpanel on Wednesday easily approved a measure to repeal a Medicare cost-cutting panel derided by Republicans as a ‘rationing board.’ Two Democrats — including the panel’s ranking member — crossed the aisle and joined Republicans in voting to nix the Independent Payment Advisory Board (IPAB). The lopsided 17-5 vote underscored the bipartisan support for repealing the board, which Obama has made the centerpiece of his efforts to reduce Medicare spending. It also provided evidence the legislation could have a shot at passing the Senate.”
“Just when you think everything that can be said about Obamacare’s constitutionality has been said, along comes another legal brief that makes a new point. The latest was filed by the Arlington-based Institute for Justice, a nonpartisan, libertarian public-interest law firm. The institute points out that the Affordable Care Act’s individual mandate — the requirement to purchase insurance — is not only an unprecedented expansion of federal power. It also undermines several centuries of contract law.”