What the Supreme Court Decision Means for Integrative Medicine

July 3, 2012
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healthcare reformYou aren’t likely to read this anywhere else….

To everyone’s surprise, John Roberts, chief justice of the Supreme Court, didn’t exactly approve or disapprove of Obama’s healthcare law. He simply rewrote important parts of it and then approved it. So what do these changes mean for integrative medicine?

The most important change Roberts made for integrative medicine is that he changed the mandate, which in turn has truly major implications for financing integrative treatments. Under President Obama’s legislation, it was a legal requirement to buy an insurance policy that met all US government requirements. Under the law as modified by Roberts, it becomes a “lawful choice” (his own words) not to buy this government-defined insurance, to buy some other kind of insurance, or to buy no insurance at all.

The financial consequence is the same. Under the original legislation, you paid a “penalty” for not complying with the law. Under Roberts, you owe a tax but can get yourself exempted from it by buying government-approved insurance. Since the financial consequences are the same, is there a difference?

Yes there is. Studies show conclusively that people are not only motivated by money. Most people, quite apart from the cost, do not want to violate the law. If the law says they must buy the government’s version of insurance, they will. If they are told it is a “lawful choice” not to buy it, they may not, even if there is a financial cost attached to it, especially if the cost is not too high.

The cost of not buying government-defined insurance under Obama’s legislation is much less than buying it. The first year cost (in 2014) for an individual is $95. This increases to $695 in 2016 and then goes up with “inflation.” Households will either pay the greater of this or 1% of their total income, rising to 2.5% in 2016.

But how does this matter for integrative medicine in particular?

In our January article, “New Regulations Threaten Insurance for CAM Patients,” we showed how Obama’s legislation and related regulations seemed to doom the Health Savings Account (HSA). This was something we had tried hard to fix in the legislation before it passed but weren’t able to do. That was very, very bad for integrative medicine.

Many people today use HSAs to pay for their integrative medicine. They then add a catastrophic policy on top of the HSA to cover hospital and other costs if something really dire happens. The cost of the HSA plus the very low-cost, high-deductible catastrophic policy may be significantly less than one of the very low-deductible, government-defined policies required under the new healthcare legislation.

It is still possible that HSAs and catastrophic insurance policies will simply disappear as the new health system kicks in. Before this ruling, that was what everyone expected. If insurance companies have no demand for such policies, they won’t be offered. Now the chances of there being a demand for such policies—and the chances of the policies themselves surviving—are greatly increased. This is because it is now more likely that millions of people will choose to pay $695 rather than buy a government-approved policy that has a low deductible and no coverage of integrative medical services. Because it is now a “lawful” choice, they will pay the $695 and then turn around and pay for an HSA and a catastrophic policy, assuming that those are still available.

Under this scenario, the cost of integrative medicine goes up. But not nearly as much as would be the case if someone were to buy a very expensive, government-approved policy and then have to pay out of pocket for all integrative services on top of that.

There have been many articles suggesting this or that “fix” to the healthcare legislation. The single change we wanted the most was to save HSAs used in conjunction with catastrophic coverage. In broader terms, the whole bill would have been transformed if people had a choice about the kind of policy they bought and didn’t have to buy a one-size-fits-all policy defined by the government in consultation with hospitals, drug companies, the AMA, and other special interests. Legislatively this would be an easy fix: just say that any policy selected by an individual qualifies as health insurance or, if that sounds too broad, then any policy that has catastrophic coverage qualifies.

Changing the nature of the mandate was not the only major change that the Roberts court made to the bill, although it is the change that most directly affects integrative medicine. There is another change that is very much worth noting.

Seven of the justices, not just five, said that the government cannot force states to adopt the proposed new Medicaid program, which is an integral part of the healthcare legislation. Under this legislation, not only would states add a lot of people to Medicaid, the federal government would also have much more say about what services are covered under Medicaid.

This is of vital importance. Over half of the presently uninsured who would become insured under the new legislation were supposed to enter the new Medicaid program. According to figures from the Congressional Budget Office, Medicaid enrollment will grow from the current 36 million, or 13% of the population, to 52 million, or 18% of the population, under the new healthcare act. Here is a chart showing the changes:

medicaid chart

Now, with this court ruling, there may not be a new Medicaid program in any given state. Moreover, as we pointed out in April, states are cutting, cutting, cutting what they offer under Medicaid. So if the federal government can neither force the states to adopt the expanded Medicaid program nor define what is in that program, there may either be fewer people entering Medicaid or those people entering may find that their insurance doesn’t cover much. They may be “insured,” but in name only.

One of the little-known features of the new healthcare act from the beginning has been that it sharply increases medical expenses for poor people even while increasing their coverage. The Roberts court ruling on Medicaid will potentially make this worse and require some kind of legislative fix. The other worry has been that the minimum coverage provisions for employers may, in effect, nearly double the cost of hiring minimum wage workers, since the new, required coverage costs nearly as much as the minimum wage itself. This could lead to massive layoffs of the poorest workers and would also seem to demand some kind of urgent fix.

71 Responses to “What the Supreme Court Decision Means for Integrative Medicine”

  1. Mac says:

    You need to answer something here. Are you asking society and insurance companies to cover all forms of unproven treatments or only the ones that you personally believe in? There needs to be some standard that is logical. When you allow CAM treatments to be covered by insurance you force all participants in that insurance plan to pay a portion of those treatments through their premiums. Since CAM is largely unproven and anecdotal, virtually any treatment could make the same claim. No treatment could be denied and we ill all be paying for crazy things that don’t work.

    Since CAM excuses itself from having to abide by accepted scientific principals it can’t then turn around and say ” Well our non-sense treatment is valid but that one is not”.

       2 likes

    • Donna Krause says:

      CAM is scientifically proven to be helpful, beneficial and curative. The “traditional medicine” big shots just lie about it and say that there isn’t any evidence supporting it. Big Lie! Many major universities, corporations, governments, private enterprises, etc. conduct studies, research, tests, create CAM products and have published books, articles, journals on the results of alternative treatments and products. Over 50% of our population already uses CAM treatments, products and supplements.

         12 likes

    • Pat says:

      I have worked with many clients after they exhausted the medical route, and some that chose to come to me as their first alternative. They have, without exception, felt improvement or complete relief of their symptoms. The reason is that energy medicine gets to the energetic cause of the problem and does not mask the symptoms with pain relievers and pills. There are also no side effects to the CAM that I use!

         2 likes

  2. bullsballs says:

    soon amerika will be worse than any third world country and no one will want to come here…

       0 likes

  3. Jayne@PHH says:

    In my area, we are looking to implement a “wellness cooperative” Our mission is to come together as a community to educate, empower and heal each other. The membership fee covers the rent and gen’l expenses and the modest per visit fee goes to the wellness provider. We are careful not to use the words health, healthcare, treat, disease, etc. for fear of stepping on the toes of big business. Is anyone else doing something or thinking of doing something similar to help those who have no insurance, have high deductible insurance or simply wanted to be cared for in a more holistic/traditional way? If so, I’d like to hear your ideas!

       10 likes

    • leslie says:

      what a fantastic idea. I have not heard of any such thing in my area. I live in Hollywood florida if any one knows of such an arrangement in my area please let me know. thanks

         0 likes

  4. Wayne says:

    The article fails to mention the unusually poor ability of the IRS to collect the penalty. If you don’t have a refund due from a tax return, your payment of the penalty is voluntary! Arrange any withholding accordingly. Those with substantial earned income credit appear to be the ones most susceptible to being required to pay the penalty.

       2 likes

  5. the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). Therefore, unless things drastically change (in the next elections), everyone will be required to have health insurance or face a tax penalty. While the tax will most likely be minimal $ compared to the cost of insurance premiums, only those who choose to not buy health insurance will feel it.

    This is “good” because when people have regular care, and don’t use the emergency room for a cold or other minor condition that could easily be handled by a medical provider, it lowers costs. Ultimately, this healthcare reform NEEDS to be about lowering costs. Covering more people with the same expensive medicine will not lower costs –as seen in the Massachusetts healthcare system in the past few years. (for more details see previous blog HERE).

    This is “bad” because not enough discussion is being placed on the fundamental way healthcare is approached. Currently we have a “disease care” system and we only spend 1% (according to JAMA) on “prevention” of disease in this country. Over 70% of all costs are isolated to 4 conditions:

    Heart Disease
    Diabetes
    Cancer
    Obesity
    Research shows that these chronic 4 conditions are largely lifestyle caused diseases. There are many large corporations that already have healthcare figured out way better than the US. When a company is big enough, they will usually choose to “self-fund” by creating their own insurance company for their employees. Now, it’s in their best interest to KEEP PEOPLE WELL!

    This is done via correctly incentivized wellness programs (that are usually optional for employees to participate in) that reward people for a healthy lifestyle. Not rocket science here, but the CEO’s are looking at the bottom line of healthcare costs, and realize it a good business decision on many levels (reduced costs, healthy happy productive employees, etc.). This has been going on for many years. Government would do well to follow their lead, and incentivize citizens to get well with $$$ incentives. Stop smoking, lose weight, etc. and here is your carrot for doing so via reduced premiums or other financial incentive. These corporate programs work, its a fact.

    The average ROI (Return On Investment) for corporations that invest in their employees in the form of a proper wellness program is between 1:3-4.5. That’s a 300-450% return on their investment in cost savings. It’s a no brainer, but the…

       5 likes

    • Mac says:

      You are absolutely right that disease prevention is not properly encouraged in this country but prevention is not the preview of CAM medicine. If you stick to preventive medicine measures which have actually been proven to be beneficial this has been entirely the work of traditional medicine. The unfortunate thing is that insurers wont reimburse physicians for the time it takes to provide these services so they are not available to the degree that they should be.

      The answer ins’t more CAM The answer is to get insurance companies to change the reimbursement structure so that physicians can do what they are trained to do.

         1 likes

  6. coalmine canary says:

    I just can’t understand why people don’t object to the very notion that A) the government is reaching into our private pocketbooks, telling us what we must or must not do with them B) threatening a penalty for those who one might say, don’t comply with the government’s unconstitutional control maniac mandates.

    Don’t we get it? Cant’ we see that this is dictatorship? FYI I am all for and all about CAM. However, at this point I want to say CAM be damned ,mainstream be damned, it’s not the point.

    The point most resoundingly is, that when the government mandates what we must or must not do with our own pocketbooks, and threatens penalties or even jail for noncompliance, hello? What’s next? Why aren’t people scared and objecting left and right about this?

    My fellow Americans, we are en masse, silently accepting this dictatorship and not even thinking about it. Discussing the other points is to side-skirt hte core issue. OF COURSE there will be NO CAM when the government mandates our purses!

    Justice Roberts wrote correctly about “lawful choice” But then contradicted himself by upholding the penalty and mandating that we must resort to GOVERNMENT-APPROVED “insurance”. What a false and misleading game! He is lying through his teeth.

    Oh my fellow Americans, wake up! Wait until they mandate what professions we must practice or must not. Wait until they make boycotts illegal, purchasing of certain foods illegal, god knows what is next. With gun-wielding raw milk raids, when will organic foods be outlawed? Surely then Americans will all say that they just want to comply with the law, and don’t want to do anything illegal? Good lord.

    When will we ever learn to think critically? When can we ever learn to invoke the word unconstitutional? When will we ever evoke the constitution itself? Goodbye, Freedom.

       22 likes

    • dan s says:

      The reason why the ACA makes sense are twofold:
      1) the mandate is necessary for guaranteed issue. With the mandate, ANYONE can get insurance, at reasonable rates,, even if they have preexisting conditions.
      2) everyone uses the emergency services, including CAM users. People that dont have insurance, often dont pay for these services. Why should those who have insurance pay for those that dont?

      Please stop the “dictatorship” rhetoric. Its ridiculous. The ACA is good law that will increase medical care access and freedom. It will dramatically increase efficiency in the insurance industry, because insurance companies will be freed from the necessity of analyzing customers and services for preexisting condition exceptions.

         2 likes

    • broginator says:

      My fellow American, if you think we live in a dictatorship, go live in North Korea for awhile. That should give you some perspective.

         0 likes

  7. RM says:

    I don’t want Medicare for my kids or me! We have autoimmune disease and I don’t want the government involved in their healthcare at all. I want to be able to afford continuing to take my oldest son who’s disease is more severe to a naturopath so he can keep using low dose naltrexone. His immunologist refuses to prescribe it for him, but it helps him so much! Personally, I worry about Obama causing restricted or no access to immune modulators or off label uses for medicine like this. I honestly wish one of his daughters got autism or PANDAS, because then he would understand how hard it is.

       8 likes

  8. DMW says:

    A labyrinth of worming around the laws, devising new ones, adding riders, amendments, and legislative fixes, simply because some people in this country refuse to allow anything that even whiffs of “socialism”. But on the other hand they gladly embrace socialism is when it comes to business losses! The answer is really quite easy – if wasn’t for the special interests that hover over the carcass of every government program we’ve all be insured properly and could get on with addressing the fixes to this bungled economy. We can easily devise a simple system such as the following: The government markets its own plan where it competes with private insurance plans. The responsibility for health insurance is transferred from the employer to the individual who will have the option to choose to take up either the government plan or one of the private plans. Conclusion: Benefits of the program: 1. Employers would be overjoyed to be unshackled from this burden. 2. Individuals would have a real choice not just a choice of the best evil. 3. Employees would be liberated to leave unsatisfactory jobs and look elsewhere based on matters other than their employer providing health insurance. Simple. Clean. No big deal. So let’s demand we get a simple government plan. What is wrong with these people in Washington!

       27 likes

    • Koos says:

      Here in South Africa we have government health care for state employees and the poor, while other people are free to choose their medical schemes as they wish. Never thought i’d do this, but seeing what is proposed for the American economy, i suddenly love this system we have…

         4 likes

    • Dr Ed Travis says:

      This is NOT about Health Care but about how to pay for Disease Care!
      If alternative approaches to real health care were mandated before the more expensive disease care model we’ve been using, the costs would plummet! However, so would the profits for the drug companies! They will fight against that at all costs… preferring to pay 3 Billion in fines to changing their business model do “DO NO HARM!” Until we address diet and seriously tax junk foods out of existence, again putting much of the food industry out of business, we will still be just doing “Disease Care:”

         19 likes

      • Suzanne says:

        I see what you are saying but what is junk food to you? In Denmark they taxed butter, meat, raw milk (if they allow it at all), etc. This is what I eat, and all organic as well and what they could consider as “junk” food. Most nutritionists and nutritionally-minded doctors would agree that I eat healthy. I don’t eat 6-12 servings of grains each day and that’s what the gov’t says is good nutrition.
        So this means that more studies have to be done to show that the way I eat is healthy because it’s good for me even though it’s different than what Big Food and so-called “modern” medicine says.

           1 likes

        • dball says:

          the “government” has been lying to us forever on just about everything…so why would you think that what they recommend as “healthy” would be any different? It’s all about keeping us sick…job security!

             0 likes

  9. Bernice Bulgatz says:

    Medicare for All…….

       7 likes

  10. Bernice Bulgatz says:

    The only positive solution to all this is to work for Medicare for All…..

       4 likes

  11. Steven Dunn says:

    This article is very inaccuarate. To claim that the new law–which is far from perfect but a great improvement over the current, “profits first” health “insurance” system–raises costs for the poor is flat out wrong. Millions of poor people suffer because they are cannot afford insurance or are shut out because of “pre-existing conditions,” which will now be illegal. Society pays the costs of the emergency room “healthcare” which the poor are forced to use when things get dire. The Medicaid expansion will cover more people, subsizdize the poor, and promote a healthier society. Yes, I know our healthcare system is far from ideal, but we are talking about basic human needs that millions are denied. I will also point out that among the bill also promotes wellness initiatives and cuts funding for the private “Medicaid Advantage” plans (from the Bush era) in favor of traditional Medicare. Overall this bill will lower costs over time and promote justice in our exceptionally greedy and unbalanced American culture, where power and monied interests too often call the shots and reap benefits while working people and the poor suffer; this bill, while far from perfect, begins the process of change. As for “integrative medicine,” for many of us this is important, but for the 30 million who potentially will be covered under this, just having access to health care may be life-changing or saving.

    Really, we ought to have National Health Insurance, like Canada and other developed countries, that have healtheir populations and lower costs–check the stats.

       15 likes

    • dball says:

      Seriously, if anything is to make a difference health wise, poor or not, if the “government” is truly concerned about the health of it’s people, then they should afford people the choice of being and staying healthy by means of prevention by means of ability to eat healthy, and by treatment that doesn’t keep people sick or make them worse by forcing “medicine” on them that they know before hand is going to cause further problems… If what is being proposed and forced upon us is so great, then why did our elustrious government representatives, especially the one for whom it is named after…why are they exempt from having to participate in this farce? And if you want to complain about what/who we as a society have to pay for….why aren’t you complaining about the millions of dollars being spent on health coverage for all those who have decided they’re above the rest of us when it comes to “what’s best for the general public” ….really? Or about all the government employees covered by insurance paid for by who? It shouldn’t be about money, it should be about being well….

         0 likes

  12. Sherry Schmidt says:

    . . . and perhaps more integrative services will be available, even for the poor. What we needed from this first step in health care reform was more accessibility. Quality and cost cannot be addressed until the system includes more of those people for whom insurance has not been available. The Andrew Weils and Jeffrey Blands have testified before Congress in the past. Now that a step has been taken in clearing the political cloud around health care reform, let the discussion about the kind of care needed begin and let’s make the less costly early interventions related to lifestyle available to even those with low incomes. We could even require that Food Stamps follow a program more like WIC to improve knowledge about healthy eating and prevent using the Stamps to buy processed foods

       9 likes

    • Sentinasan says:

      Did you know that WIC specifically prohibits buying organic foods with the coupons?

         0 likes

  13. Brad Roon says:

    This entire sham is illegal. There is no govt authority invested in ANY body of govt which gives legal control over health decisions of the people. See this generally accurate article re: govt powers.

    The inaccuracy is in thinking either Romney (her choice) or Obama are a serious choice.

    http://www.newswithviews.com/Publius/huldah109.htm

    Since the fed govt provably has no authority over our health choices, and the state constitutions do not claim to be able to dictate these issues, this is a right that was retained by the people, and the people have historically practiced this choice. This brings up the question – when did the govt receive the authority to make these dictates to me? You and i never surrendered this right to the state and they never passed this power over to the feds – which would be illegal for them to do anyway.

    That means the right to choose our health modality remains with us. NOBODY has the legal authority to force us to pay for profit corporations, especially people like me that will not be able to use these policies.

    Our corporations are running the govt, and we all know this. Someone needs to take the corporations into a back room and slap the snot out of both ends of them. When i say corporations i do NOT imply the legal entity that impersonally makes decisions based on facts alone. That does not even exist. Legal papers do not make decisions. Rich people in suits with large amounts of greed make every decision in a corporation. So it is these rich greedy people hiding behind the lie of corporate respectability who are attacking we the people.

    b

       17 likes

    • coalmine canary says:

      Brad Roon, right on! About saying that they have no right over our health choices.
      Further, I want to add that they have no right to dictate what we must do, or not do, with our own pocketbooks.

      I am simply amazed, and aghast, by the support from other bloggers here, and that they don’t “get it” about this, and don’t raise objections to it.

      I mean, when the government tells us that we must buy something, or be fined if we don’t, then what is next ?

      Come on people, wake up and smell the dictatorship!

      Next, boycotts will be illegal, we must be mandated to purchase more products/services OR ELSE…..

      WAKE UP AMERICA! Stop supporting and consenting to the dictatorship, or we are doomed! Our own part in it is our own fault. Silence is complicity.

         9 likes

    • Rich says:

      Identifying the individual greedy corporate rich, their family and friends in an online realtime database will be a good start to bring them out of the shadows of the ‘corporate veil’. Put them in a global fish bowl where the masses can report instantly on where they just landed, what hotel, concert, restaurant, or resort they’re at, where their kids are partying, and then go out to meet them and educate them to our reality of life. Shrinking their world will help them to understand they are emersed in ours, and surrounded by the masses of cockroaches they see us as.

         2 likes

  14. Michael Mangino says:

    Sounds like greed and the folks that love it won again.

       5 likes

  15. L.P. says:

    This *Absurdity* absolutely MUST BE REPEALED!!!!!!!
    Anyone who thinks this new bill is good…in any way…NEEDS their head examined…and that goes for Cheif Justice John Roberts and the rest of that *gang*.
    The government has NO right….OR business dictating what Americans MUST buy….or else.

       11 likes

    • dan s says:

      The ACA is a very good law. it will promote efficiency in the medical system and open the system to the millions who have preexisting conditions. Those with preexisting conditions will be free to move, change jobs and do a million other things.

      the ACA is good law.

      Everyone uses medical services, so everyone must pay into the system.

      People who drive cars have to have insurance. Same concept.

         1 likes

  16. Gertrude Lamb says:

    First I’ve heard of HSAs. Still don’t know what CAM stands for. One would normally assume the link would lead to a definition. But it didn’t.
    Whatever medical plan is in place, one thing is sure–we poor people on poor-paying plans will still get poor quality medical care. Found out the hard way on Medicaid , before I got Medicare A, B, D–not that having Medicare made much difference, it is still too-low-pay to suit doctors who have patients with private insurance. What we poor folks get is”Meatball Medicine” as one doctor described it to me. Other MDs told me the only reason I didn’t get knee surgery and, another time, didn’t get equal-quality hysterectomy surgery that didn’t leave me half-sewn-up and genitally mutilated (they said it saved 20 minutes operating time not to sew me all the way back up), was because it is so hard to find surgeons willing to work for what little Medicaid/Medicare pay, that they prefer to spend their time on higher-pay patients, and save time on Medicaid surgeries. I was warned that complaining about it would get me blacklisted so no doctor would accept me as a patient. All they have to do is lie on the patient notes. And they do–as I later learned as a medical secretary, being routinely required to type doctors re-dictated patient notes so as to discredit the patient whenever a patient filed a complaint with the Board.
    That’s how the system works now, before the new plan. Add 20-30 million extra patients without adding extra doctors and it can’t work well, whatever plan is used.
    But I don’t really need any medical plan anymore, thanks to supplements, which fixed nearly all the problems that I used to see doctors for. Just with supplements and avoiding tap water, in only 3 weeks, things went from “high-risk patient” to normal, despite being a heart attack survivor with blood sugar problems. Thanks to the progress supplements enabled, I was taken off all medications over 5 years ago. My cardiologist says I no longer need even annual checkups. All due to supplements. Especially bromelain pineapple enzyme supplement–that’s the one that had my cardiologist literally jigging on his toes with glee at the improvement.
    About all that would scare me is if FDA outlaws supplements. I’d want to flee the country.

       16 likes

    • Lizzie says:

      may I know what the improvement was related to with the bromeliad supplement, please?

         0 likes

    • Jan says:

      Congratulations for taking your health care into your own hands. I’ve long believed that, on a voluntary basis, Medicaid should offer an HSA option. Once the infrastructure was set up, you could use your HSA with any therapist (of any kind) that was licensed in your state. That would include any from orthopedic surgeons to massage therapists. Imagine, Medicaid patients could get their teeth fixed and none would worry about which doctors accept Medicaid. I’d also do this with indigent Medicare patients.

      You are right to worry about losing access to your supplements. The whold medical monopoly, which includes the FDA is really frightening. Benjamin Rush, a physician who signed the Declaration of Independence wanted medical freedom written into the Constitution. What a far-sighted,perceptive man!

         0 likes

  17. Harry says:

    Geesh! Can we have a new government already?

       2 likes

  18. Weatherwax says:

    Ah, so it’s just like what the GOP did in Congress — rip away even more of the plan so that it’s not going to work. Figures.

    America needs a healthcare system that is not tied to the insurance industry. Medicine for profit will always mean the quality of care is shortchanged for million$ bonuses.

       3 likes

  19. Shankari Rise says:

    I am 66 years old now and on Medicare which I will not use very much as my plan has always been and still is TO STAY HEALTHY by not taking any pharmaceuticals, eating raw and organic, and gardening.
    In my 50’s I went without health “insurance” for over 10 years and saved over $40,000 which allowed me to actually HAVE A LIFE instead of funding greedy and immoral insurance companies.

    I also do not believe in the Western medical system except for injuries and broken bones, so I would not ever take their drugs or listen to their outdated beliefs about health. They do not know how to teach people about how to STAY HEALTHY.
    I would only use acupuncture, energy medicine, chiropractic and emotional clearing and not ever listen to “medical advice”.

       30 likes

  20. ild1227 says:

    I still say you cannot force someone to pay For something they cannot afford. FIRST, our government puts us in a position where we are forced to break the law, then our government chooses to punish us for breaking the law! What is next? Debtors prison?!

       10 likes

    • Sentinasan says:

      I’ve wondered about that too — if they put people in prison for not buying their health insurance or paying the illegal fine, then they’ll be costing the taxpayers thousands of dollars more.

         0 likes

  21. Ted Birnbaum says:

    The stuff about “lawful choice” was really splitting hairs and misleading on the part of Roberts. If ANH has any spare resources…they should be investigating Roberts thoroughly…to see if he was blackmailed, bribed or in any way coerced by Obama…if a link is found that will have the most game changing effect. Nevertheless the article did provide some good info…about the initial penalty and the effect of the Supreme Court decision on Medicaid.

       4 likes

  22. gnafu says:

    Aside from the above article, I thought the Supreme Court was to decide if the ObamaCare – government health insurance- was constitutional or unconstitutional and not to add their own writings/changes to make it constitutional. What am I missing here?

       5 likes

  23. Thanks for your insights; is it still true that with PPACA, there will be an HSA withdrawal tax hike, from 10-20%?( I think it was on PPACA p 1,959); also OTC’s (over the counter drugs) are no longer considered a qualified medical expense

    So what do we need to do to stand up for our rights to purchase our natural health products and services through an HSA? Is that bill to expand the use of HSA’s for natural health still in committee?

    I’ve asked recently for quotes on catastrophic plans and the cost was prohibitive.

    Thanks for all your help here, we need to link arms and demand what we need to stay healthy!

       6 likes

  24. Chris Chirinos says:

    Worst article ever! Unclear, weak transitions, choppy, incomplete, rambling, and just plain amateur. Where was the editor, surely this was a rough draft? Wow.

       0 likes

  25. Emily Dale says:

    As a user of Integrative Medicine services exclusively, I have had to pay my providers, which has been difficult financially, but essential for my good health and peace of mind. I rarely use Medicare, but appreciate that it is available to all who use traditional allopathic providers. The suggestions proposed as a result of the Roberts decision make sense, and might have even covered some of the expenses of my Integrative practitioners. were I younger than 65, which I am not. I am a healthy 86 year-old and am grateful for having found my practitioners some 25 years ago when I had no medical insurance. (I refuse to call it “health” insurance as it only deals will illness and injuries)

       6 likes

  26. Terry Muniz says:

    The whole issue of sickness insurance, could probably be almost completely eliminated if we just observed the suggestions shown by the Chine Study. There is a 1.5 hour education on this and other wellness subjects on the documentary movie, ForksoverKnives. At amazon.com or FoK web site.

       1 likes

  27. Linda N says:

    Legislative Fixes? What I think I see is that this whole thing is being engineered Politically to steer us towards a Single Payer System. Which will really sound the death nell of integrative/alternative care….Supplements being totally outlawed, all the while making certain that the only type of care that anyone will be able to receive will be drugs, surgery, and radiation.

       3 likes

  28. ToeTagTunny says:

    So, basically what your saying is the whole thing’s a waste.. The poor will be underinsured while having to find companies who would be willing to pay more than minimum wages in order for the employee to pay for insurance AND maintain a living.. Seems the only one’s benefitting from all this will be the g’ment who will gladly take your money whether you like it or not. By far, I am not pro private insurance (it’s smells along the lines of Vegas where the house is betting your money that you won’t get sick and if you do then it has to be a ’specific’ sick) however, at least their competitive, offering the saving of money and/or better coverage.. I cringe in thinking what ‘exemptions’ the g’ment could slap on this law at any given time because their the only casino in town. The processes one had to go through before this passed was atrocious, people in pain waiting hours to “turn and cough”. Obviously this will continue only more so as it grows. Getting us conditioned for future bread lines I’m presuming.

       3 likes

  29. Journe says:

    I am absolutely 100% against this Obamacare PLan. I absolutely am more than dissapointed in Chief Justice Roberts actually “making Word changes last minute” from Mandate Penalty thru the Commerce Act to a TAX. For me, it is way to clear that Pres.Obama has had a Huge Political influence on the media, which would also include our Supreme Courts as they read this junk.

    I remember though, reading about a year ago, that IRS would be the one collecting the Penalty or Tax as it is. They also hiring at least 1500 new IRS Agents to help on collecting this. They also Building a Big New Office Building with all the furnishings in many places, including here in Orange County, Calif. So all this, which is NOT included in the Cost of Healthcare, will really be more additional huge costs. MY curiosity is exactly what is planned to do with the Revenues of this IRS Tax collection???? Goes into the treasury, then what? Is it added to our General Budget to be used for what??? Anything Congress wants?? Surely not to help Americans!!!

    Congress will need to come up with constructive Health care plans Bi Partisan and guided only to specific problems, not afecting every consumer who wants to keep their “promised Health Plan and Promised Doctor, which is now all a lie by Obama.

    Clearly, we need to build more jobs in our economy first so that the unemployed and poor can get to work to pay for their own healthcare or at the least a good portion of it. Only the extreme disabled for whatever reason or elderly that can’t contribute anymore, should have Help from the governments, thus taxpayers. NO Universal Health Care, NO Obamacare. NO TAX, NO Penalty, No mandates. Even if all the poor/sick can pay $5.00 a month, thats something and leave all the rest of us alone.

       4 likes

  30. Ann Fuller says:

    That was clear as mud.
    I had an HSA and it could not be used for integrative care. Integrative came out of my pocket. With my insurance I could not purchase the most modern care they chose what and where I could purchase care and trust me it was a much lower quality than when I bought BC & BS.

       2 likes

  31. Mary Richter says:

    I am a retired civil servant who did payroll and worked with many laborers. We had excellent mandatory health insurance. including full dental one dollar co pays for prescriptions 2 dollar copays for dr. and free eyeglass plan, 20 $ for ER. This was in the late 80s early 90s. If 1 % of the people I worked with went to the Dr. or dentist on a regular basis it was a lot. They’re teeth were rotting out of their mouths. Most would only go in an extreme emergency.
    My point is that you can force everyone to have health insurance but you cannot force them to see the doctor on a regular basis. Or is that the next step.

       5 likes

  32. Janet C says:

    Because all the money comes from the people for people’s health care, and whoever controls the health care dollar controls health care, the dollar should remain in the hand of the people who’s health care it is in the form of HSA’s. If people put half of their premium into an HSA which they could price shop for reasonable prices and the other half into a greater risk pool (and if they smoke, diabetes or weight out of control which are entirely self inlicted chronic illnesses they pay morel, if they maintain a reasonable weight and exercise twice a week they pay less,) the money would go much further- espepcially without all the paper pushing for the first $2-3K.
    HSA’s are critical to cost effective health care because this would allow true market driven health care. It eliminates the high cost of the middlemen (insurance CEO’s making millions per year and working for larger bonuses and shareholders’ quarterly profits) and of course, the pharmaceutical industry could not easily charge the high prices they do, but rather the medication prices might come down closer to what the rest of the world pays as patients are not shielded from the costs.. Same goes for radiology and surgical procedures that are overpriced in some areas.

       1 likes

  33. S. D. says:

    Assuming that the Affordable Health Care Act survives, suspect that those of us in the shrinking middle class will pay more for what health care we are able to obtain. If anyone has a chronic condition and has used a health care savings account (HSA) with a conventional insurance, the amount you are able to set aside pretax decreases from $5,000 to $2,500. This is also a significant impact if you have dependents that have chronic conditions or have special needs. As of 2011, you are also no longer allowed to pay for over the counter, non-prescription medications with your pretax HSA. With the decrease in the savings from a HSA, there is also an increase from 7.5% of adjusted gross income (AGI) to 10% of AGI before your medical expenses are deductible to reduce your federal income tax bill. There are also many new taxes and fees on medical device manufactures, and other companies. Another important point is that the regulations to implement the 363,086 words are not written as of yet. As we all know regulations require regulators to monitor and report compliance – so expect more government employees to regulate. Hopefully, by now we all realize that there is no magic pile of money to pay for all of this – so whatever a company pays in taxes and fees become a part of the cost of doing business and are passed along to those who buy the products or services. Also every extra dollar we spend on taxes (from the HSA reductions for example) or other healthcare costs becomes a dollar that cannot be spent in this capitalistic economy.

    Don’t get me wrong, there is goodness is finding a way to offer healthcare to those who do not currently have it and there is also goodness in requiring insurance companies to cover preexisting, having children covered on their parent’s policy until age 26 and other reforms. Just remember that nothing is free….There are already some who say that there will be consolidations in the healthcare industry to achieve competitive scale – can you say too big to fail?

       2 likes

  34. Carolyn says:

    The government doesn’t do anything right. Why we would give them control over our health care is beyond me.

       2 likes

    • Sarah H. says:

      I don’t remember voting, on this, they never asked “we the people”. The government is in control, the world is backwards. Our civil liberties are being taken away day by day. We need to stop voting for the big parties and start paying attention to the independants everybody is so worried about wasting their votes on. Don’t we waste our votes voting for these dems and republicans every year anyway? You’re absolutely right the government doesn’t do anything right, but we allow it by fear of voting for the wrong people instead of voting for people who might actually make a difference.

         3 likes

  35. Doug says:

    what a bunch of mindless uncaring autocratic douchebags!!!!!

       2 likes

  36. Jerome Plotnick says:

    We need a preventive alternative health care bill or act so we can prevent most illnesses and diseases before they begin. This means do away with the present barbaric allopathic drug and treating symptoms and not the whole person. Hippocrates and Parcelsus Fathers of Medince both ststed, ” Treat the person not the symptoms.” Vis Medicatix Naturae-The Healing Power of Nature.” “Your food is your medicine and your medicine is ypour food.” Benjamin Franklin stated, “An ounce of prevention is worth a pound of cure.” Thomas Edison stated, ” The doctor of the future would teach the patient the care of the human frame and mind.”
    The Obama Health Care plan is the status quot and business as usual with no successful outcomes only more synthetic toxic drugs, medicnes, chemo, radiation and needless surgeries.\
    Wake up American citizens and smell the roses. Eliminate toxic disease by cleaning up our air, water, earth, Chqange your thinkling and get away from government intervention into pour fredoms and Constitutional Rights. Take back our country resist the sdtaus quot. Become a non conformist and take care of yourself as the government in cahoots with the AMA, FDA, FTC, etc. are not looking out for your best interests. Take individual responsibility for your health. Hreal the Spirit, the Spirit will heal the mind, and the mind will heal the body. Positive thinking is more powerful then any allopathic conventional treatment. Change is inevitable, its the only thing that is constant in the universe and that you can count on. Change your thinking and get away from government control. We used to have herbal, homeopathy as our mainstream mediicne but it did not produce great profits it only proiduced great successful cures and outcomes for the sick. Have Faith, Have Belief, Think Positive, Forgiveness, Unconditional Love, Calm Down, Take Action, and Trust in GOD. Jerome Plotnick, PhD., Nat. D., H.H.C.

       7 likes

  37. Bruce Rodkey says:

    I live in a metropolitan area of about 750,000 people. Do you think I can find an integrative physician anywhere?

       1 likes

  38. The president’s stated intentions have been for integrative medicine to be part of the covered system. We don’t know how things will end up, but that is a sensible goal– to have real insurance coverage for the types of treatment people really want and need, not merely HSAs.

       2 likes

  39. This is a well thought-out review of the current status of the effects on insurance. I shall have to

    re-read it several times. The challenges as a result of the ‘legality’ of Obamacare are many.

    They can be minimized when the voters seek a new leader who is constitutionally oriented.

       3 likes

  40. This insurance is the worse legislation i’ve ever seen. It should be repealed and or Obama impeached!!
    Even Canada is talking about it’s being bad. They come here or over seas for healrth care because theirs is so bad and thats what Obama is trying to do to us!!
    Also, our medication should not be being made over seas, it should be made here, give those jobs to our people.
    The FDA needs to be overhauled also, most of the meds they approve of are no good or have really bad side effects.
    Wonder who has the bells to do this!!

       3 likes

  41. Dennis says:

    So, the major question here that none of the brains have thought of is how this monster affects the privacy of the patient and their right to choose the treatment they think is best for them. If you think it is a done deal then let me remind you of two Supreme Court decisions that this monster will directly affect:
    Griswold V Connetticuit, and
    Roe v Wade.

    Both these decisions were decided upon the privacy of the patient and the patient’s choice of medical treatment. Contrary to popular opinion these two cases are though to be about contraception and abortion. Like I said they were on the “penumbra” of privacy that exists under the 1st, 4th, 5th and 14th Amendments. It had nothing to do with contraception and abortion except that they were the treatments chosen by the women that the privacy protects. I know I wrote a 30 page brief on the case as an assignment in school. If you don’t believe me find an attorney woth their salt and look into it. In fact the Court held that that state governments did not have the authority to intervene to protect the life of the fetus or inseption as it was a privacy matter of the patient. Now i don’t know about you but it seems that the privacy matter extends to the type of treatment and our private records. Otherwise the whole thing is suddenly overturned by the Obamacare monster.

    Now if you really want to twist the tail of this donkey-gotta love that analogy-hit them with a suit. Hammer them and claim that the law now inlcudes special provisions that are not offered to healthcare generally. It invades the privacy of all people and it also dictates the treatment offered invading the doctor patient privlege. Insiste that this overturns the principle that Griswold and Roe were decide on. Wanna see some liberal law makers run for the hills??????

       2 likes

  42. Kate says:

    You make some excellent points and as someone who uses complimentary medicne almost exclusively, this is good news. Currently I can only afford catastrophic insurance with a $7500 deductible so my holistic health care is out of pocket. I can’t afford an HSA on top of that. Obamacare has it’s flaws and will require improving, but it is a MAJOR step in the right direction for affordable care for all.

       1 likes

  43. William Wilgus says:

    And here I thought it was ILLEGAL for the SUPREME COURT to MAKE LAW. It is? Oh gee, would somebody please tell Roberts that?

       3 likes

  44. Baerta Graff says:

    Yikes! Thanks; it’s good to be informed.

       1 likes

  45. Another hostile takeover by President Obamanation has begun. To utterly destroy the USA as we know it. It’s become so ridiculous that I actually laugh at it all now instead of throwing things at my tv lol!!! But instead of going more proactive and dumping money into our preventative industry the drug companies win again. Sometimes I just want to blow up the planet and start all over. But in the Words of Jesus Christ Himself “Let him who does evil continue to do evil, and let him who does good continue to do good for God will judge them both.” I say WOE to those who do evil in the sight of the LORD!!!!!!!!!!!!!

       1 likes

  46. carol cagle says:

    I haven’t heard one word about what choices a person would have under this tax. Does it include Chiropractic, homeopathic, acupuncture, dental or any other type of care a person might want to choose, or will we be forced to pay for care we don’t want.

       2 likes

  47. MaryAnn Ellison says:

    I do not understand why I have not yet heard the following fact mentioned by anyone on either side of this argument:

    In 2006, Bush’s Medicare Part D drug coverage went into effect for seniors and disabled people who had Medicare. INCLUDED in this legislation was a PENALTY for anyone who did not purchase this Part D drug coverage when they FIRST BECAME ELIGIBLE. This penalty ACCRUES every month until the individual is FORCED to apply for Medicare Part D coverage at some time in the future.
    Over a period of time, this could amount to a very large and unmanageable sum for individuals on a fixed income.

    Why was THIS MANDATE never litigated to the Supreme Court???

    Was it because the drug coverage business was all “privatized”, i.e. doled out to individual insurance companies at added expense to those having to purchase coverage or be penalized?

    I see hypocracy on the part of those who object so strenuously to Obamacare while finding no issues with a similar MANDATE enacted under a Republican President!

       2 likes

  48. Barb says:

    So are you saying that you would not want thirty nine million people to have access to medical care?

       0 likes

    • GRANNY says:

      The master brain of our Constitution, Thomas Jefferson, should come back to
      haunt Obama, Roberts and the rest of them responsble for graduallly taking away
      the freedom that was guaranteed, Obama is trying to make this a socialistic nation, and
      I’m afraid he might succeed if re-elected. Glad I’m too old to be around to be forced to be
      part of it.

         2 likes

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