LETTER: League of Women Voters of Missouri opposes Proposition C

Saturday, July 24, 2010 | 6:08 p.m. CDT; updated 1:49 p.m. CDT, Monday, August 2, 2010

League of Women Voters of Missouri opposes Proposition C, the health care proposal on the Aug. 3 ballot that weakens the new federal health care law. The Cole County Circuit Court has recently ruled against a constitutional challenge to the proposal, and it will remain on the ballot, pending any appeal.

The new federal law, the Patient Protection and Affordable Care Act, provides universal coverage with access to affordable, quality care for all Americans. League supports this law. Proposition C undermines a key component of the law by allowing Missourians to opt out of buying health insurance without having to pay a penalty. League opposes this proposal.

On August 3, vote NO on Proposition C.

Lael Von Holt and Linda Kaiser live in Columbia. Lois Detrick lives in Springfield.



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John Schultz July 25, 2010 | 1:48 a.m.

So the League thinks that the federal government can mandate purchase of a good or service? Anyone asked them where the Constitution grants Congress that power? Will we be buying GM products next year?

(Report Comment)
Tim Dance July 25, 2010 | 3:52 a.m.

Access to health care should be an essential government function. Police protection is not considered a "good". Profiting off the sick is immoral and shouldn't be at the whim of the "free market" Kudos to the League.

(Report Comment)
Mike Martin July 25, 2010 | 10:50 a.m.

Shame on you, Tim Dance, for this cynical, uninformed comment.

For every dedicated, hard-working private practice physician, nurse, and medical professional, your jab about "profiting off the sick" is outrageously off the mark.

Market-driven medicine has served this country remarkably well.

I also speak from experience. Our free-market health care system has been outstanding to my wife and I at Ellis Fischel Cancer Center, where the last thing on anyone's mind is profiting from the sick and where we've experienced some of the finest medical care in the world.

Ironically, our medical system fails more at the government than private level. I recently wrote a story about underfunded so-called "high-Medicaid" hospitals, where poor minorities tend to cluster, and where racial disparities in health care emerge.

High-Medicaid hospitals are those that have a patient population 40% or more funded by Medicaid. They are also chronically resource deficient.

Better funding for those facilities rather than forcing everyone into the same government-run system would be a better, more cost-effective approach.

Finally, the Obama-driven health care proposal fails in a critical way: It doesn't address the supply side of medicine much at all, like reducing the cost of medical education and increasing the numbers of quality physicians.

If it continues to miss this critical piece, by pushing demand for health care services through the roof, Obamacare is doomed.

(Report Comment)
Mark Foecking July 25, 2010 | 4:37 p.m.

I've never seen a convincing study that shows that uncompensated care is increasing the cost of health care significantly. Most uncompensated care is done at public facilities (like UMH), and is covered by taxes, not health care costs to paying patients. Perhaps one could object to that (although, again, it's not a big outlay relative to a lot of government spending), but as far as the premise of Prop C, having some people opting out of insurance won't increase the cost of health care much at all.

There was a series in the Missourian where they explored this:

At this point in my life, I think health insurance is as essential as food, clothing, and shelter. But some people don't, and don't have a lot of health care expense. The few catastrophic cases that happen could be borne by paying patients or government without a lot of added expense.

Would that attitude make insurance more expensive? Sure. How much more? I'm not sure, and somehow I don't think it would be enough to make the government take away a fairly significant freedom.

Let people make their health insurance decision for themselves.


(Report Comment)
Gregg Bush July 25, 2010 | 5:59 p.m.

The LWV is on to something - and I'm convinced.
Governments mandate purchases all the time. I'm forced to purchase police care, fire care, road care, sewer care, book care (libraries), electrical grid care, military care, border care, judicial care, airline safety care (air traffic controllers), natural vista care (parks), bridge care, and future care (education or social security) - health care doesn't seem too big of a stretch.
Let's revisit the Preamble to the US Constitution shall we? "We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America."
An argument could be made that access to doctors promotes the general welfare so that we don't have people with manageable medical conditions using our roadways - potentially injuring others.
Frankly, I'd prefer to just be taxed and let sick people have access to doctors without the fear of going bankrupt - like we do with the fire department. If my house never burns, it's still money well spent in case my neighbor's house burns. Japan, Denmark, Sweden, Finland, Holland and more all have it figured out. Are they so much smarter than us?

(Report Comment)
John Schultz July 25, 2010 | 6:50 p.m.

Well Gregg, should we expect Congress to provide our housing and food for free as well if they are to promote the general welfare in the manner you wish? The General Welfare Clause is not a portion of Article I, Section 8, which outlines the powers that the Constitution gave to Congress, so I don't find the argument persuasive (unfortunately, the Supreme Court did when FDR threatened to pack it). You can read what James Madison thought of Congress attempting to exceed its power from Section 8 in this veto of a spending bill from when he served as President, particularly the fourth paragraph:

As for mandated purchases, I find your list a bit specious. All of the cases you listed are based on a taxing entity. Correct me if I'm wrong, but where has the federal government ever before said that people must buy a good or be fined for it? I can avoid library taxes by renting and riding a bike. My sewer is not provided by the city (until recently I had a septic tank), my electric service is not either, and my garbage hauler is private enterprise.

Tim, you've been griping about corporate socialism and the evil profit the past couple of months. Do you thus believe that riders of the bus system should pay the actual costs for their rides instead of being subsidized by sales tax money?

(Report Comment)
Tim Dance July 25, 2010 | 8:37 p.m.


Those people you listed are not the one's profiting. It is the ones that made billions of dollars in profit. The insurance companies that have kicked people off of plans when they got sick or couldn't get coverage because of a pre-existing condition to bolster the bottom line. Funny the insurance companies never entered you mind while you listing the "offended" parties to me.

When one of my family members who worked for 38 years in one company has their savings wiped out because they get cancer, you bet I'm a little cynical. Not uninformed, I assure Mr. Martin.


The "griping" about corporate socialism was to point out the hypocrisy of the "free marketeers" They decry socialism, unless they can make money off of it.

Having a healthy populace is definitely proving for the general welfare of our country. People need to stop listening to right wing hate mongers and mis-guided freedom fighters and start voting for their own economic self interest. They want to go back to a time when life and death decisions were made based on a balance sheet.

(Report Comment)
Mike Martin July 26, 2010 | 7:40 a.m.

Tim Dance:

Indeed, I'm including private insurance as well -- so far, real heroes in the case of my wife and I at Ellis Fischel.

A private insurance company is paying all of our bills, which have been running roughly $10,000/month before contract rates are applied.

Your family member who was wiped out after getting cancer has/had many strategies available to pay his/her medical bills. They -- or family members -- just have to spend the time asking questions, and get over any feelings of helplessness. After all, it's that important, right?

Hospital bills bankrupting people are actually rare events, despite what you hear and read.

In the past, when I had no insurance or only major medical, I used a common private sector business strategy -- cost negotiation with hospital and physician financial offices -- to vastly reduce what I had to pay.

Two pregnancies and a fractured neck vertebrae could have seriously put my family and I in a financial hole, but because I was pro-active about payment, we ended up paying far, far less in a mutually agreeable way.

In one after-the-fact negotiation, I received bills that included $5.00 for one aspirin and related outrages from a local hospital whose finance office felt no need to listen to my pleas.

For $25.00, I filed suit against the hospital in small claims court (claims up to $5,000), naming the office manager as a co-defendant.

A hospital financial officer would have had to appear (no lawyers allowed) and needless to say, we re-negotiated the bill about two weeks before our trial date.

That $5 aspirin went down to 50 cents.

(Report Comment)
John Schultz July 26, 2010 | 10:17 a.m.

Tim, if the voters want themselves some free healthcare, where will it stop next? Retirement? Food? Housing? A government-provided card? Where will the incentive be to actually work and support one's family if the voters can give themselves what they want?

The price of car insurance is based upon market factors, such as your age, marital status, and past driving history. Why should health insurance be any different? Should someone with poorer health pay the same for their health insurance as someone who is in tip-top shape? I recently switched jobs and didn't like the indemnity plan that my new employer offered, so I went to the private market to get a Blue Cross plan for $155/month. I was charged a slightly higher rate due to my height/weight ratio, something I understand from their point of view.

(Report Comment)
Gregg Bush July 26, 2010 | 10:45 a.m.

"Hospital bills bankrupting people are actually rare events, despite what you hear and read."
The only thing more rare than a medical bankruptcy is a non-medical bankruptcy according to a Harvard study from 2005 and an American Journal of Medicine study from 2007 data. Links provided below.
John - I don't believe in free things. There is no such thing as free. No where do I say things should be free. Misrepresenting opinions is an easy way to discredit phantom arguments.
But you ask a reasonable question: "Correct me if I'm wrong, but where has the federal government ever before said that people must buy a good or be fined for it?" I can't think of anywhere - but I'm not exhaustive in my knowledge. What I can think of is justice care on the local level. If I were to pay or even just ask a person to use force or violence to exact justice on another, being that I'm an aggrieved party, I may be fined or jailed. But I may use a State sanctioned officer to do the same thing after due process.
"Well Gregg, should we expect Congress to provide our housing and food for free as well if they are to promote the general welfare in the manner you wish?" In the manner that I wish? No - I'm definitely not smart enough for that. Again, I said nothing about free; however, I fail to see how homelessness and hunger, in a land of wealth, is somehow what the framers had in mind. A reasonable person could think that ensuring access to affordable and safe housing and access to affordable and safe food is in line with the Constitutionally mandated mission of promoting the general welfare. If the marketplace provides unsafe housing and unsafe food, I believe we can demand the branches of government to fulfill their Constitutionally mandated mission since dangerous housing and dangerous food explicitly does not promote the general welfare. A question that a policy maker could ask his- or herself could be: "does this policy promote the general welfare?" And reasonable people can disagree. Regarding the specifics of mandated health insurance - I thought it was a bad idea in the '90s; it's still a bad idea. Alas - the union is never to be perfect, just more perfect.
And thanks to LWV!

(Report Comment)
John Schultz July 26, 2010 | 11:58 a.m.

Gregg, good point, I should have put free in quotes as it obviously wouldn't be so, although the recipient of that hypothetical government program might consider it such if they didn't have to pay for it directly.

(Report Comment)
Mike Martin July 26, 2010 | 2:16 p.m.

One of the big problems with studies like the one Gregg Bush cites is that they often back an agenda.

After reading the study, I'm immediately struck by a red flag: a conclusion that suggests an agenda -- nationalized health care.

"Medical impoverishment, although common in poor nations, is almost unheard of in wealthy countries other
than the US...All have some form of national health insurance...The US health care financing system is broken..." the study authors claim.

The American Journal of Medicine, which published this study, also published this op-ed, which pitches a nationalized health care plan:

I also find the quotes at the end of the first story about the study troubling. Those quotes use the study to support this conclusion:

"With national health insurance ('Medicare for All'), we could provide comprehensive, lifelong coverage to all Americans for the same amount we are spending now and end the cruelty of ruining families financially when they get sick."

Finally, I don't think powerful political lobbying organizations like AARP -- a supporter of this study -- should be backing non-biased academic research, particularly about an issue -- health care -- that is #1 among their member concerns.

Agenda-driven research is all too common, largely because funding is so difficult to find these days.

It's also a major source of consternation in the scientific community, and something readers should consider cautiously.

(Report Comment)
Gregg Bush July 26, 2010 | 4:20 p.m.

I find this sentence curious: "Finally, I don't think powerful political lobbying organizations like AARP -- a supporter of this study -- should be backing non-biased academic research, particularly about an issue -- health care -- that is #1 among their member concerns."

Should AARP be backing biased academic research about an issue #2 or #3 among their member concerns? Or did I misread this?

(Report Comment)
Mike Martin July 26, 2010 | 7:43 p.m.

Health care researchers who want their work considered "non-biased" and scientifically objective should not be taking support from AARP, a powerful lobbying organization that considers health care reform among its top priorities.

Pretty simple.

(Report Comment)
Ray Shapiro July 26, 2010 | 10:48 p.m.

The League of Women Voters should rename themselves as the Missouri League of Obama Trucklers. (After all, it is obvious who they are in League with.)
Why would a group, which historically pushed for freedoms of opportunity, to now endorse the destruction of individual rights and freedoms, free enterprise and state rights and responsibilities to protect our state's people and commerce.
Vote YES on Proposition C and protect yourself from further infringement on our Republic.

("The Missouri Healthcare Freedom Act
Here's the official summary.

Upon voter approval, this proposed constitutional amendment prohibits any person, employer, or health care provider from being compelled to participate in any health care system. Individuals and employers may pay directly for lawful health care services without being subject to fines or penalties, and health care providers can accept payment for health care services from individuals or employers without being subject to fines or penalties. The purchase or sale of health care insurance in private health care systems cannot be prohibited by law or rule.")

("Protect Your Health Care Freedom

The President and Congress have given us a health care reform package that will force people into government-defined health plans and penalize them for paying for services with cash!

Missouri’s Proposition C, on the August 3 primary ballot, will protect us from those government mandates by expressly stating that the government may not “penalize citizens for refusing to purchase private health insurance or infringe upon the right to offer or accept direct payment for lawful healthcare services.”

Furthermore, the august 3 vote is the FIRST TIME any voters in the country will have the opportunity to vote yes in order to protect their freedom from government regulation.")

(Report Comment)
Tim Dance July 26, 2010 | 11:04 p.m.

Wow, the rich and powerful got you all convinced this is a freedom issue. Pretty sad. :(

(Report Comment)
Ellis Smith July 27, 2010 | 6:20 a.m.

Memory sometimes fails, but years ago wasn't League of Women Voters famous for and highly respected for taking an impartial stance. They sponsored public forums, where candidates would speak and issues were debated, and they worked to increase voter registration and get out the vote on election day.

Once an organization like that starts taking partisan stances they lose credibility. Apparently their present leadership doesn't understand that.

(Report Comment)
Yvonne McCue July 29, 2010 | 2:50 p.m.

The League of Women Voters believes that responsible government should be responsive to the will of the people, that government should maintain an equitable and flexible system of taxation, promote the conservaton and development of natural resources in the public interest, share in the solution of economic and social problems that affect the general welfare, promote a sound economy, and adopt domestic policies that facilitate the solution of international problems.

According to the LWV's own beliefs that "responsible government should be responsive to the will of the people", opposition to Proposition C is in favor of government not the "will of the people." WE THE PEOPLE voiced our opposition to this mandated health care. WE THE PEOPLE were told to wait until it was enacted to see what was in it. WE THE PEOPLE were told that our tax dollars would not be used to fund abortions. Oh, the will of the people was not taken into consideration. The so called representatives voted against the will of the people.

So when people opt not to buy the mandated government insurance will The League of Women Voters help finance those that are fined and eventually jailed by the federal government. Does that mean Missouri will need more jails and prisons

(Report Comment)

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