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The Health Reform Debate Rages On: A Look at Both Sides of the Issue

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Since before the Patient Protection and Affordable Care Act (PPACA) was passed, the Democrats and Republicans have been hashing out the details and arguing over which or their sides has it right – will reform provide more quality of care, or less? Is it constitutional, or unconstitutional? Is it socialism or simply an expansion of our existing private system?

Now, months after the act’s passage, the debate continues, and there are no signs that either side will slow down any time soon.

Here are some of the top arguments from both sides on the key issues involved in the PPACA.

Quality of Care Improvements

Pro: “Patient care under Medicare will improve as pilot programs to improve efficiencies are implemented. Doctors and hospitals are encouraged to coordinate care through payment incentives. For the first time, Medicare will reward quality, not quantity; thus, bonus payments will be given to those doctors and hospitals that provide good quality care.”

Alliance for Retired Americans
April 2010

Con: “…our care will suffer. If the Democrats’ plans become law, fewer than 700,000 physicians would be available to treat a patient population growing in size, aging in years, shunning medical education and receiving ‘free’ health care or insurance coverage from the government in increasing numbers.

“The result will be longer wait times to see a doctor and a decline in the high quality of care Americans are accustomed to as overworked physicians try to keep up.”

Investor’s Business Daily
March 4, 2010

Health Reform as Socialism

Pro: “Opponents of health insurance reform continue to spread myths, including peddling the bogus notion that the health reform bill is ‘socialism’ and a ‘government takeover of health care.’ The fact is the reform legislation builds on our existing private health insurance system…

“[H]ealth insurance reform legislation expands private health insurance in America, and is based on increasing choice and competition… among a variety of private insurance plans.”

Nancy Pelosi
March 19, 2010

Con: “Obama is a socialist. If you take over banks, if you take over car companies, if you take over financial institutions, the way that he has – now the health care system. If you’re going to use every crooked deal that you can come up with to get a bill like that passed – most recently the health care bill – that is by definition, if you look up the dictionary definition of socialism, this is it.”

Sean Hannity
March 25, 2010


Pro: “The Constitution gives Congress the power to tax and spend money for the general welfare. This tax [PPACA] promotes the general welfare because it makes health care more widely available and affordable. Under existing law, therefore, the tax is clearly constitutional…

“Many important and popular government programs are based [on] Congress’s ability to give incentives through taxation and redistribute tax revenues for public purposes. To strike down the individual mandate the Supreme Court would have to undermine many years of precedents justifying these programs that stretch back to the New Deal (and in the case of the rules for direct taxes, to the very founding of the country).

“Opponents of the individual mandate insist that they are only defending individual freedom, but they are actually taking a far more radical position. They are really claiming that it is unconstitutional to make Americans pay taxes.”

Jack M. Balkin, JD, PhD
Knight Professor of Constitutional Law and the First Amendment at Yale Law School
March 28, 2010

Con: “Can Congress really require that every person purchase health insurance from a private company or face a penalty? The answer lies in the commerce clause of the Constitution, which grants Congress the power ‘to regulate commerce… among the several states.’

“…[T]he individual mandate extends the commerce clause’s power beyond economic activity, to economic inactivity. That is unprecedented. While Congress has used its taxing power to fund Social Security and Medicare, never before has it used its commerce power to mandate that an individual person engage in an economic transaction with a private company. Regulating the auto industry or paying ‘cash for clunkers’ is one thing; making everyone buy a Chevy is quite another. Even during World War II, the federal government did not mandate that individual citizens purchase war bonds.”

Randy E. Barnett, JD
Carmack Waterhouse Professor of Legal Theory at the Georgetown University Law Center
March 21, 2010

Insurance Premium Reductions

Pro: “We estimate that, on net, the combination of provisions in the new law will… lower premiums by nearly $2,000 per family…

“Without reform, premiums are expected to increase from $13,305 in 2010 to $21,458 in 2019. Relative to this increase, premiums under reform increase only three-quarters as much. By 2019, family premiums are nearly $2,000 lower. Adding reductions in out-of-pocket costs and lower taxes for Medicare and Medicaid will result in estimated savings for the typical family of over $2,500 that year.”

Center for American Progress
May 2010

Con: “Throughout the yearlong debate over health care reform, President Obama promised that the legislation would reduce the spiraling cost of health care … But a couple of new government reports confirm what many of us who opposed a federal takeover of the health care system feared all along – higher costs…

“CMS [Centers for Medicare and Medicaid Services] says that the health care law will impose billions of dollars in annual fees on manufacturers and importers of brand-name prescription drugs and on health insurance plans, and new taxes on medical device sales. CMS said it anticipates that these new fees and taxes will be passed down to consumers in the form of higher drug and device prices and higher insurance premiums, raising health care costs from $2.1 billion in 2011 to $18.2 billion in 2018.

“Throughout the health care debate, Americans were told the Democrats’ health care reform measure would make premiums more affordable; instead, as the president’s own actuary at CMS confirms, Americans will face higher premiums…”

Sen. Lisa Murkowski (R-AK)
May 18, 2010



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