Another Court Rules Obama Care Unconstitutional

[wmw999 2,122]

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That's not really true. If someone comes into the ER with a non-emergent complaint (i.e. using the ER as a clinic), we can and DO triage them out. We don't treat them in the ER and have them follow up with another physician.

Does that vary from ER to ER? Because I've read some stuff that makes it sound like a significant impact to some ERs

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[rushmc 18]

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Rush, do you know the difference between a direct quote and a quote out of context?

So, I went and read it just for you (and me)
At first I thought, OK, quade has a point. But then when you look at it, in the context of the judges written order, I see the judges use of the Obama quote as very very profound.

Think about it

The judge stated that if the gov can, under the clause he is writting about, force everyone to buy insurance then the gov should be able to force all to buy a home. Or force all to eat your veggies (he also stated in the order) So where is the limit? Where does the power end?

This judge went over the history Commerce Clause. The times when it's meaning was expanded and when the meaning was tightened up. His concern is how far can it go. Here he determined it (Obamacare) was going too far.



At the time Obama was arguing against the mandate because he was a canidate running against Clinton for the nomination. She was supporting the mandate. But then Obama flip flopped and signed a law doing just what he was arguing against.

It appears to me the judge was right on and the context is perfect, although it is juxtaposed to Obama’s meaning and intent in the interview by doing so he created his own argument against said mandates and gov power

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[dmcoco84 4]

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That's not really true. If someone comes into the ER with a non-emergent complaint (i.e. using the ER as a clinic), we can and DO triage them out. We don't treat them in the ER and have them follow up with another physician.

Does that vary from ER to ER? Because I've read some stuff that makes it sound like a significant impact to some ERs

Wendy P.

Yeah... mind elaborating?

Having spent the last 4 years working in a local community ER, that's kind of a broad statement...

You turfin GOMERS Doc!?!?!?

[Southern_Man 0]

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That's not really true. If someone comes into the ER with a non-emergent complaint (i.e. using the ER as a clinic), we can and DO triage them out. We don't treat them in the ER and have them follow up with another physician.

Does that vary from ER to ER? Because I've read some stuff that makes it sound like a significant impact to some ERs

Wendy P.

It's a complicated issue. Yes, procedures vary from ER to ER. If, for example, somebody comes in with heartburn that is causing discomfort, for example, they ER may have to go through some very expensive testing to rule out an MI, because some of the symptoms can be the same. They are not required to treat somebody for heartburn.

"What if there were no hypothetical questions?"

[rushmc 18]

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That's not really true. If someone comes into the ER with a non-emergent complaint (i.e. using the ER as a clinic), we can and DO triage them out. We don't treat them in the ER and have them follow up with another physician.

Does that vary from ER to ER? Because I've read some stuff that makes it sound like a significant impact to some ERs

Wendy P.

It's a complicated issue. Yes, procedures vary from ER to ER. If, for example, somebody comes in with heartburn that is causing discomfort, for example, they ER may have to go through some very expensive testing to rule out an MI, because some of the symptoms can be the same. They are not required to treat somebody for heartburn.

MI?

Myocardial infarction ?

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[Southern_Man 0]

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>Honestly, we should work on eliminating EMTALA.

OK. Scenario -

10 year old girl comes in; she's been hit by a car. She will die without treatment. Hospital staff knows the family and knows they won't pay.

Should they let her die?

That is a decision the hospital and ER docs should be able to make, not a decision that is forced on them from the federal government.

"What if there were no hypothetical questions?"

[Southern_Man 0]

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MI?

Myocardial infarction ?

Yes

"What if there were no hypothetical questions?"

[DaVinci 0]

This is better than an expensive program that is expensive, unable to be paid for, and unconstitutional

[dmcoco84 4]

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It's a complicated issue. Yes, procedures vary from ER to ER. If, for example, somebody comes in with heartburn that is causing discomfort, for example, they ER may have to go through some very expensive testing to rule out an MI, because some of the symptoms can be the same. They are not required to treat somebody for heartburn.

Yeeeeeah... not really.

Cardiac vs Heartburn... is pretty easy to rule out.

A patient with no cardiac history nor major risk factors, will get a 12 lead EKG (Cheap), basic blood panels (including cardiac enzymes - Cheap) and a GI cocktail (usually Mylanta and/or other) including lidocaine (Cheap).

If GI related, symptoms change pretty quickly.

Right Doc?

[rehmwa 2]

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This is better than an expensive program that is expensive, unable to be paid for, and unconstitutional

don't forget expensive

...
Driving is a one dimensional activity - a monkey can do it - being proud of your driving abilities is like being proud of being able to put on pants

[Southern_Man 0]

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Yeeeeeah... not really.

Cardiac vs Heartburn... is pretty easy to rule out.

A patient with no cardiac history nor major risk factors, will get a 12 lead EKG (Cheap), basic blood panels (including cardiac enzymes - Cheap) and a GI cocktail (usually Mylanta and/or other) including lidocaine (Cheap).

If GI related, symptoms change pretty quickly.

Right Doc?

I'm not a doctor. I really just picked an example for illustration purposes. I think I picked that example becaue I think most people are familiar with both heartburn and the symptoms of MI and can understand how those symptoms overlap in some cases. The question was whether the ER could triage out people with non-emergent conditions and whether that would differ from ER to ER.

The point of my example was that yes, the standard would differ from ER to ER. And that it could still be a burden to the ER to determine that it was not an emergent condition--the hospital has an affirmative obligation to provide a screening to determine if there is an emergency medical condition. If there is not emergency medical condition the patient can be triaged out or referred to a primary care physician. What that screening looks like and how much it costs are going to differ based both on hospital protocols and the presenting symptoms.

So, in my example, the hospital still has to screen for MI. They are not required to treat for heartburn. This imposes a burden on the hospital. The the burden (yes, the screening is relative cheap compared to many medical procedures) still exists and the hospital and staff may or may not get paid for the heartburn screening. In the meantime they will have tied up resources that cannot go to treating other patients. In this particular case, you are right, the adjective very expensive was misplaced. I'm sure you could come up with examples where the screening and triage was much, much more expensive even when little or no treatment was required, or the treatment was not required by the hospital because it did not qualify as an emergency medical condition under EMTALA.

Here is a good FAQ on EMTALA:

http://www.emtala.com/faq.htm

Note that it is authored by an attorney who specializes in defense of medical malpractice, so consider the source but I found it overall the answer to be consistent with what I have read elsewhere and it was well written and easily understandable.

"What if there were no hypothetical questions?"

[Lindsey 0]

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That's not really true. If someone comes into the ER with a non-emergent complaint (i.e. using the ER as a clinic), we can and DO triage them out. We don't treat them in the ER and have them follow up with another physician.

Does that vary from ER to ER? Because I've read some stuff that makes it sound like a significant impact to some ERs

Wendy P.

ABSOLUTELY it varies from ER to ER, and from physician to physician in each ER. But the physican can make that call. We do have some control over the over-spending in THIS area. We don't HAVE to let people use the ER for primary care.

Some ERs and doctors may not WANT that business to go away, because it is a lot of dollars.

linz

--
A conservative is just a liberal who's been mugged. A liberal is just a conservative who's been to jail

[rushmc 18]

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>As far as who wins? I am for the US and the US Constitution

Which Rush is for the US constitution? The one for activist judges legislating from the bench, or the one against it?

This will be the third time I ask
Do you know of a court ruling that is still in force today, that you feel was a right wing activist ruling.

I will also ask if you have read the ruling
Very interesting IMO

So, you imply this is an activist ruling from the bench
Why?
What makes you think that?

Thanks

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[quade 3]

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This will be the third time I ask

Do you know of a court ruling that is still in force today, that you feel was a right wing activist ruling.

Uh . . . http://en.wikipedia.org/wiki/Bush_v._Gore.

quade -
The World's Most Boring Skydiver

[rushmc 18]

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This will be the third time I ask

Do you know of a court ruling that is still in force today, that you feel was a right wing activist ruling.

Uh . . . http://en.wikipedia.org/wiki/Bush_v._Gore.

Now that is a good one

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[DanG 1]

It was an activist ruling because he declared the entire law unconstitutional instead of severing the individual mandate. He had no legal basis for declaring all the provisions of the law unconstitutional.

- Dan G

[rushmc 18]

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It was an activist ruling because he declared the entire law unconstitutional instead of severing the individual mandate. He had no legal basis for declaring all the provisions of the law unconstitutional.

The bill was written as non severable because of the way it was presented and passed

The dems could not present this as a severable bill because the fund raising mandates involved and the law under which is was passed
Had the madate been severed the bill had no chance (not that it did anyway) to see the savings predicted by the CBO
Had those saving not been realized then the bill would sun set after 10 years

An activists ruling would have been seen if this judge had re-written parts of the bill, which he did not

The whole bill revolved around the mandate
There for the whole bill went down

The dems are victims of thier own arogance

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[DanG 1]

That's a political opinion, not a legal one. If the judge thought that the mandate was unconstitutional, he should have done what the VA judge did, and servered it. What to do with the bill after that is up to Congress.

- Dan G

[rushmc 18]

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That's a political opinion, not a legal one. If the judge thought that the mandate was unconstitutional, he should have done what the VA judge did, and servered it. What to do with the bill after that is up to Congress.

This topic was discussed before this bill was even passed
http://www.redstate.com/ben_domenech/2010/08/17/severability-and-obamacare/

There are many more links out there should you care to look

There is a political opinion in your post
It just is not mine.

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[rushmc 18]

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That's a political opinion, not a legal one. If the judge thought that the mandate was unconstitutional, he should have done what the VA judge did, and servered it. What to do with the bill after that is up to Congress.

On a side note
I am glad to see you must agree with the Iowa Supreme court justices being voted out for being activists since they re-wrote the marriage laws of Iowa from the bench and did not allow the legislature to fix the law

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[DanG 1]

Yeah, and if you had read the link you provided the blogger points out that even without a severability clause, it would be normal practice to sever the unconstitutional portion and let the rest stand.

Politically it might be a bad idea. Legally it is the non-activist thing to do.

- Dan G

[DanG 1]

You see wrong.

Activist does not mean, "things rushmc doesn't like."

As far as their being voted out, that's up to the people of Iowa, but I have never liked the idea of elected judges. Especially Supreme Court judges. The judicial branch is supposed to be insulated from politics.

- Dan G

[rushmc 18]

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You see wrong.

Activist does not mean, "things rushmc doesn't like."

As far as their being voted out, that's up to the people of Iowa, but I have never liked the idea of elected judges. Especially Supreme Court judges. The judicial branch is supposed to be insulated from politics.

Your anger and disapointment are blinding you to the facts

There is no severability clause in the bill
Therefore any judge has the ability to void the whole bill should they see fit

He did this

Activists you say?

Nah
Just a bad day for liberalism

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[rushmc 18]

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You see wrong.

Activist does not mean, "things rushmc doesn't like."

As far as their being voted out, that's up to the people of Iowa, but I have never liked the idea of elected judges. Especially Supreme Court judges. The judicial branch is supposed to be insulated from politics.

The Iowa judges are not elected here
They are appointed

The vote is a retention vote so they can not become activists without the possibilty of being held to account

They wrote law from the bench

YOUR definition of an activist judge

Now they are gone

Good

"America will never be destroyed from the outside,
if we falter and lose our freedoms,
it will be because we destroyed ourselves."
Abraham Lincoln

[DanG 1]

In the Iowa gay marriage thread, you were repeatedly, and from all sides, told why the judges' ruling was non-activist. Obviously, you didn't listen.

I do not expect you to listen here, either.

- Dan G