Why Obamacare Was Ruled ​Unconstitut​ional

Strict rationing like in the UK? http://www.dailymail.co.uk/health/article-1263223/NHS-rationing-body-denies-15-life-saving-drugs-cancer-patients.html

I can't speak for the other countries listed, but I feel the need to defend our NHS from, what I feel is, an unreasonable and largely unfounded criticism.

First off, the Daily Mail is not a reputable newspaper. They're a tabloid, our equivalent of Fox News, if you will. They often get many things wrong, for example they claim that Brian May's PhD is in astrology, their science reporting is often off too, they like to lump things into a "causes cancer or cures cancer?" taxonomical system.

Now on to the specific article you linked to:

I'll start off with saying that NHS care is not "rationed" as you imagine food supplies were during World War II. There are no quotas of what kind of treatment you are entitled to. The story over these cancer drugs is that it was determined that the cost/benefit ratio simply wasn't worth it: these drugs are only useful for extending the lives of terminal cancer patients by a few weeks at most but at a disproportionate cost.

In the UK you can still get private healthcare (yes, really) and if you can afford it, or if your private health insurance scheme covers it, you can get these drugs. The article is about the NHS reasoning that it isn't worth it to provide them, for free, to these patients, especially as the money would be better off being spent elsewhere. This kind of utilitarian budgeting (no matter how grim it is) happens under every system.

The situation would be no different than in the USA, except that instead of a non-existent federal (or state) agency deciding it isn't worth it, it would be the cancer victim's insurance provider, and they would probably decide it wasn't worth it (since most of them are for-profit, after all; and the person's going to be dead soon anyway). Except this happens all the time so much that you don't even hear about it in the news, so much there's an eHow article about it.

The NHS is not inherently or systematically "broken" or somehow a flawed system. No system is perfect, and many systems are arguably better than others (by many different measures, such as "number of people driven to bankruptcy" or even "lives saved as a proportion of the population"). My own, personal, complaints about the NHS largely relate to the very drab interior decoration and styling of many of the older 1960s hopsitals (namely my local A&E).

@W3bbo:

I understand all that, but from what I've seen more treatments are covered by private insurance in the US than public insurance in the UK, and also more are covered by other European health care systems simply because they control costs in other ways.

That would simply make sense, because you're working with a limited pool of money to cover everyone; whereas in a private system you're only covering people who pay what you ask.

Additionally, I fully believe that insurance costs in the US can be lowered by market reforms and increasing competition, which should add to that by allowing more treatments to be available than are available now. 

No-one one here has, but the general rhetoric of many "constitutionalist" politicians and socio-political movements implies connotations of a kind of inerrancy in the constitution. Note that I'm not citing anyone in particular over this.

Presidents and others are sworn to uphold it, yet it can be amended; if it's a living document then what happens if an amendment is made that a person who made a sworn oath cannot consciously abide with?

I can't tell if "So is it you support tyranny eh? Or is it you just don't understand the civil society and/or a social contract?" is you making a strawman argument or a false-dichotomy, but you don't need a written constitution to establish a social contract between the government and the people. Lots of democracies and nations have an unwritten constitution, like the UK, NZ, and Israel.

A) That would violate the President's (already broken) pledge not to raise anyone’s taxes who makes less than $200k a year.

B) The American people have time and time again rejected the idea of a single payer health care system in this country.

C) That would have been too much of a straight forward way to achieving the end they want, something that would be slowed down by B..

I did not have the tax-rise pledge in my mind, thank you for bringing that to my attention.

Odd that you have dreams regarding the way another country such as the US chooses to organize itself in such a personal way.

It's not like people don't develop designs on other nations. During the Cold War a key precept of contemporary conservative thought was how to subjugate Russia and the Soviet Union to their will.

11 minutes ago, W3bbo wrote

No-one one here has, but the general rhetoric of many "constitutionalist" politicians and socio-political movements implies connotations of a kind of inerrancy in the constitution. Note that I'm not citing anyone in particular over this.

The problem in our time is that the side which has said the Constitution is vague and flexible has been using that as an excuse to find whatever they want in it, even when its not there. Whether finding positive rights in the text nobody knew were there, like the right to have an abortion or the right for same sex couples to marry, or on the other hand ignoring language that was written in, like we have with the individual mandate or gun control laws.

The Constitution can also be read in an overly strict, reactionary way that adheres to the letter of the law but ignores the intent, but that was a more common problem in the court system 100 years ago than it is today. You'd have a hard time finding a reactionary justice today; even the conservatives are activist on their own issues (Citizens United, or Scalia saying its fine for the federal government to ban personal posession of marijuana ).

But some adherence to an objective reading of the Constitution is necessary because if officials are allowed to ignore it in some ways, they'll ignore it in other ways. One thing that annoyed me is people who argued the Constitution should be interpreted subjectively later being the loudest to protest that Bush was violating it. You can't say its subjective and complain about it being violated at the same time, you're contradicting yourself. You also can't support liberal justices interpreting it subjectively and complain about conservative justices interpreting it subjectively without being a hypocrite yourself.

Trying to use the court to create law has also been the source of most of the deep divisions in US politics today. If all of these issues were dealt with through legitimate processes it would lead to a lot less anger and emnity.

but you don't need a written constitution to establish a social contract between the government and the people. Lots of democracies and nations have an unwritten constitution, like the UK, NZ, and Israel.

I'm sorry I didn't directly address your point.

First, if you do have a written Constitution, justices should respect it -- if you don't have a written Constitution, then that's another matter entirely.

Personally I think the process is good, and its good that a society has an ongoing debate about what government should be.. and the US Constitution happens to be a good start because a lot of thought went into creating it and a lot of blood spent defending it. We should have respect for that heritage, and if we move away from the original document, we should have a good reason to...  and if there's a good reason to you, should be able to win an argument in your favor by convincing the public.

Complaining about not being able to pass an amendment is a concession that either you don't have an argument, or that the public that the government is supposed to be representing is stupid and incapable. Or, I guess the government could be corrupt, but if it is, I don't know why you'd want to give it more of a blank cheque.