–The next healthcare struggle and how it could be solved

Mitchell’s laws:
●The more budgets are cut and taxes increased, the weaker an economy becomes.

●Until the 99% understand the need for federal deficits, the 1% will rule.
●To survive long term, a monetarily non-sovereign government must have a positive balance of payments.
●Austerity = poverty and leads to civil disorder.
●Those, who do not understand the differences between Monetary Sovereignty and monetary non-sovereignty, do not understand economics.


Obamacare is now legal. Very few people know what’s in it (See: The facts about “Obamacare,” without all the political BS. What you really need to know), so the vast majority feels quite strongly about it.

Perhaps now that people have made their irrevocable decisions, they probably will start to learn about it, and just possibly will vote on the facts (or am I wishful thinking?)

Anyway, the next real battle has to do with Medicaid, and an unnecessary battle it is:

Mystery After The Health Care Ruling: Which States Will Refuse Medicaid Expansion?
June 28th, 2012
Charles Ornstein

For many people without insurance, a key question raised by the Supreme Court’s decision today to uphold the Affordable Care Act is whether states will decline to participate in the law’s big Medicaid expansion.

Although the court upheld the law’s individual mandate to buy insurance, it found that the act could not force states to extend Medicaid to millions by threatening to withhold federal funding.

Translation: The states, being monetarily non-sovereign, cannot create dollars at will. Most states are struggling financially. Who can blame them for not wanting the additional expense of more Medicaid? So the government tried to force them, but the Supreme Court said, “No, no, boys.”

The act, signed by President Obama in March 2010, required “states to extend Medicaid coverage to non-elderly individuals with incomes up to 133 percent of the poverty line, or about $30,700 for a family of four,” according to a March 2012 report by the Center on Budget and Policy Priorities, a liberal think tank. That alone was expected to reach nearly 16 million people by 2019, one of the law’s main ways of reducing the ranks of the uninsured.

Translation: With all the brouhaha about the mandate (which had a comparatively small effect on Americans), we forgot the focus of the new law, to get more people insured. Half of them will come from an expansion of Medicaid.

Under the law, the federal government would cover nearly 93 percent of the costs of the Medicaid expansion from 2014-22, according to the Center on Budget and Policy Priorities.

“Specifically, the federal government will assume 100 percent of the Medicaid costs of covering newly eligible individuals for the first three years that the expansion is in effect (2014-16). Federal support will then phase down slightly over the following several years, and by 2020 (and for all subsequent years), the federal government will pay 90 percent of the costs of covering these individuals. According to CBO, between 2014 and 2022, the federal government will pay $931 billion of the cost of the Medicaid expansion, while states will pay roughly $73 billion, or 7 percent.”

Translation: Each state will have to pay the government $7 million (on average) to get the government to pump $100 million back into the state’s economy. Forget about the morality of providing health care to our poorest people, the economics alone makes sense. $100 in exchange for $7 million — sounds good to me.

According to the Urban Institute analysis, some heavily Republican states account for a large share of uninsured that could benefit from the Medicaid expansion. Expanding eligibility in Texas alone would provide coverage to 1.8 million additional people. Expanding Medicaid in Florida, as planned, would cover another 951,000 people.

After the court’s ruling, Republican governors said they hoped that Mitt Romney would be elected president in November and the law would be repealed.

Translation: We don’t care that it helps our poor people. (We might feel otherwise if it helped rich people.) We don’t care that it will add millions of dollars to our economy. We hate Obama; we hate Obamacare. That’s all that counts.

Bottom line: Our Monetarily Sovereign, federal government should provide free Medicare for every man, woman and child in America. That would make Medicaid unnecessary.

Apparently, this is too much to expect. But they have offered to give each state $100 in return for every $7 the state spends. Some states don’t want the money, because it comes from Obama.

I’m ashamed to admit I live in Illinois, the worst governed, most dishonest state in the union, and Illinois has not yet agreed to accept the government’s money. It’s a Democratic state, so I can’t blame this stupidity on the Republicans (though Texas probably will change that).

But people, think about it: Pay $7 million to receive $100 million. What’s your problem?

Rodger Malcolm Mitchell
Monetary Sovereignty

No nation can tax itself into prosperity, nor grow without money growth. Monetary Sovereignty: Cutting federal deficits to grow the economy is like applying leeches to cure anemia. Two key equations in economics:
Federal Deficits – Net Imports = Net Private Savings
Gross Domestic Product = Federal Spending + Private Investment and Consumption + Net exports


9 thoughts on “–The next healthcare struggle and how it could be solved

  1. RMM,

    Have you seen this clip by Lawrence O’Donnell? (http://www.youtube.com/watch?v=MHiz4hazV94) Skip to the 2:25 mark to get to the meat of it. The first 2 minutes or so is just highlighting some Republican hypocrisy.

    He makes a very interesting case that there is no actual health care mandate in the bill. How much of a game changer is this if the penalty/tax is completely unenforceable? It seems like that part of the bill was a necessary component to prevent the rise in health care costs.


  2. Thanks, JK, a truly wonderful video. This is the most relevant section:

    ‘‘(1) IN GENERAL.—The penalty provided by this section
    shall be paid upon notice and demand by the Secretary, and
    except as provided in paragraph (2), shall be assessed and collected in the same manner as an assessable penalty under subchapter B of chapter 68.
    ‘‘(2) SPECIAL RULES.—Notwithstanding any other provision
    of law—
    ‘‘(A) WAIVER OF CRIMINAL PENALTIES.—In the case of
    any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to
    any criminal prosecution or penalty with respect to such
    ‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary shall not—
    ‘‘(i) file notice of lien with respect to any property
    of a taxpayer by reason of any failure to pay the penalty imposed by this section, or
    ‘‘(ii) levy on any such property with respect to such failure.

    We already knew the mandate was unnecessary (the government simply could pay for everyone’s Medicare). Now we see it also is unenforceable??

    So, the government will have to pay more for Obamacare, which is economically stimulative.

    As I’ve said forever, our Monetarily Sovereign federal government should provide free Medicare for every man, woman and child in America.

    Thanks again, JK

    Rodger Malcolm Mitchell

    P.S. I wonder what will happen to all those people who use TurboTax et al. ???


    1. We know our monetarily sovereign government can provide the funding for a medicare for all. Sheesh. Sooner or later we’ll get there. It’s looking more like later in the Great USA.

      But if the mandate is unenforceable, and all the new requirements stay as law e.g. people with “pre existing conditions” can’t be turned away, this is going to drive health insurance costs upward as they have to pay for more adverse outcomes for sick people… which will then be passed on to all of us in higher health insurance costs, right?


      1. JK,

        Not really! I believe not. If the health insurance market becomes truly competitive, as there are provisions in the Act for so doing, and if nobody can be denied for preexisting conditions, and that those with preexisting conditions cannot be made to pay higher rates, as is provided for in the Act, I believe that the profits of the Health Insurance industry will quickly diminish. This is why the insurance companies wanted the act to be declared unconstitutional. Too many limits on how health insurance companies could act were in the ACA.

        Ultimately this will cause insurance companies to drop out of the health insurance business. When this happens, the door to “Medicare For All” opens up. Already, as has been pointed out by Rodger, Medicaid has been greatly expanded in this Act.


  3. incredible!! now i’ve heard everything!! there is no individual mandate or, more precisely, the language of an individual mandate is there, but there are no penalties for violating it.

    i tell you, george orwell was about as prophetic as one can be, cuz if this ain’t doublespeak, then what is??


  4. Rodger,
    Can you help clarify something about the individual mandate and the penalty. If I understand this correctly:
    – One does not need to purchase insurance beforehand, but one can if needed at the last minute. There is no way to mandate per-purchase of insurance like we have today.
    – Insurance companies cannot refuse coverage if one asks for coverage at the last minute even if one has per-existing conditions.
    – If one doesn’t have insurance for the entire year and didn’t use a medical facility that year, one would still have to pay the penalty to the government for not having insurance (though this cannot be enforced based on what you said.).

    So far so good, now comes my questions:

    – So can one can walk-in to a medical institution (not just an ER) without insurance and ask & get service ? or will they be asked to purchase insurance and then come back?
    – If the institution has to provide the service to all irrespective of their insured status, who will the institution bill if one are not insured ? Will they bill the patient and like they do currently send collection notices for unpaid bills? So one can still go bankrupt due to unpaid medical bills after 2014? OR will they just bill the government and expect to be reimbursed? They obviously can’t bill any insurance company.



    1. I doubt you ever will be allowed to purchase insurance retroactively, i.e. wait until you’re in the hospital to buy insurance to cover the hospital stay.

      You are asking the right questions.

      With a 2,000+ page bill, there will be many things to work out in the next few years. The whole notion of requiring insurance companies to cover everyone who applies, while making the penalty for non-application so low, makes no sense, and will need to be changed.

      The simplest, best solution is Medicare for everyone. Since that’s the simplest, best, it’s also the last one the government will implement. Instead, the “tax” for non-compliance probably will be raised.


  5. Some states want to abandon Medicaid expansion.

    Some states don’t get the fact that they make money on the Medicaid expansion. For three years, the federal government will support the whole thing –100% — pumping billions of dollars into each state’s economy. Even after that, the federal government will pump in 90% — $10 million for every $1 million the state spends — a tremendous boost for each state’s economy.

    Or the states do get it, but don’t really care about their citizens. Take your pick.


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