WGBH Radio; The Callie Crossley Show

I'm Cally Crossley This is the Cali Crossley Show. Now that the Supreme Court has wrapped up its final day of oral arguments on President Obama's health care law we wrap up our healthcare coverage with a look at what's at stake. After three days of arguments and many questions were raised and many remain unanswered. Is the individual mandate all but gone. Could the entire health law be toast if Justice Kennedy is the swing vote. Which way will he swing. Of course there's no ruling yet. The real action will take place behind the scenes when justices discuss whether the law should survive. But if it doesn't how would a court rejection of the health care plan affect President Obama's re-election prospects. And how will his opponents play that on the campaign trail. Up next is it code blue for Obamacare or will the Supreme Court throw it a lifeline. First the news. From NPR News in Washington I'm Lakshmi saying the number of

children diagnosed with autism is going up. NPR's Jon Hamilton reports that as many as one in eight children in the U.S. has an autism spectrum disorder autism figures have been rising for decades and estimates from the Centers for Disease Control and Prevention show the number of affected kids has nearly doubled since 2002. But experts can't explain the rise. One possibility is that parents and health professionals are simply identifying more kids with the disorder. A study of children in South Korea published last year supports that idea. Figures from the Korean government indicate autism is very rare in that country. But researchers found that as many as one child in 38 had the disorder. Another possible explanation for the rising numbers is that more children are actually developing autism. But so far researchers haven't been able to find a cause for such an increase. Jon Hamilton NPR News. As health researchers mull over the latest findings on autism the nation's highest court is considering the fate of the sweeping health care law. Do they

overturn all or part of the health care law or let it stand. NPR's Craig Windham reports the justices are considering oral arguments from the last three days. The justices will meet tomorrow and each will state their tentative position on the case. A justice on the majority side will be assigned to draft an opinion which will then be circulated and reviewed. But University of Maryland law professor Michael Greenberger says even then the final outcome may still be in doubt in the circulation process especially if it's a 5 4 vote. Somebody have to reading the opinion. Men may decide to switch their vote and that happens a lot. So the court's decision on the health care law will not be known until the justices issue a final opinion which is expected in June. Craig Wyndham NPR News Washington. Arab leaders attending a regional summit in Iraq today are endorsing a peace plans for Syria that they say needs to be implemented immediately. The UN's envoy to Syria Kofi Annan said earlier this week that the Syrian government had accepted his six point proposal for a truce and political talks to end its year old conflict.

But in the days since the military continued shelling rebellious areas including homes the day after President Bashar Assad toured bombed out neighborhoods and spaces in the middle of labor strikes today thousands of protesters marched through Madrid against the country's austerity measures aimed at keeping Spain's economy from becoming an out of control financial problem for the European Union. The EU has already had to invest in a multibillion dollar bailout to Greece another country that's seen frequent labor demonstrations after it made a series of deep cuts to spending. In order to get a financial rescue and that's wearing on stocks at last check Dow was down 50 points at thirteen thousand seventy six. This is NPR News. Good afternoon from the WGBH radio newsroom in Boston I'm Christina Cohen with some of the local stories we're following. State police are looking for a man they say drove a car at state troopers working a traffic detail at the Boston Quincy line. A spokesman says there was some gunfire at Neponset circle at about 9:30 this morning. But it isn't clear who opened fire and there are no reports of

injuries. Governor Deval Patrick says MBT riders will likely see more drastic service cuts in the future unless a comprehensive solution is found for the state's transportation funding shortfall. Meanwhile the MTA says February was its busiest month on record. Acting ti general manager Jonathan Davis says weekday ridership on the Boston area transit system was more than 8 percent higher last month than in February 2011 he says higher gasoline prices and unseasonably mild temperatures helped boost the numbers. A new report says foreclosures in Rhode Island have taken a heavy toll on renters in a state with a large stock of multi-family homes shrinking the inventory of available apartments and driving up prices. The nonprofit housing works Rhode Island coalition found that nearly a third of all foreclosures in the state during the last three years re multi-family homes. Housing advocates are backing state legislation that would prohibit lenders from effecting tenants from a foreclosed property except for just cause like failing to pay rent or damaging the property. The bill goes further than protections afforded under federal law. The New Hampshire House of Representatives has voted

to put sixteen million dollars left over from last fiscal year into the state savings account and spend the remaining 1.5 million dollar surplus on services for the disabled. Democratic Representative Robert Foose argued the money might be needed to balance the current budget. In sports the Washington Capitals are in town to play the Bruins tonight and the weather forecast for this afternoon Mostly cloudy with a slight chance of showers highs in the upper 40s tonight mostly cloudy in the evening then clearing with lows in the mid 30s right now it's 42 in Boston 47 in wester and 46 in Providence. Support for NPR comes from sit for less proud NPR sponsor since 2003. Selling all colors of the Herman Miller air on chair including sit for less true black. Online it's set for less dot com and from living essentials distributor a five hour energy with block with flavors including grape Berry in Orange in stores and at a five hour energy dot.com. The time is two one of six. Good afternoon. I'm Cally Crossley. Now that the Supreme Court has wrapped up its final day of oral arguments on President Obama's health care law we wrap up our

healthcare coverage with a look at what's at stake. After three days of arguments many questions were raised and many remain unanswered. Joining us to talk through what happened and what's next is just Raven. He's a Supreme Court correspondent for The Wall Street Journal. Jess Bravin Welcome back. Thanks Kelli. First I want to start this way what are the chief points that we should pay attention to because listening to the oral arguments it was while it was you know gripping in some ways that I didn't expect. It's a lot so just trying to weed out some of the main points that that we the people should pay attention to would be helpful. Well first off we should say that that the Supreme Court took this issue very seriously. And as you say. Left us uncertain how they are going to come out that this will be a real cliffhanger of a decision and it will be a few months of tremendous suspense for both this legislation for the president and his political adversaries and more broadly

for the kinds of options that the federal government will have on the table in the future to address policy problems. So there is a lot at stake and the Supreme Court's only confirmed a lot of the conventional wisdom that we had going into it. Now the narrower questions are do the various challenge provisions of the Patient Protection and Affordable Care Act survive or not. The centerpiece was really the novel financing mechanism that the Act contains which is something called the individual mandate that most Americans carry health insurance most Americans already do carry health insurance either from their employers or. Through Medicare or Medicaid programs. But 40 million Americans don't. And that's that's the group that was really targeted by this legislation. The question is whether that mechanism that Congress approved is constitutional. And if it's not in the view of the Supreme Court what else is in this

massive piece of legislation also has to fall. Much has been made of the what some described as hostile questioning by really across the board all of the justices depending on who they were directing their comments to. What should we make of that. Well I don't think that we should think of it in terms of hostile and that they hate the people who they're asking questions of or even that they are you know irredeemably opposed to what the advocates are saying. It indicates though that these justices have read the briefs very carefully are very aware of the issues and are intent on poking as many holes as they can on the advocates who come before them. But we can draw some conclusions from the way the justices frame their questions because some justices are fairly transparent about their leanings in the way that they explain things. Others are a bit more opaque.

The soo many court observers feel is the least likely to conceal where he's headed is Justice Antonin Scalia. His questions are often simply statements of what he has already decided the proper outcome is and based on what he had to say and how he said it seemed quite clear that he is not going to vote to uphold the individual mandate provision nor the rest of the Affordable Care Act. Again we don't know for sure he didn't raise it. You know it wasn't a vote taken at the oral argument but from every indication he does not believe that this measure is to tional. We can say the same for just the Samuel Alito so to the extent that we were observers weren't sure where those two justices might end up. We left the arguments I think with a fair degree of confidence that they do not believe that this measure is. You know aside from those two is it also clear but as as one who has observed them in other

scenarios not just in the in this situation that some of the justices just ask the tough questions as you said but that doesn't necessarily mean you know anything except that they want to get the good defense from whomever is presenting the side to them. Well I think that that we can say really there are only two members of the court leaning we're not fairly clear by the end of the argument. Those were the ones we expected. Justice Anthony Kennedy and the Chief Justice John Roberts. The four more liberal members of the Court Justice Ruth Bader Ginsberg Brier Sotomayor and Elena Kagan were expected going into these arguments to assume that Congress had the authority to do this and leave the question of health care financing up to the elected branches and not want to interfere with that. And there are questions certainly confirmed that that was where they're

coming from. JUSTICE KENNEDY In this case as in other cases is the perhaps the hardest to predict. From the way he chased this question that he seems to ask questions about thing he is really pondering and trying to get to the answer of of the posed to using the forum to speak to the other justices or telegraph what he's thinking or or score rhetorical points. And Justice Kennedy in B. I guess we will say that the key day Tuesday were two hours of argument over the individual mandate expressed concerns about both sides of the lawsuit. He had concerns that the individual mandate was a novel form of financing something that did for the first time require Americans to go out and buy something on the private marketplace just simply for being alive. On the other hand he also acknowledged toward the end of the argument that this market

for health care is different from all other markets and that people who don't carry insurance do affect it. And so that. That suggests that he is aware of the strong arguments on both sides and left the argument perhaps uncertain which would be the least objectionable outcome. Now by taking the case you know that that's an indication that they they felt they needed to or wanted to make a statement about this act in all of the parts of it that are that some people find controversial. Well the question for some of us just outside do the lower court decisions by which this act made its way up the chain to the Supreme Court have any influence from a legal perspective on the justices as they approached the law. They certainly have an influence. And in fact the justices rely on the lower courts to

air out many of these issues. They they like to say that they appreciate that work the lower courts do in exploring the same questions and they prefer to have various lower courts to tackle these questions so they can look at those opinions look at how other judges have reasoned out the legal questions and take those into consideration when they make their own decision. However they're not bound by them. They certainly look at them. They think about the reasoning and how it might. Confirm or conflict with their own inclination. I do want to take a step back for a moment if I could. Cowan just clarify though for listeners what this case is about and what it's not about. Sure. This is not a case about fundamental rights such as the right to free speech or freedom of religion. It's not about that kind of constitutional issue. It's about a structural issue in the government of the United States and the question being which aspect or which

element of the United States government and it component fifty states has the power to make people buy health insurance if they decide that's a good idea. There is no and no one argues there is no fundamental right to not carry health insurance and certainly people of Massachusetts. Now it's a question of whether the federal government which has specified powers under the United States Constitution has that specific power not whether states have that power. Lee and the power that the United States government has spoken to say that they do is that the power to regulate interstate commerce. And as that power has been interpreted over the years it also includes the power to regulate things that have a substantial effect on interstate commerce. And the Congress asserted that the failure of so many people to be able to afford to carry health insurance has a substantial effect on interstate commerce on the health care marketplace by distorting the

provision of health care so that costs are transferred to taxpayers at an insurance rate parents don't have insurance that they're going to emergency rooms are retaining reserves in a way. So it is really a question about who can make someone carry health insurance which a government entity can not whether there is a right to not have health insurance. I want to follow up that what you just said with a piece that you wrote about the absence of a single word tax in which you articulate that if it had been called a tax rather than a penalty we might be in a different space. Would you explain that. Sure. The other power that the United States the federal government asserts justifies the patient protection Affordable Care Act. And it is the taxing power Congress has the power to levy taxes under the Constitution and it has the power to provide for the general welfare of the United

States that provide of course spent. So if the government were to impose taxes and then bend them to provide health care or do related things it would be much harder to make a constitutional challenge that what Congress is doing lay outside of ours. For instance the United States government already taxes and spends to provide health care for millions and millions of people through the Medicare program. Anyone over 65 qualifies for Medicare. Medicare is a single payer health insurance program run by the US government and it runs it by imposing taxes and bending them if the penalty. But as with people who don't carry health insurance under the Affordable Care Act are assessed what's called a penalty. It's a shared responsibility penalty. Which is keyed to income and collected along with the income tax. The government asserts that to do that it is exercising the

same types of power it does when it imposes taxes. However the courts have not been very sympathetic to that argument. Part of the reason is that a lot of lawmakers and the president took pains to say this bill does not include any taxes. There are political reasons why people might want to do that. If it had said there is a tax we are levying a tax on those who fail to carry specified forms of health insurance or done similar things then it would have been a lot easier for the government to say we are exercising our taxing power. There isn't really a constitutional argument against our power to do just that. And as I said that piece the House version of the Affordable Care Act. Use the word tax and there were discussions about whether they should use tax or the penalty and I assume no one said this explicit. P but I assume that someone decided that Americans would prefer to think of themselves as being

penalized for failing to carry health insurance than being taxed for failing to carry health insurance. I don't know whether that's true but any but. But the version that ultimately the president signed. Use the word penalty and that has come back to really undermine the government's argument that it's a constitutional bill by virtue of the taxing power. So now having listened to these three days of very intense back and forth can we assume that they will definitely rule on this this summer. Well you know if the Supreme Court so they can do whatever they want and indeed one day did concern a procedural question whether this law with the type of law they can only be challenged after the penalties are posed under a 19th century statute involving tax assessment. It seemed unlikely that the court was going to accept that argument even though it spent.

I did it centering it at oral arguments or any address at that rate and yet but it seems very unlikely that they're going to say well we're just going to postpone hearing this question until the individual mandate and the penalties assessed for noncompliance. It's going to affect starting in 2014 so I would be very surprised if they choose not to reach the merits of the argument in the case. That means that we have an opinion. To me the court followed it you know for practice injury through the years issuing all decisions by the end of June. All right well we'll want to talk to you then. OK we're talking about health care on trial and I've been speaking with Jess Bravin. He's a Supreme Court correspondent for The Wall Street Journal thank you so much Jess any time. Coming up we continue the conversation with New Hampshire insiders Arnie Arnesen and Fergus Cullen. We'll look at how health care is being played out on the presidential campaign trail. Join the

conversation at 8 7 7 3 0 1 eighty nine seventy eight 7 7 3 0 1 89 70. Will Romney care or Obamacare influenced the way you vote at the polls come November 8 7 7 3 a one eighty nine seventy eight 7 7 3 0 1 89 70. This is WGBH Boston Public Radio. This program is on WGBH. Thanks to you and the Harvard innovation lab a university wide center for innovation where entrepreneurs from Harvard the Austin Community Boston and beyond engage in teaching and learning about entrepreneurship. Information at I lab at Harvard dot edu. And Sam it's Blackstone. I think it's always been a connection between with WGBH brand stands for and what Sam's factum stands for. Roger Sam its president. We're both about sought

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your help is essential when hosting station events providing studio tours and making sure that everything runs as smoothly as possible behind the scenes. Learn more at WGBH dot org slash volunteer. News and 10 40 days can only mean that it's tax time. I'm Carol Miller. This week on innovation have we imagine reinventing our tax system. Saturday morning at 7:00 here on the 9.7. Welcome back to the Calla Crossley Show. If you're just joining us we're talking about health care on trial. Yesterday the Supreme Court wrapped up its final day of oral arguments on President Obama's Patient Protection and Affordable Care Act. If the Supreme Court rejects Obama's health care plan how would that affect his re-election prospects. How will his opponents play this on the campaign trail. Joining us to talk about how health care will affect the presidential election are Arnie Arnesen

and Fergus Cullen Fergus Cullen is a public affairs consultant the former chairman of the New Hampshire Republican Party and editorial page columnist with The New Hampshire Union Leader Arnie Arnesen is a radio and TV commentator based in New Hampshire. Welcome back you two. Oh you can join us at 8 7 7 3 0 1 8 0 1 7 8 8 7 7 3 0 1 89 70. Well the health care debate influence your vote in November. Has this changed the way you look at the candidates. 8 7 7 3 0 1 89 70 8 7 7 3 0 1 89 70 and you can write to our Facebook page or send me a tweet at Cali cross-link. So first let's get your response to the oral arguments in the Supreme Court. Looking at them with your political hat on. Fergus I'll start with you. What did you take away from it. But you know a year ago this week Kelly I was in the United States Supreme Court because I was a bit player in a case but they are urging valving to have taxpayer funded

campaign guys you know throw everything this week was something I had done a year ago. I got to the U.S. Supreme Court building got there like I 30 in the morning high because number 12 or 13 I'm alive I got a ticket. When I got in here my case argued and one of the things that was so interesting to me that day was first of all the court is tiny It's about the size of a basketball court without any of the bleachers and the justices are very practical people. They were talking in very accessible language. They're concerned about the practical application but the law that they are we've been hearing and listening to the oral argument this week which I found fascinating that I was reminded of that that the people are regular people very talented very bright one went on the road you know to be to the time if you will like you or I would. And they're trying to figure out a practical application of the law that is before them. Well I found out that health insurance is kind of like eating broccoli and buying buy burial insurance. Kind of. And in fact I do have to share something with you just because it's

as Fergus started off with describing the court. I do have to tell you that it was also an opportunity for people who are in the humor business to really have an amazing plan ahead for them. The report just came out from the bar which reported he was commenting on the fact that Justice Samuel Alito actually compare compare the Obama health care plan to burial insurance. And I just want to read you two sentences Calley because it kind of describes a little bit of the problem for Republicans. And he said the following message was released today by the National Alliance of funeral directors this week several Republican Supreme Court justices have argued that the Affordable Care Act supported by the Obama administration is unconstitutional. At the National Alliance the funeral directors we couldn't agree more. It was revolutionary hero war hero Patrick Henry who said Give me liberty or give me death. From that moment on legal scholars have agreed that the Constitution guarantees every American the liberty to be dead. Here at the Alliance we will fight for your right to be dead to the death. And he then goes on. Of course to say that you know it was a very tough day for the Obama administration those three days. There is a

lot not to like about this bill. There are a lot of issues like can you actually require someone to purchase a private health insurance plan. Is this economic activity or enact inactivity. All of these things and I think the the real point here is is that two things happened. If you didn't know what the Obama health care plan has already done you learned a lot in those three days because the sad story about the Affordable Health Care Plan is they did such a terrible job of selling it to the public not to the court but to the public. And in those three days you saw what has already rolled out the benefits of what has already rolled out. And the question isn't just what will happen if they find it unconstitutional and throw out the baby with the bathwater. But what will be the repercussions for millions of Americans who have already seen it. Nifty can benefit from this health care plan and for the insurance industry and for hospitals and people in the medical community. We're already made significant changes to accommodate it. It's not

just a question of overturning a law. It really is a huge dramatic change in economic activity and taking away from people something they've already learned to depend on just to get put on the table a couple of things that you're referring to are the the preexisting condition rule that doesn't allow insurance companies to not give you insurance if you have a pre an existing condition. The fact that you can put your child on your insurance till you're 26 and the closing of the donut hole for prescription drugs with older Americans these are the things that a number that are in play now that some Americans as Arny has suggested have come to appreciate. But here we are from a political standpoint and the bottom line is that ma a lot of people did not view this through those specific kinds of details. They viewed it as a law that seemed to have government overreach. That's been the the general perspective of people who are opposing this and certainly the lawyers who are arguing that this was a government overreach and way beyond what the federal government should be

allowed to do. So with that in mind and understanding that we're looking toward November and that this ruling is going to come out in June as I was just told by the Supreme Court correspondent from The Wall Street Journal what is. The potential impact on the presidential campaign from now on I mean there's been some but from now on Arnie and Fergus go ahead. Well I think the first the media impact is that the fact that the court was due to hearing the case validate much of the argument that conservatives like myself have been making against Obamacare. I mean you know Nancy Pelosi everyone was part of the. Oh you know this is just politics what the conservatives are saying but you know you hear that you know six hours of hearing but very serious questions from the justices clearly validating that there are serious questions being raised about the constitutionality of this law. I think that's the first impact. Now as Mitt Romney appears to be in the mop up stage of the presidential primary. Best term that Politico used today to drive it. I think they

actually have credibility on this issue because my my view is that for Republicans their health care plan cannot be don't get hurt and don't get sick. It has to be beyond just we're going to repeal Obamacare. It also has to be. And here's my positive plan to address the serious concerns for many Americans. So if health care was a liability for Mitt Romney in the primaries I think it's about to become an asset for him in a general election context. Do you agree. I live and forget that because I want to know what Romney is going to say because it's very easy to say I'm going to get rid of something and carry you were just pointing out all the people who have benefited from it. Let me just remind everyone they got rid of the donut hole for people over the age of 65. How many people. Over the age of 65 a Republican and you know it's one thing to talk about all of this is an overreach of government but you like the check. You want someone to pay the bill. What I mean is the part of the problem is is that the consequences of having lost Obamacare is also

going to come into bold relief. And Mitt Romney can not only say I'm going to overturn it because it may turn out to be unconstitutional and the court will have done the heavy lifting for him. The problem is he's now going to have to belly up to the box and say what he will do that is not his own plan which is Romney care that turned out to be successful in Massachusetts. And on top of that he has another problem. It isn't just the court. It isn't just as Romney care. It isn't just that he has to come up with a solution. You also have to look at the Ryan budget which if you play out the Ryan budget does an incredibly devastating thing that things like Medicare and to a lot of programs that states rely on to basically provide health care to their residents. So it's ironic he's really in a box. He's got a bad past. He can't just say no anymore. He's got to come up with. What's your answer. And then he has to figure out how his answer can actually work with the Ryan budget plan which is actually very devastating to people who are concerned about expanding health care.

From Needham Go ahead please you're on the Cali Crossley Show WGBH. Thank you Guy thanks for taking my call. I just I just want to say that you know that this whole thing is really an exercise in futility because you can't really have an honest debate about this health care process problem because health care itself does not exist in a free enterprise system that serves like Santorum who on Monday we're talking about it is a free enterprise. I don't even understand it because each state has or takes it upon themselves in a monopoly to determine what happens within that state when it comes to health care. So it's apples and oranges. All health care does what Obamacare does is it actually threatens those monopolies and that's why you know all of a sudden outside of monopoly you have the ability for someone else to buy health care outside of that which of course monopolies don't like. And but that's really the problem is that it's all about money and the health care industry's influence on Congress. You know it goes way back to the McCarran Ferguson Act way back in the 1940s that says that if you have a commission in your state in your state you

don't have to bypass all the anti-trust laws. I mean it's baseball and health care are really two of the two industries United States they're exempt from antitrust. So my dear it is. Yes but so where does that leave you. The Affordable Care Act and who will you vote for and will this influence your vote if it actually doesn't influence my vote at all I mean I think that there are some positive things in the Obama health care become out you know like number one I have children who are having trouble. You know they're under the age of 26 so it certainly does help that they're having trouble finding work and and I have health insurance and it does give them that ability to be covered under me up into the age of 26. There are certainly pieces of it that I'm taking I can take advantage of the positive things and you know I think there's actually a positive thing about offering contraceptives you know for women's health and all that I think there's a lot of good things but I think all the parties involved Democrats and Republicans aren't speaking truthfully about this issue. And I haven't voted for a Democrat or Republican from

Flight nine thousand ninety two because none of them do speak truthfully about a lot of these issues and especially this issue in particular which is a very emotional issue. And all they do is take advantage of it. And none of them speak honestly about the fact that no matter what they do at any point in time from now until forever as long as the states are operating as a monopoly within that with within that helps. There's nothing you can do and the funny thing is I think that you'd really hit me once about a year ago and I can't remember the person who was in it was something from the Obama administration was talking about Georgia and saying that Georgia only had Blue Cross Blue Shield. Well that in itself is a red flag why does one state only have one option because they only get themselves that one option I live in Massachusetts. We only have 4 5 options for health care. We don't have is if we don't have companies from Roger you're not voting I take it in the end. Oh no I'm voting I always vote because my argument is a vote wasted is the vote not voting. So I vote for Ron Paul or even if I write I write my own name

and I'm still voting. OK but you haven't but it but this is but you're not sure it's going to be a Democrat or Republican it'll be somebody big and probably not one of the those to it won't be any one of those. All right. OK I thank you very much for the call. Thank you. Well you can see that you know Arnie and Ferguson a lot of people are you know very paying attention closely I guess. But golly look what he just said look what look at the benefit I benefit because I have children under the age of 26 and they can now piggyback on my health insurance. I understand the benefits of you know I may be a senior. Look at all the things he said. Here's the problem when you get rid of the individual mandate as they try to bifurcate the bill and separated out all those other things have to stay out too because the system can't work unless everyone buys in and the person who knows this better than anyone else. The person who was the most articulate why it has to work with an individual mandate is Mitt Romney. Mitt Romney goes on at

right back in 2006 and 2007 when he talks about the fact that the reason why you have to obtain medical insurance is because we can't have free riders people who exploited the medical system use the system and their uninsured use the emergency rooms to clog up the system. If we're all my players we can bring down costs. We can include children and parents health insurance. We can still the donut hole and I think that's what's the problem. Mitt understands the truth because he articulated Farkas go ahead Fergus. But aren't you. Well I'm going to agree with you about the problem about the uninsured especially if they're younger healthier people. Well let the dollars too that there are other solutions to that problem other than a one size fits all there and I don't ever get it. Woke up like a local low cost catastrophic coverage available for young single people. But it doesn't have to be a federal solution but I think a step back and remember who was actually in court there this past week. It was 20 30 30 they were suing the

federal government. Massachusetts not one of those 46 states. Neither was New Hampshire. They were there because they were concerned about the dramatic expansion of Medicare. That's why they were suing the state. Bagus bagus can we can you please give me the Republican or Democratic label attached to each of the states. We're all 26 states controlled by Republicans. Was this a partisan agenda. And isn't it interesting what you said Medicaid and that overall program for the federal dollars basically prop up most of the healthcare for proud people and to state the top players because they give up part of their dollars to cover their poor are uninsured it is ironic and you heard it on the bench over the last three days. But you know what if the feds are going to help you take care of your poor people then the feds have a right to then determine what the rules are. If you don't want the federal dollars then guess what. Send the check back and you do it on your own. And there isn't one state in the nation that wants to take care of the

poor are uninsured. Not one. Well this is kind of sort of what Roger was saying when he called and he's kind of angry about the disingenuousness of the conversation Fergus from his perspective. Oh he's But I don't. Where is Fergus I won't forget to respond. Well I thought Roger was Oh Kerry well informed caller I mean you know there's no question about that but I believe you have a fundamentally that is a strategic goal of the left to get as many people as possible hosts on and dependent on some form of government and I believe this is very consistent with Obamacare and so it's very interesting that a cult of valid libertarian Instead they're saying you know I think it's great I think to have these benefits especially if they're targeted a little class people I just fundamentally believe this begins the strategic goal of the left and a huge part of the motivation behind Obamacare and I hear Arnie basically echoing that. You know this is great we're providing all the taxpayer funded government benefits to Archer larger segments of the population. Once you provide those benefits you'll never be able to take them away and I think that

actually is a concern to people like I have with them. OK we're going to take this up because I want you all to focus when we come back on the political implications of both of your stances on this and what Roger has said. Roger said he's right and somebody else is. A man is really kind of disgusted. We're talking about health care on trial and how the health care debate will play out on the campaign trail. You can join the conversation at 8 7 7 3 0 1 89 70 8 7 7 3 0 1 89 70. You can write to our Facebook page or send me a tweet at Kelly Crossley this is eighty nine point seven WGBH Boston Public Radio. Coming. From. Funding for our programs comes from you and the Xenu Bedford April 4th through 7th living in exile. A radical retelling of Homer's Iliad performed in a living room challenging us to question our indifference and disengagement from the war

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soldier this September. It's a 10 day tour through the southern countries are violent. We visit ancient burial mounds and majestic castles traverse the wonderfully named mountains. Visit Dublin and Kilkenny castles and enjoy nightly music sessions. This trip with an up fast and you won't want to miss out. To register visit WGBH dot org slash learning tours. This week. EVH focuses on health care. We inquire into whether we are over diagnosed. Local impact of a national issue. Hear the reports all this week here on eighty nine point seven WGBH Boston Public Radio. Welcome back to the Calla Crossley Show. If you're just tuning in we're talking about health care and how it's playing out on the campaign trail. I'm joined by public affairs consultant Fergus Cullen. He's the former chairman of the New Hampshire Republican Party and an editorial page columnist with The New Hampshire Union Leader. Also on the line from New Hampshire is radio and TV commentator Arnie

Arnesen. All right Fergus I want to just put this on the table because this is something actually I didn't know until the Supreme Court arguments got underway. I didn't realize that the individual mandate which is at the center of so much of the discussion before the Supreme Court and as a matter of fact for those 26 states that came to protest what is now being called Obamacare that this originally was a conservative approach to health care reform. And let me reference this quote from an article by The Heritage Foundation. When President Clinton was putting forth his version of the health care reform act or what he had hoped to become the health care reform and he wanted employers to pick up the cost of insurance and the Heritage Foundation which is a conservative. I said no and individual mandate is the way to go and here's their quote. There is an implicit contract between households and society based on the notion that health insurance is not like other forms of insurance protection. If a young

man wrecks his portion does not have the foresight to obtain insurance. We make a misery but society feels no obligation to repair his car. Health care is different. If a man is struck down by a heart attack in the street Americans will care for him whether or not he has insurance. If we find that he spends his money on other things rather than insurance we may be angry but we will not deny him services even if that means more prudent citizens in paying the tab. A mandate on individuals recognizes this implicit contract. Now it should be said also that the Cato Institute which is another think tank did not agree with this approach. Having said that there is a lot out there. There's been obviously a huge shift in the way that conservatives such as yourself view the individual mandate which is the heart of the argument. How will this play out politically. The shift the change and in some ways I guess Mitt Romney's stance has a mirrored this shift. Well that's a very good point Cal because the individual mandate was put forward by conservative

thinkers in the 90s in response to Hillary care which was considered a much worse much greater threat. So this was the conservative alternative which was considered more palatable when it looked like a Democratic legislature under the Clinton administration was going to run away with a big government health care solution. Now the question one of the questions that the court looked at this week was well where does it end. You have to if the federal government can compel you to purchase something now what else will they be able to compel you to part just will for example him. First up being X we're going to have mandatory exercise because we all agree that being healthy is something that benefit be enquired society and being unhealthy is something which puts a caught on and I have to be entire society and you know you to notice that my questioning from the justices. They are absolutely tipping their hand in terms of where they're going. My feeling was that Justice Kennedy everyone acknowledges but he's playing both on this issue that to him line of questioning was

fundamentally skeptical about the individual mandate and you know while you never know what a court is going to be doing because you know right with the issue of decision I think was reassured I found I was gratified to see just the kind of the expressing that the system about the mandate. I was actually more interested in the in the shift. So there's been a shift of opinion in conservative circles about some. And so I think it. Mirrors Mitt Romney's shift as well and I wanted to hear from you whether how you think that's going to be interpreted down the line Fergus. Well again I think that Mitt Romney has actually survived the primaries in a way that gives them credibility to talk on that. You know you can say listen my wife has serious health issues. I have a large family. I know how important it is to have insurance in Massachusetts. We acknowledge that this is a serious concern for almost all of our population. And so we try to do something about it. And I learned from that experience as well. Would I go with an individual mandate again. Probably not.

Here's why. But here's a positive way we can also increase the number of people who are insured to address the kinds of concerns that Ari Ari raised earlier about free riders and people who only buy care buy insurance when they're sick or they know they need something you know a classic example of dental care you know because oftentimes someone with their employer might have regular health insurance but not dental care. They find out they've got a couple of cavities or need some work done. Then they buy the dental insurance. You know so you have to you know that's a that's a real problem in right Durance world. And there are ways to fix this again without necessarily wiring does everybody do it. So you don't think that's going to be. Political liability Arnie will it be up a lot a lot. First of all Mitt Romney thought he was being the Heritage Foundation's fair haired child when he embraced the individual mandate in Massachusetts. It was what the Republicans wanted and why did they want it Cali. Because it made insurance companies which are made insurance company is not

going to listen to me Fargas if you listen to the debate before the Supreme Court one of the the the the group that they were the most concerned about were not the uninsured. What about the poor insurance companies. Might they lose money. Understand this is always been about making sure our insurance companies are successful and profitable. Just the way the pharmaceutical drug benefit made sure the pharmaceutical companies were successful and profitable. We don't allow competition in Medicare for pharmaceutical drugs. We now in fact pay the donut hole because of Obamacare. And what did Mitt Romney do but he did what he thought he was being told to do which is keep it with the private insurance companies because if we keep it private if we keep it with insurance it will be a capitalist model as soon as Barack Obama embraced the Heritage Foundation Mitt Romney plan. It suddenly became communist It suddenly became socialist and a country that can take you to war a country I can tell you to

pay taxes a country that can pay to do a lot. Not me can tell you to buy health insurance. It's kind of ironic David from Cambridge Go ahead please you're on the Cali Crossley Show WGBH. David Luiz day that my mate will try to pick him up but for some reason we're having a problem with that line. David I just want to OK there you go. OK I'll now Fargas says you OK go ahead. Sorry I didn't want to say look there's yes Republicans believe in having private health insurance that means having insurance companies that survive a process. Liberals like Arnie I believe are in support of having one payer think payer system with the government has to go there. So yes the Republicans are saying we do want to have private companies involved in this to consumers. Some choices about where they get their insurance. In fact maybe have fewer mandates or think they are covered so that younger healthier people can get affordable coverage. Instead of doing what I did until I got married which was you know going away

is that with the health insurance of the state paying as I go and not having insurance is the practical economic decision I made and it's made by a lot of younger healthier people. I'm almost 40 I'm very I have three kids you know I can't afford to take the kind of risk. So Fergus let me ask this question. I'm driving back to the politics of this as hard as I can. Florida Senator Marco Rubio has come out and endorsed Romney and essentially what he said is what Mitt Romney has been saying hey there are different solutions for different states. It worked for Massachusetts when he was there. But I'm OK with the fact that he instituted a plan for Massachusetts and he doesn't have to do that as president for the rest of the United States. Mark Rubio a rising star in the Republican Party. What is the impact of his endorsement and the argument that he's making on behalf of Mitt Romney. Well I get I think that the argument Romney did use service to him in terms of getting him through the primary day was that I wouldn't do this on a national level. But the important thing politically I think is that Romney has preserved his ability to talk about

health care and do so with credibility because he's actually tried to do something serious and thoughtful on it made some mistakes. He acknowledges that. But to many Republicans you know we we still abraded when we debated Hillary care back in 1994 after a two year fight. But then too many Republicans walked away from the issue. And meanwhile people continue to have the audacity to get hurt and you get to have concerns about health care and where Republicans could have stepped forward with a positive plan to address things like lack of insurance with younger single healthy people that they did not and that as a weakness the failure of my party and the conservative people in it. Well now they're going to stand on it to fix. But now I have a different question for you Arnie. Morning Joe host and former Republican Congressman Joe Scarborough posited this week that he thought that actually a loss and a loss and overturning of the Affordable Health Care Act would be a political advantage for President Obama and he put it this way. He

said you know now he's running against a so-called conservative court and that actually you know he's able to point to some other unpopular decisions by this court such as Citizens United and say this is what we're talking about people you know is this what you want. And I thought it was kind of fascinated by that argument I wonder what you think about it. Well I guess he's worried about some form of apathy coming into this election which I think that Romney should be even more worried about what happens if they overturn Obamacare is that there are going to be a group of people that somebody's going to wake up and smell the coffee and that is is that the Republicans had an opportunity just heard Barbara say and they squandered it or they walked away from it or maybe something else. Calley they don't have a solution. They don't have a solution that fixes it. And he will then turn to the young people in this country when they lose their access to their family's health insurance plan saying can you pay your debt if you're college to find a job that actually pays you are you under employed and now can you afford health insurance.

Well as Fergus said be a crapshoot and pray you don't get hit by a car or develop cancer. And the problem is if you do develop. Cancer get hit by insurance get hit by a car. Someone will cover you but it will be the rest of us because you won't have your own insurance. So I think what's interesting is it will excite the base. It will make young people wake up and smell the coffee because they're getting hammered every which way. And when you look at what the Republican solution is there is none. There is none. And that Mitt's Mitt Romney has embraced the Ryan budget plan. There is even less of a solution. There are greater burden. There are greater halls. You're on your own Jack. It's not affordable for small business and it's not affordable for families. Romney has a real problem. And Barack Obama can say we offered solutions. They were beginning to work. And all they want to do is say no. So Fergus there are those who have written that they believe it might be you know Arnie says it's going to be a definite problem for Mitt Romney that it's kind of a draw politically for the two of them. I

know you've argued that it's a great thing for Mitt Romney in that you know folks like Marco Rubio's stance articulate what Mitt has been saying Mitt Romney has been saying and that's good to have that kind of support from the rest of the party. But some people say you know because of where they've coming where they're both coming from you know President Obama had a plan. Based on Mitt Romney's plan that is actually politically big drama. What do you think. Well I can I just think that you you know sometimes you'd rather win and sometimes did rather have the issue and I think this is one of those issues where you know Republicans have to use the opportunity if they didn't they didn't take advantage of politically or in terms of policy. Now they're going to have a chance to do that over in terms of if the court overturns the law and that and gives Obama the opportunity to run against a conservative court that's going to be great for rallying the liberal base. People like Arnie you will buy into that argument but I think you lose is among centrists voters because the fundamental

Republican argument is that President Obama is a nice guy but he hasn't been up to the job of being president. I wondered in terms of foreign policy is blundered in terms of stimulus and now Obama carried too much from all of the failed as well so he would reinforce with all those reservations and criticism backed Republican fact that this is a guy just you know wasn't prepared to be president. First of all it was on foreign policy account I don't I think you fuckin down the wrong up the wrong tree. And on the new economy we're beginning to see signs of the economy recovering it and Fergus may not want to tell you but the report just came out from the Commerce Department that in our state of New Hampshire we've seen a 5 percent growth in income growth the eighth highest growth in the country so if nothing else in New Hampshire you know his bad economic policy isn't high actually hitting us here. And in addition to which I think there's something else right you know is that there's been trumped tremendous reluctance to embrace Mitt Romney. He shouldn't be playing out this long. Rick Santorum should never have seen daylight let alone be so be at the point where he still engage in this

race. And they will then use what Rick Santorum has said which is not at the base of the Republican Party. How can you trust Mitt Romney on this issue of all the candidates. You're going to put forward in the November election Mitt Romney has less credibility on health care than any one else. And all they need to do is remind the folks that that's what's at times said. That's what Newt Gingrich said. That's what Ron Paul has said. And they represent the majority of folks who have voted in this Republican primary. Yes Mitt Romney may be more organized yet Miss Mitt Romney may have had more money on this campaign. Yes Mitt Romney has been running for eight years. But this is a buzz saw for him in November of 2012. OK so quickly from each of you when the court and it's seems clear that the court is going to decide is it going to be a big deal going into the elections. RS I think so I think I think the timing is going to require that and the decision is almost certainly going to come out in June and so then you're going to have both sides reacting to it and doing

so well there is all the alternative. You know elections are about choices. Obama's team will be saying well here's our reaction what the court decided OK and the Republicans will lose but yeah this will be a major issue this year because they took on the case. All right seconds Arni big deal. I actually think it will be a big deal because it impacts so much of the economy. I think this is a huge decision the court knows it Obama knows it. Romney knows it and I think eventually they're going to teach the American people it matters. All right thank you very much. Lively as always. We've been talking about health care and how this issue is influencing the presidential race I've been. Joined by Arnie Arneson and Fergus Cullen Fergus Cullen is a public affairs consultant the former chairman of the New Hampshire Republican Party and it Tauriel page columnist with The New Hampshire Union Leader Arnie Arnesen is a radio and TV commentator based in New Hampshire for complete Supreme Court health care coverage. You can visit WGBH news dot org. Today's show was engineered by Antonio and produced by Chelsea

murders will Rose live at Abbey Ruzicka This is the Calla Crossley Show a production of WGBH Boston Public Radio.