Questions for Martha McSally: Jim Nintzel doesn’t get an answer either – again

Posted by AzBlueMeanie:

In this new series, "Questions for Martha McSally," we pose questions to the McSally campaign about her positions on current hot topics — I am not going to give her a free pass until after the GOP primary like our local media did in 2012.

ChickenbunkerJim Nintzel of the Tucson Weekly and host of the Arizona Illustrated political roundtable tried to get Martha McSally to take a position on the current hot topic of gay marriage and "ObamaCare" and – suprise! – McSally is still hiding in the bunker with no ready answer to substantive questions. This is one incredibly ill-informed and ill-prepared candidate for someone who has been running for office since 2010. In Sickness and in Health:

What about gay marriage? Are you evolving on that at all?

Am I evolving on that?

A lot of people seem to be evolving on that. You said last time out that you supported a constitutional amendment to limit marriage to one man and one woman. Now we have it in all these states.

I believe it's primarily a state issue. When you're answering these surveys, sometimes it's a "yes/no" question when really it should be an essay answer that's appropriate.

So you don't support a federal constitutional amendment anymore?

I am not planning on spending my political capital on that type of issue. The way it was framed to me was, "If everything changed in the country and if somehow there was the voice of the people to come forward"—which is what you would need to have for the constitutional amendment to come up—"is that something you would vote for or against?" I don't think that's a practical reality. If we have any kind of constitutional amendment come up, I think a balanced budget should be the priority. My focus is putting people back to work, getting the economy going again, saving Davis-Monthan and the A-10, making sure that we're able to get our debt under control, making sure we protect Social Security and Medicare, and getting our border secure.

So philosophically, on the question, you …

Philosophically, I believe marriage is between one man and one woman, and it should be left to the states.

So the federal constitutional amendment, you would not support that any longer?

In a hypothetical situation, where the country has decided this is very important and they've gotten the support across the board in the country for it to come up—that's a hypothetical situation. That's not happening anytime soon.

Let's break this down. First of all, fundamental constitutional rights — and marriage is a fundamental constitutional right according to the U.S. Supreme Court in Loving v. Virginia, 388 U.S. 1 (1967), striking down Virginia's miscegenation law (inter-racial marriage) as a violation of the 14th Amendment's equal protection clause, because it invidiously classified on the basis of race, and it violated the due process clause because it unduly interfered with the "fundamental freedom" of marriage ("Marriage is one of the 'basic civil rights of man,' fundamental to our very existence and survival") — is not subject to a popular vote of the people. That's what makes them fundamental constitutional rights.

This is also why state laws and constitutional prohibitions of same-sex marriage will be struck down by the U.S. Supreme Court in coming years, in addition to application of the "full faith and credit" clause of the Constitution which requires states to recognize the validity of lawful acts of other states (this particularly applies to marriage and divorce).

So Martha McSally is opposed to the "fundamental freedom" of marriage ("Marriage is one of the 'basic civil rights of man,' fundamental to our very existence and survival") for same-sex partners lawfully married in other states, but not yet recognized by other states.

McSally's "states' rights" argument was addressed by the U.S. Supreme Court in Loving:

While the state court is no doubt correct in asserting that marriage is a social relation subject to the State's police power, Maynard v. Hill, 125 U.S. 190 (1888), the State does not contend in its argument before this Court that its powers to regulate marriage are unlimited notwithstanding the commands of the Fourteenth Amendment. Nor could it do so in light of Meyer v. Nebraska, 262 U.S. 390 (1923), and Skinner v. Oklahoma, 316 U.S. 535 (1942).

In other words, if a state law or constitutional provision violates the 14th Amendment, Article 3 federal courts will not hesitate to strike it down as violative of the U.S. Constitution. So McSally's "states' rights" argument is lame and ineffectual.

McSally uses a hypothetical to say that if "the country" wanted a federal constitutional amendment banning same-sex marriage that she would indeed vote in favor of that discriminatory amendment which would undo the validity of same-sex marriages lawfully performed in 16 states, and counting. Of course, McSally had her own marriage annulled, a legal status as if the marriage had never occured, so maybe this explains her indifference to the fundamental freedom of marriage of others.

On the Affordable Care Act: full repeal or fix what's there now?

A lot of people talk about "fix what's there now" like kids being able to stay on their parents' insurance until they're 26 or things like that. That's not the foundation of the Affordable Care Act. If we're talking about the foundation, like the legs of the stool of the Affordable Care Act, its foundation is that everybody gets into the game to help pay for everybody getting into the game. And the foundation is mandates, penalties and taxes. It doesn't fundamentally address bringing the cost of health care down to make it affordable and available. We're still paying a ridiculous amount of money for procedures. I'm not talking about the premiums and the things that have happened recently. So fundamentally, the structure of it is flawed. There are ways for us, hopefully, to bring the cost of health care down that make it affordable and available so people could actually choose to get health insurance instead of being ordered: "This is the health insurance we have for you and here are all the features in it."

But isn't the cost curve bending?

In the last month? Are you kidding me?

No, not in the last month. Over the last couple of years, you've seen the projections go down. The cost is still growing, but it's growing at a smaller rate.

But we're still paying, per capita, 50 percent more than the next country in the world on health care and we're not healthier for it. There are some other alternatives that are out there. Congressman Tom Price has one. He's a medical doctor in Congress and he's written up a plan that I've spent a little time studying. I don't necessarily agree 100 percent with it. He's trying to bring the cost down so that people can afford it, so they can choose to afford it and it's more available. There's visibility, there's competition, buying insurance across state lines, more preventative health care versus pay-for-service, where doctors get paid whenever they do something to you or give you a drug or do a procedure on you. Some reasonable reforms to the defensive medicine that some doctors are practicing to avoid frivolous lawsuits. I still want people who have been hurt to be able to file for those things if they have been hurt by a bad doctor, but I think there are some reasonable things we can do to bring down those costs so that they are not ordering unnecessary tests and those types of things. And that's not all federal-level stuff. . .

Oy. The whole purpose of the Affordable Care Care Act is to "fundamentally address bringing the cost of health care down to make it affordable and available." Duh, it's in the title. 

The New York Times reported Cost of Health Care Law Is Seen as Decreasing:

[O]n at least one front, the Affordable Care Act is beating expectations: its cost.

Over the next few years, the government is expected to spend billions of dollars less than originally projected on the law, analysts said, with both the Medicaid expansion and the subsidies for private insurance plans ending up less expensive than anticipated.

* * *

Already, the Congressional Budget Office has quietly erased hundreds of billions of dollars from its projections. It now estimates that Medicare spending in 2020 will be $137 billion lower than it thought in 2010, a drop of 15 percent; Medicaid spending will be $85 billion, or 16 percent, lower; and private health insurance premiums are expected to be about 9 percent lower.

Some economists say they believe that the Congressional Budget Office might be underestimating the long-term effect of the slowdown, because it expects that spending growth will eventually return to its previous trend line. David M. Cutler, a Harvard economist and former Obama adviser, cautiously suggests that the slower growth might stick around, and if so the savings for the government might be a whopping $750 billion over 10 years, he says.

* * *

Insurance and hospital executives in Massachusetts, Illinois and California, among other places where reforms have gone the furthest, report a consensus that spending growth had become unsustainable, and that expectations that Washington would force changes to the system spurred them to make changes themselves.

Whatever the reasons, the overall slowdown in health costs has led to lower 2014 insurance premiums than analysts anticipated. That means not only cheaper plans for many consumers, but significant savings for the government.

Last month, the White House Council of Economic Advisers released a report showing that the health care spending growth rate was 1.3% between 2010 and 2013, the lowest three-year growth margin since the metric was first calculated in 1965. The White House attributed the low growth rate — which it based on previously released CMS data — in large part to changes under the ACA.

Specifically, the CEA report said that ACA provisions that lower Medicare overpayments for the elderly to private insurers and medical providers have helped curb health care costs. In addition, the report noted that ACA reforms have decreased hospitals' readmission rates.

So yes, Ms. McSally, the medical cost curve is bending downward due in part to the reforms of the Affordable Care Act. You are correct, however, that The United States still spends far more than any of other country on a per capita basis and as a percent of the national economy, and receives far less health care in return. The New York Times editorlalized, The Shame of American Health Care:

Even as Americans struggle with the changes required by health care reform, an international survey released last week by the Commonwealth Fund, a research organization, shows why change is so necessary.

The report found that by virtually all measures of cost, access to care and ease of dealing with insurance problems, Americans fared poorly compared with people in other advanced countries. The survey covered 20,000 adults in the United States and 10 other industrial nations — Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and Britain, all of which put in place universal or near-universal health coverage decades ago. The United States spends far more than any of these countries on a per capita basis and as a percent of the national economy.

For that, it gets meager results. Some 37 percent of American adults went without recommended care, did not see a doctor when sick or failed to fill prescriptions in the past year because of costs, compared with 4 percent in Britain and 6 percent in Sweden. Nearly a quarter of American adults could not pay medical bills or had serious problems paying them compared with less than 13 percent in France and 7 percent or less in five other countries. Even Americans who were insured for the entire year were more likely than adults abroad to forgo care because of costs, an indication of how skimpy some insurance policies are.

The "greatest healthcare system in the world," indeed.

Rep. Tom Price's bill is the "Empowering Patients First Act" Short Summary (one would think McSally could remember the name of this bill). This bill retains some of the popular elements of "ObamaCare," but relies on income tax deductions for the private insurance market, and a refundable tax credit for low income individuals. For pre-existing conditions, it would create a high risk/reinsurance pool possibly funded by federal block grants.

Individuals would be allowed to shop for insurance across state lines, which undermines already weak state insurance regulatory agencies, and would create a "race to the bottom" for the least amount of state regulatory burden. This would not improve the quality of insurance coverage or enforcement, and would leave the policy holder subject to a choice of venue selected by the insurer.

This is tied to "tort reform" measures that would cap non-economic damages (a violation of the Arizona Constitution) and "create health care tribunals, also known as health courts, in each state, and add affirmative defenses through provider-established best practice measures." This is a solution in search of a problem, and does not measurably reduce the cost of healthcare. US malpractice lawsuits less than 1% of healthcare costs – UPI.com. See Facts and Myths About Medical Malpractice.

Finally, Medicaid and SCHIP beneficiaries would be given the option of a voucher to purchase private insurance — always with the vouchers! — and states would have to cover  90% of those below 200% of the federal poverty level before they can expand eligibility levels under Medicaid and SCHIP. This would lead to reduced coverage for the poor. Red States have refused to enact the expanded Medicaid provisions of ObamaCare at 130% of the federal poverty level, leaving many uninsured.

So this is a bad alternative that is going nowhere. McSally's superficial knowledge of the bill, which she acknowledges that she has "spent a little time studying. I don't necessarily agree 100 percent with it," demonstrates that she does not know what she is talking about. She relies on the standardized anti-ObamaCare GOPropaganda talking points, and a non-viable GOP alternative plan.

Voters in Congressional District 2 have the right to know your positions on current hot topics, Ms. McSally. Feel free to answer these questions by posting a comment. More questions to follow.

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