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Obamacare: Obama just straight up lied to you, in your face (2 Viewers)

This stupid case and issue is just another temporary "outrage" for the suckers to gobble up. There will be another one in a couple weeks. But you know what is funny? Nothing ever really gets done about any of them. Remember how Obama is weak on foreign policy? Well, we dont have ambassadors in one quarter of the countries where we have embassies, including Russia (!!!), or in a bunch of the countries whose young kids are swarming our borders. Truly returded.

Remember the VA scandal? The hideous logjam of veteran claims which have tripled and quadrupled over the years because of our government deciding to go to war overseas in two places for over a decade but not simultaneously increasing funding to the VA? Well, Congress did nothing about that even with the major vet organizations like the American Legion screaming at them to do something, anything.

We are a stupid people and we choose stupid people to represent us. Dont get hung up on the sparkly light distractions.

 
I'm going to meet you just over on your side of the line and say that I have not explicitly heard "the tax credits/subsidies are hereby being conditioned on the creation of a state exchange by the state." Now that is the letter of the law, so there's that. And the Finance committee is all about taxes and using that as a hook to gain state regulation, but no I guess no one has explicitly said 'this for that' yet.
Well the consultant guy did, but his sales pitch was a bit self serving.
The consultant guy said it on a few separate occasions, but he now says that he misspoke. (It didn't seem like he misspoke; it seemed like he meant what he said.)

I don't think the Supreme Court will consider what the consultant guy said, though. It's not in evidence, and I don't think it's the kind of thing that judges take judicial notice of.

 
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I'm going to meet you just over on your side of the line and say that I have not explicitly heard "the tax credits/subsidies are hereby being conditioned on the creation of a state exchange by the state." Now that is the letter of the law, so there's that. And the Finance committee is all about taxes and using that as a hook to gain state regulation, but no I guess no one has explicitly said 'this for that' yet.
Well the consultant guy did, but his sales pitch was a bit self serving.
The consultant guy said it on a few separate occasions, but he now says that he misspoke. (It didn't seem like he misspoke; it seemed like he meant what he said.)

I don't think the Supreme Court will consider what the consultant guy said, though. It's not in evidence, and I don't think it's the kind of thing that judges take judicial notice of.
Is there a place to see what is in evidence? (I guess that the opinions only highlight the evidence that the judge felt compelling and doesn't really show everything that is there.)

 
As always, matttyl you raise fine issues. But I have to point out that your moral dilemma is at least as old as Medicare, which is a 50 year program at this point. Under Medicare, you can have people who retire after years of living healthy, eating right, and exercising, and other people retire after years of living like crap. And the healthy ones have to pay for the unhealthy ones. Under your premise, that's immoral, and it's hard to argue the point, except to say that it's the price we choose to pay to have Medicare.

It seems to me it's the same thing here. Whether its Obamacare (the specifics of which I disapproved of) or whether it's some other form of government involvement, we as a society have chosen that we're going to collectively help those of us who can't afford medical care to obtain it- and that means inequity. That means that there will be those who screw up and we're going to have to pay for them. That means some sort of transfer of wealth. But it's the price we have chosen to pay. Personally, at least in theory, I'm willing to pay that price in order to make sure that there's no one out there in this country that can't get health care.
First off I didn't say it's "immoral", I said it may be a moral dilemma. As far as Medicare, you realize that it's costing about $600B this year alone, right?Specifically on the part I bolded - this hep C drug is 84,000 per person (currently). There are approximately 3.2m in America with it. That's $269B if we'd somehow be able to get it to all those people immediately. Divide that cost by our population, and it comes out to $856 per person, on average. I believe you're in a family of 4, correct? Would you and your family be willing to part with $3,424 right now to insure that everyone (in America) that we think has hep C (many people don't know they have it) is cured of it (to the extent that this drug cures hep C)?
No. But I don't think that's gonna happen.
So, you want us all to pay for people here in this country illegally but are not willing to pay to for a life-threatening cure for millions of legal citizens? Got it.ETA (and I'm sure many agree) - I ####### hate you.....

 
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I'm going to meet you just over on your side of the line and say that I have not explicitly heard "the tax credits/subsidies are hereby being conditioned on the creation of a state exchange by the state." Now that is the letter of the law, so there's that. And the Finance committee is all about taxes and using that as a hook to gain state regulation, but no I guess no one has explicitly said 'this for that' yet.
Well the consultant guy did, but his sales pitch was a bit self serving.
The consultant guy said it on a few separate occasions, but he now says that he misspoke. (It didn't seem like he misspoke; it seemed like he meant what he said.)

I don't think the Supreme Court will consider what the consultant guy said, though. It's not in evidence, and I don't think it's the kind of thing that judges take judicial notice of.
Is there a place to see what is in evidence? (I guess that the opinions only highlight the evidence that the judge felt compelling and doesn't really show everything that is there.)
You could go to the courthouse. ;) I'm not sure what's available on Pacer.

But the reason I say that the Gruber speeches are not in evidence is that I don't think they're admissible. A court may consider legislative intent, but extrinsic evidence of legislative intent must be in an admissible form. Stuff that's typically admissible includes different versions of the bill that the legislature had considered, showing the evolution of the language; reports made available to the legislature as a whole before their vote; statements made on the floor of the legislature; etc. -- generally, stuff that the legislature as a whole may have been aware of before the vote.

What's generally not admissible are statements made by individual legislators or staffers or others about what they individually thought the law intended, especially when such statements are made after the law was passed.

Since the Gruber statements were not made to Congress, and were made after the ACA was signed into law, I don't see how they'd be admissible for the purpose of establishing legislative intent.

 
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I'm going to meet you just over on your side of the line and say that I have not explicitly heard "the tax credits/subsidies are hereby being conditioned on the creation of a state exchange by the state." Now that is the letter of the law, so there's that. And the Finance committee is all about taxes and using that as a hook to gain state regulation, but no I guess no one has explicitly said 'this for that' yet.
Well the consultant guy did, but his sales pitch was a bit self serving.
The consultant guy said it on a few separate occasions, but he now says that he misspoke. (It didn't seem like he misspoke; it seemed like he meant what he said.)

I don't think the Supreme Court will consider what the consultant guy said, though. It's not in evidence, and I don't think it's the kind of thing that judges take judicial notice of.
Is there a place to see what is in evidence? (I guess that the opinions only highlight the evidence that the judge felt compelling and doesn't really show everything that is there.)
You could go to the courthouse. ;) I'm not sure what's available on Pacer.

But the reason I say that the Gruber speeches are not in evidence is that I don't think they're admissible. A court may consider legislative intent, but extrinsic evidence of legislative intent must be in an admissible form. Stuff that's typically admissible includes different versions of the bill that the legislature had considered, showing the evolution of the language; reports made available to the legislature as a whole before their vote; statements made on the floor of the legislature; etc. -- generally, stuff that the legislature as a whole may have been aware of before the vote.

What's generally not admissible are statements made by individual legislators or staffers or others about what they individually thought the law intended, especially when such statements are made after the law was passed.

Since the Gruber statements were not made to Congress, and were made after the ACA was signed into law, I don't see how they'd be admissible for the purpose of establishing legislative intent.
Thanks. I find this case interesting because I think the public analysis of the bill at the time and ever since agrees with the IRS, but I think that some of the federalism issues here could very well had been discussed and the actual claim could be true. :shrug:

 
First off I asked a question; I was not making an argument. There seem to be a couple of people here eager to laugh at my lack of knowledge. That doesn't bother me. I'm always willing to learn something new.

But I don't think my question was stupid. No matter how many billions it costs a company to produce that first pill, the price is not going to stay at $84,000. Obviously it has to come way down from there, or there is no profit to be made. Honestly I was hoping someone with knowledge of the drug industry could answer how this process works. On the other hand if you simply want to mock me for my ignorance, go right ahead; I'm sure that's entertaining too.
:doh: Tim, did you even read what I posted? They made $2.3b in sales of this drug alone in the first 3 months it was on the market. They reported 2nd quarter sales of $3.5b.

You don't need to know much about the drug industry, you just need to know about basic economics.

Suppose all drinking water in the world is gone overnight. Suppose you are the only bottler of drinking water the next morning. Sure, you can do the "right thing" and give it away, or you could realize you literally have the monopoly on a life saving product and make all the money you can. This company is choosing the later route.

And what do you mean "there is no profit to be made" if they don't lower the cost? This was the largest launch of a drug in the history of mankind. $2.3B sold in 3 months. The insurance company (or Medicaid) is "generally" required to purchase the FDA approved drug, regardless of cost, if there is no alternative on the market - which in the case of this drug there isn't.
I kept meaning to comment on this scenario. There is no way that any one person could control all of the water supply, or anything analogous. If they tried, it would be seized.
Well one company has the cure on hep C. What's that worth per person? Apparently $84k each. I hope you got my point.
And I hope you got mine. If 3.5 million Americans start demanding that drug, the government won't let the price stay at $84,000.00. Plus, I assume the drug company knew this going in.
Lets say the drop it to $10k per person - 3.2m Americans still need it. That's $32B in sales. Honestly, even there the company may only break even on all the R&D money and the acquisition cost of the other company they purchased, and all the other associated costs for all the hep C drugs (and other drugs for other diseases) which never made it to the market to make their first dollar.

Even at that total price (32B), it's still just over $100 for every man, woman and child in this country. Your family willing to part with $400 right now so that everyone who needs the drug get it, and the company also just breaks even in the process?
lol I don't know matttyl, you keep asking these what if questions about how much I'm willing to pay. I'm a 21st century American, dammit! I want somebody else to pay.
Tim, this isn't a "what if" question. The price of the drug is currently $84k per person for a 12 week regimen. That money has got to some from somewhere. If the drug is being given to someone on Medicaid, it's coming from tax money - if it's being given to someone on private insurance, it's coming from other people with that carrier's insurance.

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist?

For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 360,000 people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?

EDIT for horrible math on my part.

 
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Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....

 
matttyl said:
timschochet said:
matttyl said:
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?

 
This is how republicans get elected! The delusional notion of the working poor that they are the givers and not the takers.
You have to admit it's kind of funny. What if they threw a social benefit and nobody came?

I have this discussion with a liberal friend of mine from the NE who likes to ask, why does the South not unionize when they have so much to gain? I typically reply, hey it's too hot to think right now let's have another beer.

 
matttyl said:
timschochet said:
matttyl said:
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?
0. There are roughly 8-10k deaths in the US each year from hep C, so we're talking a mortality rate of less than one third of one percent per year of all people in the US with it.

Lets say you're going to give the treatment to just 10% of those with the disease this year, at $84k per patient which is the current cost. That's roughly $27 Billion this year. Since some states are claiming they will need $1-2 billion on their own, that number may actually be low. Is spending $27 Billion per year, as a country, really worth (at a best case scenario) preventing 10k lives, most of which were (and possibly still are) intravenous drug users? That works out to $2.7 million per saved life/prevented death.

What say you?

 
http://talkingpointsmemo.com/livewire/medicare-solvent-four-years-longer-obamacare

The Medicare insurance trust fund will be solvent until 2030, four years longer than projected last year, according to a trustees report released Monday.

The trustees report chalked up the new projection to the recent slowdown in health spending growth and various cost-saving reforms enacted under Obamacare.

"In recent years U.S. national health expenditure (NHE) growth has slowed relative to previous historical patterns," the report read.

It added: "The Board assumes that the various cost-reduction measures ... will occur as the Affordable Care Act requires." (Obamacare has been credited in recent years with extending the life of Medicare beyond 2016, the year it was projected to go in the red prior to the ACA's enactment.)

Terrible news for Obama and the ACA somehow. I'm sure Mattyl will enlighten us.

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?
0. There are roughly 8-10k deaths in the US each year from hep C, so we're talking a mortality rate of less than one third of one percent per year of all people in the US with it. Lets say you're going to give the treatment to just 10% of those with the disease this year, at $84k per patient which is the current cost. That's roughly $27 Billion this year. Since some states are claiming they will need $1-2 billion on their own, that number may actually be low. Is spending $27 Billion per year, as a country, really worth (at a best case scenario) preventing 10k lives, most of which were (and possibly still are) intravenous drug users? That works out to $2.7 million per saved life/prevented death.

What say you?
8-10k people dying per year is part of the costs. Are there others costs associated with hep C? How much are we currently spending on treating these folks hat theoretically could be save by using this new, albeit expensive treatment?

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?
0. There are roughly 8-10k deaths in the US each year from hep C, so we're talking a mortality rate of less than one third of one percent per year of all people in the US with it. Lets say you're going to give the treatment to just 10% of those with the disease this year, at $84k per patient which is the current cost. That's roughly $27 Billion this year. Since some states are claiming they will need $1-2 billion on their own, that number may actually be low. Is spending $27 Billion per year, as a country, really worth (at a best case scenario) preventing 10k lives, most of which were (and possibly still are) intravenous drug users? That works out to $2.7 million per saved life/prevented death.

What say you?
8-10k people dying per year is part of the costs. Are there others costs associated with hep C? How much are we currently spending on treating these folks hat theoretically could be save by using this new, albeit expensive treatment?
In total, no idea. Do you know? There are other drugs already on the market that didn't work nearly as well, but that weren't as expensive. Also, on a case by case basis some did receive a liver transplant - which can cost hundreds of thousands of dollars. Keep mind though, that if the liver didn't go to this hep C person, it would have undoubtedly gone to a non hep C patient with a different condition - so the fact that it went to a hep C patient didn't add anything to the total bottom line of medical expenditures. In that Oregon's Medicaid program is saying they will spend as much on this one drug alone this year as they did on all pharmaceuticals last year, just goes to show that this new treatment costs far more than what we're currently spending on treating folks with this condition. I'm sure you'd agree with that.

I'm just asking a somewhat rhetorical question that is actually a reality today. Is spending $84k (which if they are covered by either Medicaid or private insurance is a cost shared by "everyone") per hep C patient justified? There is no easy answer to that. Reports are showing that the average per person's insurance cost could go up by hundreds of dollars a year because of this one drug alone. Are you ok with that?

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?
0. There are roughly 8-10k deaths in the US each year from hep C, so we're talking a mortality rate of less than one third of one percent per year of all people in the US with it. Lets say you're going to give the treatment to just 10% of those with the disease this year, at $84k per patient which is the current cost. That's roughly $27 Billion this year. Since some states are claiming they will need $1-2 billion on their own, that number may actually be low. Is spending $27 Billion per year, as a country, really worth (at a best case scenario) preventing 10k lives, most of which were (and possibly still are) intravenous drug users? That works out to $2.7 million per saved life/prevented death.

What say you?
8-10k people dying per year is part of the costs. Are there others costs associated with hep C? How much are we currently spending on treating these folks hat theoretically could be save by using this new, albeit expensive treatment?
In total, no idea. Do you know? There are other drugs already on the market that didn't work nearly as well, but that weren't as expensive. Also, on a case by case basis some did receive a liver transplant - which can cost hundreds of thousands of dollars. Keep mind though, that if the liver didn't go to this hep C person, it would have undoubtedly gone to a non hep C patient with a different condition - so the fact that it went to a hep C patient didn't add anything to the total bottom line of medical expenditures. In that Oregon's Medicaid program is saying they will spend as much on this one drug alone this year as they did on all pharmaceuticals last year, just goes to show that this new treatment costs far more than what we're currently spending on treating folks with this condition. I'm sure you'd agree with that.I'm just asking a somewhat rhetorical question that is actually a reality today. Is spending $84k (which if they are covered by either Medicaid or private insurance is a cost shared by "everyone") per hep C patient justified? There is no easy answer to that. Reports are showing that the average per person's insurance cost could go up by hundreds of dollars a year because of this one drug alone. Are you ok with that?
I don't know what the answers are - I would need to do some reading and analysis to figure out my position on the issue. My point to you is that you are always quick to throw out huge, scary numbers yet you admittedly haven't considered all of the ancillary fiscal benefits. Seems like would be part of the thought process before get OUTRAGED over those dirty drug users getting $84k treatments on your dime.

 
Yes it was a "what if" question, because you took a price of $10,000 and multiplied it by everyone who might need that drug, in order to come up with a sum that somebody is going to have to pay. My assumption is that long before we get close to the "everyone" stage, the price will have gone way down to a point where I'll never feel impacted- not $10,000 a pill, but perhaps a few hundred per bottle.
So then the current crisis in Oregon, where they are expecting to pay ~$360 million in Medicare claims for this drug alone doesn't currently exist? For the record, that's only about 4,285 patients needing the drug in Oregon who are on Medicaid. I wonder how many people have hep C in California? It has about 12% of the population of the US - so if they have an average amount of folks, that would be about 38 million people living in California who have hep C. Are you going to deny them a cure pending a price reduction of the drug? Aren't you all for spending millions if not billions on illegal immigrants, but you don't want to spend money on people in this country legally who currently have a potentially fatal disease?
You're the second person who's raised the illegal immigration question, as if it represents some tough dilemma for me. It doesnt, because I personally believe that illegals represent a net economic benefit and therefore don't really cost us anything. But even if they did, your question is still a what if of grand proportions. You keep assuming that there will be a huge cost to this treatment in perpetuity.
You don't consider $360M in one state alone a huge cost? And that's in Oregon alone. I wonder what that cost will be in California....
What's the cost for non-treatment?
0. There are roughly 8-10k deaths in the US each year from hep C, so we're talking a mortality rate of less than one third of one percent per year of all people in the US with it. Lets say you're going to give the treatment to just 10% of those with the disease this year, at $84k per patient which is the current cost. That's roughly $27 Billion this year. Since some states are claiming they will need $1-2 billion on their own, that number may actually be low. Is spending $27 Billion per year, as a country, really worth (at a best case scenario) preventing 10k lives, most of which were (and possibly still are) intravenous drug users? That works out to $2.7 million per saved life/prevented death.

What say you?
8-10k people dying per year is part of the costs. Are there others costs associated with hep C? How much are we currently spending on treating these folks hat theoretically could be save by using this new, albeit expensive treatment?
In total, no idea. Do you know? There are other drugs already on the market that didn't work nearly as well, but that weren't as expensive. Also, on a case by case basis some did receive a liver transplant - which can cost hundreds of thousands of dollars. Keep mind though, that if the liver didn't go to this hep C person, it would have undoubtedly gone to a non hep C patient with a different condition - so the fact that it went to a hep C patient didn't add anything to the total bottom line of medical expenditures. In that Oregon's Medicaid program is saying they will spend as much on this one drug alone this year as they did on all pharmaceuticals last year, just goes to show that this new treatment costs far more than what we're currently spending on treating folks with this condition. I'm sure you'd agree with that.I'm just asking a somewhat rhetorical question that is actually a reality today. Is spending $84k (which if they are covered by either Medicaid or private insurance is a cost shared by "everyone") per hep C patient justified? There is no easy answer to that. Reports are showing that the average per person's insurance cost could go up by hundreds of dollars a year because of this one drug alone. Are you ok with that?
I don't know what the answers are - I would need to do some reading and analysis to figure out my position on the issue. My point to you is that you are always quick to throw out huge, scary numbers yet you admittedly haven't considered all of the ancillary fiscal benefits. Seems like would be part of the thought process before get OUTRAGED over those dirty drug users getting $84k treatments on your dime.
I guess you missed my point. Personally, I'm not outraged - at least not yet. I understand that it's the situation we have with our heath care in this country. I brought up the topic of the $84k drug (that treats hep C, but really what it treats is beside the point) to show a huge reason of why insurance premiums HAVE TO go up. Many in this thread, especially those on the left, are very quick to blame insurance companies for their increased health insurance premiums. If they were to look behind the veil to see why the insurance premiums are going up, one huge reason being these very expensive drugs coming to the market, they would see why. It's not the insurance companies simply jacking up rates because they want to, it's them responding to changing market circumstances. A year ago they didn't have to cover this extremely expensive drug because it didn't exist, but now they do because there really is no other alternative and it received FDA clearance. People thought that the implementation of the 80-20 rule (in 2011 or 12 I think) would keep insurance premiums in check, but reports still show that individual insurance prices went up by 10% even before the 2014 rollout of the ACA individual market - which itself lead to huge increases in premiums.

Just so we're clear, my point would be the same no matter if the drug is for hep C (which is the case here, which does put a bit of spin on it), or for HIV or for lung cancer or for colon cancer or for breast cancer. The fact that the drug exists and can very likely cure a disease is a wonderful thing, the fact that it costs $84k was my point. That cost HAS TO trickle down to the consumer somehow (either via increased taxes if it's for a Medicaid recipient, or higher insurance premiums if it's for someone with health insurance).

 
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I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
:lmao:

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
Even if we as a society stopped doing everything else and spent literally 100% of our resources on health care -- which would be very stupid -- the fact that our resources are finite and would therefore run out is itself a form of rationing.

In any case, the fact that it would be stupid to spend literally 100% of our resources on health care means that rationing would be a good idea even if it weren't physically inevitable.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
So you're all for all 3.2m Americans with hep C to get this "miracle cure" today at a price-tag of $84k each? If your answer is anything but yes, then you feel there needs to be rationing.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
Even if we as a society stopped doing everything else and spent literally 100% of our resources on health care -- which would be very stupid -- the fact that our resources are finite and would therefore run out is itself a form of rationing.

In any case, the fact that it would be stupid to spend literally 100% of our resources on health care means that rationing would be a good idea even if it weren't physically inevitable.
Yes, I get that too. But I was under the impression that Rich was referring to a much more direct form of rationing- "death panels" and such. I think that's a stretch.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
Even if we as a society stopped doing everything else and spent literally 100% of our resources on health care -- which would be very stupid -- the fact that our resources are finite and would therefore run out is itself a form of rationing.

In any case, the fact that it would be stupid to spend literally 100% of our resources on health care means that rationing would be a good idea even if it weren't physically inevitable.
Yes, I get that too. But I was under the impression that Rich was referring to a much more direct form of rationing- "death panels" and such. I think that's a stretch.
Yes, I think you were in fact making quite a stretch with what he said to make it what you thought he said. Everyone thinks the term "rationing" is some horrible thing and you're some horrible right wing nut job if you even mention the word, till you know that it already exists and what it really entails. Tim, again, do you think we should pay $84k for each and every person with hep C in this country?

 
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.

 
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.
I don't think I put nearly that many IFs in there. I'm talking about the stark reality that exists today. The price of the drug IS $84k. It IS not going down significantly anytime soon (within the next 12 months). There IS no other cure. The conditiona isn't extremely fatal, but does kill 8-10k Americans a year, but it does ravage internal organs. Very few people, no matter if they are hep C positive or not can afford $84k out of pocket for medical expenses (which is the reason they have medical insurance). Anyone who has hep C is dealing with serious medical concerns - while it may not be immediately fatal, it can quickly progress there.

As for your answer, I sure hope you have a good place to come up with all that money. That's over a quarter of a trillion. I should go buy some stock in that company immediately.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
I get the argument, but it's not necessarily true. I'm not convinced that there has to be rationing.
Even if we as a society stopped doing everything else and spent literally 100% of our resources on health care -- which would be very stupid -- the fact that our resources are finite and would therefore run out is itself a form of rationing.

In any case, the fact that it would be stupid to spend literally 100% of our resources on health care means that rationing would be a good idea even if it weren't physically inevitable.
Yes, I get that too. But I was under the impression that Rich was referring to a much more direct form of rationing- "death panels" and such. I think that's a stretch.
Rich didn't come even close to referring to "death panels" and such.

 
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.
This from a guy who thinks his country doctor is an expert economist.

 
I think the basic point is that with ANY system of care, there has to be some form of rationing. With an entirely private system, rationing occurs naturally based on which patients can afford which treatments.

With a system funded primarily by the government, rationing needs to be performed on some other basis. Government (or anyone else) simply can't afford to pay for every conceivable treatment for every single person. Whether it's Hep C today, HIV miracle drug X tomorrow, or something else the day after, the same thing will continue to happen. It's not "right-wing crazy" to point out that rationing will need to happen. It's also not "right-wing crazy" to note that we haven't yet worked out exactly how the rationing will occur, and what the criteria will be. It's not crazy to be a little concerned about this.
IMO any system that would preclude any individual from seeking to pay for any treatment he so desired within his means would be immoral and wrong.

I've seen public health care, it exists and I have no problem with it. But I think if even if it were instituted then individuals should still be able to avoid it if they so desired and pay any doctor to perform whatever treatment they so desire.

I also don't think we should reduce quality for any person or group of persons for increasing quantity or access for others.

Broad stroke stuff and I'm sure it's been covered here in lo these 306 pages but just to reiterate when the wonks are trotting this stuff out they should be totally honest with people with what is being proposed with their health care.

 
Just wondering, if this "Affordable" health care Act is so peachy keen & fair, why so many waivers & opt outs for so few? Congressmen, unions, etc.

 
Just wondering, if this "Affordable" health care Act is so peachy keen & fair, why so many waivers & opt outs for so few? Congressmen, unions, etc.
Political connection and corruption (ie quid pro quo) nets political favoritism and special treatment.

Ordinary citizens don't get that.

 
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.
Tim, you still claim to be a libertarian?

 
BassNBrew said:
timschochet said:
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.
Tim, you still claim to be a libertarian?
No. There are still a lot of libertarian principles I believe in, but now I believe in a safety net.
 
BassNBrew said:
timschochet said:
You keep asking me the same question. I'll answer it as best as I can:

IF the price for the cure is fixed at $84,000. and

IF it's not going to go down anytime soon, and

IF there is no other cure, and

IF Hepatitis C is fatal or severe (I know very little about this disease), and

IF those people that have hep C cannot afford to pay for this cure themselves, and

IF the people who need it have to have the drug NOW and can't wait for the price to go down,

then yes, we the people, through our government, should pay for each and every person to have access to this drug. My answer is yes.
Tim, you still claim to be a libertarian?
No. There are still a lot of libertarian principles I believe in, but now I believe in a safety net.
From Libertarianism to Fabianism, a journey rarely made.

 
I think it is important to note that the 84K is "for a full course of Sovaldi treatment, for the most common type of hepatitis C." It is not a permanent cost. ETA: Or is it???? In the same article-

He suggested another standard for measuring the value of Sovaldi, something called "cost-per-cure." As Alton explained it, that makes Sovaldi look like a bargain.

The older hepatitis C treatment regimens take longer and are less effective, and Alton estimated their cost-per-cure at somewhere between $150,000 and $200,000. Included are companion drugs that patients must also take.

"With a Sovaldi regimen we're actually getting down to $115,000 per cure," said Alton. "So it is actually, on a per-cure basis, much less costly."

I don't see how a one time cure of $115K for hepatitis C should be looked at any different that a $110K open heart surgery. Sure at first there will be more utilization, but if this "is a cure" then it will hopefully be largely one and done. Especially since this saves money in the long run (if we take the corporate shills word for it.) That being said I'm pretty certain that $36K would have more than covered all the research and development cost. Though it may not have covered the rent seekers that are lining up.

 
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SaintsInDome2006 said:
irishidiot said:
Just wondering, if this "Affordable" health care Act is so peachy keen & fair, why so many waivers & opt outs for so few? Congressmen, unions, etc.
Political connection and corruption (ie quid pro quo) nets political favoritism and special treatment.

Ordinary citizens don't get that.
But I thought this administration was going to "drain the swamp". No more special "quid pro quo" and any bill up for consideration in either house would be available to view on-line at least 48 hours in advance of any vote. I was told this would be the most "open & transparent" administration in history. I was going to save about $2500 for my family in health care costs. I also thought the world was going to love us. Cripes, what happened?

Re: "Open & Transparent". This was a goner when E. Holder, attorney general, was granted "executive privledge" in the over the border gun sales(fast & furious).

Regardless, what happened? Just bad luck or more of the same old stuff?

 
7/29/2014

Liberal WaPo Blogger Inadvertently Strengthens Argument from Halbig Majority

In 1994, Colombian soccer player Andres Escobar was murdered after accidentally scoring a goal for the opposing U.S. team in the World Cup. For some reason, I was reminded of that story after learning that Washington Post blogger Greg Sargent, a big ObamaCare fan, has scored a big goal for conservatives in the Halbig case — by unwittingly advancing the arguments of the Halbig plaintiffs who oppose subsidies on federal exchanges.

Sargent started out really excited by his find, bless his heart. Look at his headline: Senate documents and interviews undercut ‘bombshell’ lawsuit against Obamacare. Isn’t that sweet?

Sargent helpfully traces the origin of the “established by the state” language in the PPACA, explaining that the Senate HELP Committee passed a version of health reform that provided for Affordable Health Benefit Gateways — something like an ObamaCare exchange. Sargent links a memo that explains, among other things: “Until a state becomes either an establishing or participating state, the residents of that state will not be eligible for premium credits.” (Premium credits are tax credits or subsidies. Remember this part, because it becomes important later.) Additionally, under the HELP Committee proposal, when the federal government set up fallback exchanges for states that had not set up their own, plans obtained on those federal exchanges would be eligible for subsidies. This is key: there was an explicit provision wherein subsidies were provided on the federal exchanges.

Later, in 2009, the Senate Finance Committee passed a version of the PPACA. For the first time, the phrase “established by the state” appeared in the law, but in this initial version there were no federal exchanges. In late 2009, the two bills were merged, and according to a staffer:

[W]e layered the HELP Committee language that established a federal fallback on top of the Finance Committee language that included ‘exchange established by the state.’
Here’s the problem that many conservatives have already identified: when the bills were merged, the HELP Committee bill’s explicit provision that subsidies were available on federal exchanges was dropped. Since Sargent’s post was published, several conservatives have convincingly argued that, applying standard rules of statutory construction, the disappearance of the provision allowing federal subsidies signifies that the drafters intended to drop it. The argument has been made by Jeff B. at Ace’s, Leon Wolf at RedState, and elsewhere. Baseball Crank gives you the basic argument in a concise tweet:

When explicit language drops out of a bill before it's final, courts treat that as proof it was removed on purpose http://t.co/nehLigBoF3— Dan McLaughlin (@baseballcrank) July 29, 2014
If Congress initially put specific language in the bill providing for subsidies on federal exchanges, and later took that language out, it’s assumed to be deliberate. Ouch!

But it gets even worse for Sargent. I’ve not seen anyone make this point yet, but Sargent has actually directly corroborated an argument made by the majority opinion in Halbig. Here is the Halbig opinion, and here is the key passage:

The government and its amici are thus left to urge the court to infer meaning from silence, arguing that “during the debates over the ACA, no one suggested, let alone explicitly stated, that a State’s citizens would lose access to the tax credits if the State failed to establish its own Exchange.”

The historical record, however, belies this claim. The Senate Committee on Health, Education, Labor, and Pensions (HELP) proposed a bill that specifically contemplated penalizing states that refused to participate in establishing “American Health Benefit Gateways,” the equivalent of Exchanges, by denying credits to such states’ residents for four years.

This is not to say that section 36B [the section of PPACA that provides for subsidies] necessarily incorporated this thinking; we agree that inferences from unenacted legislation are too uncertain to be a helpful guide to the intent behind a specific provision.

But the HELP Committee’s bill certainly demonstrates that members of Congress at least considered the notion of using subsidies as an incentive to gain states’ cooperation.
Conservatives discussing Halbig have argued that the “established by the state” language was designed to provide an incentive for states to establish exchanges — by withholding subsidies unless the states established the exchanges. Lefties like Sargent say that theory was cynically concocted after the fact. But the Halbig court said, in essence: no, actually, it is not outlandish to think that Congress might have intended to withhold subsidies as an incentive for states to establish exchanges. After all, the HELP Committee did exactly that, in related legislation. The only thing that keeps this from being a slam dunk argument is, we can’t establish a direct connection between the HELP Committee legislation and the language in the PPACA.

But Greg Sargent just did.

The Halbig majority couldn’t say that the provision for subsidies “necessarily incorporated” the thinking of the HELP Committee. Now, thanks to the work of Greg Sargent, the Halbig plaintiffs can argue exactly that — because now we know that the language of PPACA was taken directly from the HELP Committee proposal.

It’s not every day that a lefty ObamaCare fan hands a huge cudgel to opponents of the law. Thanks, Greg!

Just . . . watch your back, buddy. Andres Escobar, the Colombian soccer player, paid a heavy price for his “own goal.” Sargent faces a crowd that is arguably more ruthless than the Colombian soccer fans: the pro-Obama hard left. Shudder. I’d hate to be in Sargent’s shoes right now.

P.S. The Fourth Circuit opinion that ruled the opposite of Halbig, holding that subsidies are available on federal exchanges, dismissed the HELP Committee proposal in a footnote (footnote 3), saying that the plaintiffs put too much emphasis on it. Now that we know the HELP Committee proposal was a precursor to the very language at issue, future courts will have a tougher time dismissing the example with an airy wave of the hand.
 
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The Halbig majority couldn’t say that the provision for subsidies “necessarily incorporated” the thinking of the HELP Committee. Now, thanks to the work of Greg Sargent, the Halbig plaintiffs can argue exactly that — because now we know that the language of PPACA was taken directly from the HELP Committee proposal.
I believe this, unlike the Gruber speeches, is admissible, and is the kind of thing that appellate judges may take judicial notice of.

 
Just wondering, if this "Affordable" health care Act is so peachy keen & fair, why so many waivers & opt outs for so few? Congressmen, unions, etc.
Political connection and corruption (ie quid pro quo) nets political favoritism and special treatment.

Ordinary citizens don't get that.
But I thought this administration was going to "drain the swamp". No more special "quid pro quo" and any bill up for consideration in either house would be available to view on-line at least 48 hours in advance of any vote. I was told this would be the most "open & transparent" administration in history. I was going to save about $2500 for my family in health care costs. I also thought the world was going to love us. Cripes, what happened?

Re: "Open & Transparent". This was a goner when E. Holder, attorney general, was granted "executive privledge" in the over the border gun sales(fast & furious).

Regardless, what happened? Just bad luck or more of the same old stuff?
Uh we elected a guy who was basically a handful of years removed from being a Chicago state senator to be President. Quid Pro Quo is the name of the game where he comes from and he has kept playing it just like the game is played there. I know he told people the opposite and it was - and is - very much what people wanted to hear, which is too bad because they really did want that.

 
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Just wondering, if this "Affordable" health care Act is so peachy keen & fair, why so many waivers & opt outs for so few? Congressmen, unions, etc.
Political connection and corruption (ie quid pro quo) nets political favoritism and special treatment.

Ordinary citizens don't get that.
Saints, you're a solid enough dude, but you're also the biggest conspiracy theory guy these boards have ever seen. I'm blown away that you still believe this stuff.

 

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